Remarks by UN Resident Coordinator, Ms. Nathalie Ndongo-Seh at the High-Level Sustainable Health Financing Dinner

Honourable Minister of Health, Senator Lizzie Nkosi,

Secretary to Cabinet, Mr. Mbuso Dlamini and all Principal Secretaries present,

EU Ambassador, H.E. Ms. Esmeralda Hernandez Aragones,

US Ambassador, H.E. Ms. Lisa Peterson,

Head of Global Fund Africa & the Middle East, Ms. Cynthia Mwase and your esteemed delegation,

Members of the Global Fund Country Coordinating Mechanism,

Distinguished ladies and gentlemen,

I am delighted to be among you this evening as we reflect on Sustainable Health Financing for our countries. This is an area that concerns all of us as development partners, government, civil society, as well as the private sector. I am therefore particularly pleased and encouraged by the presence here today of key health partners and leaders.

Good health is at the centre of our vision of a more sustainable, inclusive, peaceful and prosperous future. It is both an outcome and a driver of progress.

Investments in health and, more broadly, in the continent’s human capital, are among the best steps we can take to ensure the success of the 2030 Agenda and the AU’s Agenda 2063 for Sustainable Development.

Africa’s progress in improving health outcomes has been remarkable. Life expectancy has increased by 20 percent from 51 to 61 years between 2000 and 2016. Access to HIV prevention and AIDS Treatment to all has improved equity, by ensuring that all those in need have access regardless of their social and economic status.

Despite these achievements, tragically, for too many, health is still inaccessible, unaffordable or altogether unavailable.  African Member States are not increasing or prioritizing health investments sufficiently and out-of-pocket health expenditure (OOP) remains too high. Each year, 100 million people around the world are driven into poverty because of the costs of health care.  This is unacceptable.

Health is a fundamental human right. That is why the Sustainable Development Goals include a target of achieving universal health coverage (SDG3) by 2030.

Funding is crucial.  Current expenditures are simply not enough. The disease burden remains high and the health sector remains weak. Africa stands on the verge of a ‘triple transition’ that will unfold over the next 15 years. This triple transition - Demographic, Epidemiological and Urbanisation - cannot be faced while using the same delivery or financing the models that we are using to address current health challenges.

We need to expand the fiscal space for health and reduce fragmentation in donor support. External development assistance for health, has shrunk in recent years, and now represents less than 1% of global health spending.

Governments also need to strengthen financial management and collect more of the so-called “sin taxes”, for example, on tobacco, alcohol and added sugar.

Ladies and gentlemen,

Our leaders have made strong commitments, and we applaud the tracking of those commitments through the Africa Scorecard on Domestic Financing for Health. The Scorecard is an advocacy tool for Member States to use in financial planning and expenditure tracking.

We need to build on the political momentum to increase equitable domestic resources for Health, building on previous Declarations. The Heads of State ‘Africa Leadership Meeting: Investing in Health’ held in Addis Ababa on the 9th of February 2019 on the side lines of the AU Summit where the AU Chairperson and Rwandan President Paul Kagame highlighted the lack of domestic investment in health. It is on those premises that the Assembly of Heads of State adopted a declaration committing all 55 AU Member States to increase domestic investment in health in order to drive human capital development and long-term economic growth across the continent.

We need to continue to advocate for increased domestic investments in health and for the continent to build resilient health systems. The core strategy for Sustainable Health Financing lies in allocating enough domestic investment and ensuring that we “Leave no one behind”. The goal of universal health coverage (UHC) is to ensure that all people obtain the health services they need without suffering financial hardship when paying for them.

Ladies and gentlemen,

With each new baby safely delivered and vaccinated in a rural village, each new case of malaria treated, and each infectious outbreak averted, we are building the foundations for the sophisticated systems needed for healthy societies.

In September last year, the UN Secretary-General launched a Strategy for Financing the 2030 Agenda for sustainable development and reiterated the UN’s commitment to continue pressing to scale up public and private finance and investment flows in the health arena.

The United Nations, through the World Health Organization, stands ready to support Member States across the health agenda, including on sustainable health financing. The

Global Action Plan for ‘Healthy Lives and Well-being for All’ coordinated by WHO is an important effort by 12 leading global health and development agencies.

We must also leverage the power of the private sector and civil society. More than half of health services are already delivered by the private sector. So, it is not a matter of increasing the involvement of the private sector: it is about improving coordination and collaboration between public and private sectors. It is about increasing the use of innovations to improve delivery and efficiency and reaching out to those left behind.

UN agencies and partners are committed to support countries in building their capacity to raise adequate and sustainable revenues for achieving Universal Health Coverage. This may include providing support to countries to implement pro-poor and pro-health fiscal policies, give more priority to health, improve the efficiency and equity of health spending, and leveraging the UN partnership to generate data and support decision-making.

There is, of course, no “one size fits all” solution.  Each country must walk its own path toward this objective.

Development partners are committed to working better to align funding with national priorities and use it to leverage more funds for health as well as shape the quality of domestic resources, and ultimately increase the impact on people’s lives.        

All our contributions towards sustainable health financing are very critical.  Together we can make health a reality for all.

I thank you.