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Thinking outside the box to strengthen health systems

G20 health experts meet in new Working Group for the first time

Members of the G20 Health Working Group

Invited by Germany’s Federal Ministry of Health, members of the newly established G20 Health Working Group met in Berlin from 28th February to 2nd March 2017 to prepare for the first ever G20 Health Ministers’ Meeting in May 2017. On the agenda were antimicrobial resistance, epidemic preparedness and, as an important part of this, health systems strengthening.

The G20 health experts agreed that better management of global health crises must go hand-in-hand with health systems strengthening, and that one cannot be achieved without the other. “There is a window of opportunity to invest in preparedness, strengthen health systems and secure the right to health”, says BMZ’s Heiko Warnken. “We need to think outside the box.”

The three-day meeting of the G20 Health Working Group brought together health experts from different countries and international organisations in this newly established forum which reflects Chancellor Angela Merkel’s commitment to a focus on health during this year’s German G20 presidency. Throughout the presidency, the Federal Ministry of Health is leading the G20 health track, i.e. all discussions and policy processes related to global health. 

During intensive discussions, which Heiko Warnken, Head of BMZ’s Health Population Policy and Social Security Division, described as “very promising”, members of the G20 Health Working Group shared their views on three key areas of antimicrobial resistance, global health crisis management and health systems strengthening.

A joint vision for health system strengthening

Members of the G20 Health Working Group

In the field of health systems strengthening, the Federal Ministry of Health cooperates closely with the Federal Ministry for Economic Collaboration and Development (BMZ). According to Heiko Warnken, Head of BMZ’s Health Population Policy and Social Security Division, it is essential that health systems worldwide (not just in G20 countries) are strengthened to prevent epidemics like the recent Ebola crisis from occurring again: “Ebola was an eye-opener and game-changer”.

G20 experts agreed that better management of global health crises must go hand-in-hand with health systems strengthening, and that one cannot be achieved without the other. According to WHO, a strong and resilient health system working in harmony with the International Health Regulations is built on trained and motivated health workers, a well-maintained infrastructure, and a reliable supply of medicines and technologies, backed by adequate funding, strong health plans and evidence-based policies.

Health System Strengthening is a complex and multi-faceted concept, involving finance, governance, quality improvements and staff training, amongst others. In essence it takes a more holistic approach to global health rather than the disease-specific “silo” approaches often adopted in the past.

Specifically, the Working Group discussed the Healthy Systems Healthy Lives Joint Vision paper - a common understanding of Health Systems Strengthening jointly drafted by WHO, the World Bank and Germany which is based on a broad consultation process by stakeholders from civil society, politics and science. Delegates came up with suggestions on how to strengthen the paper (for example by placing greater emphasis on the role of communities and gender issues) for the final draft, which will be presented at the WHO Assembly following the G20 Health Ministers’ meeting. 

The way forward

Germany’s own development cooperation has already shifted towards the three priority areas discussed by the Working Group. Multilateral and bilateral discussions and approaches have been going on for some time, and the Ministry for Economic Cooperation and Development recently launched a new Marshall Plan with Africa, which will support and leverage the efforts being made by partner governments, as well as bring in the private sector to fill the gaps.

The input from G20 health experts was invaluable, said Heiko Warnken: “Health systems strengthening is crucial for preventing, detecting and responding to health threats. This is why Germany promotes a joint understanding and common approach towards health systems strengthening, as proposed in Healthy System - Healthy Lives.” He welcomed the G20 Health Working Group’s confirmation of Health Systems Strengthening as a key concern for the G20 health track. “We always need to remind people that whilst it continues to be important to deal with specific diseases, we also need to focus on health systems. G20 countries are in a good position to lead by example as well as to offer support to others.”

Ruth Evans & Michaela Wilczek
March 2017


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