Accelerating universal health coverage for a more resilient world: the road to the 2027 high level meeting

Nine years later, there is still no end in sight. Bangladesh has hosted more than a million Rohingyas, and at a great cost. That burden has never been matched by the world's attention, or its funding. This is not a story of passive waiting. Bangladesh has survived the crisis, even where the world's response has too often treated it as an inconvenience, not an asset. And still, what little permanence people manage to rebuild gets torn through again and again. For a child born here, this is not temporary displacement. It is simply childhood. This is not an appeal for sympathy. It is an argument for repatriation that is safe, voluntary and dignified. For justice sustained, for funding that doesn't age out of the news cycle, for political will that is enforced, not symbolic. Bangladesh is not appealing to the world. Bangladesh is convening it.

Thank you everyone for coming here and we call on the I would like to thank everyone and end this event by calling on the international community to fulfill its responsibilities and turn today's solidarity into lasting solutions.

Thank you very much.

Your Excellencies, honorable ministers, distinguished invited guests, ladies and gentlemen, we are starting our events of this afternoon on accelerating universal health coverage for a more resilient world. You are all welcome. We are delighted that you have found time and prioritized this event among many other choices this week in New York. My name is Magda Robalo. I'm the co-chair of the UHC 2030 Steering Committee, and I'm going to be your moderator for the next hour or so. It is indeed my pleasure to welcome you to this afternoon seventh annual ministerial meeting of the Group of Friends of Universal Health Coverage and Global Health. Before we get started, allow me to propose a few, in fact, two quick housekeeping notes. The first one, we have simultaneous interpretation available in Arabic, French, and Spanish. Please use the headsets at your seats to listen in your preferred language. The second housekeeping note is that we have a full program in front of us. Already, we are slightly late. So I want to encourage all speakers to keep their remarks to the time allotted. And if needed, I will kindly and respectfully request you to conclude so that we respect other people's time. I know many of us in this room will have to run to other events. I would like to thank the co-chairs of the Group of Friends, Georgia, Japan, and Thailand, for their steadfast commitment to keeping UHC high on the agenda not only as a health issue, but as a driver of social progress, economic development, and sustainable growth. This group provides an important platform for member states to share experience and sustain political attention for universal health coverage. We are preparing for the 2027 high-level meeting. and we are seeking concrete commitments to drive reforms that accelerate progress towards the 2030 Sustainable Development Goal deadline. Our work together is more important than ever. It is long past time for the global commitment to universal health coverage to deliver on its promise of realizing the right to health for everyone, everywhere. We have a collective responsibility to meet the needs of the people we are here to serve. These are words we have repeated often for more than a decade. Yet, more than half of the world's population still lack access to essential health services, and billions of people continue to experience impoverishing out-of-pocket payments. Inequalities are worsening. with the poorest and most vulnerable bearing the greatest burden of unaffordable health costs and unmet needs. A successful high-level meeting next year must bring a renewed focus on health equity. We know that for there to be real progress, political commitment must be matched by sustained investment. We also know where to focus our efforts, making healthcare more affordable, strengthening primary healthcare as the foundation of our systems, and ensuring we have the skilled and supported health workers we need to deliver services, quality services to the people. We must listen to the people we serve. We must give communities a real voice. in shaping the policies and services that affect them. And underpinning all of this is the need for good data so we can identify who's been left behind, more than who's been left behind, who's been pushed behind, make better informed policy decisions and hold ourselves accountable for progress. The high-level meeting this week on pandemic prevention, preparedness and response is a useful reminder that UHC and health security are not separate agendas. Both depend on equitable health systems rooted in primary health care, systems that can maintain essential services and prevent, prepare for, and respond to health emergencies, making sure people are protected during and after emergencies. We are also at a critical juncture for the global health architecture reform. Just on Monday, we had the launch of the Accra Reset report with its five shifts and 10 recommendations. And the reform is an opportunity to make it more fit for purpose, building on the WHO/UNAIDS work. Our task now is to bring these efforts together and turn our shared commitment into meaningful progress and measurable results for people everywhere. With these introductory remarks, it is now my great pleasure to invite our hosts, the co-chairs of the Group of Friends, to give opening remarks. And I will start with His Excellency Mr. Toshimitsu Motegi, the Minister of Foreign Affairs of Japan. Honorable Minister, you have the floor.

