Joining the dots: civil society, the G20 and access to health

Working in global health sometimes feels like a succession of meetings in different parts of the world.

But returning recently from the C20 Summit in Japan, I’ve reflected on the importance of opportunities to bring civil society organisations from different countries together. At last month’s summit, working across different thematic areas, we were able to engage with large-scale – and sometimes nebulous – international processes. We ended by presenting Japanese Prime Minister Shinzo Abe with the extensive C20 policy pack for him to put forward our recommendations at the G20 Summit in Osaka in June.

The Civil20 was set up as one of the seven engagement groups of the G20 to ensure that “world leaders listen not only to the voices representing the governmental and business sectors, but also to the proposals and demands of civil society as a whole.”

It’s an amazingly diverse group. For me, the summit was a brilliant opportunity to look at my own area of expertise – health equity and access – in relation to a wide range of other issues, such as education, violence against children, gender equality, climate change, tax justice, transparency and infrastructure.

I was struck that it’s not just government departments who need to work outside their siloes and support multi- sectoral collaboration. Civil society organisations stand to gain a lot from coming together more and strengthening the links between our various areas of work.

Big in Japan: the global health agenda

In the area of global health and universal health coverage (UHC), the role of the G20 this year is critical. Under Japan’s leadership, G20 ministries of finance and health will come together for the first time as part of G20 Finance Track to discuss:

  • the importance of financing UHC appropriately
  • employing a ‘whole of government approach’
  • ensuring that health is a key priority for G20 governments domestically and as part of their role as development partners.

In this way, Japan is bringing global attention to the role the G20 can play in promoting collaboration – between ministries of health and finance in low- and middle-income countries, and with donor governments – to achieve equitable access to good-quality health services.

The C20 Health Working Group in Japan discussed the importance of raising more resources for health and making sure they are allocated equitably – through progressive, pre-paid, compulsory, pooled public sources, such as taxation or compulsory social health insurance. Our key ask is that all governments should increase equitable public financing, to achieve a government spending target on health of at least 5% of gross domestic product. Donor governments from the G20 must support low- and middle-income countries to achieve this.

We often see development assistance for health that is poorly aligned with national priorities, threatening the long-term sustainability of health systems. G20 governments, as part of their development spend, must support countries’ priorities and efforts on child survival. And they must strengthen national capacity and systems on taxation.

We often talk about bringing ministries of finance and health together. That’s why the G20 feels like an important marker – ahead of the High Level Meeting on UHC  taking place in September at the United Nations General Assembly.

In order to support low- and middle-income country governments to come to that meeting with concrete commitments, G20 ministries of finance must support the development of credible UHC financing strategies that bring together ministries of finance and of health. G20 ministries of finance need to:

  • work directly with ministries of finance and of health to build confidence in the value of investing in the health system
  • support countries to establish and strengthen the required finance structures – such as national tax authorities
  • empower countries to make decisions on their own health priorities, and improve alignment and effectiveness – both among G20 donors and with recipient country governments.

The beat goes on

So, yes, I beat my own drum on UHC financing at the C20. But it was refreshing to be with advocates from all over the world who – in spite of our different priorities and thematic expertise – are all working to ensure we hold governments to account on their commitments.

What really struck me was the role we have in ensuring equity throughout the resource generation and allocation process. And our responsibility to represent the communities governments aim to serve – so that we bring their needs and priorities to the forefront.

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