Published in The Lancet in 2020, this brief article by Gita Sen examines the accountability challenges affecting the health-related Sustainable Development Goals for women, children, and adolescents. Drawing on the 2020 Independent Accountability Panel (IAP) report, the text discusses how COVID-19 disrupted essential health services, exacerbated gender-based violence, and reversed prior survival gains.

The publication outlines the IAP’s accountability framework, which is built on four interdependent pillars: Commit, Justify, Implement, and Progress. Addressing systemic failures and wasted health spending, the article discusses three core actions: investing in data systems for vital registration and equity tracking, institutionalising formal accountability mechanisms, and democratising oversight to ensure community participation triggers remedial action.