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G7 Global Plan for UHC Action Agenda
May 14, 2023
In order for the international community to accelerate collective action towards the realization of universal health coverage (UHC) and mobilize political will towards the United Nations General Assembly (UNGA) High-Level Meeting (HLM) on UHC, UHC 2030, a multi-stakeholder partnership whose secretariat is hosted by the World Health Organization (WHO), the Organisation for Economic Co-operation and Development (OECD) and the World Bank, launched its flagship "UHC Action Agenda" at the end of March 2023. We, the G7 Health Ministers in collaboration with relevant sectors and stakeholders within their respective mandates, aim to undertake robust and concrete steps in line with the eight action areas stipulated in the "UHC Action Agenda" through the "G7 Global Plan for UHC Action Agenda". This plan is designed to facilitate priority actions that the G7 members aim to employ and complement the "UHC Action Agenda", in support of country-led efforts to implement UHC, and to maximise impact of the UNGA HLM on UHC and beyond to achieve UHC worldwide.
The "G7 Global Plan for UHC Action Agenda" contains an overall description and specific G7 key actions based on the "UHC Action Agenda", which was developed by UHC2030 based on extensive consultations with stakeholders and partners. Each of the following eight action areas contains (1) the Title (Action area), (2) the description of the area derived from UHC Action Agenda (i.e. why it is important), (3) an overall description or direction for G7 actions, and (4) Key G7 Actions (i.e., what the G7 should do). (1) and (2) are cited from the "UHC Action Agenda".
We, the G7 Health Ministers, will continue to work collaboratively to support international progress towards achieving UHC, building on our commitment to UHC for our own citizens in the post-COVID-19 era. In addition to the "G7 Global Plan for UHC Action Agenda" presented in this document, we note the importance of a global hub function, in support of relevant international organisations, including for financing, knowledge management, and human resources on UHC.
Collectively, collaboratively and also in line with the "Global Action Plan for Healthy Lives and Well-being for All", we will accelerate our efforts towards the achievement of more resilient, equitable, and sustainable UHC across the globe by 2030 – the target year for achieving the Sustainable Development Goals (SDGs) and expected to be Japan's next G7 Presidency year. In particular, we will take full advantage of the "UHC Action Agenda" and the "G7 Global Plan for UHC Action Agenda" to promote a coherent, integrated and aligned action-oriented global health agenda across the three HLMs in 2023 on UHC, pandemic prevention, preparedness and response (PPR), and tuberculosis to maximise synergies of those meetings. Furthermore, given the current crowded space in the health sector at a global level, it is essential to strengthen synergies, coordination and coherence. In this context, we also note, without prejudging the outcome, a preliminary idea of exploring an UNGA HLM on health to comprehensively discuss all relevant health challenges in the future and to ensure synergies of existing processes with a view to avoiding fragmentation and duplication.
We, the G7 Health Ministers, in collaboration with all relevant sectors and stakeholders, renew our determination to assist the achievement of UHC by 2030 to leave no one behind, including through following up on this plan.
"Political leaders have now experienced how important UHC is to their societies and economies, given their experiences during the pandemic and the ongoing impact of conflicts and the climate crisis." (UHC Action Agenda)
G7 Health Ministers aim to mobilise political will globally towards the achievement of more resilient, equitable, and sustainable health systems that can achieve UHC across the globe by 2030, including by demonstrating sustained determination as G7 to contribute to UHC.
We will endeavour to incorporate and maintain UHC as a goal in our national health policy frameworks in line with Health in All Policies, strategically connected to broader inter-ministerial priorities such as social and economic progress, environmental protection, and the fight against and adaption to climate change, including through a One Health approach.
On the global stage, we will provide sustained strategic and political leadership to champion UHC, and we will draw on development assistance, the expertise and networks with our civil society partners, and other means to consistently promote UHC as a national and regional political priority delivered through multisectoral, whole-of-government and whole-of-society approaches. We support the UHC2030 coalition in its mission to bring together all UHC actions at national, regional and international levels to strengthen coordination and collaboration.
We recognise and promote greater focus toward Primary Health Care (PHC) as a cornerstone to achievement of UHC.
"Health is enshrined as a fundamental right of every human being, and it is the duty of governments to protect, promote and fulfil the right to health. Countries will benefit economically and socially by investing in health because UHC makes a significant contribution to reducing poverty and promoting equity and social cohesion." (UHC Action Agenda)
G7 Health Ministers reinforce the importance of understanding and addressing the needs of the people in vulnerable and marginalised situations.
