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; Dr Ruth Nigatu, Ministry of Health, Ethiopia; 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; Jin Hashimoto, Toshihiro Kitamura, Ministry of Foreign Affairs, Japan; Gerald Manthalu, Ministry of Health, Malawi; Jennie van de Weerd, Ministry of Foreign Affairs, Netherlands; Kristine Husøy Ornaheim, Ministry of Foreign Affairs, Norway; Paul Fife, Norad, Norway; Dr Aamer Ikram, Pakistan; Dr Lwazi Manzi, Head of Secretariat, AU Covid-19 Commission, South Africa; Hampus Holmer, Ministry of Foreign Affairs, Sweden; Samrita Sidhu, Jo Scott-Nicholls, FCDO, United Kingdom; Dr Atul Gawande, USAID; Dr Ahmed Ogwell Ouma, Africa CDC; Gabriella Fésüs, Birgitte Hagelund, Gregoire Lacoin, DG International Partnerships, the European Commission; Katy Kydd Wright, Global Fund Advocates Network; Cecilia Lodonu-Senoo, Hope for Future Generations; Eve Dorin-Blanchard, Institute for Global Health and Development, Guinea-Bissau; Oswaldo Adolfo Rada Londoño, Senderos Asociación Mutual; Lori Sloate, United Nations Foundation; Beck Smith, Clare Battle, Wellcome; Anurita Bains, UNICEF; Dr Susan Sparkes, WHO.
Secretariat: Linda Muller.
Welcome and overview of working group objectives for the coming months
The Co-Chairs welcomed participants to the first meeting of the Lusaka Agenda Working Group, noting the group’s membership is drawn from, and beyond, the former Future of Global Health Initiatives Steering Group. The Co-Chairs underscored that the group is time-bound (to end-April 2024), inclusive and informal, with two key objectives over the coming months:
- anchoring the Lusaka Agenda on the agendas of global health initiative (GHI) boards and the African Union (AU), and beginning to drive its implementation.
- engaging with stakeholders, including GHIs, civil society, and a broader group of donor and implementing countries, to design arrangements for ongoing collaboration to advance Lusaka Agenda conclusions, including embedding the five Lusaka Agenda shifts in the broader global health financing ecosystem.
The importance of meaningful engagement of civil society was stressed by several participants and these principles for the meaningful involvement of civil society and communities in global health governance were referred to. The engagement of the private sector was also encouraged as arrangements for ongoing collaboration are designed.
Anchoring Lusaka Agenda conclusions on the agendas of GHI boards: aligning on priority asks and actions
Recognizing that full implementation of the Lusaka Agenda conclusions will extend beyond the four-month time horizon of the interim working group, meeting participants aligned around and discussed three areas for priority actions by GHI boards, recognizing that additional actions would be required post-April:
1. Joint work, with the four joint workstreams between Gavi and Global Fund (malaria, health systems strengthening, country engagement and back-office functions) serving as a jumping-off point, to seek clarity on how they relate to and advance, Lusaka Agenda near-term actions, noting that Lusaka Agenda calls for joint work are more far-reaching than these workstreams.
2. Joint oversight through establishment of a working group comprised of Global Fund, Gavi and GFF committee representatives to provide working-level oversight and advice and reporting back to their home committees.
3. Country implementation, including work through pathfinder countries to accelerate progress on the key shifts and capture learnings.
Working group members aligned on the importance of taking action to embed these actions in the agendas of upcoming GHI committee meetings and board retreats and of aligning ahead of time on key messages and actions for working group members to drive Lusaka Agenda implementation. Several Lusaka Agenda Working Group members noted the need for the development for a terms of reference for the Gavi/Global Fund/GFF working group.
Several meeting participants highlighted the importance of driving implementation of the Lusaka Agenda’s five key shifts also in the broader health financing ecosystem, with specific references to the Pandemic Fund, WHO, the World Bank and regional development banks.
Several working group members identified ways in which they are/could engage with GHI governance mechanisms, with several donors noting the opportunity upcoming replenishments present to drive change.
Meeting participants expressed support for the Co-Chairs’ proposal for donor and implementing country constituencies to write to Global Fund board leadership summarizing priority asks and actions. Co-Chairs agreed that the letter could be made public.
Seizing the opportunity to drive change in Africa
While implementation of the Lusaka Agenda will be overseen by GHI boards, there was a call for external accountability mechanisms to monitor this implementation. Working group members heard an update on work underway to establish such an AU accountability mechanism, with the engagement of Heads of State, Minsters of Finance and Ministers of Health. Upcoming African moments, including the African Union Summit and related ministerial meetings, provide an opportunity to socialize the Lusaka Agenda and galvanize country commitments.
Africa CDC reported that it is engaging with GHI CEOs to help drive implementation of the Lusaka Agenda conclusions, including related to the identification of pathfinder countries. Several donors indicated they would work through their country offices to socialize the Lusaka Agenda and called for the Secretariat to develop a core narrative that they could share with their country offices.
Recognizing work being undertaken by several African working group members, the Secretariat will convene a call of African working group members to map out how we are driving engagement in Africa and how we can keep each other updated on the status of various activities, with the intention also of having a report back to the working group at its next meeting.
Arrangements to catalyse implementation of Lusaka Agenda conclusions post-April:
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. Recognizing this, the Co-Chairs highlighted the need to use the next three months to: a) clarify areas where ongoing collaboration will be needed beyond April in order to ensure sustainable oversight and implementation of the Lusaka Agenda conclusions, and b) put in place the arrangements needed to take these forward after the funding and hosting of the current Secretariat comes to an end.
Four potential areas for ongoing collaboration beyond April were highlighted:
1. Implementation of the Lusaka Agenda through GHI boards and committees
2. Progress towards a joint vision for a more coordinated approach to R&D, manufacturing and market shaping (Lusaka Agenda shift 5)
3. Embedding leadership and accountability in Africa
4. Broader collaboration to drive the evolution of the global health financing ecosystem (for example, using the Lusaka Agendas as a springboard for engagement with a wider range of global health funders and institutions).
A light-touch and rapid consultation (facilitated by Wellcome Trust) will be conducted over the coming weeks, to understand perspectives on the pathways needed to ensure progress in areas one and four, and to start to identify the arrangements needed to take these forward beyond this interim period. Consultations will include those within and beyond the Lusaka Agenda Working Group, and will aim to be as balanced and inclusive as possible across geographies and stakeholder groups, recognising that time constraints will necessitate a rapid process. Where possible, light-touch analysis of existing arrangements will be conducted to complement consultations. The preliminary outcomes of this work will be brought back to the Lusaka Agenda Working Group for further consideration at the next meeting on 7 March.
An informal meeting of parties interested in supporting area two (progress towards a joint vision for a more coordinated approach to R&D, manufacturing and market shaping) will be convened by Wellcome, to explore next steps.
Next steps
The Lusaka Agenda Working Group will meet next on 7 March at 5:30 am Seattle/8:30 am Ottawa/1:30 pm Accra, London/4:30 pm Nairobi/10:30 pm Tokyo.
For transparency, working group membership, meeting notes and related documents will be posted on a new follow up page on the FGHI website.