Meeting Notes

Participants

Co-Chairs:

Jean-Bernard Parenteau, Global Affairs Canada; Desta Lakew, Amref Health Africa.

Participants:

Kristen Chenier, Ayah Nayfeh, Global Affairs Canada; Dr Polydor Mbongani Kabila, Democratic Republic of the Congo; Mikaël Garnier-Lavalley, Ministry of Health, France; Harriet Ludwig, BMZ, Andreas Zeidler, GIZ, Germany; Lynda Wardhani, Ministry of Foreign Affairs, Indonesia;  Eleonora Mei, Ministry of Finance and Treasury, Italy; Jin Hashimoto, Ministry of Foreign Affairs, Japan; Gerald Manthalu, Ministry of Health, Malawi; Sharif Egal, Ministry of Foreign Affairs, Netherlands; Dr Kristine Onarheim, Ministry of Foreign Affairs, Paul Fife, NORAD, Norway; Magnus Lennartsson, Ministry of Foreign Affairs, Sweden; Samrita Sidhu, Shayon Mukerjee, FCDO, United Kingdom; Atul Gawande, USAID; Dr Ngashi Ngongo, Dr Landry Tsague, Africa CDC; Birgitte Hagelund, Grégoire Lacoin, DG International Partnerships, the European Commission; Susan Mochache, Aaron Mulakai, African Constituency Bureau for the Global Fund; Dr Lwazi Manzi, AU PPPR Commission, South Africa; Hannah Cameron, Bill & Melinda Gates Foundation; Katy Kydd Wright, Global Fund Advocates Network; Cecilia Senoo, Hope for Future Generations; Dr Magda Robalo, Marjolaine Nicod, UHC 2030; Dr Ahmed Ogwell Ouma, Molly Moss, United Nations Foundation; Clare Battle, Wellcome; Anurita Bains, Benjamin Schreiber, UNICEF; Dr Susan Sparkes, WHO; Dr Akudo Ikpeazu, WHO-AFRO.

Secretariat: Linda Muller.

Progress toward our Lusaka Agenda indicators of success for end-June; what we have achieved and looking ahead

Lusaka Agenda Working Group Co-Chairs Desta Lakew and Jean-Bernard Parenteau reviewed progress toward Lusaka Agenda indicators of success for end-June (see meeting slide deck and annex below) and shared an update received from Gavi, the Global Fund and the Global Financing Facility (3Gs) on the Joint Committee Working Group (JCWG) and pathfinder country process.

The 3Gs are sharing JCWG draft terms of reference through their committee mechanisms and expect to issue calls for expressions of interest for JCWG membership in the weeks ahead. They will work together to ensure diverse representation and balance across donor and implementer (including countries and civil society) constituencies and expect the first JCWG meeting to take place in August/September. The participation of WHO and the World Bank in the JCWG is under discussion.

On the pathfinder country process, further to their development of a ‘factbase’ that maps Gavi, Global Fund and GFF investments globally and the articulation of a set of proposed pathfinder identification considerations, the 3Gs are now working with their country teams and engaging with a small cohort of countries – within and beyond Africa – on visions of success and interest in being part of a first wave of pathfinders for their four joint workstreams (malaria, health systems strengthening, country engagement and back-office functions). It was noted that these workstreams are a subset of the Lusaka Agenda.

LAWG members supported these actions by the 3Gs and heard that Africa CDC, WHO-AFRO, the African Union Commission and the African Constituency Bureau (ACB) for the Global Fund will work together to identify and support a broader group of African champions to drive implementation of the Lusaka Agenda’s key shifts on the continent. There was recognition that the intent of the Lusaka Agenda, and of the Africa Union decision to “support the establishment of an accountability mechanism within the African Union architecture to ensure effective implementation of the Lusaka Agenda in Africa”, is for all countries and partners to implement the Lusaka Agenda shifts in contextually-appropriate ways.

One LAWG member underscored that global and regional health institutions (including WHO and Africa CDC) will be instrumental in driving forward the primary health care and domestic financing agendas. It was noted that the Lusaka Agenda’s key shifts are well-articulated in WHO’s Fourteenth General Programme of Work (GPW14) and that Member States will be following their implementation closely.

The reference to the Future of Global Health Initiatives (FGHI) process in the Apulia G7 Leaders’ Communiqué and the African Union Lusaka Agenda decision were warmly welcomed as two examples of  impressive momentum that the Lusaka Agenda is creating around long-discussed key shifts for the evolution of the global health financing ecosystem. LAWG members noted the importance of also embedding the key shifts in the work of the Pandemic Fund.

The need for more work to move the Lusaka Agenda discussions and actions from the global level down to countries was stressed by several meeting participants. The 12-13 June Technical Consultation on the Lusaka Agenda, convened by WHO-AFRO, in partnership with Africa CDC and the ACB, was cited as an important initiative in this regard.

