Friends of the Lusaka Agenda

2025’s shock waves in global health financing prompted a reset in thinking about how health services are financed globally. In this rapidly changing context, the Lusaka Agenda provides an important framework and jumping off point for strategic changes in health financing, toward a vision of domestically-financed health systems and universal health coverage that leave no-one behind.

As countries, communities and health organizations grappled with seismic health financing and service delivery disruptions, the UK FCDO, the Malawi Ministry of Health and Gem Hub Initiative (Nigeria) in 2025 hosted quarterly convenings of Friends of the Lusaka Agenda to sustain an open and inclusive forum for dialogue on advancing the Lusaka Agenda, even as work intensified to use it as a springboard for more substantive reform of the global health architecture.

As they handed over the co-chairmanship of the Friends of the Lusaka Agenda for 2026 to the European Commission (INTPA), Ghana and UHC 2030’s Civil Society Engagement Mechanism, the 2025 co-chairs shared these reflections:

While 2025 was a year in global health like no other, there has also been progress in driving reform. Several countries are leading the way and we are seeing responses from major health institutions that give us hooks to continue working together next year, with the opportunity that national health compacts could further provide.

It feels like a time where we’re encouraging thousands of flowers to bloom in the interest of getting legitimacy, hearing all voices and creating lots of ideas. We will now need to work together in 2026 to drive real accountability and real action on already-agreed commitments, and at some point bring key future reform ideas together for impact.

We hope that the Friends of Lusaka Agenda has emerged as a trusted forum for sharing information, for collaborating and for supporting coherency efforts as we try to shape the new global health ecosystem.

Samrita Sidhu, Gerald Manthalu, Oyeyemi Pitan
Friends of the Lusaka Agenda 2025 Co-Chairs