1. OVERVIEW OF MACROECONOMIC & HEALTH KEY POINTS FROM THE OCTOBER 2003 GLOBAL CONSULTATION Briefing for Permanent Mission Representatives

2. The CMH Report: key recommendations Priorities investments to high-burden disease and conditions Priorities investments to high-burden disease and conditions Cost the gap to expand access to available interventions Cost the gap to expand access to available interventions Set domestic and external expenditure targets Set domestic and external expenditure targets Partnership commitment to address the gap at global and country levels Partnership commitment to address the gap at global and country levels WHO,World Bank & IMF provide support WHO,World Bank & IMF provide support

3. Macroeconomics & Health: support to countries Disseminate CMH Report findings Disseminate CMH Report findings Advocate for increased and equitable investment in health and social sectors Advocate for increased and equitable investment in health and social sectors Support to analyse and cost funding gaps Support to analyse and cost funding gaps Aid the process of creation of an investment plan Aid the process of creation of an investment plan Assist national efforts to scale up Assist national efforts to scale up

4. Dialogues with countries June 2002 1 st Global Consultation: CMH Report follow-up Participants included 20 developing countries, world bank, bilateral donors and Gates Foundation Participants included 20 developing countries, world bank, bilateral donors and Gates Foundation 1 st Consultation translates CMH Report into country-led strategies 1 st Consultation translates CMH Report into country-led strategies –Country-specific approach, integrated into existing poverty reduction strategies –Calls for substantial increase in resources 3 Regional Meetings in 2003 SEARO,EMRO,AFRO SEARO,EMRO,AFRO 30 countries made plans relevant to national and regional contexts 30 countries made plans relevant to national and regional contexts

5. October 2003 Consultation: 40 countries participated 31 Ministers of Health plus 19 from Finance and Planning Ministries 31 Ministers of Health plus 19 from Finance and Planning Ministries World Bank, Asian Development Bank, IMF World Bank, Asian Development Bank, IMF 74 WHO staff from country offices, regions and HQ 74 WHO staff from country offices, regions and HQ 6 NGOs and 10 UN organizations 6 NGOs and 10 UN organizations Civil society and private sector Civil society and private sector 5 sub-regional entities (e.g. CARICOM, ORAS & NEPAD) 5 sub-regional entities (e.g. CARICOM, ORAS & NEPAD) 11 academic institutions 11 academic institutions Several major media agencies Several major media agencies

6. Consultation participants agreed to: Foster political commitment to health across ministries by improving the analysis of benefits of investing in public health Foster political commitment to health across ministries by improving the analysis of benefits of investing in public health Put health investments in a macroeconomic framework: What is cost-effective, appropriates, realistic? How could it be achieved? Put health investments in a macroeconomic framework: What is cost-effective, appropriates, realistic? How could it be achieved? Work to greatly increase total resources: internal and external Work to greatly increase total resources: internal and external Increase health system efficiency and synergies across sectors Increase health system efficiency and synergies across sectors Develop innovative donor/recipient partnerships relation Develop innovative donor/recipient partnerships relation Deal with human resources gaps which constitute main impediment to progress Deal with human resources gaps which constitute main impediment to progress

7. Overview: Declaration of the October Consultation Health placed within a broad commitment for social justice, good governance and peace Health placed within a broad commitment for social justice, good governance and peace Finding effective ways to address health systems challenges Finding effective ways to address health systems challenges Support strategies for increased investments and their implementation Support strategies for increased investments and their implementation A broad partnership that honours donor commitments A broad partnership that honours donor commitments Linking to ‘3 by 5’ to meet the HIV/AIDS global health emergency Linking to ‘3 by 5’ to meet the HIV/AIDS global health emergency Strengthen appropriate national and sub-regional mechanisms Strengthen appropriate national and sub-regional mechanisms Orient priorities toward pro-poor approaches, eg. Within PRSPs Orient priorities toward pro-poor approaches, eg. Within PRSPs Focus upon capacity building, leadership skills and incentive for skilled human resources Focus upon capacity building, leadership skills and incentive for skilled human resources

8. Pressing Issues Innovative and creative support to countries Innovative and creative support to countries Sustainable investments in infrastructure and human resources Sustainable investments in infrastructure and human resources Address challengers of middle-income countries Address challengers of middle-income countries –Scaling up requires external support that does not increase debt burden –Impact of high AIDS burden on human resources Discuss the role of global public health goods in the country context Discuss the role of global public health goods in the country context