The International Health Partnership and Related Initiatives (IHP+) and Civil Society Engagement

Susanne Weber-Mosdorf, Assistant Director General, WHO Joy Phumaphi, Vice President, Human Development, World Bank June 24, 2008

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• • • • • • •

What is the IHP+?

A

renewed effort

to support countries in achieving their

health MDGs (1b, 4, 5, 6)

Through a single

harmonized in-country implementation effort

With scaled-up

financial, technical and institutional support

health MDGs for

How will it be implemented?

Country-focused and

country-led

Builds on

existing structures, mechanisms, and country health plans

Provides

long term, predictable financing

national plans and strategies for results-oriented Ensures

mutual accountability

commitments for delivering on compact 2

IHP Signatories

• • As of 23 June 2008, the IHP global compact has been signed by: –

Ten Ministers

from developing country governments (Burundi, Cambodia, Ethiopia, Kenya, Madagascar, Mali, Mozambique, Nepal, Nigeria, Zambia), –

Nine international organizations

(WHO, World Bank, Global Fund, GAVI Alliance, UNFPA, UNAIDS, UNICEF, UNDP,

EC

), –

Eleven bilateral donors

(Australia, Canada,

Germany, Italy, Netherlands, UK

), and Norway,

Finland, France, Portugal, Sweden,

and –

Two other donors

(Bill & Melinda Gates Foundation & African Development Bank).

IHP+ Countries

In addition to signatories of the IHP global compact, the following developing countries are participating countries from IHP related initiatives (IHP+) – Benin, Burkina Faso, Ghana, Niger 3

IHP+ Related Initiatives

International Health Partnership Catalytic Initiative to Save a Million Lives UN SG MDG Africa Initiative Innovative Results Based Financing Providing for Health Initiative Global Health Workforce Alliance Health Metrics Network GAVI Health Systems Strengthening Global Fund National Strategy Applications Deliver Now For Women and Children

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Why now?

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Progress towards MDGs: inadequate

Trend in Under-Five Deaths, 1960-2015 (Millions deaths per year) 25

Africa Asia Other

20

4.1

3.6

15

2.7

1.8

1.4

10

13.5

10.9

8.3

1.1

4.1

7 5.1

0.8

3

5

0.1

2.2

2 2.9

3.2

3.5

4.1

4.6

4.9

5.1

0 1960 1970 1980 1990 2000 2005 2015 with achievement of 2015 with current Trend MDGs

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Health system constraints: unaddressed

• • • •

Human resources

Production, retention and migration

Infrastructure

L

ogistics, procurement, physical infrastructure

Catastrophic health spending

Reduction of out-of-pocket expenditure, social protection

Ineffective delivery

Integration and coordination, primary care, community engagement, non state providers, management 7

Investment in health: insufficient

8

International funding: unpredictable

40 35 30 25 20 15 10 5 0 2000 2001 2002 2003 2004 Benin Burundi Ethiopia Mali Niger 9

Support to countries: inefficient

GTZ CIDA Norad USAID RNE Sida PEPFAR GFATM CF HSSP CCM NCTP UNAIDS MOH WHO DAC UNICEF T-MAP WB GFCCP UNTG PRSP MOF SWAP 3/5 INT NGO MOEC PMO NACP CCAIDS CTU LOCALGVT CIVIL SOCIETY PRIVATE SECTOR

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The Paris Declaration on Aid Effectiveness

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Objectives of the IHP+

2.

3.

4.

Four main objectives consistent with the Paris Declaration on Aid Effectiveness: 1.

Developing

results-focused, country-led

compacts that rally all development partners around one national health plan; one M&E framework; and one review process, thus improving harmonization, alignment, focus on results and mutual accountability Generating and disseminating relevant knowledge, guidance and tools Enhancing coordination and efficiency at country, regional and global levels Ensuring mutual accountability and monitoring of performance 12

• • • • • • •

Value-Added of the IHP+

Country-focused and country-led activities

ONE costed, results-oriented national health plan

Build consensus and inclusion of all stakeholders through

Country Compacts

Long-term predictable financing for strengthening health systems which addresses volatility, fiduciary and procurement issues Improved harmonization and alignment of aid which reduces fragmentation and transaction costs Improved coordination between country governments and development partners Strengthened mutual accountability and transparency 13

Systems and programmes: getting results

Maternal & Child Health

National strategy Vital registration IMCI Emergency obstetrics Continuum of care common agenda?

more efficient?

better outcomes?

