• Good morning, and a very warm welcome to you at this 9th HHA Regional Directors’ meeting. It’s good to put names to faces – it’s the first time we’re actually meeting in person for the HHA!
• The last time we had discussions was our important teleconference in November 2016 when we agreed to meet here, now – 3 years after the last HHA RD’s meeting.
• So I’m very grateful to UNFPA WCARO for hosting this meeting here in Dakar. Thank you, Mr Ngom.
[Important developments since 2013]
• So much has changed since 2013. The Ebola outbreak in West Africa yielded major lessons on the need for more robust and resilient health systems in the Region;
• We saw the adoption of 2030 Agenda for Sustainable Development Goals (SDGs) in September 2015 - a major milestone for the future;
• The means better coordination and greater coherence now more than ever before to implement the ambitious agenda for health under SDG3;
• WHO in the African Region is transforming. We’re demonstrating its commitment to bring better health and prosperity to Africa’s people through our Transformation Agenda with far-reaching changes to deliver results.
• We’re managing our work in countries more efficiently to play a transformational role in the Region through Universal Health Coverage, strengthened health security and as a catalyst for action on the health SDGs.
[Background of HHA for new Regional Directors]
• Some of the Regional Directors here today are new, so I’d like to give you some background to this meeting.
• The Harmonization for Health in Africa initiative was set up in 2006 as a regional mechanism – strongly endorsed by Ministers of Health - to implement the Paris Declaration on aid effectiveness in the health sector, particularly for health system strengthening.
• HHA partners committed to align and coordinate country-led evidence based policies, plans and budgets.
• It was expected that the HHA mechanism would lead to greater efficiency and strengthen country health systems through more coherent support and minimize fragmentation and duplication.
• Now, in the new era of SDGs - and with such an ambitious agenda of UHC – the HHA’s role is more important than ever.
• It is excellently positioned for mutual action - together, we can push for stronger, more sustainable and more resilient health systems necessary to improve health outcomes in all countries.
[HHA achievements]
• In its 10 or so years, the HHA has made some significant contributions:
o It opened dialogue between development partners, Ministers of Health and Finance, parliamentarians and civil society among others for more efficient, effective public, private and aid spending on health.
o These efforts culminated in 2012 in the Tunis Declaration on Value for money, Sustainability and Accountability at a meeting by the African Union Commission and Economic Commission for Africa. The Tunis Declaration later guided the HHA work.
o The African Investment Case document was a major HHA product - guiding advocacy and dialogue for efficient management of health resources and increased investment in the health sector.
• The HHA’s support to countries has included:
o National health development strategies and plans;
o Strengthening coordination of health development partners;
o Providing technical support in health financing (such as policies, strategies, National Health Accounts, costing, Performance Based Financing);
o Establishing and enhancing National Health Observatories;
o Training in pharmaceutical, procurement and supply management.
• For Reproductive, Maternal, Child and Adolescent Health, HHA helped to:
o implement strategies and plans to improve women and children’s health -including family planning and PMTCT;
o implement the country accountability framework for women’s and child health;
o develop an accountability information roadmap;
o develop proposals on lifesaving commodities.
• HHA has led to sharing experiences and best practices in various areas of health system strengthening, such as South-South exchanges of experiences on health financing strategies.
[Independent HHA Reviews]
• These achievements notwithstanding, the HHA has had two independent reviews, demonstrating its own accountability and best practice.
• The first five-year review – done in 2011 - identified several shortcomings and constraints which included:
o strengthening the HHA presence at country level;
o enhancing HHA governance by explicitly defining and clarifying the leadership;
o developing and implementing a communication strategy;
o adopting a flexible funding mechanism; and
o Strengthening the Secretariat with additional human and financial resources.
• This review led to action: an HHA basket fund was created; a communications strategy developed along with an HHA operational guide; and an administrative assistant was hired for the Secretariat.
• The 2nd Independent HHA Review (2012-2015) was commissioned in 2016 and the findings were discussed at the HHA Technical Meeting in Brazzaville in October last year. The concrete proposals which emerged will be presented during this RDs’ meeting.
[HHA Regional Directors’ teleconference, 8 November 2016]
• I was greatly encouraged by your participation during the teleconference we held on 8 November 2016, which clearly expressed your interest in harmonizing interventions for better health outcomes.
• We agreed that:
o The HHA mechanism is relevant, valuable and powerful – as seen from the Tunis meeting – when it functions properly;
o We should find areas of common interest for engaging all HHA partners to work together. This includes harmonizing interventions on health systems strengthening which focus on priority areas with clear wins - such as health financing, like Value-for-Money activities - and governance, where the partnership was greater than the sum of its parts;
o Work should continue with Ministries of Health, Finance, Parliamentarians and others such as civil society for more results at country level;
o Our support at country level should be more coherent, particularly for HHA support around the health-related SDGs;
o The new HHA priorities will require a stronger HHA Secretariat;
o We should address the funding issue related to implementation of the joint action plan and coordination, and avoid duplication in the pursuit of common objectives in the Region; and that we should
o Strengthen communication - demonstrate the added value of the partnership as a regional coordination mechanism.
[Objectives of the 9th Annual HHA Regional Directors’ meeting]
• This interest augurs well for a positive outcome of our meeting here in Dakar.
• Our objectives for this 9th HHA Regional Directors’ meeting are:
o To consider the strategic orientations and priorities proposed by the Technical Team, and define the way forward in repositioning the HHA in the context of the Sustainable Development Goals (SDGs) and Universal Health Coverage to support the health development agenda in Africa.
o To consider and adopt approaches for better harmonization of the HHA with existing global, regional and country level coordination mechanisms.
• We will also pay special attention to approving the recommendations of the Technical Working Group, particularly:
o Priority areas of work
o HHA guiding principles and governance structures
o Strengthening the Secretariat’s coordination capacities in line with the demands of the new priorities;
o Sustainable funding for coordination functions and implementation of our decisions;
o Agreeing on a joint action plan (2017-2018) and our joint letter to countries.
In closing
• There are high expectations for this meeting which comes after a 3-year break.
• We look forward to clear orientation for the Steering Committee and the Secretariat on the way forward for the HHA mechanism.
• I thank all the Steering Committee for the great work done to prepare for the current meeting, and the product which will be the basis of the Regional Directors’ discussions and decisions.
• In conclusion, I encourage our Regional Directors to have frank and fruitful discussions on the way forward for the HHA mechanism, leading to concrete decisions and orientations for the Steering Committee and Secretariat.
• Now is our chance to prove the power of the HHA mechanism - and demonstrate our collective commitment in the new era of SDGs and its UHC agenda - through our unified purpose of better health outcomes for all of Africa’s people.
Thank you.