Lusaka Agenda Working Group Meeting 6 March 2024

Participants
Co-Chairs:
Jean-Bernard Parenteau, Global Affairs Canada; Dr Patrick Kuma-Aboagye, Ministry of Health, Ghana; Desta Lakew, Amref Health Africa.

Participants:
Kristen Chenier, Ayah Nayfeh, Global Affairs Canada; Dr Polydor Mbongani Kabila, Democratic Republic of the Congo; Harriet Ludwig, BMZ, Andreas Zeidler, GIZ, Germany;  Lynda Wardhani, Ministry of Foreign Affairs, Indonesia; Eugenia Palagi, Federica Polselli, Ministry of Foreign Affairs and International Cooperation, Italy; Eleonora Mei, Ministry of Finance and Treasury, Italy; Susan Mochache, African Constituency Bureau of the Global Fund; Gerald Manthalu, Ministry of Health, Malawi; Kristine Husøy Ornaheim, Ministry of Foreign Affairs, Norway;  Dr Aamer Ikram, Pakistan; Magnus Lennartsson, Hampus Holmer, Ministry of Foreign Affairs, Sweden; Samrita Sidhu, Jo Scott-Nicholls, FCDO, United Kingdom; Dr Atul Gawande, Nidhi Bouri, USAID; Dr Ahmed Ogwell Ouma, Africa CDC; Kieran Daly, Sue Graves, BMGF; Gabriella Fésüs, DG International Partnerships, the European Commission; Katy Kydd Wright, Global Fund Advocates Network;  Magda Robalo, Institute for Global Health and Development, Guinea-Bissau;  Lori Sloate, United Nations Foundation; Clare Battle, Wellcome; Anurita Bains, UNICEF; Hajime Inoue, World Bank; Dr Susan Sparkes, WHO, Akudo Ikpeazu, WHO-AFRO.

Guests (for pathfinder country update agenda item):
Hope Johnson, Gavi; Bruno Rivalan, Global Financing Facility; Katie Kampf, Global Fund.

Secretariat: Linda Muller.

Co-Chair’s update

Lusaka Agenda Working Group Co-Chair Desta Lakew provided an update on Lusaka Agenda activities since the 8 February working group meeting (see meeting slide deck for details).  

Anchoring Lusaka Agenda conclusions on the agendas of global health initiative (GHI) boards, including an update on pathfinder country process & next steps

Pathfinder country process

Gavi, the Global Fund and the Global Financing Facility Secretariat focal points joined for this agenda item to provide an update on their proposed approach to identifying pathfinder countries (see meeting slide deck for details). The approach was framed as an initial step to guide internal discussion with GHI governance bodies and noted the next step of engaging in-country stakeholders before coming to a final decision. Working group members welcomed the update and requested additional information on the process (including timeframe for decision) and the setting out of joint expectations and vision for success to guide country-level engagement. Some working group members called for a more country-driven process based on expressions of interest from countries rather than selection by GHIs, and prioritizing alignment with country systems. It was also noted that all countries – not just pathfinders – should feel empowered to use the Lusaka Agenda as a platform to engage differently with GHIs. The representatives from Gavi, Global Fund and the Global Financing Facility highlighted that the pathfinder country approach would not include additional resources but rather focus on enhancing ways of working.

Anchoring the Lusaka Agenda on the agendas of GHI boards

There was broad support for a joint letter to Gavi, Global Fund and GFF board leadership, signed by interested Gavi, Global Fund and GFF board members and alternates, calling for the establishment of a joint committee working group, requesting an update on joint work and requesting the Lusaka Agenda be included on the agendas of upcoming GHI meetings. There was also recognition of the positive engagement of the three GHIs on the Lusaka Agenda (as reflected during February’s GFF Trust Fund Committee retreat, the Global Fund Strategy Committee papers shared ahead of the 14-15 March committee meeting and the participation of Secretariat focal points in the working group call), with acknowledgement also of the tension among some GF board constituencies.

Working group members aligned around holding the letter for optimal impact until after the upcoming Global Fund committee meetings (Strategy and Ethics & Governance) and adjusting messages as needed before moving to signature and dispatch. The Co-Chairs will revert the week of 18 March with an updated letter for consideration and appreciated the commitment of working group members in facilitating signatures of board members and alternates.

The importance of engagement with GHI board constituencies to advance the Lusaka Agenda objectives was underscored, particularly ahead of upcoming committee and board meetings.

Catalyzing change in Africa

The African Union (AU) in February reappointed South African President Ramaphosa as AU PPPR champion and the February AU Summit endorsed his recommendation to “support the establishment of an accountability mechanism within the African Union architecture to ensure effective implementation of the Lusaka Agenda in Africa”.  It was proposed that the PPPR championship and Africa CDC lead a discussion with the Lusaka Agenda Working Group once the AU decisions are published.

The Africa Constituency Bureau (ACB) for the Global Fund shared perspectives on how to drive implementation of the Lusaka Agenda conclusions on the African continent. The approach sets out plans for engagement through GHI boards, complemented by work – by the ACB, together with WHO-AFRO, Africa CDC and Regional Economic Communities – to secure technical and political ownership and commitment at both the country and regional levels. Several working group members supported the approach and level of ambition of this proposal, highlighting the important role of WHO-AFRO and ministries of finance (see attached Africa’s Perspective on the Lusaka Agenda as a Strategic Initiative for Sustained Impact, shared by the ACB in follow-up to the working group meeting).

Towards common metrics & measurement for health system strengthening

WHO provided an update on work to drive towards common metrics and measurement for health system strengthening, which is one of the Lusaka Agenda near term priorities. Working group members welcomed the update and supported the effort to drive this forward.

Considering collaboration post-April: survey results so far, issues raised, next steps

Recognising that the current interim Lusaka Agenda Working Group is supported by a part-time Secretariat that will wrap up its work at the end of April 2024, Wellcome facilitated a rapid consultation to identify the arrangements that may be needed to ensure progress on the Lusaka Agenda beyond April 2024. Over the past few weeks, a survey was developed and shared with working group members and other interested partners: 17 responses have been received so far. Emerging survey results were shared during the meeting (see meeting slide deck) and working group members supported the idea of setting-up a small sub-group to further iterate thinking on post-April arrangements.

Working group members who have not yet done so were encouraged to complete the survey (found here) at their earliest convenience. Those interested in joining the future arrangements sub-group should contact Clare Battle (c.battle@wellcome.org).

Next steps

The Lusaka Agenda Working Group will next meet next on 11 April. For transparency, working group membership, meeting notes and related documents are posted on a follow-up page on the FGHI website.