- 1 - Tenth Strategic Advisory Group Face-to-Face Meeting (22 October 2019) Note for the record Attended: Apologies: GHC Unit (GHCU): Claire Beck (CB) Andre Griekspoor (AG), Chair Trina Helderman (TH), Co-chair Michelle Gayer (MG) Jorge Martinez (JM) Sonia Walia (SW) Haley West (HW) Rachael Cummings (RC) David Lai (DL) Linda Doull (LD) Elisabetta Minelli (EM) 10.1 Introduction Discussion Decision Action AG presented the meeting agenda and objectives. • SAG agreed on agenda and meeting objectives. 10.2 Update on current GHC status and workplan deliverables (L. Doull) Discussion Decision Action LD presented the update and progress report for Q3 and highlighted priority activities for Q4. • LD reported on the GHC presentation at the WHO Health Security Council on 21 October and the following asks to the Director-General: 1) Strengthen investments in Health • SAG agreed on questions for M. Ryan. • SAG to address M. Ryan in the afternoon with the agreed questions.
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Tenth Strategic Advisory Group Face-to-Face Meeting (22 ... · • SAG to write a letter to M. Ryan to address any funding gap, once 2020-2023 strategy and 2020-2021 work-plan developed.
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Transcript
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Tenth Strategic Advisory Group
Face-to-Face Meeting (22 October 2019)
Note for the record
Attended: Apologies: GHC Unit (GHCU):
Claire Beck (CB)
Andre Griekspoor (AG), Chair
Trina Helderman (TH), Co-chair
Michelle Gayer (MG)
Jorge Martinez (JM)
Sonia Walia (SW)
Haley West (HW)
Rachael Cummings (RC)
David Lai (DL)
Linda Doull (LD)
Elisabetta Minelli (EM)
10.1 Introduction
Discussion Decision Action
AG presented the meeting agenda and objectives. • SAG agreed on agenda
and meeting objectives.
10.2 Update on current GHC status and workplan deliverables (L. Doull)
Discussion Decision Action
LD presented the update and progress report for Q3 and
highlighted priority activities for Q4.
• LD reported on the GHC presentation at the WHO Health
Security Council on 21 October and the following asks to
the Director-General: 1) Strengthen investments in Health
• SAG agreed on
questions for M. Ryan.
• SAG to address M.
Ryan in the afternoon
with the agreed
questions.
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Cluster Coordinator & Information Management
positions; 2) Spearhead the launch of new Health Cluster
Coordination Guidance for Heads of WHO Country
Offices as Cluster Lead Agency; 3) As IASC Principal /
CLA – advocate at the highest level to protect & enable
partners to coordinate & deliver collective action.
• LD provided an overview of the latest IASC
developments: review of coordination architecture has
been postponed; Grand Bargain workstreams
expanding to implement the New Way of Working.
• LD updated on the recent developments from the
Transformation and explained the revised structure of the
WHO Health Emergencies Programme including the 3
partner networks. GOARN is situated in the office of the
Assistance-Director General for Response; EMTs within
Country Readiness Team under the Preparedness Division
and the GHC sits within Health Emergency Interventions
within Emergency Response Division. WHE Executive-
Director’s view is that the previous concept of
centralising the operational partnership networks
diminished understanding of their different identities’ and
role: while GOARN and EMTs are specialist surge
mechanisms, the GHC is a coordination platform that
delivers services. LD also described the organizational
shift from a process-based to a result-based
management approach aligned to the strategic
outcomes of delineated in the General Programme of
Work 13 and the 10 strategic outputs for the WHE
Programme. The GHC cuts across three outputs focused
on country readiness; acute response; and fragile,
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conflict and vulnerable countries1. Output networks are
being created across the three level of the organization
with budget allocation based on the following
assumptions: 70% previous biennium budget; 20% at
discretion of output network team lead ; 10% ADG
discretion. Resource mobilization function has been
centralised and currently not clear whether funding will
be available for the GHC activities beyond 31 January
2020, when the current USAID WHO HLTH EMGY PROG
award ends. No-cost extension on this award is not
permitted.
• Regional activity and staffing plans for 2020-2021 have
yet to be shared. Output consultations between
headquarters and regional offices will happen in
November.
SAG noted the following points:
• Recognition of the trend for WHE to focus on outbreaks,
rather than humanitarian emergencies. All hazard
approach is mentioned less often.
• Importance of linking HC work to preparedness and
readiness.
• Revised language from “alternative” to
“complementary” coordination solutions.
In addition, SAG discussed the following points:
• Current WHO leadership prioritizes strengthening national
health systems as first responders to emergencies.
1 Output 2.1.3 Countries operationally ready to assess and manage identified risks and vulnerabilities
Output 2.3.2 Acute health emergencies rapidly responded to, leveraging relevant national and international capacities
Output 2.3.3 Essential health services and systems maintained and strengthened in fragile, conflict and vulnerable settings.
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However, this may not be feasible in certain contexts
and more conflict-sensitive analysis is needed. Discussion
should focus on: when the country requires assistance,
what is the vision on coordination and strengthening
national capacities? International partners often work
through national partners, capacitating the national
staff.
