High Level Taskforce on Innovative International Finance for Health Systems

Global health was under the spotlight earlier this month at the first meeting of a new Ministerial Task Force. It brings together world political leaders with the aim of mobilizing more resources for health in developing countries.

Halfway to 2015, numerous countries are lagging behind in reaching the Millennium Development Goals (MDGs). Many developing countries have developed and costed national health plans with scenarios for scaling up efforts to reach the health MDGs. Yet they lack the resources to implement these plans.

The High-Level Taskforce was created to help countries and their partners fill national financing gaps by mobilizing additional resources, increasing the financial efficiency of health financing and enhancing the effective use of funds.

The Taskforce will make recommendations on the mix of innovative international financing mechanisms needed to deliver the extra resources required. In this context "innovation" covers non-traditional donors as well as non-traditional mechanisms for raising revenue in addition to ODA. The Taskforce will also promote international support to ensure that these recommendations are implemented.

Strengthening assistance at a time of financial crisis

Finding additional funds at a time when the global economy is in turmoil is a major challenge. Any reduction in health investments can have long term consequences for population health, and force new groups and nations into poverty.

The High-Level Taskforce will explore and recommend actions which will allow international assistance to be strengthened during the period of crisis and social sector investments to be protected despite economic fluctuations. The Taskforce will submit a report to the G8 summit in 2009. Three working groups have been established to identify the financing gaps, analyze the needs and assess the best way to channel funds.

Norway takes an active role in the Task Force through the participation of Prime Minister Jens Stoltenberg. Special Advisor Tore Godal will support this work and Sr. Advisor Helga Fogstad in Norad's Global Health and AIDS Department has been requested to be on the Working Group analysing Constraints for Scaling up and Costs.

IHP - a relevant but still ambiguous approach

The HLTF followed from the work started in the International Health Partnership and related initiatives (IHP+) which was established last year to accelerate actions in order to scale-up coverage and use of health services. The HLTF aims to have donors and countries rally around and increase their support to validated country plans with costed scenarios and financing gaps.

The key concept in IHP is the development of country compacts. Country compacts are agreements between government and countries on the most effective ways of providing aid - and the Paris and Accra principles of national ownership, harmonization, alignment, managing for results and mutual accountability are key. The "financing gaps" may vary by country, but the largest observed gaps relate to scaling up the health workforce, expanding services to under-served communities, and developing capacity for better monitoring of results.

A Short-term review of the newly established International Health Partnership (IHP+) was commissioned to assess its progress. The report concluded that the IHP+ has established a relevant response to address constraints to the health Millennium Development Goals (MDGs). However, its relevance and modus operandi are not widely understood. A number of respondents are still questioning the added value the initiative brings at the country level, especially in countries where measures to improve aid effectiveness have already been undertaken for some time.

It is still too early to assess what impacts or external effects that can be attributed to the IHP+, although it appears to be adding momentum to improved harmonisation and alignment in some countries, mostly by building on existing country structures and sector-wide approaches (SWAps). As the impacts of the IHP+ are likely to vary between countries, it is important to question whether the changes will be adequate to bring about the phase-shift that is needed to achieve the health MDGs.

Norway is supportive of the principles of IHP, namely its focus on national ownership, strengthening of national plans and budgets, common frameworks for monitoring, reporting and shared accountability. Norway participates in the steering group of IHP and contributes financially to the IHP+ work plan with funding through WHO.

The Norwegian embassies are encouraged to keep themselves oriented about the process at country level and to assist national government and development partners in countries where this is relevant.

To note is also that civil society representatives on the IHP+ Scaling-up Reference Group have now been selected: Dr. Lola Dare of Nigeria and Sue Perez from the UK.

A ministerial meeting will be held in Geneva on 4-5 February 2009. The objective is to review the progress of IHP+ and related initiatives.