We commit to sustain our development cooperation on health to address health inequities and inequalities within and among countries particularly LMICs, consistent with the aim of the UN 2030 Agenda of leaving no one behind.
We support the design and implementation of health policies and programmes that integrate gender equality and human rights, include a focus on anti-discrimination, including on the basis of sexual orientation and gender identity, accessibility, and affordability, and consistently advocate for alignment with applicable international human rights instruments and other relevant international conventions.
We will support efforts to strengthen national health information systems, including to support the institutionalisation of civil registration and vital statistics to improve the availability, quality, and protection of health data, including monitoring of equitable access, financial hardship, quality and equitable provision of care, and essential service provision, with particular emphasis on people in vulnerable and marginalised situations, and to accelerate evidence-based policy making.
We will support the development of international frameworks that can improve the monitoring and evaluation of health systems strengthening investments, and their contributions to UHC, as a means to strengthen the evidence around what works.
"Policies, laws and regulations that integrate UHC and health security and create an enabling environment for use of health technologies and innovations will strengthen future economic and social resilience." (UHC Action Agenda)
G7 Health Ministers intend to work with stakeholders to strengthen legal frameworks where necessary, to support progress towards UHC in line with country-led priorities.
We will advocate for and support creating enabling national legislative frameworks that build safe, equitable and resilient health systems, taking into account the leave no one behind agenda in full, including sexual and reproductive health and rights, and call on relevant international organisations to provide support to LMICs in this field.
We aim to promote the expansion of equitable, safe, accessible, and affordable use of health technologies and innovations, paying attention to protecting patient privacy and addressing the digital divide, including internet connectivity and common use of digital platforms.
We will advocate, where appropriate, for the development of frameworks for health data governance, and promoting health literacy and access of patients to their own data in a person-centred way that fully respects data protection and privacy.
We will sustain and endeavour to scale up partnerships and engagements with LMICs and regional organisations to accelerate the development and adoption of health technologies tailored to their population needs, while avoiding duplication.
"The health and care workforce is essential for ensuring healthy people, societies and economies and plays a crucial role during pandemics, conflicts, natural disasters and other emergencies. In all situations, women play a prominent role, delivering most front-line essential health and care services." (UHC Action Agenda)
G7 Health Ministers intend to support countries to develop the health and care workforces needed to achieve UHC, including through development cooperation that supports the development of national workforce plans and strengthens the health and care workforce to ensure they are well-trained, supported, remunerated and equipped to deliver high-quality health services.
We aim to advocate in international forums and with political leaders for sustained attention and action on addressing the health and care workforce shortages globally as a vital step towards achieving good health and wellbeing for all at all ages and for the wider sustainable development agenda.
We will work towards aligning G7's development assistance and technical cooperation, including through multilateral partners, with national health workforce development strategies that promote the education, lifelong-learning employment, and retention of an adequate and sustainable supply of competent, skilled, and motivated health and care workers, including those providing PHC, focusing on their efficient and equitable distribution, especially in rural, hard-to-reach, and underserved areas, and ensure decent and safe working conditions and appropriate remuneration while paying close attention to gender equity.
We will support policy and actions on the health and care workforce within their health systems, striving to produce an adequate domestic supply of graduates and employment to meet national health and care workforce demands. In this context, we recognise the need for an equitable geographic distribution of health workers in countries as well as between countries according to country specific necessities.
We aim to develop and invest in actions to facilitate the delivery of care, through multi-disciplinary teams of health and care workers, such as nurses, midwives and associated health and care professionals to improve the quality of health and care and foster trust and acceptability.
We will ensure that international health and care worker recruitment is in line with the WHO Global Code of Practice on the International Recruitment of Health Personnel, and that labour migration arrangements between countries entail proportional benefits for both parties, protect migrant health and care workers as well as protect health systems of countries of origin from health workforce shortages.
We will support global action for improvement of quality, respectful care and patient safety as a significant cornerstone of achieving UHC, for example, by working towards all health facilities provide for hygiene at the point of care together with safe water and sanitation services, also including the implementation of healthcare infection prevention and control programmes, since poor patient safety puts people in danger and challenges health resources.
