Global Health Policy Forum finds consensus on healthcare user fee removal

This second meeting of the Global Health Policy Forum again saw great participation levels with more than forty participants from across the European Commission, United Nations agencies, the WHO, NGOs, academics and the private sector. The meeting was co-chaired by Dr. Canice Nolan of the European Commission’s Health and Consumer Directorate General (DG SANCO) and Frazer Goodwin of the European Public Health Alliance – member of Action for Global Health.

The Commission commenced the meeting by outlining the revised timetable they have for consultations to aid their preparations of a policy document on Global Health. A public online consultation is planned for this process which should commence at the start of the week beginning 12 October 2009. The consultation will be online for eight weeks and be complimented by consultations at several other events such as the EU Health Policy Forum on 16 October, the Global Responsibilities for Global Health Rights conference in Brussels on 19 and 20 October, and the European Development Days event in Stockholm from 22 to 24 October 2009. A high level meeting also intended to contribute to the consultations originally scheduled for the end of January has now been moved to 11 February 2010 to prevent a diary clash with the Davos Global Economic Forum.

Following this update, the main focus of discussions were upon the conclusion of the High Level Task Force on Innovative Financing for Health Systems and the issue of user fee abolition. This discussion was facilitated by contributions from Simon Wright of Save the Children UK and Anna Mariot from Oxfam.

Firstly, an outline of the announcements made at the United Nations General Assembly following conclusion of the High Level Task Force was presented, from the perspective of UK NGOs. With the High Level Task Force being co-Chaired by UK Premier Gordon Brown, and a general election looming in which he is behind in the polls it was expected that the United Nations General Assembly would have provided him an opportunity to announce a new commitment or initiatives. However, despite some announcements from partner countries of their policies to remove user fees (all of which were already policies in these countries) none of the donors, the UK included, announced any new or additional support.

In addition to the review of the High Level Task Force and the United Nations General Assembly, an outline was then given of the publication “Your money or your Life”. This publication has been widely supported across the NGO movement and calls on world leaders to act now to allow the removal of user fees.

The debate that followed ensured that all of the considerations necessary for health care free at the point of use were considered. Contributions were provided by Commission officials from different DGs, representatives from ILO, UNICEF, WHO, as well as many NGOs. Points that were raised in the debate included the need to:

 ensure that funding for health systems was provided to ensure quality care not just “free care”,
 provide predictability of aid to ensure coverage of recurrent costs so necessary for health service provision,
 include conditions and treatments in the “basic package” that go beyond ailments explicitly covered in the health MDGs, including the growing disease burden from chronic conditions,
 make the most of the opportunities to learn and share experiences across the social sectors, particularly from the education sector,
 involve and engage community health workers within the health system throughout as a means to support and strengthen health systems,
 elaborate and use performance frameworks for budget support aid modalities that lead to and support stronger health systems,
 find ways of ensuring health systems are financed to reduce the impact of health care costs for poor people, and not just in poor countries,
 facilitate the development of strong systems of social protection to ensure that equitable health systems could be financed,
 ensure that European donors and the EC do not lessen the support to the sector because of application of the division of labour across development cooperation.

Whilst there was no consensus amongst participants on what priorities there were for the removal of user fees, there was a broad consensus that such a move would be beneficial. However it was clear that there were differing views on what would be necessary to attain this policy objective.

The next Global Health Policy Forum is to be held on Tuesday November 10 and the topics to be discussed will be Policy Coherence for Development and potentially an update on the progress towards the WHO resolution on primary health care.

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 The first monthly Global Health policy forum - Towards the Communication on the "EU role in Global Health"
 European Commission plans Communication on Global Health

Oxfam’s Policy Paper "Your Money or Your Life? - Will leaders act now to save lives and make health care free in poor countries?" is to be found here.