Par Denis Porignon. Plénière d'ouverture du Colloque Post-Vancouver 2016, sur la recherche francophone sur les politiques et systèmes de santé dans les pays à faible et moyen revenu, organisé par la Chaire REALISME, à l’IRSPUM, Montréal, le 21 novembre 2016.

1. 1 |
Health systems governance for UHC:
from global policy to operations in countries
EU-Luxembourg / WHO Universal Health Coverage
Partnership
Dr. Denis Porignon – WHO/HQ/HGF
Montreal, November 2016

2. 2 |
I. Health Systems, UHC, SDGs

3. 3 |
A new WHO Framework for UHC
as part of the SDGs
WHO,2016

4. 4 |
WHO
G7
Multi & Bi-laterals
Timely - renewed interest for HSS
UHC
2030

5. 5 |
Health Systems Strengthening is
about leveraging domestic resources
Source: Based on WHO’s work as part of the Lancet Commission Global Health 2035; WHO analyses prepared for the 3rd FfD Conference and HSS roadmap; Institute for Health Metrics and
Evaluation (IHME) estimates for 2013 http://vizhub.healthdata.org/fgh/; WHO Global Health Expenditure Database (GHED) 2013 (http://apps.who.int/nha/database, accessed 15 February 2016)
 The minimum additional investment required in the health sector for
countries to attain the SDGs by 2030 amounts US$55 billion per year
 Between US$35-40 billion of these US$ 55 Billion per year must be
spent on HSS efforts
 In 2013, ODA for funding HSS reached US$ 2.3 Billion or only 6% of
total ODA for health, whereas funding for disease-specific programs
(e.g. fighting HIV/AIDS or malaria) amounted to US$34 billion
 Even in fragile states, about 75% of total health spending come from
domestic sources (95% in middle income countries)
 However, in most fragile and low income countries OOP is
unacceptably high (50% of THE): domestic resources are not optimally
distributed

6. 6 |
 A critical issue is about channelling funding in the
right direction
 There is a need to bring back governance in the
domestic space
 There is a need to build or strengthen institutions
that will allow this
 But one size doesn't fit all... => there is a need for a
tailored approach
Therefore..

7. 7 |
FIT for purpose… country contexts matters!
 Strategy 1: Building Health system Foundations in least
developed and fragile countries
 Strategy 2: Strengthening health system Institutions in
least developed countries where foundations are already in
place
 Strategy 3: Supporting health system Transformation in
countries with mature health systems
A right combination of “essential investments” (strategy 1) and “software
support" (strategies 1 to 3) is needed to build strong health systems and
achieve results in UHC and health security

8. 8 |
Health Systems Contexts and the WHO FIT strategies

9. 9 |
Tailored strategies, tailored products
Foundation
Institution
• Assessment of district health
management and local health
services
• Coordination mechanisms for
harmonisation & alignment with
NHPSP (e.g. JANS, IHP+)
• Consensus on mandates, roles and
responsibilities, and legal and
regulatory systems
• Formulation of health strategic plans
• Convene and facilitate policy
dialogue at local level including
building capacities of local
communities
• Training in health district
management
• Monitoring and evaluation of
performance at national and local
level
• Hands-on expert advice on local
health system organization
• Assessment of legal & institutional
framework and National Regulatory
Authorities (NRA)
• Policy dialogue on public accountability
and “citizen’s voice” at national, sub-
national or local level (e.g. national health
assemblies)
• Develop organizational capacity for
reforms including legislative framework
• Integrate/harmonise/align national
disease strategies plans into NHPSPs,
including periodic reviews
• Design needed institutional reforms
• Conduct annual transparent reviews of
health progress and system performance
led by country independent institutions
• Support setting institutional
arrangements to better inform policy with
evidence
• Ensure alignment of National Health
Strategies with public finance
management
• Independent evaluations of health
reforms to facilitate informed pluralistic
policy debate
• Generation of evidence for priority
topics to feed thematic policy dialogues
• Facilitating peer-to-peer assistance on
specific technical reform issues
• Evidence sharing on factors having an
impact on longer term sustainability of
UHC-related reforms
• Capacity building for regulatory systems
and networking initiatives in order to
facilitate the reliance on the mutual
expertise of countries
Transformation
Governance

10. 10 |
II. More concretely?