"UHC is an important foundation for healthy people, societies and economies and makes countries more resilient in health emergencies. Consistent levels of public spending on health are central to progress towards UHC. Primary health care (PHC) is a critical investment for both UHC and health security." (UHC Action Agenda)
Recognising that the path to UHC rests on national political commitment to invest the public resources required, G7 Health Ministers emphasise optimising global financial resources to complement domestic financing for UHC in alignment with national health priorities. We support an inclusive and evidence-based process to address and strengthen policy dialogues on key UHC issues, as outlined below. Domestic funding is still crucial to achieve UHC in every country. Mobilisation of additional financial resources through the use of innovative financing approaches including private sector financing, albeit with appropriate regulatory overview, is necessary to close the financing gaps in the health sector in many countries. It is also necessary to strengthen the role the private sector could play in global health including through innovative ways of financing, such as impact investments in the field of global health. We also highlight benefits of investments in health promotion and disease prevention, which reduce the costs of treatments and therefore positively affect UHC. We welcome the work of the G7 development finance institutions and other investors to ensure that private and public capital is deployed to build strong and inclusive health systems.
We intend to advocate in international forums and with partner governments for increased domestic public resources for health and the adoption of nationally appropriate spending targets for health, recognising that health is an investment not a cost, and promote prioritising investment in primary health care as cornerstone to achieving UHC the goal of driving down catastrophic health expenditure and the numbers of people impoverished by paying for health services.
We will work towards aligning our development assistance, bilaterally, regionally and multilaterally, to support partner countries in setting national health and financing priorities for UHC to strengthen health systems, improve resilience, prevent diseases, promote health and foster and sustain investment in health services for their whole population with a focus on high-quality and cost-effective health systems strengthening and PHC.
We aim to promote partnership arrangements and collaboration platforms that strengthen alignment of global health financing amongst Global Health Initiatives (GHIs), including Gavi, Unitaid, Global Fund, the Global Financing Facility, and the Pandemic Fund, in a way that complements domestic health financing and development needs in partner countries for reorientation of health systems towards primary health care and the achievement of UHC and aligns with the core mandates of those initiatives.
We intend to support the definition and implementation of government-led, inclusive and evidence-based processes to prioritise packages of gender-responsive essential health services with financial protection in each partner country, and support coordination of the support of relevant GHIs and international financial institutions (IFIs). We will urge that packages take into account inequalities in countries, including income, geography, gender, disability, and age, among others.
We will engage with the GHIs and the IFIs on the integration of UHC into their portfolios, strategies and programmes to ensure that countries can leverage their domestic resources using international financing instruments offered by the MDBs and that international financing mechanisms align and complement domestic priorities and plans to accelerate progress towards achieving UHC and better health for all.
We intend to support financial management capacity in LMICs as well as identify and disseminate evidence-based innovations for value-based health care to improve the cost-effectiveness of health system investments, efficiency in spending, and promote investment in health care delivery, including by supporting capacity development of government officials at national and sub-national levels in health financing, policy-making, and public health, working with other technical partners and related programmes, such as the WHO UHC Partnership, the WHO Academy, the UHC2030 coalition, the P4H network and the World Bank UHC Technical Assistance Program.
We will cooperate with LMICs to plan for the sustainability of various grants.
We will encourage public and private sectors to promote sustainable and adequate financing, including through impact investments in global health with an aim to contribute to generating positive and measurable impacts alongside financial returns, and will take the initiative in promoting impact investments in global health through funding and partnering with relevant stakeholders including Development Finance Institutions, and financial investors from the health sector. Such activities will be complementary to existing work supported by the G7 including the International Financial Reporting Standards Foundation's International Sustainability Standards Board.
"Governments cannot make progress towards universal health coverage without stakeholders that play a critical role in developing, reviewing and implementing national health policy frameworks." (UHC Action Agenda)
Building on the principle of leaving no one behind stipulated in the Action area 2, G7 Health Ministers can foster and facilitate inclusive participation of relevant stakeholders and anti-discriminatory practices in health-related decision-making and accountability mechanisms.
We aim to advocate for inclusive national governance and a meaningful whole-of-government and whole-of-society approaches for UHC by institutionalising participatory mechanisms that are supported by adequate, stable financial resources, and reflects the role played by civil society in representing the interests of populations and health service users and the role of different sectors and ministries in achieving and sustaining UHC.
We intend to support governments and other partners to implement and institutionalise inclusive mechanisms that empower all societal groups to engage in health decision-making, paying special attention to women and girls and people in vulnerable and marginalised situations, including local civil society organisations that represent them. In this regard, we also emphasise the importance of multi-sectoral action, including to strengthen provision of water, sanitation and hygiene and enhance climate resilience to as part of efforts to achieve and sustain UHC. We will encourage relevant partners to provide technical assistance and resources to build capacity in LMICs to develop such inclusive, participatory mechanisms.
