CISDI at the 77th World Health Assembly

From May 27th to June 1st, 2024, representatives from 194 member states of the World Health Organization (WHO) convened for the 77th World Health Assembly (WHA). The agenda encompassed discussions on various critical topics, including evaluations of the progress made in attaining Universal Health Coverage (UHC), negotiation on a Pandemic Agreement, and amendment to the International Health Regulations (IHR) (2005). This assembly provided a significant opportunity for global collaboration and strategic planning to address pressing health challenges and shape the future of global health.

As a part of the larger global networks of civil society that want to seize the opportunity to co-create global health priorities and strategies, the Center for Indonesia’s Strategic Development Initiatives (CISDI) went to Geneva, Switzerland, to host and attend several WHA side events.

Before heading to Geneva, CISDI and 17 other civil society organizations (CSOs) in Indonesia gathered to map the challenges, aspirations, and needs of civil society and marginalized communities to be advocated at the global level. This civil society coalition has successfully formulated a policy memo consisting of priorities and recommendations for the 77th WHA, focusing on Universal Health Coverage (UHC) and the Pandemic Agreement. 

The policy memo has been sent to Indonesia’s Ministry of Health and Ministry of Foreign Affairs to be used as a reference for the Republic of Indonesia's delegations in Geneva. It also serves as the key points for the talking points that CISDI brought at various gatherings on the sidelines of the 77th WHA. The policy memo can be found here. 

This collaborative initiative was driven by a shared commitment to redress prevailing power imbalances and foster a more equitable and inclusive global health landscape. By pooling their expertise, resources, and insights, the Indonesian civil society coalition endeavored to pave the way for a more just and equitable world where the health needs of all communities are prioritized and addressed with urgency.   

Here is what to know more about the side events that CISDI hosted at the 77th WHA:

Six Years To Universal Health Coverage (UHC) 2030: Time to Unite and Mobilize Global Health Actors

On May 28th, 2024, the Center for Indonesia's Strategic Development Initiatives (CISDI) and PATH collaborated to host the 77th World Health Assembly (WHA) Side Event titled "Six Years To Universal Health Coverage (UHC) 2030: Time to Unite and Mobilize Global Health Actors." This significant gathering emphasized the critical need for unified global health action to achieve UHC by 2030, developing and aligning a roadmap that addresses the key drivers and enablers of UHC. The panel discussion served as a platform to initiate a robust dialogue and formulate actionable strategies towards fostering more collaborative and united advocacy for UHC.

A diverse assembly of esteemed participants representing academia, civil society, students, and the World Health Organization (WHO), attended the event in person, with several others joining virtually. This inclusive mix of attendees underscored the broad spectrum of stakeholders invested in advancing UHC objectives.   

Key Takeaways

The several key takeaways emerging from the discussion included: 

• UHC is not limited to Universal Health Care. The discourse around UHC needs to be broader than care or health services. Furthermore, UHC is needed to ensure equitable health for all.
• Equity principles must be embedded in all collective efforts to achieve UHC. Different contexts, multiple groups, and diverse needs should be considered when discussing and implementing the financing and other strategies to achieve UHC.
• UHC requires strong political commitments. UHC is a deeply political issue and it requires a political commitment that translates into a real legal framework, inclusive system and tangible action. Over the last decades, low prioritization of and less commitment on UHC have resulted in the slow or stagnant progress of UHC. We require stronger commitment from the government to allocate resources in achieving UHC by 2030. 
• Social security and health systems based on solidarity are needed to address health needs, accessibility, poverty, and other systemic issues that affect health. We must be more vocal about social security and other aspects of UHC if we want to achieve UHC by 2030.
• UHC relies heavily on resilient primary health care (PHC) and the strong support of community health workers (CHWs). Investments need to be allocated better to support PHC and CHWs. PHC offers multifactorial benefits to the stability of countries beyond having good health outcomes. CHWs serve as essential extensions of the PHC to reach the communities, yet we often regard their work as voluntary. Legal framework and concrete implementation plan to enforce donor and investments into supporting PHC, CHWs and the overall UHC plan at the global and national levels should be put in place.  
• Financing for UHC needs to consider the contexts and embrace innovative forms. Different geographies and diverse political dynamics provide lessons and learnings on the financing for UHC. Countries need the flexibility, adaptability and openness to determine the appropriate innovative financing that would work for their respective needs and in accordance with their technical capabilities.
• Multi-sector and multi-actor coordination reduce fragmentation in realizing UHC. Different global health actors have different agendas and priorities. All global health actors across sectors from the community level up to international fora should not work in silos. Instead, these actors shall collaborate to align strategies, coordinate agendas and unify voices.
• Civil society participation and local partnerships are imperative for advocacy and accountability. Coalition of CSOs ensure advocacy yet mechanisms to meaningfully engage CSOs with the government need to be established. The adoption of the resolution of Social Participation for UHC can be beneficial. Partnerships among CSOs are also complementary to the existing global partnerships, to provide holistic “bottom-up” inputs and a sense of accountability for the government and global actors.  

