77th World Health Assembly Side Event: Setting Priorities and Optimising Resources | WHO

Opening Remarks by WHO Regional Director for Africa, Dr Matshidiso Moeti

Excellencies, ladies and gentlemen, 

I’m pleased to join you this evening to highlight the importance of making effective choices in health.

I commend our collaboration with the Africa CDC on the health economics and financing programme, which raises policy awareness on this critical issue.

The idea of priority setting is not new, but it becomes even more important in today’s circumstances in our region and globally. 

In the aftermath of the COVID-19 pandemic, there has been renewed emphasis on reorienting health systems towards primary health care to make progress on universal health coverage and health security. 

This focus on primary health care requires more resources invested in health – and better and smarter investments. 

In the African region, the financing level from domestic public resources for health remains inadequate compared to the resource requirements. 

In 2021, the current health spending in the region was, on average, US$ 132.8 per person, with the government share being US$65 per person. 

This contrasts the estimated total costs to achieve the SDGs of about US$249 per person per year. At the same time, the current fiscal constraints facing countries in the region threaten efforts to mobilise additional resources for health.

External funding continues to play an important role in financing health in our region, comprising, on average, over 20% of current health spending between 2011 and 2021 and equal to or more than 40% in eleven countries. 

Last year’s global UHC monitoring report from WHO and the World Bank shows that although access to essential health services has improved in Africa, coverage is still less than half of the population. 

Further, there is little progress in reducing the proportion of the population who face financial hardship in accessing health services or forego health seeking, with a slight increase from 7.8% in 2000 to 8.6% in 2019.

All this emphasize the need for priority-setting in countries, and it must be done with the appropriate evidence base. However, countries still need the tools to translate the evidence to make effective decisions and prioritise adequately.

We have championed this cause for a decade now.

In the WHO African Region, we support evidence-based priority setting:

We work with countries on designing essential health service packages, especially in the context of national strategies and plans, which define what benefits the population is entitled to and where. 

We advocate and support countries on resource allocation decisions within the health system, which determine how resources are shared and targeted to interventions, providers, geographic areas, or levels of care. 

This has been a valuable tool for demonstrating commitment towards primary health care and making equitable allocation based on need and capacity to benefit.

We also provide technical guidance for establishing essential medicines lists, which orients procurement decisions and access to safe and quality medical products.

We work to show regional progress using evidence-based priority-setting tools, such as the regional report on the status of health technology assessment published last year. This has provided information to help other partners plan their assistance to countries.

Progress requires that all stakeholders work together, exemplified in the collaboration among partners in Rwanda to support the assessment of cancer interventions for the benefit package of the national community-based health insurance scheme. It demonstrates what can be achieved when every actor works in alignment and synergy.

We have also demonstrated this collaboration with Africa CDC in raising awareness and building the capacity of policymakers in Eastern and Western Africa on priority setting in health.

We are also pleased to have lent our technical expertise in developing the continental framework on priority setting along with other regional experts and groups. 

We remain committed to sustaining this collaboration and partnership, and providing technical guidance to countries in the African region, for improved health outcomes and well-being.

Thank you.