The problem and what needs to change
There is widespread recognition that countries should have ownership over their own health agendas.
There is also recognition that for low- and middle-income countries to effectively deliver on their health agendas and strengthen health systems, external resources need to be fully aligned in support of national health plans. This approach will ensure a more sustainable and effective global health ecosystem in the coming decades. There is common agreement that there is some way to go to achieving this. Getting there will require reappraisal of, and greater alignment across, the global health ecosystem.
Building greater alignment, particularly around health systems strengthening, and a more sustainable global health ecosystem is even more urgent as the world faces increasing epidemiological and demographic changes and global health inequities: from aging populations; to the growing burden of non-communicable diseases, mental health, and infectious diseases; and growing threats from environmental degradation, climate change and new disease outbreaks. The COVID-19 pandemic has shown us that many of these challenges cannot be contained within individual borders.
While the lessons from the COVID-19 pandemic are still fresh, now is the time to take stock of how our global health ecosystem can best meet current and new health challenges, in a way that is sustainable, reduces transaction costs on countries, and reinforces country leadership. โโ
A lever for impact
One of the most important levers in the global health ecosystem that the world has for countries to chart a path to universal health coverage is Global Health Initiatives (GHIs), which complement the roles of WHO and other UN agencies and the World Bank and other MDBs. Over the last two decades, the GHIs have contributed to the biggest health wins in human history.โ
They have made enormous progress in protecting lives and improving the health of people, particularly in low-resource settings. They have made significant progress against individual diseases like polio, HIV/AIDS, tuberculosis and malaria, improved maternal and child health, and increased coverage of specific interventions like vaccines, diagnostics and therapeutics, among others.
A system for the future
There is now an opportunity for the global community to reflect, through an evidence-based process, on how the GHIs can be optimised, in the context of the wider global health architecture and global health financing system. โ
The process aims by the end of 2023 to provide specific recommendations for GHIs to better align and strengthen their support for national priorities, plans and budgets, and shape a global health financing ecosystem that is fit for purpose through to 2030 and beyond, in line with the 2030 Agenda on Sustainable Development, mainly Goal 3 on good health and well-being.
We want to ensure that the GHIs can do their work in the most effective, efficient, equitable, and resilient and sustainable way, as they support countries to build capacities and strengthen the health system capabilities they need to respond to health challenges and drive towards universal health coverage.
This process is mindful of other processes such as the ongoing negotiation of Pandemic Treaty, the discussion on the Amendments to the International Health Regulations, and the operationalisation of the Pandemic Fund and is linking to/building on the work of the Global Action Plan for Healthy Lives and Well-being for All, UHC 2030 and the Global Financing Facility Alignment Working Group.