Frequently asked questions

1. What is the Global Action Plan for Healthy Lives and Well-being for All (SDG3 GAP)?

The Global Action Plan for Healthy Lives and Well-being for All (SDG3 GAP) was launched at the UN General Assembly in September 2019.  The SDG3 GAP is a set of commitments by 13 agencies that play significant roles in health, development and humanitarian responses to help countries accelerate progress on the health-related targets of the Sustainable Development Goals (SDGs) through stronger collaboration. The SDG3 GAP describes how the 13 signatory agencies are adopting new ways of working, building on existing successful collaborations in countries, and jointly aligning their support around national plans and strategies that are country-owned and -led. Although referred to as a “global” plan, the added value of the SDG3 GAP lies in coordinated support, action and progress in countries.

SDG3 GAP agencies are guided by four commitments: Engage, Accelerate, Align and Account. 

2. Why was the SDG3 GAP created?

Progress towards the health-related SDGs is lagging in many countries, as less than 10% of SDG3 targets are on track and for selected health-related SDGs, less than one third are likely to reach their 2030 targets. At the same time, multiple and interlocking crises and increasingly constrained resources, threaten to further derail progress towards these global goals. A key way to respond to and ensure an equitable and resilient recovery towards achieving the health-related SDGs is for multilateral agencies to align even more closely in providing effective and efficient joint support to countries, which is the foundation of the SDG3 GAP. See SDG3 GAP brochure. 

3. Who are the signatory agencies of the SDG3 GAP?

The signatories to the SDG3 GAP are Gavi, the Vaccine Alliance; Global Financing Facility for Women, Children and Adolescents (GFF); Global Fund to Fight AIDS, TB and Malaria; International Labour Organization (ILO); Joint United Nations Programme on HIV/AIDS (UNAIDS); United Nations Development Programme (UNDP); United Nations Population Fund (UNFPA); United Nations Children’s Fund (UNICEF); Unitaid; United Nations Entity for Gender Equality and the Empowerment of Women (UN Women); World Bank Group; World Food Programme (WFP) and World Health Organization (WHO).

4. How are the SDG3 GAP agencies supporting countries to accelerate progress on the health-related SDGs?

Achieving impact at the country level continues to be the primary aim of the 13 signatory agencies, not only in the context of the SDG3 GAP, but also more broadly.

It is countries that achieve the SDGs and countries that know what is needed to meet their targets. Therefore, amplifying countries’ voices and views on how the agencies can better support their national priorities and plans, is essential. To this end, the SDG3 GAP’s monitoring framework, established in 2021, is a recurring survey of governments’ perceptions of how well multilateral agencies and other development partners cooperate, coordinate and align with national priorities. The SDG3 GAP Secretariat has conducted two such surveys so far, in 2021/22 and 2023/24. Countries have indicated areas of successful coordination as well as challenges in collaboration. Importantly, they have suggested specific improvements to collaboration and coordination for agencies to consider. 

The SDG3 GAP accelerators, all with a commitment to gender equality, were created to focus collaboration among partner agencies on programmatic areas crucial to accelerating progress on the health-related SDGs in countries. For example, the Primary Health Care accelerator (PHC-A) is focusing on 20 priority countries to support their delivery of a comprehensive package of essential health services and contribute to universal health care, through a primary health-care approach. Another example is the work of the Sustainable Financing for Health accelerator (SFH-A), which is providing a range of pooled or co-financed operations in countries and has identified some key issues and lessons learned from their joint financing of health-systems strengthening in low- and middle-income countries. Examples of how joined-up support is provided at country level are shown in SDG3 GAP country case studies.

Finally, work under the SDG3 GAP aspires to underpin alignment among other initiatives, partnerships and collaborations, so that more efficient joined-up support is provided to countries, and greater impact is achieved on the ground. SDG3 GAP partners support alignment with and across other existing and emerging health-related initiatives, including the Lusaka Agenda, Gavi’s “6.0 Health Systems Strategy”, the World Bank's Evolution Roadmap, WHO's 14th Global Program of Work , UHC2023, H6/Every Woman, Every Child, and the Health Data Collaborative.

5. What has been achieved since the launch of the SDG3 GAP in 2019?

The number of countries engaged under SDG3 GAP has increased from 37 in 2021 to 69 in 2024. Focused on 20 priority countries, the PHC-A has good traction across agencies and other development partners and is well-positioned to respond to country demand – there is no other platform for interagency collaboration on primary health care. The SFH-A provides an important platform for collaboration on health financing (technical assistance, advocacy, capacity building and joint financing), for partners to provide inputs into the Future of Global Health Initiatives (FGHI) process and the commitments laid out in the Lusaka Agenda (2023), and for sharing information more broadly about health financing issues across the agencies, with specific focus on value for money, efficiency, joint programming and innovative funding.

