Participants

Co-Chairs: Mercy Mwangangi, Kenyan Ministry of Health and John-Arne Røttingen, Norwegian  Ministry of Foreign Affairs.

Steering Group members and alternates: Penny Dewi Herasati, Ministry of Foreign Affairs, Indonesia;  Ruth Nigatu, Ministry of Health, Ethiopia; Marion Okoh-Owuso (for Patrick Kuma-Aboagye) Ghana  Health Service; Claire Moran, FCDO, UK; Kieran Daly, Bill & Melinda Gates Foundation; Kristen  Chenier, Global Affairs Canada; Takeshi Akahori, Ministry of Foreign Affairs, Japan; Desta Lakew,  Amref; Alex Harris, Wellcome.

Observers: Hajime Inoue, Health, Nutrition, and Population, World Bank and Hendrik Schmitz  Guinote, Office of the Chef de Cabinet, WHO.

Other: Clare Battle, Wellcome; Linda Muller (incoming Head of Secretariat).

Regrets: Atul Gawande, USAID; Roger Kamba, Democratic Republic of the Congo.

Objectives

The objectives of this first meeting of the FGHI Steering Group were for Steering Group members to  be oriented to, and provide feedback on, the FGHI concept and proposed governance, protocols and  ways of working, and to commit to meaningful engagement in the FGHI process.

Opening

Following Steering Group member introductions, the co-chairs presented the FGHI objectives, the  wider context, proposed FHGI governance, timeline and Steering Group ways of working. See  meeting slide deck and meeting materials1for details.

There was broad support for these objectives, with several members calling for a sharpening of the  FGHI narrative (what we are and are not), intentions vis a vis other initiatives, outputs and endpoint. 

It was emphasized that the FGHI is a time-limited process to drive change and increase impact of  investments in UHC. Of note, the FGHI is not a formal intergovernmental process.

The co-chairs invited the Steering Group to work with them to co-shape the FGHI process, in  anticipation of adjustments being made along the way.

Reflecting Steering Group comments, the FGHI Research and Learning Task Team will conduct a  landscaping analysis of existing initiatives, with a view to identifying gaps and opportunities for – and pathways towards – better alignment of the GHI landscape behind Agenda 2030 goals. This will  include ensuring the process is informed by broader learning about how other processes have  worked (or not) and informed by lived experiences of low- and middle-income countries (LMICs).

The increasing complexity of the global health ecosystem was noted by several members. The FGHI  discussion is taking place within a wider context of ongoing global health architecture reforms  including related to pandemic preparedness and response (PPR), research and development and  surveillance. Steering Group members called for the FGHI platform to take a long-term, “beyond  PPR” view to reform, with anLMICorientation, and strong links to discussions on UHC.

Members emphasized the importance of balancing the need for open and frank discussions and  agility (easier in a smaller group) with the desire for an inclusive process. Reference groups – including of global/regional health organizations and domestic financing partners – were highlighted as an important element of the FGHI governance. Early engagement with GHIs will be important and  the upcoming Global Health Summit provides an opportunity for FGHI co-chairs to meet with leaders  of GHIs. Steering Group members agreed that, at the discretion of the co-chairs, some Steering  Group discussions would be limited to members, without observers (World Health Organization and  World Bank). Further discussion is needed on how the Steering Group reaches out to the broader  community.

From Talk to Action

Several members identified their roles as GHI board members/stakeholders as major levers of  change and committed to using these roles to drive the FGHI agenda. It was proposed that the  Steering Group develop a collective voice in board meetings. Clear and compelling communications  materials/messaging will be instrumental for effective Steering Group engagement with other  stakeholders.

Indonesia’s 2022 G20 Presidency and Japan’s 2023 Presidency of the G7 are other significant levers.  Some members underscored their commitment to tap into feedback from their country networks. 

Linking to Other Networks, Processes and Moments

A desire was expressed to inform, and deliver recommendations to, the High-Level Meeting on UHC  at the 2023 United Nations General Assembly. The World Health Assembly and G7 and G20 meetings  were identified as other key political moments. The importance of linking to/learning from other  networks and processes, including the Sustainable Development Goal (SDG) 3 Global Action Plan and  ongoing initiatives, including those related to PPR and experiences of the Access to COVID 19 Tools  Accelerator and COVAX were noted and opportunities to do so need to be mapped out. The  Research and Learning Task Team will be helpful in considering what can be learnt from previous  initiatives and moving toward solutions. 

Several members referred to the benefits of the agnostic nature of the FGHI process (no foregone  conclusions about what change might look like) and noted that we are at a moment in time where a  comprehensive, system-wide look at GHIs is needed.

Secretariat Update and Next Steps

The outcomes of today’s discussions will inform an open discussion on the FGHI research and  learning work stream on 11 October; the 17 October breakfast roundtable hosted by the FGHI co chairs during the World Health Summit in Berlin and bilateral meetings they will hold during the  Summit. Suggestions for bilateral meetings the co-chairs should request are welcome.

The next virtual Steering Group meetings will focus on content and pathways forward and are  scheduled for:

• Tuesday, 1 November, 2 pm UK

• Thursday, 1 December, 2 pm UK

Wellcome and the co-chairs are in the process of formalizing the FGHI Secretariat, which will  facilitate and support the process going forward.

1 FGHI Concept Note, draft FGHI Governance Paper, Secretariat Update and draft Steering Group  Protocols and Ways of Working.