HEARD recently hosted the second in a series of high-level retreats around domestic financing and prioritisation of health under the United Nations Sustainable Development Goals, better known as SDGs.

The meeting took place at the Thanda Private Game Reserve in Hluhluwe, South Africa between 28 June – 1 July 2017. A core group of former and current Ministers of Health from the Eastern and Southern region of Africa (ESA), academics, representatives of regional and sub-regional intergovernmental organisations, as well as high-level representatives of multilateral organisations dispensed with formalities and engaged in open discussion under Chatham House Rules.

The meeting aimed to create a platform for shared regional experiences and learning, to identify key entry points, to offer practical innovations, and to ultimately assist regional governments in setting actionable priorities. These will best secure broad, sustainable advances in health coverage, at costs, which are feasible, both financially and politically. Guided by three overarching themes, the day and a half meeting revolved around planning for the transition to reduced levels of donor funding, the expansion of domestic fiscal space for health, how to accommodate expectations of larger and more effective health systems, particularly for Sexual and Reproductive Health and Rights (SRHR) and non-communicable diseases (NCDs), and toward the advancement of Universal Health Coverage (UHC) under the SDGs.

Ensuring adequate health coverage in the context of limited resources is not unique to any African country, but the pressures and demands related to health are becoming critical. The rising costs of long-standing disease trends such as HIV and AIDS, Tuberculosis and Malaria must contend with a rise in non-communicable diseases and the prevention-related health demands of the youthful demographic profile making up the region. Universal health coverage is a core target of the SDGs and offers the region a powerful framework with system-wide implications for health. However, many countries remain unprepared for the ambitious transition and will require additional resources to implement the necessary changes and build capacity. While there is broad consensus that health systems need to do more, and do more effectively, there is less agreement on how to address the financial needs of health systems in low and middle-income countries, especially in a climate of decreasing international assistance. Options will vary among countries, many of which have prospects of strong economic growth. However, strong coordination and alignment of country efforts are needed, as well as investment in delivering the highest impact health interventions and addressing system barriers and other social determinants of health.

The meeting outcome document will be posted shortly.