11. 11 |
www.uhcpartnership.net
The EU-Luxembourg / WHO UHC Partnership
www.who.int/healthsystems/publications/nhpsp-handbook/en/
Supporting Policy Dialogue
on National Health Policies, Strategies and
Plans for Universal Health Coverage
[30 countries 2012-2018]
+

12. 12 |
The UHC-partnership in 2011
 SDGs, WHA resolutions on
PHC, HSS, PCC, UHC,
 IHP+ and UHC 2030
 EU concern
 WHO roles in countries
 GD Luxembourg's involvement
(2012)

13. 13 |
Support to countries 2011-2018
 3 phases of countries –
in 30 countries
 Support to policy dialogue
 Complexity
 Variability needs, systemic
interactions, possible results
("open" uncertainty)
 Flexibility
 Contribution vs attribution
“set of formal and informal
exchanges aimed at
facilitating policy change,
influencing policy design
and fostering further
processes for decision-making
where stakeholders of the
different health system levels
participate and contribute”
(WHO, 2016)

14. 14 |
AREAS of ACTIVITIES TYPE of ACTIVITIESLEVELS of ACTIVITIES
Major focus
Major areas of work

15. 15 |
BURKINAFASO BURUNDI CABOVERDE CHAD DRCONGO GUINEA
GUINEA
BISSAU
KYRGYZ
REPUBLIC
LAOPDR LIBERIA MALI MOROCCO MOZAMBIQUE NIGER MOLDOVA SENEGAL SIERRALEONE
SOUTH
AFRICA
SOUTHSUDAN SUDAN
TAJIKI-
STAN
TIMORLESTE TOGO TUNISIA UKRAINE VIETNAM YEMEN ZAMBIA
UpdateNationalHealth
Development Plan:
- nationalandlocalworkshopson
NHPSPforUHC
- developNHSPandoperational
plansforUHC
Planning&Coordination:
UpdateHealthPersonnel
DevelopmentStrategy2010-
2020,develop5yearaction
plan2016-2020.
Development ofnational
plans:
- implementation,monitoring
andevaluationof theNational
healthdevelopmentplanatall
levels
Developandimplementnew
nationalhealthsectorstrategic
plan(NHSSP):consultative
meetings,workshops
FinalizeNationalHealthPolicy:
- high-levelmeeting toadoptand
launchtheNHP
- publish,printanddisseminate
ConsolidatedHealthSector
AnnualOperationalPlanning,
CostingandBudgeting
EvaluatePNDS2012-2015:
- Workshoptofinalizeevaluation
report.
- Validationof reportbytechnical
committeeandotherstakeholders
5-yearHealthSectorPlan2016-
2020:
- operationalandimplementation
plans,incl:annualmilestones,
targets,programmesand
activities,SDGs.
Standardizedandharmonized
districtlevelannualoperational
plansfor13districts:- annual
planning workshop
DevelopHealthSectorStrategic
Plan:
- Nationallevelconsultative
dialoguewithstakeholders
C dfi li HSSP
StrengthenNationalHealth
SectorCoordination
- Developandinstitutionalize
mechanismsforequity-based
policydevelopmentandplanning
atlocallevel
StrengthenCommunityHealth
StrategicPlan
PNDS:Patient centredcare
- strengthenHWF(updateHWF
policy,careerplan,HWF
observatory);developtrainings
inPediatryandSurgery.
- Mid-termevaluationPNDS
2011-2020
- Annualhealthsector
review
M&E:
-EvaluationPNDS2012-2016
- JointAnnualHealthSector
Review
DevelopM&EguideforPDS
2016-2020,inlinewithJANS
EstablishNationalHealth
Observatory
Annualhealthsectorreviewand
report
ModifiedJoint AnnualHealth
SectorReview:
- ToR,content,toolsfortheJAR
- datacollection,subnationalpre-
JARvisits
- nationalJARdialogue
DevelopHMISStrategicPlan
2016-2020. buildcapacityfor
datamanagementand
analysis,andtomonitorSDG
goals
- Developpoliciesforplacing and
retaining qualifiedstaff inhard-to-
reachareas.
- AlignHRpolicies,strategies&
planswithVietnamhealth
systemsdesignframework
MonitoringSystemfor
ServiceAvailability:
- ConductHeRAMSrelated
activities
- DevelopHealthServices
ProfilebasedonHeRAMS
Stronglocalhealthsystems:
Strengthencapacity:
- implementationandmonitoring
of essentialhealthservices
packages
- atdistricthealthlevel
- communityparticipationin
developmentof localhealth
systems
M&EofNHSSP andHMIS
strategy:
- MICS6Survey
- DHIS2.0development
- MidyearandannualM&E
programmereviewmeetings
- ReviewHMISstrategicplan
- Developnewstrategicplan
Conduct SARA
EPI/HMISDataQuality
Assessment
5
Joint AnnualHealthSector
Review
- StrengthenJointAnnualHealth
Review(JAHR) tomonitorY1of
new5-yearHSP(2016-2020);
- developtheHealthSystemsin
TransitionforVietnam