Taking forward the Lusaka Agenda in Africa

The ACB’s Susan Mochache provided an update on the excellent 12-13 June Technical Consultation on the Lusaka Agenda in Addis Ababa (see meeting slides) and the work it has set in motion for the development of an implementation roadmap and accountability framework to be presented to Minsters of Health at the WHO Africa Regional Committee meeting in Brazzaville in August.

The June meeting was an important moment, ahead of the 26-30 August Regional Committee meeting, an Extraordinary African Union Summit on Health being planned for October/November, the November Conference on Public Health in Africa and the Africa Health Agenda International Conference in early 2025. Further to the AU decision, Africa CDC and the African Union Commission are leading work to develop an accountability framework and to determine where in the African Union architecture it should be situated.

Africa CDC, WHO-AFRO and the ACB are developing a project concept and budget to advance the Lusaka Agenda on the continent, including by working with Regional Economic Communities for country-level socialization and engagement. They will then seek funding for this important work. They welcome engagement by civil society organizations (CSOs) in this endeavour.

Hope for Future Generation’s Cecilia Senoo reported that African CSOs who participated in the Addis consultation are now engaging with a broader group of CSOs at national, regional and global levels, to consider how CSOs can advance the Lusaka Agenda’s key shifts in their work. In support of this, they are developing a Lusaka Agenda Myths and Facts document, as well as planning a CSO webinar. They  are additionally considering convening an Africa CSO meeting in July in the lead up to the WHO-AFR Regional Committee meeting.  Meeting participants welcomed these initiatives and underscored the vital role of CSOs in the implementation of the Lusaka Agenda.

Beyond June 2024: informal touchpoints and championing the Lusaka Agenda

In frank recognition that Lusaka Agenda implementation is a long game, meeting participants committed to advancing the Agenda’s key shifts in their work in the months and years to come. LAWG members expressed an interest in having informal touchpoints after the end-June sunsetting of the Working Group and Secretariat, including on the margins of the United Nations General Assembly (UNGA) in New York in September. LAWG members were encouraged to use the LAWG email distribution list to continue collaboration.

The United Nations Foundation offered to play an interim coordinating role as work continues to define arrangements for ongoing collaboration related to coordination of Lusaka Agenda implementation, global advocacy and accountability activities and exploration of wider implications of the Lusaka Agenda conclusions for health financing and development assistance for health. A subgroup of the LAWG will continue to work informally to refine thinking around potential arrangement(s) for on-going collaboration and further thinking will be brought to the September meeting.

UHC 2030 Co-Chair Dr Magda Robalo spoke to UHC 2030’s offer to use its platform to provide light-touch secretariat support, to organize high-level meetings where it matters, to convene and elevate discussions to decision-makers and more (see meeting slide deck). Several LAWG members supported this offer.

Closing reflections

The Co-Chairs paid tribute to the pioneering work of FGHI Co-Chairs John-Arne Røttingen and Mercy Mwangangi and of Wellcome, and recognized the impressive contributions of LAWG members in embedding the Lusaka Agenda on the agendas of the Boards of global health initiatives (GHIs) and the African Union, and beginning to drive its implementation. In turn, LAWG members recognized the leadership of LAWG Co-Chairs Jean-Bernard Parenteau, Dr Patrick Kuma-Aboagye and Desta Lakew and appreciated the support of the Secretariat.

Working Group members welcomed the Co-Chairs’ proposal of a Co-Chair statement, to be posted on the Lusaka Agenda page of the FGHI website.

Jean-Bernard shared a request from the 3Gs that LAWG members: continue to remind people that the Lusaka Agenda is bigger than the four joint GHI workstreams; respect that GHI monitoring will be through the JCWG and governing bodies; continue to help to bring the Lusaka Agenda alive in countries: and, even as work begins on the four joint workstreams, drive for a more ambitious vision for change.

Annex 1: Lusaka Agenda indicators of success for end-June

Indicator of Success Update
Establishment of the Joint Committee Working Group Draft TORs shared and call for Expressions of Interest to go out within weeks. First meeting expected in Aug/Sept.
Progress on pathfinder/champion country process. Internal global 3G mapping complete and country/regional consultations underway. Selection of first wave countries and visions of success to follow, with complementary Africa-led phase proposed.
A timeline for joint board calls on HSS and in-country collaboration. TBD – still to be raised with 3Gs.
Progress on a common set of HSS metrics and tools for use by GHIs, donors, countries and other bilateral partners. WHO-led HSS metrics workshop held June 25-26 with GHIs, countries, donors, countries and other bilateral partners.
A roadmap towards the identification and establishment of arrangements for ongoing collaboration Subgroup will continue to work beyond June 2024 to identify potential arrangements. Further thinking to be brought to the proposed UNGA side meeting in Sept 2024.
A roadmap for taking forward the Lusaka Agenda in Africa. AFRO, Africa CDC and ACB developing a roadmap for how they will work together to support countries in advancing the Lusaka Agenda.