Driving Strategic Changes in Health Financing Through the Lusaka Agenda
Meeting Summary | 20 May, 2025 | Geneva & Online
A side event in the margins of the Seventy-eighth World Health Assembly, co-convened by the Civil Society Engagement Mechanism for UHC2030, UHC2030, the United Nations Foundation, WACI Health, Democratic Republic of the Congo National Council on UHC, and in partnership with the Government of Canada.
Background
2025’s shock waves in global health financing are prompting a reset in how health is financed and delivered globally. In this rapidly changing context, the Lusaka Agenda provides a relevant framework and jumping off point for strategic changes in health financing and sustainable progress delivering on a vision of domestically-financed health systems and universal health coverage (UHC) that leaves no-one behind. On the margins of the Seventy-eighth World Health Assembly (WHA78), this side event focused on how civil society organizations are helping to shape the implementation and monitoring of ongoing work. The session, attended by over 125 key stakeholders in-person and online – including champion countries, global health initiatives, civil society, global and regional health organizations and donors – took stock of recent developments and considered next steps to strengthen collaboration, alignment, and accountability.
Speakers
Master of Ceremonies: Ms. Molly Moss, Director, Global Health, UN Foundation
Welcome Remarks: Dr. Pam Cipriano, Steering Committee Co-Chair, UHC2030 and President of the International Council of Nurses
Scene-Setting Remarks: Dr. Lwazi Manzi, Head of Secretariat, President Cyril Ramaphosa’s African Union Pandemic Prevention, Preparedness and Response Commission
Panel Discussion: Moderated by Ms. Rosemary Mburu, Executive Director, WACI Health
Dr. Mebratu Massebo, Chief of Staff, Ministry of Health, Ethiopia
Dr. Polydor Mbongani Kabila, Coordinator, National Council on Universal Health Coverage, DRC
Dr. Landry Tsague, Director of the Centre for Primary Health Care (PHC), Africa CDC
Ms. Hannah Burris, Chief of Staff, Gavi
Closing Remarks: Dr. Susan Sparkes, Health Financing Policy Unit, World Health Organization
Key Messages
At a critical juncture for global health financing, the Lusaka Agenda offers a roadmap toward improved efficiency, sustainability, and equity across health financing and service delivery. Despite progress in expanding health service coverage, financial protection is declining in over 70% of countries. Meanwhile, a steep drop in official development assistance (ODA) has exacerbated the challenge of financing health in low-resource settings.
Against these headwinds, civil society and global health partners must work in lockstep to sustain political will to implement existing commitments, including the 2019 & 2023 political declarations on Universal Health Coverage, and to explore innovative approaches in line with the Lusaka Agenda. As a starting point, participants emphasized the importance of collaboration among, and financial support to, global health initiatives (GHIs), including Gavi, the Global Fund and the Global Financing Facility (GFF), to ensure their life-saving work continues in ways that advance country priorities. Additionally, participants noted the importance of leveraging the Lusaka Agenda in various decision-making fora, including the G20’s Joint Finance and Health Task Force, to engage other sectors and promote synergies across reform efforts.
While critical steps are underway to improve coordination across the diverse and inextricably linked mandates of global health, more work is to be done. The Joint Committee Working Group, bringing together committee members of Gavi, the Global Fund, and the GFF, has opened a channel to collectively assess country-level needs and bottlenecks, and develop efficient strategies to address those challenges. Programs focused on malaria, primary health care (PHC), and health system strengthening, for instance, were identified by the organizations’ governing bodies as key entry points for streamlining work across the GHIs. At the national level, we are seeing some governments working across ministries and engaging civil society, and donor partners to align interventions with country priorities. Where possible, these efforts are being brought together under one budget and one monitoring and evaluation framework. Trials of innovative and blended financing, such as new lending arrangements, both within and beyond Africa, were highlighted.
Participants embraced the Lusaka Agenda’s relevance in broad efforts to reduce fragmentation across global health financing, but also noted that stakeholders hold different perspectives and priorities for its implementation. Therefore, a call was issued to reinforce a more coherent and consistent narrative around the Lusaka Agenda and its implementation strategy. Civil society has been leading these efforts, including publication of a document outlining shared priorities across the Lusaka Agenda’s five key shifts.
Building structures for accountability is imperative as focus shifts to implementation. The African continent is demonstrating ownership of the Lusaka Agenda in the development of an accountability framework and scorecard under the auspices of the African Union Commission (AUC) and Africa CDC.
The framework, to be endorsed by Heads of State at the next AU Summit in 2026, will leverage this political support to drive regular reporting on progress. Effective implementation of the framework will rely on clearly defined methods, metrics, and multi-stakeholder participation. Participants recognized civil society as a key contributor to this process, as well as subsequent efforts to monitor and report data once the framework is operationalized. It was widely agreed that this mechanism will be an important milestone for broadening the reach and impact of this Agenda to collectively and sustainably address health financing challenges.
Finally, in light of the recent seismic disruption in global health financing, it was recognized that the Lusaka Agenda is increasingly seen as a catalyst for more substantive reform of the global health architecture. In this context, participants welcomed news of European Commission plans to launch a consultation process to dig into what such a reform could look like.
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Please find the link to the meeting recording here, passcode %5@mj?dl