The Regional Health Alliance for the Eastern Mediterranean Region is a collaborative platform among 17 UN agencies led by WHO’s Regional Office for the Eastern Mediterranean, and was established in 2020 to drive support for the SDG3 GAP way of working, given the regional context, including emergency response, migration, and refugee-focused agencies.  So far, it remains the only such regional initiative mirrored to the SDG3 GAP.

A joint Independent Evaluation of the SDG3 GAP was launched in 2023, to inform partners’ learning, continued improvement and mutual accountability in their efforts to strengthen collaboration with countries, in line with the “account” commitment, past the half-way point to Agenda 2030.

6. What is the offer to countries and how can countries make best use of the SDG3 GAP?

A joint letter from the Principals to the agencies’ country-facing teams and UN Resident Coordinators in January 2022 has refined the signatory agencies’ offer to countries and the added value of the SDG3 GAP collaboration in support of countries priorities to accelerate progress on the health-related SDGs.

SDG3 GAP learnings recognize that there is an urgent need for the multilateral system to better utilise increasingly constrained resources through better collaboration. This is needed to support countries’ capacities and health systems to achieve better health outcomes overall, while building resilience to deliver services even in the face of shocks such as pandemics. This fifth annual progress report of the SDG3 GAP focuses on enhanced alignment among signatory agencies and with countries to strengthen health systems at country level.

7. How is SDG3 GAP governed?

SDG3 GAP constitutes a commitment by the Principals of the 13 signatory agencies to stronger collaboration to achieve better health outcomes in countries. Each SDG3 GAP agency is formally accountable only to their respective governing bodies. The limited capacity of agencies’ accountability mechanisms to focus on collaboration across the broader health ecosystem is a key challenge, exacerbated by the cost of collaboration. 

Accountability also occurs through the annual joint SDG3 GAP progress reports, independent evaluations and the monitoring framework which solicits feedback from governments. Opportunities for “joint governance” approaches, such as joint discussions on SDG3 GAP implementation in agencies’ governing bodies, for example, to review progress in implementing evaluation findings, have been piloted and can now be scaled up.

8. What are the challenges in strengthening SDG-focused collaboration and how can they be addressed?

Weak incentives for collaboration have so far prevented transformational change in how development partners work together. While the SDG3 GAP seems to be adding value in certain areas, contexts and countries, incentives and funding for stronger collaboration among agencies remain weak. For example, there is limited capacity in existing accountability mechanisms, including governing bodies of signatory agencies, to focus on collaboration across the broader health ecosystem.

Aligning funding with country priorities is a recurring request from countries and a persistent challenge due to parameters that are external to the SDG3 GAP. The way funding is allocated by global health funding mechanisms is typically determined by the policies and incentives created by agencies’ governing bodies, potentially limiting the ability of SDG3 GAP signatory agencies to commit in the context of SDG3 GAP.

Addressing widening inequities amid fiscal constraints is also a key challenge, highlighting the added value of work under the SDG3 GAP to increase efficiencies through synergistic investments and a focus on PHC.

Civil society and communities play a key role in strengthening PHC and work under other SDG3 GAP accelerator themes, including health determinants and gender equality. Through the implementation plan based on 2023 recommendations, SDG3 GAP signatory agencies are exploring how the SDG3 GAP can better promote and support civil society and community engagement and empowerment for recovery towards the SDGs. 

Further scaling up work at country level, with support from global and regional levels, as well as further integrating equity considerations across accelerators, are ongoing challenges.  Countries and their partners will need to ensure that recovery towards the SDGs is resilient in the face of overlapping crises such as political and economic instability, armed conflict, food insecurity, the climate crisis, rising inequality and risks of future pandemics, highlighting the importance of work across SDG3 GAP programmatic themes and the health-related SDGs.

9. What is next for the SDG3 GAP? 

Successes achieved in the five years of the SDG3 GAP, point to the enormous potential of what is possible when the right leadership is in place in both countries and agencies. In anticipation of the findings of the joint independent evaluation of the SDG3 GAP, expected in September 2024, and recognizing other emerging agendas, the 2024 SDG3 GAP progress report contributes to the basis for further discussions among the 13 signatory agencies, on how to further improve the alignment and collaboration across multilateral health, development and humanitarian agencies to achieve progress towards the health-related SDGs. This could include substantially rethinking approaches taken, both inside the scope of SDG3 GAP, and outside of it.