Comments

Informative and varifiable

Thanks Lindy for highlighting the conclusions of this important ODI study. In public policy, hard data such as the business costings included in the study can be vital for informing evidence-based decision-making and getting decision-makers attention. It appears early days for such studies, and sampling of more firms would help improve understanding of some of the surprising results (the level of male referenced gender violence) and the variability across the three firms surveyed. I wondered whether such a measure could be incorporated into broader tools such as the World Bank’s work on “The Costs of Doing Business”. However, that measure only covers the costs of regulation and not broader issues directly relevant to business environment such as security costs or even macro-economic stability issues such as the shortage of foreign exchange facing PNG businesses. Additional similar studies should be encouraged to help get domestic violence firmly onto the central policy agenda.

I discussed some of these issues with The Wire <a href="http://www.thewire.org.au/storyDetail.aspx?ID=13259#.Vh9Tcr0S5PA.twitter" rel="nofollow">here</a>.

According to the OECD, the point seven target has a <a href="http://www.oecd.org/dac/stats/the07odagnitarget-ahistory.htm" rel="nofollow">long history</a> stretching back to 1969!

Thanks for your comment Alex. I agree that promoting women into roles of responsibility is important for a variety of reasons and could definitely make significant contributions to achieving SDGs in other areas. For example, we know that women often give greater priority to areas such as health and education spending (at least at the household and community level). But often it is not just a case of promoting women. There is also a need to remove or reduce the barriers to their participation, and to enable them to be able to lead, rather than to simply be in a higher position without authority and influence. Removing the barriers, particularly those that stem from attitudes or culture, is particularly tricky, and a long-term challenge.

I don't think "treating women unequally is good for your bottom line" is the best argument to use when engaging the private sector if we are actually trying to achieve gender equality. The approach would surely only perpetuate the issue, and send a message that it was somehow OK to undervalue women's labour, even if they are in positions of responsibility.

Hi Kate - thanks for your comment. You're raising an important issue, but my take is pretty much the exact opposite of what you're suggesting. While issues of international trade, finance and taxation fall squarely into what the UN might usefully tackle, inequality within countries is a national issue that has little prospect of being addressed through global targets.

Thanks Belinda for highlighting this critical but undervalued aspect of global health. One of the key errors people make when thinking about emergency care in LMICs is to imagine their local emergency department, or something they've seen on television transposed into a low resource environment. People imagine rooms full of expensive equipment and high technology interventions when they think about emergency care. But the most valuable and important aspects of safe and effective emergency care are not expensive and not complicated. Elizabeth Molyneux and colleagues illustrated this so well in their <a href="http://www.who.int/bulletin/volumes/84/4/314.pdf" rel="nofollow">study</a> on transforming a busy and poor-functioning children's outpatients clinic in Malawi. Molyneux showed that by training staff in emergency care skills, introducing some emergency care systems (such as a simple 3-scale triage system) and re-designing and renovating the environment, mortality can be substantially reduced. This is the 'staff', 'systems', 'space (and 'stuff') that Paul Farmer also talks about in his terrific <a href="http://www.lrb.co.uk/v37/n03/paul-farmer/who-lives-and-who-dies" rel="nofollow">article</a> in the London Review of Books earlier this year. None of these components are high cost or high technology. But they do require some investment in clinicians and their hospitals; neither of which have received much interest or attention in the global health discourse so far. People in poor countries need both public health interventions (sanitation, immunisations etc.) and safe and effective clinical care. A hospital or clinic that can be trusted to provide emergency care inculcates public confidence that is crucial for times of increased need. The importance of accessible and trustworthy hospitals (or lack of them) to an effective Ebola response in West Africa illustrates how critical clinical care is to a functional health system. As you have illustrated, Belinda, there is hope and movement for a more integrated approach ahead. Those of us working in the field of global emergency care welcome your article and the opportunity to discuss these critical issues with policy and thought-leaders in our region. Great work! Dr Georgina Phillips, FACEM

So you believe this lesser pay is justified?

Ensuring that disease targeted investments do not undermine investments towards other health objectives seems like common sense but proves to be less than common. The Ebola episode seemed to focus the attentions of those making investment decisions on the importance of health systems but that focus may already be dissipating. Very important to keep this at the forefront of the debate.

Many thanks for the clarification.

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