Next Steps

The perspectives shared during this discussion mark a crucial advancement in emphasizing the pressing need for global health actors to come together with greater urgency and solidarity than ever before. Through the dialogue there is an urge to: 

1. Push for robust South-South and South-North partnerships, establishing stronger cooperation to address UHC challenges collectively.
2. Foster collaborations among civil society and other development actors to propel the UHC agenda forward, ensuring equity principles are embedded in our efforts and proposed innovations. 
3. Promote research initiatives aimed at driving innovations and evidence-based strategies to overcome barriers and achieve UHC. 

This multifaceted approach will be instrumental in propelling progress toward achieving UHC by 2030.

Access the minutes of the meeting here.

Access the recorded discussion here. 

Shifting Dynamics: Activating Meaningful Civil Society Involvement in Global Health Governance

On May 29th, 2024, the Center for Indonesia's Strategic Development Initiatives (CISDI) hosted the 77th World Health Assembly (WHA) Side Event titled "Shifting Dynamics: Activating Meaningful Civil Society Involvement in Global Health Governance." This significant gathering emphasized the critical need to advance the commitment to strengthening global health governance through meaningful civil society involvement in the face of reduced multilateralism. The objective of the panel discussion was to encourage a thorough dialogue and develop an action plan aimed at achieving more inclusive, collaborative, and efficient global health governance, with a specific emphasis on strengthening civil society participation.

At the event, esteemed participants representing academia, civil society, students, and the World Health Organization (WHO) convened in person. This inclusive assembly highlighted the broad range of stakeholders dedicated to advancing global health objectives. 

Key Takeaways

The several key takeaways emerging from the discussion included: 

• Civil society is facing challenging predicaments that present considerable obstacles to navigate:
• Declining democracy on a global scale, particularly during and after the COVID-19 pandemic, has significant impacts on global health governance and the scope for civil society participation.
• In many countries, there is very little domestic financial support for civil society, which can impede its local initiatives. This challenge is particularly pronounced for policy advocacy groups that aim to challenge policymakers.
• Lessons learned from the COVID-19 pandemic underscore the critical importance of community involvement. Since pandemics originate within communities, it is imperative to integrate community participation into our strategies and recognize its pivotal role in crafting effective solutions. 
• Civil society is growing in ability, but we must bridge the gap between the government and the communities we all collectively serve.  
• Strengthening Global North-South civil society collaboration is vital. There is a need to see this from an equity lens over equality. Northern CSOs are often perceived as having more credibility, but incorporating the perspectives of Southern CSOs can be highly enriching. Collaboration should be prioritized as essential in this regard.  
• Civil society is often viewed as a force for social mobilization, yet its role as a vital knowledge provider should not be overlooked. Researchers should break out of their silos and actively engage with both civil society and policymakers to ensure their work translates into real-world impact. As a triangle, we need policy-makers, the epistemic community, and also the people to move the wheel. 
• The greater civil society's involvement, the higher the likelihood of success. From Pandemic Fund’s experience, we are witnessing notable enhancements in papers, and now we are also beginning to observe improvements in the implementation.
• For the success of the civil society movement, there are lessons to be learned from the HIV pandemic and its movement. No other health advocacy group has implemented such a strategic and impactful approach as the HIV movement. We need to reflect very much on what is enabling the HIV movement to be that successful.

Next Steps

The perspectives shared in this discussion highlighted the crucial importance of recognizing the indispensable role that civil society plays in bridging the gaps between policymakers and communities and fostering transparency and social accountability. This discussion serves as a call to action for collective efforts to:

1. Break the silos in civil society advocacy and/or movements, encouraging the exchange of good practices and uniting efforts among civil society across health issues for a more meaningful civil society involvement in global health governance.
2. Strengthen South-South and South-North equitable partnerships, forging stronger ties to address global health challenges collectively, such as ensuring communities are included in pandemic surveillance. 
3. Promote the meaningful acknowledgment and involvement of knowledge generation or co-creation with civil society, especially those that aim to increase evidence-based strategies for equitable global health governance.

Access the minutes of the meeting here.

Access the recorded discussion here.

We hope more civil society members especially from the Global South can join the discussions on global health issues in the upcoming global forums.