5th -7th March, 2019 Kigali Rwanda.
dRPC-PAS increased efforts to support the National Institute of Policy and Strategic Studies ( NIPSS) who’s focus of this year’s executive course is on health by exposing focal executives of NIPSS to key learnings from international counterparts in the AHAIC 2019.
Day One in Review
The conference had attendees joining this week of 1,500+ delegates and 60 partners from 47 countries.
Professor Philip Cotton got the day off to a great start with a provocative pre-plenary special lecture on morality and health. He attempted to demonstrate that “nothing must stand in our way to get to the people we want to reach.”
In Plenary I, experts put their heads together to discuss the next frontiers in primary health care as a key pathway to achieving universal health coverage. “It’s time to go to scale on primary health care,” noted Dr Jean Kagubare from the Bill & Melinda Gates Foundation. Rwanda, where more than 90% of people are insured, has already shown that this is possible.
At the Opening Ceremony, Africa Health 2019 co-chairs Hon Dr Diane Gashumba, Minister of Health of Rwanda, and Dr Githinji Gitahi, Global CEO of Amref Health Africa, welcomed conference attendees.
“Access to health care should not be a lottery of where you are born and how wealthy your family is,” noted Dr Gitahi in a compelling opening speech. The highlight of the Opening Ceremony was no doubt the cross-generational discussion led by Marie Claire Wangari, the representative from the Youth Pre-conference, who asked her elders to sit on the stage steps for an informal discussion among equals.
During the morning’s inter-ministerial panel, high-level representatives from the Health Ministries of Rwanda, Ethiopia, Kenya and Uganda shared their countries’ progress on UHC and the role of the private sector, community health workers and individuals in achieving health for all
Health leaders were recognised for their commitment to advancing health for all in their countries. Hon Dr Gashumba, Minister of Health of Rwanda, received the UHC Presidential Champion award on behalf of HE Paul Kagame, President of Rwanda, and Hon Dr Amir Aman, Minister of Health, Ethiopia, accepted the UHC Ministerial Champion award for their exemplary efforts to expand health care access to their populations.
Day Two in Review
In the morning, we had a wide-ranging discussion in Plenary III about how to finance the expansion of universal health coverage. The panel was kicked off by a fireside chat with two impressive women – Yacine Sambe Diouf from the Ministry of Economy and Finance in Senegal and Dr Angela Gichaga, CEO of Financing Alliance for Health. Diouf gave health advocates some expert advice on how to better engage with finance ministries: understand competing priorities for different sectors, allow time for gradual budget increases, and demonstrate results for the money that is already allocated. We were also delighted to hear that Senegal is planning to meet the Abuja Declaration target of dedicating 15% of the state budget to health in three years.
Hon Dr Diane Gashumba opened Plenary IV on access to care, in conversation with Senait Fiseha Alemu, a Health Extension Worker from Ethiopia. They discussed a range of ways to motivate community health workers, including performance-based remuneration, education and professional development opportunities, and the importance of community recognition. Raj Kumar from Devex then led a dynamic discussion about how to move “reaching the last mile” from slogan to action, calling on the experience of the audience members in an interactive dialogue.
HE Toyin Saraki (Founder-President of The Wellbeing Foundation Africa), Hon Sarah Opendi (State Minister for Health, Uganda), and others joined together for a great conversation around social accountability for UHC hosted by PATH together with Amref Health Africa. “We must match the intelligence and knowledge of communities with global innovation. Too often national or global policy decisions simply don’t make it effectively to the frontline,” said HE Saraki.
During a session on community-led innovation to advance UHC in Africa and Asia, Priya Balasubramaniam (Senior Public Health Scientist, Public Health Foundation of India – PHFI) noted that “the future of health systems and UHC will rest on regional sharing between countries with similar contexts.” Small group discussions during this session – hosted by Amref Health Africa, Takeda and PHFI – focused on community health systems strengthening, innovation, and financing and partnerships to advance UHC.
dRPC-PAS side session : Unlocking the potential Universal Health Coverage as a domestic resource base to meet child and family health funding gaps in Nigeria.
The session started 3:45pm and ended 5:15pm at AD4. Attendance was at capacity with 40 participants. The moderator was Dr Nasirdeen Usman, with panelists, Senator Olanrewaju Tejuoso, Dr Muhammed Dogo-Muhammad Waziri, Dr Enyantu Ifenne, Prof Tanyigna Kyauta Bulus and Dr Nneka Orji-Achugo. We had a rich discussion until we were bereft of time.
