1. World Health Organization
1 August 2018
Applying the Paris Principles on Aid Effectiveness: What does this mean for AIDS Financing?
The contribution of health systems strengthening to achieving universal access
Dr Carissa Etienne
Assistant Director-General Health Systems and Services

2. World Health Organization
1 August 2018
OUTLINE
Health systems challenges
The emerging vision of universal access
Health financing and social protection
Investing in health

3. Health systems challenges
World Health Organization
1 August 2018
Health systems challenges
1. Human resources Infrastructure
3. Catastrophic health spending Ineffective delivery
5. Insufficient funds
1. Human resources Production, retention and migration
2. Infrastructure Logistics, procurement, physical infrastructure
3. Catastrophic health spending Reduction of out-of-pocket expenditure, social protection
4. Ineffective delivery Integration and coordination, primary care, community engagement, non-state providers, management
5. Insufficient funds
Lack of long term predictable financing

4. What is a health system?
A health system consists of all organizations, people and actions whose primary intent is to promote, restore or maintain health.

5. Health systems continued…
World Health Organization
Health systems continued…
1 August 2018
Health systems building blocks

6. The emerging vision of universal access
World Health Organization
The emerging vision of universal access
1 August 2018
All actions to strengthen health systems MUST be built upon the core principles and values of Primary Health Care
Social justice
Equity
Solidarity
"Health for all" is relevant for ALL countries
Guided by responsiveness to people’s needs and their growing expectations
“Putting people at the centre of health care”
Organization of health services is a country specific decision and country-led process

7. The emerging vision continued…
Framework for PHC reforms
Health equity
Solidarity
Social inclusion
(Universal Coverage reforms)
People – centred care
(Primary Care reforms)
What citizens aspire to for
their society
What citizens expect for their personal life and that of their families
Health authorities
one can rely on
(Leadership reforms)
Communities where
health is secured
(Public Policy reforms)

8. Health financing and social protection
World Health Organization
1 August 2018
Health financing and social protection
World Health Assembly 2005: All Member States adopted a resolution on Sustainable health financing, universal coverage and social health insurance.
The resolution urged countries to develop health financing systems that:
Ensure all people have access to needed services
Do not expose users to risks of financial catastrophe and impoverishment
2. The resolution recognized the diversity of national health systems and the need for unique responses

9. Health financing and social protection continued…
Number of People with Catastrophic Expenditure and Impoverishment due to Health Spending
impoverished
financial catastrophe
Eastern Mediterranean
Africa
Europe
South-East Asia
America
Western Pacific 30 60 90
Number of people (millions)

10. Health financing and social protection continued…
Specific policies
Conditional cash transfers subject to fulfilling certain conditions (e.g. vaccinations)
Vouchers (e.g. to better access health services)
Waivers and exemptions
Policies integrating the poor
Universal provision of health services (UK)
Explicit inclusion of the poor in social health insurance (F)

11. Investment in Health: how do we improve?
World Health Organization
1 August 2018
Investment in Health: how do we improve?
1. Raise additional funds where health needs are high and revenues insufficient.
2. Reduce reliance on high out of pocket payments by moving towards pre- payment.
3. Improve social protection by ensuring the poor and other vulnerable groups have access to necessary personal and non personal services.
4. Improve efficiency of resource use by focusing on the appropriate mix of resources.
5. Promote transparency and accountability in health financing systems.

12. The International Health Partnership and related initiatives: IHP+
Objectives
Develop results-focused, country-led compacts that rally all development partners around one national health plan; one M&E framework; and one review process.
Generate and disseminate relevant knowledge, guidance and tools.
Enhance coordination and efficiency at country, regional and global levels.
Ensure mutual accountability and monitoring of performance.

13. IHP Signatories
As of 23 May 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, Finland, Sweden, UK, Norway, Germany, France, Italy, Portugal, Canada and Netherlands), and
Two other donors (Bill & Melinda Gates Foundation & African Development Bank).

14. Value-added of the IHP+
Country-focused and country-led activities.
One costed ,results-oriented country 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.

15. World Health Organization
1 August 2018
Thank you!