Meeting Notes

Participants

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

Steering Group members and alternates: Kristen Chenier, Global Affairs Canada; Roman Macaya, Costa  Rica; Dr Ruth Nigatu, Ministry of Health, Ethiopia; Ibu Penny Dewi Herasati, Ministry of Foreign Affairs,  Indonesia; Ambassador Takeshi Akahori, Ministry of Foreign Affairs, Japan; Claire Moran, FCDO, UK; Atul  Gawande, USAID; Dr Ahmed Ogwell Ouma, Africa CDC; Gabriella Fésüs, DG International Partnerships,  European Commission; Desta Lakew, Amref Health Africa; Oswaldo Adolfo Rada Londoño, Senderos  Asociación Mutual; Kieran Daly, Bill & Melinda Gates Foundation; Alex Harris, Wellcome.

Observers: Tara Prasad, Supply Division, UNICEF; Hajime Inoue, Health, Nutrition, and Population, World  Bank; Hendrik Schmitz-Guinote, Office of the Chef de Cabinet, WHO.

Secretariat: Linda Muller.

Regrets

Dr Roger Kamba, Democratic Republic of the Congo; Dr Patrick Kuma-Aboagye, Ghana Health Service; RD  Marte, APCASO.

Meeting objectives

The objectives of the meeting were for the Steering Group:

• to discuss and provide feedback on the FGHI 2023 roadmap and consider events and processes to  move from research outputs to commitment to collective action 

• to discuss ways of amplifying global south perspectives in the FGHI process 

• to be updated on trends in development assistance for health, including health systems  strengthening financing.

Discussion on FGHI 2023 Roadmap: Aligning on the pathway from research report to a set of FGHI Steering  Group recommendations for collective action

Steering Group members welcomed the FGHI 2023 roadmap presentation and in their reflections several  suggested that the form and content of a Steering Group consensus statement/set of agreements for  collective action would need to be informed by the eventual outcomes of the research report. Early research  findings will help drive the conversation forward. Several Steering Group members called for a statement/set  of recommendations to be open for endorsement by other governments and global health stakeholders and  to be as ambitious as possible.

The Steering Group discussed the need to develop a plan for post-2023 follow-up related to implementation  of recommendations and for members to work, individually and collectively, to build political momentum for  this. The Co-Chairs emphasised that key follow-ups will sit with Steering Group members, given their roles as  board members and key global health initiative stakeholders. 

The Secretariat was urged to identify key moments/opportunities to effect change, including by mapping GHI  strategy periods and replenishment cycles and likely scales of financial “asks” as important information to  inform Steering Group action, looking at this also in the context of reforms underway at WHO and the World

Bank. The need to link with other processes, including the G20 Health & Financing Task Force and political  and regional institutions including the African Union was highlighted. The World Bank offered to make a  contribution on the role of the Bank in streamlining and increasing domestic financing

Steering Group members emphasized the need to engage countries beyond Africa, including in Latin America  and South-East Asia. The Pan American Health Organization (PAHO) was suggested as a platform to amplify  the FGHI process with Latin American countries and DC-based think tanks were identified as an additional  channel for FGHI amplification. 

In discussing the series of June-December events along the pathway from research report to a set of FGHI  Steering Group recommendations for collective action, the value-add of Steering Group members coming  together in-person was noted. Where this is not possible, hybrid meeting options were appreciated by  Steering Group members. (Of note the 4-6 October Wilton Park in the UK will be in-person only.) Steering  Group members were encouraged to indicate their availability for these meetings by filling out the on-line  poll: Steering Group Members Attendance to FGHI Meetings Poll.

The importance of engaging GHIs in the FGHI process was underscored. The Co-Chairs met with GHI  leadership in the margins of the WHO Executive Board and the research consortium is conducting key  informant interviews with GHI leadership and staff. GHIs will be invited to key FGHI events on the pathway  from research report to a set of FGHI Steering Group recommendations for collective action and will have  the opportunity to provide feedback on the interim research findings and on the final report, to help to  inform Steering Group recommendations. The World Health Assembly provides another opportunity for  engagement. Steering Group members were encouraged to share any feedback they might hear from GHIs  on the FGHI process.

Discussion on Amplifying voices from the global south in the FGHI process

The Amref-led discussion was framed around three themes that emerged during the FGHI panel at the March  Africa Health Agenda International Conference (AHAIC) in Kigali: 

• countries have different needs and priorities and GHIs need to be more flexible in addressing these, while countries also strengthen domestic financing

• power imbalances need to be addressed: Africa cannot continue to agree to global goals and  prescriptive demands

• calls for increased regional/national transparency and accountability of health funding.

Africa CDC affirmed that these challenges had informed the development of its New Public Health Order,  noting that vertical interventions have resulted in fragmentation of support and highlighting the power  asymmetry that exists on the continent, with those with resources having all the power. In highlighting the  convergence between the FGHI process and the New Public Health Order, Africa CDC noted that the FGHI  process could help to address these issues by generating an evidence base and amplifying voices from the  global south, including Africa. The FGHI Co-Chair stressed the need for increased regional/national  transparency and accountability of health funding on the continent and expressed her hope that the FGHI  process could contribute to the development of an accountability platform. In the discussion it was noted  that similar transparency issues exist also in Latin America. 

Trends in Development assistance for health, including health systems strengthening financing

Time did not permit a discussion on the presentation by the Institute for Health Metric and Evaluation’s Joe  Dieleman. Steering Group members were encouraged to send questions to the FGHI Secretariat which can  in turn collate them and facilitate responses from Joe.