We will promote trust and transparency by working with partners to strengthen accountability in health governance and by addressing conflicts of interest, power imbalances and interference to minimise any negative impacts on individuals and societies.
We will support increasing global and public awareness, international solidarity, international cooperation and action towards the achievement of UHC through active participation in events and activities to commemorate International Universal Health Coverage Day on 12 December of every year.
To support more ODA being aligned to national health and financing priorities for UHC, we commit to progressive alignment of the monitoring of development assistance for health with nationally available indicators and data systems to support ongoing strengthening of national health information systems and reducing duplicative reporting requirements.
"Gender equality, including equal rights and equal access to services, is critical to achieving UHC and leaving no one behind. Gender equality in the health workforce is a necessary component for achieving UHC." (UHC Action Agenda)
G7 Health Ministers fully acknowledge the impact that gender inequality has on health, noting that ensuring gender equity in the health and care workforce is also critical to maximising the potential and advancement of protections and safeguarding.
We aim to promote gender equity in the design of health policies and the delivery of health services by working with partners to strengthen the gender responsiveness of health policies and health services, nationally and in global health, including through our development cooperation and multilateral cooperation.
We intend to take steps to ensure gender-responsive policies and health services, including universal access to reproductive, maternal, newborn, child and adolescent health and comprehensive sexual and reproductive health and rights for all, especially including for those in vulnerable and marginalised situations. Given the well-coordinated and funded rollback on gender and rights movement at country and multilateral levels, the G7 will step up our efforts to work together on promoting SRHR and explore ways to assess the impact on sexual and reproductive health services and rights.
We promote efforts to achieve gender equity in health systems and that women are supported and empowered to play a full, equal and meaningful leadership and decision-making role in health at all levels, including in the value and remuneration of health and care workers, which includes community health workers, and advocating for the recognition, reduction and redistribution of unpaid care work, and the reward of paid care work adequately, guaranteeing care workers representation. We recognise the advocacy work done in the framework of the Gender Equal Health and Care Workforce Initiative.
We aim to support collecting and analysing gender disaggregated data to improve policy and programme design to ensure that no one is left behind and to support capacity building to improve knowledge management in LMICs.
"UHC and global health security are intertwined goals anchored in the health systems of every country. Leaders must act now to design and resource integrated approaches to support both UHC and PPR capacities for health emergencies within wider efforts to build equitable, resilient health systems." (UHC Action Agenda)
G7 Health Ministers consider that primary health care is the foundation of health systems, and advocate for the UNGA HLMs on UHC, pandemic PPR and TB in September 2023 to reflect and coherent and synergistic, where appropriate, particularly through a focus on strengthening health systems, including by tackling antimicrobial resistance (AMR) and implementing a One Heath approach.
We commit to further strengthening community trust and confidence in science, vaccines and public health institutions, and to proactively counter health misinformation and disinformation.
We will support efforts to strengthen essential public health functions that contribute to both UHC and health security in national health policy frameworks, including prevention and tackling AMR.
We underscore the importance of building bridges across sectors toward achieving UHC and health security.
We will support countries to prioritise investment in the training and mobilisation of a quality health and care workforce, and we recognise the PHC workforce including community health workers as key for the recovery and advancement of the provision of essential health services as well as preparedness and response.
We will also support policy and contribute actions to develop a well-trained workforce to perform essential public health functions, including disease surveillance, emergency preparedness and response, and laboratory diagnostics, to enhance early detection and response of health security threats and promote health system resilience, including from climate-related crises, in line with the WHO roadmap for national workforce capacity to implement the essential public health functions.
We will work to strengthen the overall resilience of health systems, especially to protect people in vulnerable and marginalised situations against interruptions in essential health services during health emergencies, including those caused by extreme climate events, at home and in LMICs, in line with humanitarian principles, working with these groups and local civil society organisations to better understand their experiences and needs.
We will seek to catalyse provide adequate, predictable and sustainable financing for health systems resilience and PPR through supporting domestic public resource mobilization and by strengthening existing multilateral financing mechanisms like the World Bank-hosted Pandemic Fund and the WHO Contingency Fund for Emergencies (CFE).
We reaffirm to support the WHO Hub for Pandemic and Epidemic Intelligence as a key institution in establishing minimum data sharing and meta-data sharing standards and guidelines for collaborative surveillance.
We support the training of highly qualified, multidisciplinary public health emergency workforce recognising the recommendations made by WHO on PPR for Health Emergencies.
Source: Official website of the G7 Health Ministers' Meeting in Nagasaki
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