HHA, A N e w W a y o f W o r k i n g T o g e t h e r Status of Preparation of the Conference of Ministers of Health and Finance F. Sergent (AfDB) and B. Cardoso (WHO/AFRO) On behalf of the HHA Ministerial Conference Preparation Group HHA Meeting of Regional Directors Day 1 - Dakar, 13 December 2009

OBJECTIVES OF THE PRESENTATION Provide background to participants who are not directly involved in the preparation of the Ministerial Conference Report on progress to date in designing and organising the conference Seek inputs from the technical group in order to improve reporting to and facilitate decision-making from RDs on Day 3, especially in view of new developments

BACKGROUND TO CONFERENCE PREPARATION HHA Action Framework in particular foresees (i) increased involvement of MOFs for MDG-focused budgeting/MTEF, leveraging domestic resources, mobilizing predictable donor aid, analyzing and expanding fiscal space for health MDGs and (ii) Policy guidance/advocacy with MOHs, MOFs, heads of State, AU, etc. Recommendation of Special Session of MOFs and MOHs in Tunis, 2009 (need to enhance MOH-MOF collaboration) Decision of HHA Regional and Sector Directors and decision to prepare the conference jointly with AU and UNECA. HHA Ministerial Conference Preparation Group established January 2010, co-chaired by AfDB and WHO Recommendation/validation from Kampalas side meeting 2010 World Health Report: focus on efficiency

ACTIVITIES, CONSTRAINTS AND PRODUCTS OF THE CONFERENCE PREPARATION GROUP Collective conference design work through task sharing, virtual communication and regular teleconferences - Regular reporting to and guidance from HHA Steering Group - Adapt to evolving thinking regarding the Africa Investment Case Progress constrained by limited involvement of AU and UNECA. New ECA position regarding conference format: slot of 2-3 hours in MOF meeting; participation of only some MOHs (teleconferences of 8 and 9 December) Key conference documents produced in draft form and endorsed by HHA Steering Group (Draft Conference Concept Note, Draft Conference Agenda, Tentative Budget)

KEY FEATURES OF CONFERENCE CONCEPT 1- Conference Objectives Conference objective: Stimulate dialogue and enhance leadership and collaboration between MOFs and MOHs for more effective financing of the health sector with a view to accelerate progress toward MDGs. « More Health for the Money » from all sources and not only « More money for Health ». Not just advocacy but forging consensus regarding the causes of ineffective financing and required remedial measures. Adoption of a « Tool of Engagement » to be used by governments to engage all stakeholders; a commitment toward concrete action for more effective sector financing. Participants: Ministers of Health and Finance, Regional Economic Communities, development partners and selected representatives from parliamentary organisations, civil society and the private sector.

KEY FEATURES OF CONFERENCE CONCEPT 2- Conference themes African Investment Case central document -presentations strongly emphasizing greater efficiency of the use of all resources i.e. not only government resources but equally important, aid and the private sector. Centrality of: -Improved health systems performance -Improved planning, budgeting, monitoring and reporting -Governance and accountability structures -Public Finance Management -Health financing options and methods

CONFERENCE AGENDA ? Conference to be mainstreamed into UNECA meeting of MOFs Initially planned for 3 ½ days (2 days technical); then 1 day and now 2-3 hours Three directions of work: - More effective and more efficient public, private and aid investments in health - Enhancing collaboration for more effective funding of health - Agreement on a Tool of Engagement Mix of presentations, discussions and formal reactions (ministers; Parliament and Civil Society)

OPTIONS To cope with new developments Limit the conference to 2-3 hours is not an option, even with very effective country preparation work Push for the requested one day mainstreamed in UNECA MOF meeting (+ country preparation work) Utilize the 2-3 hour slot e.g. to test the validity of conference approach and themes with MOFs jointly with a selection of MOHs and other stakeholders + stand alone event (+ country preparation work)

CONFERENCE BUDGET ? USD 1.4 million for the initial 3 ½ day design USD 600,000 for a one-day conference (assuming HHA does not have to pay for MOF air tickets) Will depend on which option we go for

PROPOSED COUNTRY-LEVEL CONFERENCE PREPARATORY WORK Proposed set up: - Establishment of an Advisory Committee composed of a selection of MOH/MOF staff present in Tunis meeting (e.g. Ethiopia, Mali, Nigeria, Rwanda) - Each HHA agency volunteers to be the focal HHA agency for the coordination of country preparation work -Country offices of HHA agencies work with MOFs, MOHs and other stakeholders through preparation committees (same format as that used for seminar on financial access) with a view to identify issues relevant to the conference, explore possible remedial measures and produce a concise brief for ministers.

QUESTIONS FOR DISCUSSION TODAY What is the best conference option? Can the conference concept be further improved? How can we use a 2-3 hour slot in the UNECA MOF meeting? Are HHA agencies ready to invest energy in country preparation work? What are the most urgent next steps?

Thank You