- Develophealthfinancing
forUHCstrategy
Nationalhealthfinancing
strategyforUHC
Healthpolicydialogue:
- CountryLearning
Programmeworkshopfor
managersatcentral,regional
anddistrictlevels
HealthFinancingStrategies:- strengthen
HFtowardsUHC:consultations;Co-chair
HFWGSecretariat;NationalHealth
Acounts2014;Capacitybuilding on
MTEF,programmecosting at
decentralizedlevel;reviewresource
allocationcriteriaformula;
InterministerialGroupworkonhealth
insurance
Assessment ofcurrent health
financingsituation(OASIS
approach)
Developandbuildconsensuson
healthfinancingoptions
Develophealthfinancingpolicy
FinalizeHeatlhFinancing
Strategy
Socialhealthprotectionand
healthfinancingtowardsUHC:
- Brief managersondeveloping
newnationalHFstrategyforUHC
- frameworkfordialoguebetween
sectorministriesandinstitutions
- dialogueonUHC progressduring
healthsectorcoordination
meetings
BuildresilienceofNational
HealthSystem:
- expandcoverageof the
nationalemergencysystemin
governorates
- Buildcapacityonstandards
andSOPsformasscasualties
ImprovedHFknowledge:
- Healthfinancing e-discussionforum
- capacitybuilding forsteering
committeemembers
- policybriefsdevelopment
NationalHealthAccounts
Costing:variousMOH
StrategiesandActionPlans
NationalHealthFinancingStrategy
forUHC(SNFS-CSU)
- draftStrategy,implementation
plan,M&Eframework
- validateandlaunchStrategy
- DevelopUHCbaselines Establishapoolfundina
targethealthdistrict
Studyonimpact offreehealth
careonhealthservicedelivery
andaccess
- Planof Action inaccordance
withnationalhealthfinancing
strategy
- FinalisenationalHFstrategy
- Rationalizebenefitspackageand
providerpaymentmechanism
towards UHC
HealthFinancingWG todevelop
SGBF
ER 5.Accurate,up-
to-date evidence
onwhatworksand
whatdoesnot
workregarding
healthfinancing
reformsforUHC is
available and
sharedacross
countries
Monitoringmechanismfor
nationalhealthfinancing
strategy
- Publishsurveyresults(SARA,
EDS-MICS)
- studiesonhealthfinancing,
publicfinancialmanagement
- documentbestpracticesin
healthpolicydialogue.
- south-southexchangeson
bestpracticesforUHC
- documentMaliexperiencein
healthpolicydialogue
Concept paper"Development of
PublicHealthSystemin
Ukraine":
- reviewandfinalizeConcept
Paperoutlining UHC reforms,
startimplementing
- Trackhealthfinancing and
healthinsurancedata,incl.for
nationalhealthaccounts
- Monitorhealthfinancial
protectionandprogresstowards
UHC
InternationalHealth
Regulations:
- staff training inmanagementof
radio-nuclearandother
emergencies,andIHRmeasures
-legalappointmentof IHRfocal
points
Visibility ofEU-
WHO Policy
Dialogue
Programme for
NHSPS andUHC
Document UHCexperience -documentGuineaexperienceinpolicy
dialogue
-publishnationalreportsandbulletins
-South-Southexchangesonbest
practicesinpolicydialogueinUHC-P
countries
Awarenessandadvocacy
programmesthroughmedia,
pamphletsandposters
Documentanddisseminate
goodpracticesandsuccess
storiesof thePartnership
Ensurevisibilityof the
Partnership
Localmediaevents;
bannersandpromotional
materials.
Usemediaandwebsiteto
raisevisibilityof EU-WHO
collaboration
ReinforcevisibilityofUHC-
Partnership
- finalisedocumentaryfilmonUHC-
PexperiencesinTogo
ER4.Countries
receivingHF
supportwillhave
implemented
financingreforms
tofacilitateUC
NationalHealthAccounts
M&E:
-Sitrep onaccountabilityfor
implementationof PRRSS
2015-17,withfocusonIHR,
PCI,healthSDGs
- JointAnnualHealthSector
Review
- finalizeSARAinframework
'actionresearchon
improvementof district
healthsystemperformance'
- UHC baselinedatasurvey
StrengthenPartnership:
- healthsectorcoordination
committees(HSCC) at
national,regional,districtand
communitylevels
- HSCC andpolicydialogue
meetings
M&ECapacity:
- Strengthenhumanresources
forM&Eof PNDS,andGHIs
- AnnualHealthSectorReview,
finalevaluationof PNDS2
- ImproveMOHwebsite:better
communicationof healthinfo
UHCStrategicPlan:
- operationalplan
- advocacytoolsforUHC :
media,employers,health
professionals
- UHC advocacywithministries,
parliament,decisionmakers,
NGOs,int'lpartners
AccountabilityandAlignment:
- regularstakeholderdialogueto
developPNDS,newhealth
strategies,GHIfunding
proposalsforstrengthened
healthsystemsandimpact
- IHP+dialoguebetween
partners.
PTFCoordination:
- steering committeemeetingsat
nationallevel
- CNPcommissions
- CNPsecretariat
DevelopNHPSP:
- PDS2016-2020
- annualreview2016
- buildmanagersand
stakeholdercapacityinhealth
policydialoguethroughCountry
Learning Programme
BomaHealthInitiative(BHI)
strategy:(communityhealth
extensionworkerstrategyto
strengthencommunitysystems)
- Inter-ministerialconsultation
- Developimplementation
guidelines,servicepackages,
training manuals
- highlevelmeeting tolaunchBHI
Buildcapacityonuseof
GuidelinesonEnhancementof
AidEffectivenessbyDPs
ParticipateinIHP+activities
ACTIVITY
TECHNICALSUPPORTFOROTHERACTIVITIES
SPECIFIC
OBJECTIVE
SO1.Tosupportthedevelopmentandimplementationofrobustnationalhealthpolicies,strategiesandplansto
increasecoveragewithessentialhealthservices,financialriskprotectionandhealthequity;
SO2-Toimprovetechnicalandinstitutionalcapacities,knowledgeandinformationforhealthsystems
andservicesadaptationandrelatedpolicydialogue
SO3.Toensureinternationalandnational
stakeholdersareincreasinglyalignedaroundNHPSP
andadheretootheraideffectivenessprinciples
EXPECTED
RESULTS
ER1.Countries
willhave
prepared/
developed/
updated/
adaptedtheir
NHPSPthrough
aninclusivepolicy
dialogueprocess
leadingtobetter
coveragewith
essentialhealth
services,financial
riskprotection
andhealth
equity;
ER2.Countries
willhaveputin
placeexpertise,
monitoringand
evaluation
systemsand
annualhealth
sectorreviews.
ER3.Countries
requestinghealth
financing(HF)
supportwillhave
modifiedtheir
financing
strategiesand
systemstomove
morerapidly
towardsuniversal
coverage(UC),
withaparticular
focusonthepoor
andvulnerable
ER 6.Atcountry
level,alignment
andharmonization
ofhealthaid
according to
national health
plansis
consolidatedand
accelerated
NationalRecoveryPolicyand
Plan:
-Activateearlyrecovery
forumof stakeholders
EvaluateandupdateNational
Compact
- Financing dialoguefornew5-
yearhealthsectorplan
- Assessmentof healthsector
funding modalities
-HPGquarterlymeetings;
TechnicalWorking Group
meetings
- Mapnewopportunitiesin HDC
(e.g.South-South,triangular)
- 2016IHP+monitoring exercise
- MaintainDP/INGOmapping
database
- INGOforumforcoordination
acrosshealthsector
NationalEarlyRecovery
Policy&Plan:
- nationalpolicydialogueto
developHealthSectorEarly
RecoveryFramework
- Establishnationalhealth
recoveryteam,buildmember
capacity
UpdateNationalPolicyand
StandardsforService
Provision:
-updateEssentialPHC Service
Package,throughworkshops
andtrainings
- HealthServicesProvision
RestorationPlantoexpand
coverage
Set upNationalHealth
PurchasingAgency(NHPA)
contractingprovidersforState
GuaranteedBenefit Package:
- reviewNHPAgovernance
optionswithkeystakeholders
Organizedeliveryofessential
publichealthservicesat national
andsubnationallevel,
incorporatingIHR
implementation:
- reviewoptionsfordeliveryand
financing of publichealth
services;
- reviewlegislationandoptions
forrestructuring publichealth
workforce.
OperationalizePRODESS:
- PRODESSannualoperational
plansin7regions
- nationalM&Eplanof
PDSSS/PRODESS
DevelopNHPSP:
-PNDSmid-termreview
andupdate2016-2020
- MoH'cartesanitaire'
- Addressdecentralization
challengesinhealthdistricts
- 5-yearplansintegrating
results-basedplanning
- UpdateHumanResources
DevelopmentPlan2016-
2020
Leadership&Governance:
- updatenationalguidelines
forannualoperationalplans,
incl.SDGsandIHR.
- 38districtoperationalplans
(PAO2017) and8plansfor
healthregions.
- finalizenationalsocial
protectionpolicy
- developCountry
CooperationStrategy(SCP3)
HumanResourcesforHealth:
-training inHealthPersonnel
ManagementInformation
Systems(HPMIS)
- Legalandregulatory
Frameworkforlicensing and
registrationsystemfor
healthcareprofessionals.
M&E
Capacitybuilding forM&Eof
NHPSP
HealthCareFinancing:
- Buildcapacityanddevelop
healthfinancing institutionsat
provinceanddistrictlevel
- reviseSOPsforlinking
