We are honoured to have served as Co-Chairs of the Lusaka Agenda Working Group over the past six months and to have worked alongside passionate allies to begin to drive implementation of key shifts for the evolution of global health initiatives (GHIs). This work will undoubtedly support our collective ambition to more effectively and efficiently complement domestic financing in support of country-led priorities toward universal health coverage (UHC).

We are inspired by the commitment of global health stakeholders to advance the Lusaka Agenda’s five key shifts, to:

  • make a stronger contribution to primary health care by effectively strengthening systems for health
  • play a catalytic role towards sustainable, domesticially-financed health services and public heath functions
  • strengthen joint approaches for achieving equity in health outcomes
  • improve efficiencies and reduce transaction costs for countries
  • coordinate approaches to products, research and development and regional manufacturing to address market and policy failures in global health.

We appreciate the engagement of countries throughout this process and the ongoing work of regional partners to drive meaningful change and impact in Africa and beyond. We further welcome the February 2024 decision of African Heads of State and Government to “support the establishment of an accountability mechanism within the African Union architecture to ensure effective implementation of the Lusaka Agenda in Africa”.

The commitment to change is further evidenced through references to the Lusaka Agenda in discussions in and around the 77th World Health Assembly and in the World Health Organization’s Fourteenth Global Programme of Work 2025-2028. The 2024 G7 Apulia Leaders’ Communiqué also pointed to the conclusions of the Future of Global Health Initiatives process and importance of strengthening alignment across the global health ecosystem.

Using GHIs – notably the Global Fund, Gavi, and the Global Financing Facility (3Gs) – as an entry point for broader change, is an important step in this process. We are encouraged by the work of the 3Gs to establish a Joint Committee Working Group to oversee collaborative work on malaria, health systems strengthening and country engagement, and by the Global Fund and Gavi’s collaboration to increase efficiencies in their enabling functions. We are further encouraged by actions by the 3Gs to engage with a small cohort of countries – within and beyond Africa – to explore interest in being part of a first wave of pathfinder countries to drive implementation of the joint workstreams.

The spirit of the Lusaka Agenda remains for all countries and partners to implement the principles and key shifts in contextually appropriate ways. We welcome the commitment of the Africa Centres for Disease Control and Prevention (Africa CDC), the World Health Organization’s Africa Regional Office (WHO-AFRO), the African Union Commission, and the African Constituency Bureau for the Global Fund to work together to identify and support a broader group of African champions to drive implementation of the Lusaka Agenda on the continent.

The robust engagement of civil society and communities – in line with the principles of meaningful involvement of communities and civil society in global health governance – will continue to be of key importance. We thank non-governmental organizations, civil society and community networks for their continued engagement and enthusiasm over the past several months to drive meaningful change and impact, with equity at the heart of our efforts. We welcome the work being carried out by CSOs to prioritize actions they will take to advance each of the five shifts and in this regard look forward to the outcomes of a Lusaka Agenda CSO meeting being planned in Africa in August 2024.

Even as the Working Group and Secretariat sunsets, we as Co-Chairs, together with Working Group members, friends and all interested stakeholders, will continue to advance the Lusaka Agenda in our work and expand implementation beyond GHIs to the broader global health financing ecosystem. A subgroup will continue to work beyond June 2024 to explore arrangements for ongoing collaboration to ensure that focus and momentum is maintained around the Agenda.

To support continued progress, the United Nations Foundation (UNF) will serve as one channel to advance strands of work related to the Lusaka Agenda, including support for Africa-related activities over the next several months. We welcome plans by UNF and UHC 2030 to convene a Lusaka Agenda meeting in the margins of the United Nations General Assembly in  September 2024.

Finally, we pay tribute to Future of Global Health Initiatives Co-Chairs Dr. John-Arne Røttingen and Dr. Mercy Mwangangi for their pioneering work during 2022-2023 and to Wellcome Trust for its financial support of this change agenda. We also wish to thank Linda Muller for important work in leading the Secretariat. We look forward to continuing to advance our collective ambition towards more equitable and resilient health systems.

Dr. Patrick Kuma-Aboagye
Director-General
Ghana Health Service

Desta Lakew
Group Director of Partnerships and External Affairs
Amref Health Africa

Jean-Bernard Parenteau
Director General, Health and Nutrition Bureau