Challenges for SEARO Implementing Countries in participation of GF governance processes & role of WHO Jigmi Singay Palitha Abeykoon Paro, Oct 2015

Watching or Shaping the Transition ? WHO stop supporting implementing block meetings ? Non implementing countries no longer in the board ? How to address Missed opportunities of Non financial benefits of GF processes ? Country Dialogue process through CCM, - Community System Strengthening - Equity for people left behind - Role of South countries in Global governance, dialogue with other south and nort countries

Fast changing transitions: Overall ODA less than country’s own investment ODA recipient to partnership Major global health funds still remaining with north Implementing to engaging in governance & policy Rapid repetitive need of policy, strategy & governance meetings in GF and global health Income still criteria for participation in GF & WB grants Country negotiations (including Privileges &immunity) still individual and not as groups or blocks Increasing pvt sect & bi-lataral influence on policy Weakening multi lateral organizations like UN Overwhelming African need crowding development scene Volatility in ODA capabilities in Europe

Opportunities: Coming GF board discussion on governance, strategy Several countries exiting GF eligibility China and many African countries looking for increasing governance role WHO’s biannual work plan starting 2015 January

Two roles WHO to play: Respond to country request for supporting exit stratgey Bi annual plan to support countries to help capacity in global health diplomacy

Issues and response for exit strategy: Consequences of exit ImplicationWHO support Financial SustainabilityPotential reversal of benefitExplore alternate mechanism including regional grant, trust funds Continued CCM structure of dialogue Such unique opportunity of harmonization and scope of dialogue missed Alternate mechanisms AccountabilityMissed opportunity of oversight role of stakeholders Sub national mapping of disease burden, resource need and response: real time monitoring Role of CBOsPeople left behind in 3 diseases would increase and missed opportunity for other diseases Alternate system of Community system of services for marginalized groups explored Engagement in GF structureCountry would not be representing in GF governance Make a case of regional representation and constituency based representation

WHOs role : from logistics of meetings to intellectual leadership and capacity development for diplomacy 1.Comprehensive WHO support country in exit strategy development : help countries look beyond finances 2.WHO responds to changing role of implementers to partners by –Support content for dialogue global,regional and local –Assist countries in policy and capacity development to engage in global health diplomacy –Health diplomacy together with health and foreign affairs –Assist process for countries to develop policy statement and agenda specific inputs for major global meetings and events : WHA, GF board, WTO dialogue

SolutionWhat WHO can do What Countries and partners can do Country exit strategyDevelop framework on comprehensive approach and support countries Help develop jointly exit startgey Consider new allocation formulaMake WHO position known to the countries, list problems with proposed formula and work together on comprehensive inclusive criteria Share materials available on this other than GF material Suggestion on new governance structure Support regional position of regional governance with or without implementing role Countries present this view point in board, Consider new strategySee equity and newer goals adopted to help countries access GF grants beyond income Implementers develop comments on new strategy and consider best inclusive option Better utilization and use of current resources and grant Develop GIS based sub district mapping of disease, response including resources to allow real time monitoring and early diagnosis and correction Countries lead and implement, WHO offer setting up, collaboration and standardization Policy stand and agenda specific briefing for each major global health meeting Support policy study groups to develop such ongoing briefings and develop forum for dialogue between countries, health/ foreign affairs Countries pay for logistical support for regional meetings while WHO can pay for smaller countries and the content

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