standardstopaymentof Health
EquityFund,community-based
healthinsurance,andFreeMCH
initiative
- improvepublicfinancial
managementprocesses
Developannualoperational
plansinlinewithrecovery
andinvestment strategic
plans:
- MOHandcountiesdevelop
bottom-upcountyand
consolidatednationalannual
plan
- Strengthenimplementation
capacityof central,countyand
healthfacilitymanagers
- Developpre-service
Harmonizedandintegrated
M&EandreviewofNHP:
- healthfacilityassessment
using SARA,qualityof care
guide,anddataverification
- standardizeandharmonize
M&Eandreviewmechanisms
- dashboardformonitoring
implementationof investment
planatnationaland
subnationallevel
Designandimplement
sustainablehealthcare
financingstrategy:
- generateevidencetoinform
sustainableHFSforaresilient
healthsystem
PNDS2016-2020:
- M&EframeworkforPNDS2016-
2020
- nationalhealthsectorreview
- resourcemobilizationround
tableforPNDS2016-2020
UHC:
- healthfinancing strategy
- UHC situationanalysis
- stakeholderconsultationon
socialprotectionpolicyforUHC
DevelopPNDS3(2017-2020)
andCompact:
- strengthenMOHstrategic
management,PNDSmonitoring
mechanisms
- developPRDSandPNDS3
(2017-2020)
- missionsto3regions
-- nationalworkshopfor
adoptionof PNDS3
- coordinationmeetingsof EDPs,
technicalpartners,MOH
Implement andmonitora
phasedsustainablehealth
carefinancingstrategicplan
Healthpartnercoordination
inlinewithIHP+andNHSSP
2015-2021:
-strengthenpartnership
structuresbetweenMOHand
DPs
- jointfinancialassessment,
managementarrangement
- conductJANS
- developcompactaround
nationalandinternational
initiatives(GFF,HSSforUHC,
HDC)
StrengthenM&EofPRODESS
implementation:
- nationalM&Eplanof
PDSSS/PRODESS
- PRODESSTechnicalCommittee
meetings
- NationalHealthAccounts
- publishannualreportsof
activities,statistics,articlesetc
PromotionofUHC-P at all
levels:
- trainmanagementteamsat
district,regionalandcentral
levelinhealthpolicydialogue
- developnewnationalcompact
- UHC-Pmonitoring missionsin
Senegal,CaboVerde
Strengthenpartnershipsforhealth
development:
- strengthencoordinationwithhealth
sectorNGOs,updateNGOdatabase
- Planning Forumwithkeygovernment
sectorsrelevanttoUHC.
UHC:roadmap/national
strategicplanforUHC
- studyonprivatehealthsector
costs
- nationalstrategyforpeople
centredcare
PartnershipandCoordination:
- encouragecivilsocietyand
privatesectorparticipationin
PDSimplementation
- revisecountryCompactin
collaborationwithpartnersand
civilsociety.
Multisectorality:
- Buildcapacity:localhealth
governance,leadership,
decentralization,UHC,
communityhealth
development
- operationalize
multisectorality,towards
improvedsocialdeterminants
of health
- developpartnershipswith
privatesector
Healthsystemstrengthening:
- roll-outof humanresources
developmentplan
- NationalHealthAccounts
- nationalhealthfinancing
strategy
- establishmentof referral
system
- researchanddocumentation
of bestpractices
District healthstrengthening:
capacitybuilding exercises;
monitoring andreviewof DHMT
capacities
HRH:UpdateHRIStodevelopHRH
profile
- reviewHRHnationalpolicyand
strategy
- developandimplementnew
policyandstrategicplan
StrengthenMoHcapacityfor
intersectoralcollaborationfor
healthwithfocuson
MalnutritionandMaternal
Mortality andachievementof
HealthSDGGoal
Developpost-2015PNDS:
- ToRs,roadmap,resource
mobilization
- workshoponoperationalizationof
SDG3
- nationalworkshoptodefine
strategicorientationsfornewPNDS
- finalizenewPNDSincluding MTEF
M&E
- Jointmonitoring (MoH,WHO,EU)
onRoadmapimplementation
- participateinexternalevaluations
of UHC-P,andrealistresearch
HealthFinancingConcept:
- Finalizeandseekgovernment
approvalforHFC,outlinereforms
tomovetowardsUHC withwide
publicconsultation.
- WHO-ledinternationalexpertise
toreviewHFC,andguide
implementation
- Buildcapacityof health
financing WGandkeyHFpolicy
makers
- Workshoponmobilizing
domesticresourcesforhealth,to
supporttransitioninpublichealth
priorityareassupportedby
external funding
- Policyadvocacyforfullbudget
subsidyfornearpoorand
vulnerablegroupstoenrolin
healthinsurance.