Day Three in Review
The morning’s Plenary V kicked off with a compelling conversation on how to define and improve quality care across diverse settings. As panelist Dr Miriam Dahir noted, “If the patient cannot accept the care, then it is not quality – we need to deliver quality care that meets the needs of the patient.” Joining Dr Dahir on the panel were Serigne Magueye Gueye, President of the West African College of Surgeons; Frasia Karua, General Manager at Amref Enterprises; and Ian Askew, Director of the Department of Reproductive Health and Research at WHO. Discussions focused on the importance of data, measurement and community-based interventions to improve quality of care.
Plenary V continued with an exciting panel on innovations that are driving change and leapfrogging progress towards UHC in Africa – including mobile phone technologies to put people in touch with doctors and quality care when they need it (Claire Morris, International Programmes Director, Babylon Health); robotics and artificial intelligence to facilitate health care delivery (Benjamin Nortey, Founder and CEO, MINT Innovations); strategies to leverage existing product supply chains to deliver essential medicines (Simon Berry, Co-founder and CEO, ColaLife); drone technology to deliver blood products to remote communities (Israel Bimpe, Head of National Implementation (Rwanda), Zipline International); and digital innovations to reach the last mile and advance health equity, such as electronic immunization registries that give frontline health workers data on each child at their fingertips (David Fleming, Vice President, Global Health Programs, PATH).
In the afternoon, Dr Kibachio Joseph Mwangi, who heads the fight against NCDs at the Kenyan Ministry of Health, started off Plenary VI by sharing his own family’s struggles to demonstrate the social and financial burden of non communicable diseases. When his own mother fell ill with cancer, she asked him three questions:
- Why should me being ill come at the expense of my granddaughters?
- Why can’t the government talk to drug manufacturers to lower the price of drugs?
- Who will take care of you, my son?
The plenary brought together a diverse group of speakers to consider the power of public-private partnerships to drive access and quality of health services, using examples from Gavi, MSD for Mothers, IFPMA, Nutrition International, and more.
Perhaps the most rousing plenary was the Closing Ceremony, dedicated to women who are literally changing the world, from the community level to the halls of global policymaking. The audience embraced each and every one of the amazing panelists – Katja Iversen, CEO of Women Deliver; Amina Jama Mahmoud, Founder of Women in Global Health Somalia; Professor Miriam Were, Champion for an AIDS-Free Generation; and Cynthia Oning’oi, a passionate advocate against female genital mutilation (FGM), who received a standing ovation for her moving speech on her fight to end FGM.
The Women in Global Health (WGH) Africa Chapter was announced in a signing ceremony between Amref Health Africa’s Dr Githinji Gitahi and WGH Executive Director Dr Rhoopa Dhatt.
On the eve of International Women’s Day, several women were recognised for their leadership and tireless work in global health: Senait Fiseha Alemu, a Health Extension Worker from Ethiopia; Nice Nailantei, Global End-FGM ambassador; Prof Miriam Were, Champion for an AIDS-Free Generation; Hon Dr Diane Gashumba, Rwanda Minister of Health; and Katja Iversen, CEO of Women Deliver.
At the closing ceremony, representatives from the Youth pre-Conference presented the draft of the Africa Health 2019 conference communiqué, which will be finalised next month after consultation with stakeholders.
Finally, 11 parliamentarians from Ghana, Kenya, Rwanda, Senegal, Tanzania and Zambia launched the “Kigali UHC communiqué,” committing to strengthen health systems, address health inequities, support community health and ensure universal access to immunization to drive progress on UHC in their countries. We are heartened by the strong political leadership on UHC we have seen throughout the conference.
KEY LEARNINGS FROM THE AHAIC 2019 FROM OTHER AFRICAN NATIONS.
LEARNINGS FROM SENEGAL.
- High level political commitment is important to muster resource mobilization for a nation.
- Planning for UHC should be done with realistic financing requests.
- Allow time for gradual increases especially with regards to requests for incremental allocations.
- Demonstrate resources impact.
- Donors should align to national strategies.
LEARNINGS FROM RWANDA.
- Education is key to Rwandan interest in healthcare funding; Education on benefits catalysed by the end of a civil war.
- Technology can be leveraged.
LEARNINGS FROM GHANA.
- Ghana has a commitment to health beyond political parties manifestos, hence this allows for consistency in health plans irrespective of governments.
- The MOH must determine health plans not governments in power, for national health plans to be successful it must outlive governments.
LEARNINGS FROM KENYA.
- Encourage public participation by ensuring the public has the right information.
- Ensure the right information by transparency in budgeting process.
- Justifications must be given for putting a line item as priority over others.
- Build the capacity of the public to understand the process by public financing laws, civic education.
NEXT STEPS.
- Convergence of all our National Policies on Health and one implementation Strategy for the country on UHC.
- Convene a UHC stakeholders platform to restrategise on moving forward and sustaining already achieved gains. The FMOH is already working on this. Needs support.
