22 February 2023

Key takeaways from the Spotlight 3 session - Building resilience to global health threats and leaving no one behind: the need for more effective development cooperation – lessons from the health sector

Effective Development Co-operation Summit - Building resilience to global health threats and leaving no one behind

Key takeaways Spotlight 3 on “Building resilience to global health threats and leaving no one behind: the need for more effective development cooperation – lessons from the health sector’’

The Spotlight 3 “Building resilience to global health threats and leaving no one behind: the need for more effective development cooperation – lessons from the health sector’’ took place on 12 December 2022, during the Geneva Effective Development Cooperation Summit. The session provided an opportunity to reflect on some of the health sector’s lessons learned on improving effective development cooperation. It was organized jointly by UHC2030 and the SDG3 Global Action Plan.

Panelists in the session highlighted how country health systems have suffered from the successive global crises including notably the HIV/AIDS crisis, Ebola, and more recently the COVID-19 pandemic. Although countries have deployed phenomenal efforts to respond to this major health crisis, low- and-middle income countries are facing significant challenges in terms of mobilizing and allocating more resources to health in the post-COVID-19 recovery phase, due to major fiscal constraints and increased debt burden. In such situation, official development assistance (ODA) must play a more critical and effective role in supporting national efforts to strengthen health systems to achieve universal health coverage and health security, and all efforts should be made to ensure ODA is coordinated and aligned to national plans. Overall, participants highlighted the importance of building strong and inclusive partnerships with all stakeholders (governments, private sector, civil society, etc) that will ensure we work better together for building more resilient and equitable health systems.

The session was moderated by Ms. Karin Hulshof, Deputy Executive Director, UNICEF. She highlighted the importance of such an opportunity for a thought provoking and constructive dialogue among different stakeholders on the importance of working better together to ensure more coherent action in deploying development cooperation for the health sector. Building the resilience of health systems is critical to ensure we leave no one behind and are better prepared for future global health threats. In this context, she emphasized the need to look at ways to prioritize support to health systems strengthening with primary health care as a foundation to achieve the intertwined goals of universal health coverage and health security. This involves working very closely together and to align ODA national priorities.

Dr. Kumanan Rasanathan, Executive Director, Alliance for Health Policy and Systems Research stressed in his keynote the importance of building resilient systems to global health threats and the crucial role development cooperation could play in this process. ODA can play a critical role in supporting national efforts to strengthen health systems towards achieving universal health coverage and health security through a primary health care approach, but there is a need to think about it differently. For example, this involves being clear about the results we want to sustain, developing and implementing policies that can successfully address these challenges, enabling a learning policy environment and driving effective implementation. To this end, through the SDG3 GAP monitoring framework, governments and relevant authorities are sharing their perspectives on how well partners collaborate with each other, and how well they align to national plans and Dr. Rasanathan mentioned how this type of feedback could provide a quality improvement mechanism for development partners. To conclude, Dr. Rasanathan called for an in-depth reflection on the following three elements for improving the effectiveness of development cooperation  in achieving better health outcomes: 1) strengthening partnerships to deliver on SDG-3 by rethinking the role and model of external funding in low income countries, 2) enhancing the voices of civil society and communities, 3) increasing transparency and accountability by addressing measurement gaps  through better tracking development assistance for health, including for health systems strengthening.

Ms. Björg Sandkjær, State Secretary for International Development, Norway intervened on Norway’s experience in using ODA both in bilateral and multilateral cooperation to support health systems strengthening efforts in developing countries. She brought in the perspectives of mutual accountability, partnership, and the importance of country ownership as main lessons learnt along the way, aiming to build resilient and equitable health systems based on primary health care. As an example, she mentioned the multilateral cooperation in which Norway was involved during the pandemic to implement the Access to COVID-19 Tools Accelerator (ACT-A), including its COVAX Initiative. This experience exposed the need for more reliance on local manufacturing and for building an enabling ecosystem around the manufacturing of products needed to respond to health crises. Another example of Norway’s successful bilateral experience is the District Health Information Software (DHIS), which provides an open access health information system tool, used in 73 countries. Ms. Björg presented this tool as a concrete example of strong partnership involving multiple stakeholders, such as multilateral organisations, academia, civil society and communities. To conclude, she highlighted the importance of supporting more inclusive health systems as the involvement of civil society and communities is key to realize the right to health for all. Besides, she mentioned the need to implement a human rights-based approach to address discriminatory norms and practices that exist in societies and ensure complete access to healthcare services. Of course, finding an appropriate and adequate financing system/insurance scheme would be decisive to leave no one behind.

H.E. Ms. Princess Adejoke Omolade Orelope Adefulire, Senior Special Assistant to the President of Nigeria on SDGs, Nigeria referred to Nigeria’s approach to make progress on SDG-3 in the context of its overall SDG framework. the country has based the success of its approach to make progress towards the SDGs, and SDG-3 in particular, on fundamental aspects including strong partnership and collaboration with the private sector, state and non-state actors, and women, youth, and civil society organizations, vulnerable populations as well as in its cooperation with other countries. Ensuring engagement, inclusiveness and the right of participation are key approaches that the Nigeria Government has used to make progress on SDG-3. Ms. Adejoke confirmed that these elements will remain at the core of Nigeria’s strategies for the coming years to ensure that no one is left behind. She also shared a few examples of initiatives and practices that Nigeria has developed including the Integrated National Financing Framework, an independent evaluation for SDG-3 and -4, the scaling-up of actions on the SDGs at both national and state levels, public and private sector investment, including through corporate social responsibility. She concluded her statement by stressing the need for a whole of society approach combined with a whole of government activities to ensure everyone has access to healthcare services.

Ms. Nurgul Djanaeva, Director, Forum of Women’s NGOs, Kyrgyzstan brought to the table the role that civil society can play in building an inclusive partnership for the health sector in Kyrgyzstan and ensuring no one is left behind in efforts to guarantee everyone has access to health services without facing financial hardship. She argued that civil society organizations (CSOs) have a deep knowledge, expertise and commitments about health systems strengthening that can be leveraged during the entire path to achieving universal health coverage. CSOs know better how to raise the voices of the unheard and the most disadvantaged groups. Unfortunately, the absence of an institutionalized framework for the CSOs to partake in the decision-making process prevents full action to improve the health system. An example of a great contribution in Kyrgyzstan comes from the country’s Alliance for Reproductive Health which significantly contributed to legal reforms and helped providing very specific needed health services to the populations. Recent statistics in Kyrgyzstan, especially in the context of COVID-19, revealed that people are still left behind. To fill the gaps and bring in the voices of all people, CSOs are very much needed. This implies building a strong inclusive system that promotes the participation of CSOs as development actors in their own rights in the various decision-making and reform processes. For that, partnership is key. However, a detailed action plan with clear description of core responsibilities and stakeholders to be involved would be necessary to be really effective.

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UHC2030 is a global movement to build stronger health systems for universal health coverage (UHC). It brings together health stakeholders and advocates to work together to advance progress towards delivering health for all by mobilizing political commitment, promoting collective action for health systems strengthening, and demanding and tracking accountability.

The SDG3 Global Action Plan

The SDG3 Global Action Plan is a platform for improving collaboration among the biggest multilateral players in global health and aims to help countries accelerate progress on the health-related SDGs through a set of commitments to strengthen collaboration across the agencies to take joint action and provide more coordinated and aligned support to country owned and led national plans and strategies.

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