1. Regional Conference on Social Health Protection in the East African Community Health Sector Days - Brussels 3 rd December 2012

2. Contents Synopsis of the Conference Health in EAC context EDPRS II Health Sector Priorities related to EAC Critical Acclaim Example Title2

3. Regional Conference on Social Health Protection in the East African Community 11-13 September 2012

4. Conference Goals Context The East African Community (EAC) expressed interest in convening a conference on Social Health Protection to exchange EAC partner sates experiences. Objective of the Conference Share best practices in social health protection in EAC countries Increase understanding of harmonization of social health protection Apply lessons and effect changes in each country’s health system to improve health coverage Develop a strategy and consensus for social health protection harmonization in the EAC region 4 Success Factor: At the close of the conference, a ministerial statement was signed and will be presented to EAC Council of Ministers.

5. Conference Agenda 5 Optional Field Visit and SimIns Workshop Goals Activities Introduce SHP Understand how different countries approach SHP: successes and challenges Introductory Speeches Key Note Speeches on SHP Market Place Country Presentations Understand the concept of SHP harmonization Explore how SHP harmonization can be applied in the EAC Develop a way-forward Presentations on harmonization Workshops – breakout sessions Market Place Synthesis and insights Witness, first hand, concepts related to SHP at the level of implementation Gain technical training in the Sim Ins tool Field visit Sim Ins Training Harmonization Strategies And Way Forward SHP Concepts And Sharing Best Practices

6. Day 1: Sharing Best Practices – Takeaway Messages 6 Universal Health Coverage is a Direction not a Destination Financial protection and access are necessary but insufficient goals; quality is essential to have impact on health outcomes. Equity should be an underpinning and intrinsic goal of any social health protection policy Lesson and investments made in one country can inform policy in another, but cannot be exported outright.

7. Day 2: Workshops and Harmonization – Takeaway Messages 7 Lesson from the EU: The regional body guides policy, but all real decisions are made at the lowest level possible. Regional vs. National: Fragmentation within the system at the national level makes implementation frameworks sub-optimal. Governance and Stewardship: Commitment and involvement of the EAC regional body and all partner state governments is paramount. Integration in the EAC: Programs such as the OHI should be integrated with harmonization efforts.

8. Ministerial Statement: Summary of Action Items 8 1.Agree on common language around SHP and UHC 2.Develop a regular forum to share best practices in the EAC 3.Support cross-regional studies on harmonization 4.Develop a Short and Medium term Regional Health Financing Strategy for achieving universal health coverage in the EAC 5.Promote coordination among all SHP stakeholders 6.Promote synergies in the production of medicines and medical products 7.Sensitize development partners in realizing the goals of the regional strategy 8.Invest in capacity building for social health protection at all levels 9.Monitor and evaluate progress

9. Next Steps – Health Financing Specific 9 Provision 4: Develop Short/Medium Term Health Financing Strategic Plan Build consensus around definitions of SHP and UHC (Provision 1) Promote Coordination among stakeholders to collaborate on plan (Provision 5) Explicitly address potential areas for EAC harmonization in plan (Provision 4) Sensitize DPs to support regional goals (Provision 7) Create a detailed map of all DP involvement in HF (Provision 5) ID gaps and barriers for capacity building plan (Provision 8) Collaborate with EAC to explore best practices from other countries (Provision 2) Explore the broader EAC regional efforts such as the OHI (Affirmation in Statement)

10. Health in the EAC EAC Regional Health Sector Strategic Plan (2012-2016) elaborates EAC’s strategy to respond to identified health situation in the region, with special emphasis on cross- border health challenges. It identifies five objectives as strategic entry-points to address identified health challenges: To harmonize health policies, legislation, strategies, regulations, guidelines, standards and protocols of the EAC Partner States To strengthen regional integrated surveillance systems, public health and sanitation, environment and climate change interventions in the EAC Partner States To strengthen health information systems and information exchange among the EAC Partner States To develop and strengthen regional health systems, institutions and infrastructures to support cooperation and integration within the health sector in the Community To strengthen human resource capacity at national and regional level to implement health interventions

11. The Health Sector Budget for FY 2012/2013 lists some areas of funding from EAC Secretariat and Development Partners: Study on the Harmonization of Health Insurance Systems HIV & AIDS Programme Cross-border Disease Surveillance and Response Sexual and Reproductive Health Project Medicines Regulatory Harmonization Project Invest in Adolescents Health Project Project on Aflatoxin and Improved Nutrition Open Health Initiative to Improve Maternal and Child Health

12. EDPRS II Health Sector Priorities related to EAC General Comments Standards in Harmonisation Issues - Rwanda must be involved in this to ensure high health care standards and effective institutional arrangements are maintained. Inputs are expected for the EAC Regional Health Sector Strategic Plan (2012-2016) and the protocol on EAC Regional Cooperation on Health. MINISANTE should plan and prepare strong position papers for upcoming EAC negotiations this can ensure prioritise areas of concern for Rwanda. Policy and Budget Alignment – When considering national activities there should be an effort to consider what EAC can offer. This will reduce duplication of efforts, expand funded options, and also help increase regional compatibility. Training - Need for training of health care workers in Rwanda and EAC. Can benefit from EAC-level initiatives and peer learning. To benefit from free movement of workers need to ensure mutual recognition of skills.

13. Patient Treatment: Ensure equal treatment and movements of patients within the region => Establish framework Health Insurance: Push for regional health insurance policies and mechanisms at the regional level to facilitate free movement of labour and people => Establish regional health insurance policy Health Systems: Strengthening of the health systems according to regional and international standards (accreditation) => Strengthen health systems Pharmaceuticals: Harmonization of regional regulations in the pharmaceuticals and food safety areas => Harmonised regulations Traditional Medicine: Harmonization of traditional medicine to promote effective methods of treatment as alternatives to modern medicine => Harmonise policy Disease Surveillance: Integrated disease surveillance and response to prevent propagation of epidemics => Design and implement integrated systems

14. Capacity: Build up human capital in the health sector by harmonising medical education to facilitate mutual recognition and the movement of health professionals across the region => harmonise medical education Behaviour Change: Pursue a communication policy of behaviour change in relation to the adoption of healthy lifestyles for the prevention of communicable and non-communicable diseases => develop a communication strategy E-Health: Stimulate ‘e-health’ for capacity building and management of health information => Establish e- health strategy Research: Cooperation and harmonisation of policies for research in health sector => Harmonise policy research Environmental Health: Environmental health for promotion of hygiene, sanitation and addressing issues caused by the environment on health across the region => develop an environmental health policy

15. Critical Acclaim Example Title15 Document: EAC Integration Activities In HSSP III- many issues, need to be prioritised Mapping: Linking national constraints / priorities to EAC solutions / projects Policy Actions: Suggestions given but Health sector needs to look at the document and choose priorities (e.g. timelines from status of agreements / protocols / policies) Indicators: Suggestions, need group discussion and to ensure they are possible to measure within existing systems Variance between and within the EAC systems