• Recognition of high number of national partners, mostly
national NGOs and Red Cross and Red Crescent
Societies, being partners of the clusters in countries. WHO
role is essential: acknowledging the value added of the
partnerships on the ground and enabling the work of
partners.
• Proposal that partners could be categorized in tiers
based on technical and operational capacity to assure
quality e.g.: tier 1- minimum generic capacity that
should be provided by any humanitarian health actor;
tier 2 agencies that have a specific expertise on certain
thematic issues; tier 3 – specialist expertise and/or can
deliver to all essential services at scale.
• Essential leadership roles at country level are WHO Head
of Country Office, Health Cluster Coordinator and
Incident Mangers, working hand in hand.
• Collaboration with the Universal Health Coverage
division looking at UHC and PHC in fragile conflict
affected settings is ongoing and fundamental.
SAG prepared for the afternoon meeting with M. Ryan, WHE
Executive Director, and agreed on the following questions:
• What is WHO’s vision on health coordination in
emergencies?
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• What is the expectation on partners’ role and
capacities? How can we mutually benefit each other?
• How will WHO invest in cluster capacities at all levels, i.e.
leadership, coordination, resource mobilization?
• Within the context of WHO Transformation, what is the
role of Regional Offices in supporting the cluster
coordination?
10.3 Partners’ capacity (T. Helderman)
TH presented the combined results of the HC international
and national partners’ capacity surveys and highlighted the
following points:
• Recognized gaps can be confirmed and are
concerning.
• Trends are similar across types of partners -
international, national and local – and similar to
trends from 2012 and 2015 international partner
surveys.
• Consistently, national partners seem to be providing
more services than international partners.
SAG discussed the following points:
• What do we do to address these gaps?
• Where should investments be made?
• Is it for international partners to invest in national
partners? Should we be building national partners’
capacities?
• Which technical areas we should invest in?
• SAG decided further
discussion is needed to
consolidate a follow-up
position on how to
address partners’
capacity gaps and
operational barriers.
• SAG decided to further
consider the possibility to
hold a multi-stakeholder
event on response
capacity, with
participants beyond
GHC partners.
• SAG decided on the
points for discussion to
be held at Strategy
Workshop on partners’
capacity gaps and
operational barriers,
• SAG to consolidate a
follow-up position on
how to address
partners’ capacity
gaps and operational
barriers.
• SAG and GHC unit to
explore the possibility to
hold a multi-
stakeholder event on
response capacity, with
participants beyond
cluster partners.
• GHC unit to complete
country level analysis of
national partners’
capacity survey data
and share with Health
Cluster Coordinators.
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SAG recognized that:
• Existing initiatives to build capacity of partners (i.e.
IAWG) may not be fulfilling their role in terms of
guidance operationalization and implementation.
• Partners are often unable to provide a full range of
services because of ear-marked funding they receive
to cover just a few services from a comprehensive
package. The model of one partner supporting one
facility in full - funded through development funding
to which humanitarian funding is complementary - is
not common. Provision or services is therefore very
fragmented.
• Funding often targets the service delivery, rather than
the process to ensure the quality of the delivery of
clinical care. For example, funding is not granted for
mentoring, supportive supervision, quality control. It is
appreciated to have trainings easily available (e.g.
Open WHO platform modules), but operationalisation
of the trainings is a gap.
• Partners draw on the same pool of people to address
humanitarian needs. There is need to expand the
pool of people. Reaching out to academic
institutions to clarify the reasons behind this capacity
gap is essential.
• Country specific analysis of national partners’
capacity survey data will be provided to Health
Cluster Coordinators for consideration on how to
practically address some of the identified gaps in
their particular contexts.
including questions for
GOARN and EMTs.
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SAG discussed the need for the Global Health Cluster to
have a view on how to address persistent technical gaps
and operational barriers which impact on timely and
effective response action.
LD highlighted the importance of organizing a multi-
stakeholder event where stakeholders beyond the Global
Health Cluster, including other WHE networks and external
stakeholders, be brought to the table to discuss solutions on
how to address current gaps. Donors have informally
indicted interest in such an event.
SAG decided the following should be brought for discussion
during the GHC Strategy Workshop session on partners’
capacity:
• Are existing initiatives to build capacity of partners
(i.e. IAWG) working?
• As part of preparedness and readiness, who invests in
building capacity, where and in what capacity
aspects?
• How do we pull on other assets, GOARN, EMTs, Health
System Strengthening/development partners to fill
these gaps?
• How do funding modalities support capacity
building?
• What is WHO’s role in improving quality, including
building capacity of partners?
The SAG agreed the following questions should be
specifically asked to GOARN and EMTs: given the
recognized gaps, how can GOARN and EMTs help build
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cluster partner capacity? Where do they see critical
capacity gaps, from their perspectives? Where can GOARN,
EMTs and the GHC work more effectively together?
10.4 GHC Strategy 2020-2023 (L. Doull)
LD presented the summary version of the strategy
consultation slide-deck, highlighting proposed points for
discussion under each strategic priority during the Strategy
Workshop. LD also presented the main points of the one
pagers of the four thematic areas: 1) coordination in