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All low- and middle-income countries face a number of critical pressures on their health systems. Some of these are particularly salient for countries that are currently or will soon be ‘transitioning’ to much lower levels of external financial support.

A common guiding principle is to maintain or even increase effective coverage for priority health services, including those currently supported with external funds.  

This does however not mean simply channelling government revenues to pay for a previously donor-funded programme. Rather, transition provides an opportunity for countries to assess how governance, financing and service delivery are configured to ensure the sustainability of effective coverage for priority interventions.  

Hence, health system strengthening (HSS) is at the core of the response to transition if progress towards UHC is to be sustained.  It also emphasizes the importance of sustainability in the transition process, which should also extend to those countries that are not imminently facing declines in donor assistance.

In the first quarter of 2017 this Technical Working Group completed a mapping of policies, definitions and ongoing work by working group members related to transition from aid. At the end of March 2017 the Working Group met to present ongoing work and define WG priority areas, outputs and products. For conclusions of this meeting please see the meeting report. Preparations are ongoing for country consultations for the production of an issue paper on Sustainability, Health System Strengthening and Transition from Aid. This is expected to be available by the end of the year. 

Objective

To explore roles, responsibilities and opportunities for collaboration among development partners, expert networks and countries to enhance efforts to sustain increased effective coverage of priority interventions with financial protection, in countries transitioning from aid.

Scope 

  1. Build consensus around core issues and objectives in response to the transition from aid, exploring revenue and health system efficiency considerations, as well as approaches to strengthening accountability for results.
  2. Develop guidance and principles for good practise pertaining to countries transitioning from ODA support, with regard to financial, programmatic and capacity issues, including but not limited to e.g. how to develop country-specific transition plans to balance the transition schedules of multiple funding partners.
  3. Explore the types of reforms and investments needed to support an effective transition process, particularly in relation to building strong and unified underlying support systems, such as for procurement, supply chain, information, as well as capacity for evidence informed priority setting processes.

Terms of reference

Face-to-face meetings

This working group met face-to-face on 30-31 March 2017 in Geneva, Switzerland.

All presentations here

Read the final report here

Meeting notes for the record

1 June 2017

17 January 2017

Participant list

The working group is chaired by:

Midori Habich former Minister of Health Peru

Kara Hanson, Professor of Health System Economics London School of Hygiene and Tropical Medicine.

UHC2030 Core team Maria Skarphedinsdottir providing the secretariat

Members

Countries

Mr Pungkas Bahjuri ALI; Director of Community Health and Nutrition; Ministry of National Planning for Development Indonesia

Ms Triin Habicht Senior Adviser to the Ministry of Health Estonia

Dr. Aquina Thulare Technical Specialist, Health Economics National Health Insurance Department of Health South Africa

Ms Regina Ombam Head, Strategy Development National Aids Control Council Kenya

Others TBC

UHC2030 hosting organizations

Ajay Tandon Lead Economist WB

Somil Nagpal Senior Health Adviser WB

Joe Kutzin Coordinator Health Financing WHO

Susan Sparkes Technical Officer Health Systems Governance and Financing WHO

Dr Anshu Banerjee Director Global Coordination WHO

Claudio Politi EPI program WHO

Diane Weil Global TB program WHO

Gilles Forte Coordinator Essential Medicines and Health Products WHO

Dr. Zubin Shroff Alliance for Health Policy and System Research WHO

Tom O’Connell Health System Governance and Finance WHO

Development partners

Matthias Reinicke Health Sector Adviser Europe Aid EC

Thomas Hurley Deputy Director Multilateral Partnerships BMGF

Julia Watson Senior Health Economist DFID

Katja Roll Senior Health Adviser GIZ

Dr Shin-ichiro Noda Center for Global Health and Medicine Japan

Arjun Vasan Senior Health Economist US Treasury

Kamiar Khadjavi Senior Adviser Global Health USAID

Michael Borowitz Head Strategic Investments and Partnerships GF

Mr Matthew Macgregor Portfolio Manager GF

Santiago Cornejo Senior Specialist Immunization Financing GAVI Alliance

Nertila Tavanxhi Technical Adviser UNAIDS

Tim Poletti Health Adviser Permanent Mission of Australia to UN

Ms. Ariane Lathuille Health Policy Officer Permanent mission of France to UN

Academia and Civil society

Sara Bennett Professor John Hopkins Bloomberg School of Public Health

Mr. Mohamed Gad Technical Analyst Imperial College UK

Bill Savedoff Senior Fellow Centre for Global Development US

Mr Michael Chaitkin Senior Program Officer Results for Development

Alice Sabino African Health Budget Network

Bruno Rivalan Head, France Office Global Health Advocates

For further information please contact: 

Maria Skarphedinsdottir, WHO and UHC2030 Core Team: skarphedinsdottirm@who.int