16. 16 |
FIT
Health System Development Towards UHC
UHC
Building
Foundations
Strengthening
Institutions
Supporting
Transformation
Health Accounts
PHC and Hospital Reform in MoldovaHRH strategy in Sierra L.
public accountability
and “citizen’s voice”
in Tunisia
HS Annual reviews
Institutional coherence of the
different agencies
of the health sector
in Morocco (ANAM,…)
Health Financing Strategy
in Burkina Faso

17. 17 |
• Problem
• The need to coordinate an
increased number of actors and
align increased donor inflows.
UHC partnership
support: Technical
support and funding
• All coordination structures at the different
levels were reviewed: their membership,
terms of reference and reporting
mechanisms.
• Restructuring of the central level MoH
• Strengthened the partner coordination unit
UHC partnership support:
Technical support to review all
coordination structures, their ToR
and membership (ER 6)
• Improved sector
coordination which will
lead to comprehensive
planning and rationalised
resource allocation.
• Improved alignment to
country priorities
As a result of the UHC
partnership
Demonstrating results [ex: DRC]
=> Realist research study ongoing in 6 countries in collaboration with
University of Montreal and McGill University: Togo, Liberia, DRC, Cabo
Verde, Burkina Faso, Niger

18. 18 |
 Objective: to identify the contexts in which the UHC-P, through WHO
support, can or cannot
– Act as a broker or convener, creating synergy among the actors involved in
policy dialogue and health planning
– Play its role as technical expert, orienting policy dialogue and health planning
in accordance with available evidence and equity principles
– Support ministries of health in their leadership and stewardship functions
 Pilot study conducted in Togo in early 2016
 HQ-AFRO-WCO joint selection of 6 countries for the study: Togo,
Liberia, DRC, Cabo Verde, Burkina Faso, Niger
Realist resarch

19. 19 |
 Strong health systems contribute to Universal Health Coverage
and health security, health outcomes, growth & employment
 SDG 3 will only be realized with consistent, immediate, and
comprehensive HSS efforts
 A reallocation of international aid and a reprioritization of
domestic health spending towards HSS is needed
 An improved global governance mechanism, UHC 2030, is
created and is likely to play a significant role in the coming years.
 Room for better collaboration/integration with Emergency
programmes
III. Focus / areas for research