Fighting AIDS

National strategy Surveillance Safe sex Treatment Continuum of care Leadership / governance

Strengthened health systems

Health financing Human resources Information systems Medical products, technologies Service delivery 14

Common Monitoring & Evaluation Framework

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IHP+ Coordination and Collaboration

• Ministry of Health • Ministry of Finance / Planning • Civil Society • Private Sector • Bilaterals/Multilaterals • International health agencies

Inter-agency country health sector teams Regular partner forums (incl. CS) Inter-agency working groups (incl. CS) Inter- agency Core Team Washington DC, Geneva, Brazzaville (HHA) Political Advocacy H8, SG Civil Society Consultative Group Scaling-up Reference Group (SuRG) 1) Business:

B&M Gates, GAVI, GF, UNAIDS, UNFPA, UNICEF, WHO, WB, and Civil Society

2) Steering:

Above, plus development Partners 16

The Country Compact

Development Partners Country Ownership Existing country mechanisms H8 Agencies Civil Society Donors Bilaterals/ multilaterals One common M&E and mutual Long-term, predictable financing accountability framework One costed, Fix health Systems bottlenecks Inter-agency country health sector teams results-oriented national health plan and budget One common review process/ validation

Country Compact

Scaling Up Effective Coverage

Improved Outcomes for MDGs 1b, 4, 5, & 6

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ONE National Health Plan

Central to the compact is the national health plan and how it will be used in the new aid environment:

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Country Health Plan

HIV/AIDS

and Budget

Malaria TB MNCH HRH

Validation/Appraisal Process Agreement on Country Compact Negotiation of Country Compact

Costed Scenario 1 Costed Scenario 2 Costed Scenario 3 Monitoring and Reporting Process Performance Benchmarks Results Framework Aid Modality Policy Matrix

Implementation of Country Compact

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• • • •

IHP+ Achievements since Sept ‘07

National Health Sector Strategies, Plans and Budgets, Country Compacts –

first compacts to be agreed by September ‘08

Monitoring and Evaluation and External Review –

draft single M&E framework agreed and under discussion at country level; external review to be completed by September.

National Plans and Strategies -

for country health plans.

working towards common appraisal/validation process

Civil Society Engagement –

growing civil society engagement • • • •

IHP+ linked to: Paris Declaration on Aid Effectiveness Results-based Financing Other global partnerships and initiatives Ouagadougou Declaration on primary health care (PHC)

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IHP+ and the European Union

• •

Eight EU member states

Global Compact are signatories of the IHP+ • The objectives and principles of the IHP+ are

in line with existing commitments

of the EU The IHP+ may serve as a

mechanism for increased collaboration

in policy planning and development at global and country levels 21

Opportunities for Collaboration

• European Parliament has called for the EC to devote 20% of its ODA to primary and secondary education and basic health care. –

IHP+

supports long term

predictable financing targets for health financing.

to health and could thus be used as

tool to achieving EC

• • The EC-proposed

MDG Contracts aid

.

would commit the EU to improve

predictability of

– These

contracts and the IHP+

could be

mutually reinforcing

if the EC and EU partners sign country compacts.

The Barcelona Commitments & the Monterrey Consensus

commit the EU to

increase financial resources

for ODA.

– The

IHP+

could serve as a

common framework for aid implementation for health

.

• The

Paris Declaration on Aid Effectiveness manage for results

.

commits the EU to harmonized efforts to – The

IHP+

represents an opportunity to for the EU to demonstrate real efforts to improve effectiveness of aid for health through

harmonization and alignment

at the global and country levels. –

IHP+

represents and opportunity to promote: use of

innovative and coordinated financing mechanisms

and

additional resources for health

without replacing commitments already made; improved consistency in financial management, accountability and transparency through results and

mutual accountability frameworks

; support of country-led, country-focused activities.

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• • • •

Value Added of Civil Society in the IHP+

Engage and provide

guidance on the implementation of the IHP+ work-plan

– assisting in the facilitation of the IHP+ process at the country level by encouraging local civil society organizations to participate in all stages of the development and implementation of country compacts; Facilitate and improve

dissemination of IHP+ outputs

– sharing good practices widely through existing networks, – supporting implementation of locally appropriate implementation methods and strategies, – establishing linkages with other existing similar or complimentary efforts.

Monitor progress

achieved as a result of the IHP+ – advising on ways to strengthen effectiveness of the IHP+ process and – effectively relaying potential and existing bottlenecks to implementation (global and country level) for problem solving (donor bottlenecks, implementation bottlenecks, etc)

Ensure responsiveness

teams, holding IHP+ development partners (donors, governments, etc.) accountable. of the IHP+ to government-led, inter-agency country 23

• • • • • • • •

Civil Society’s Engagement in the IHP+

Civil Society Forum held in Geneva, including more than 80 Civil Society representatives (more than half from the south) Consultation on mode of engagement has taken place Revised Concept Note on Civil Society Engagement Concept Note on CS Engagement at the Country Level circulated for comment 2 CS members on steering SuRG 2 CS members on business SuRG 1 CS member will join each thematic working group A consultative group will be formed – CS developing selection process 24

• • • • •

Summing Up

MDG goals 1b, 4, 5 and 6 will not be achieved without a revised and streamlined approach to implementation, which will require

collaboration of all development partners

.

The IHP+ is an opportunity to

harmonize and align development partners

for improved health-related MDG outcomes, in line with the Paris Declaration on Aid Effectiveness.

The focus of IHP+ is

results at the country-level

.

There is significant opportunity for

collaboration between the EU and the IHP+

for delivering results

Civil Society is key

IHP+ to ensuring successful implementation of the 25

The Way Forward

• • • • Enhance strong political commitments to

long-term, predictable financing for health MDGs Widen engagement

Support in IHP+ to include more key players

existing commitments

(e.g. HIV/AIDS, TB, malaria, and maternal, newborn, and child health)

Remove bottlenecks

in the global health architecture 26

Thank You!

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