Distinguished guests, ladies and gentlemen, thank you all for joining us today for this important meeting. It is my great pleasure to once again co-host this year's ministerial meeting of Group of Friends on Universal Health Coverage together with Thailand and Georgia. Global health has long been one of the main pillars of Japan's foreign policy, and we are committed to promoting UHC to realize human security. UHC not only directly impacts people's health, but it also helps countries to confront major economic, social, and security risks. I would like to make two points today. First, UHC is indispensable in preparing for future health crises. Addressing infectious diseases requires international cooperation. In response to the recent Ebola virus outbreak, Japan has provided 8.5 million U.S. dollars in emergency grants to the Democratic Republic of the Congo and Uganda. The government of Japan remains committed to providing necessary support. No one can predict the next health crisis. building resilient health systems between crises is key. Therefore, we strongly hope that the high-level meeting on pandemic prevention, preparedness, and response to be held the day after tomorrow will further reaffirm and strengthen international cooperation, including the WHO Pandemic Agreement. Second, Achieving UHC requires the establishment of resilient, sustainable, and self-reliant health systems that respect country ownership. Japan attaches particular importance to strengthening countries' resilience and enabling them to address their own development challenges in a sustainable manner. In this spirit, the government of Japan is working with WHO and the World Bank to advance the UHC Knowledge Hub Initiative. The UHC Knowledge Hub supports capacity building for policy practitioners from ministries of health and finance in low and middle income countries, aiming to strengthen health financing. Japan hosted the first in-person training in Tokyo in February, attended by senior officials from eight countries in Asia and Africa. Finally, I would like to express my sincere appreciation to the Government of Thailand as co-facilitator of next year's UN General Assembly High-Level Meeting on UHC. The Government of Japan remains firmly committed to achieving UHC and to contributing to the success of the High-Level Meeting on UHC next year. Thank you for your kind attention.

Thank you. Thank you, Honorable Minister, Mr. Toshimitsu Motegi, for your kind words. I would like now to invite His Excellency, Mr. Mikheil Saakashvili. I apologize for mispronouncing your name. I am saying it pretty well.

It's not easy to pronounce my name.

Minister of Internally Displaced Persons from the Occupied Territories, Health, Labour and Social Affairs from Georgia. You have the floor.

Thank you. Excellencies, distinguished colleagues, ladies and gentlemen, it is my pleasure to join you today on behalf of Georgia as one of the co-chairs of the Group of Friends of Universal Health Coverage in Global Health. As we approach the 2027 High-Level Meeting on Universal Health Coverage, we must translate our political commitments into concrete national actions that ensure access to quality and affordable health care for all. Georgia's experience demonstrates that sustained political commitment, accompanied by comprehensive reforms, can deliver meaningful progress towards universal health coverage. Since introducing our universal health coverage programs in 2013, we have expanded population coverage to more than 95%. We have progressively broadened the benefit package, reduced patient payments, and increased public investment in health care. At the same time, we recognize that population coverage alone does not guarantee universal health coverage. Financial protection remains a major challenge, particularly in health systems with a predominantly private provider landscape. This is why Georgia is pursuing a new generation of reforms focused on three interconnected priorities. First, Strengthening primary health care. In 2025, last year, we launched a comprehensive primary health care reform, introducing age-adjusted capitation and result-based financing, expanding essential services, and strengthening incentives for prevention and effective management of chronic diseases. Our ambition is to shift from a hospital-centered model towards a people-centered health system that prevents illnesses, detects diseases early, and ensures continuity of care. Second, improving affordability and the efficiency of health spendings. We have introduced diagnosis-related group financing for inpatient services. and implemented pharmaceutical pricing reforms, including external reference pricing and managed entry agreements for innovative medicines. These measures aim to improve efficiency, enhance access to essential innovative treatments, and ensure that limited public resources deliver greater value for patients. Third, investing in quality health workforce, and system resilience. We are strengthening quality assurance through international accreditation requirements for healthcare providers, introducing minimum salary standards for health professionals, and advancing digital health and health information systems. These reforms are essential not only for improving routine service delivery, but also for ensuring that our health system can respond effectively to future crisis. Excellencies, Georgia's experience also highlights an important lesson. Expanding coverage must go hand in hand with stronger strategic purchasing, effective regulation, and sustainable financing. As we prepare for 2027 High-Level Meeting, we believe that our collective efforts should prioritize sustainable, adequate, fair, and efficient health financing, with particular attention to reducing out-of-pocket payments and strengthening primary health care. We must ensure that progress is measured not only by the number of people covered, but also by whether they can access the services they need without experiencing financial hardships. Georgia remains firmly committed to advancing this agenda, sharing our reform experience, and working closely with our fellow co-chairs, Japan and Thailand. and all partners to translate global commitments into tangible improvements in people's lives. Let us make 2027 high level meeting a turning point in accelerating progress towards health for all. Thank you very much for your attention. Thank you.

Thank you very much, honorable Michael Sari Veladze. Next time I'll get it right. Getting ready for the 2027 high-level meeting. It is now my distinguished pleasure to invite His Excellency, the Vice Minister of Foreign Affairs of Thailand, Mr. Vichavate E. Sarapatit. to address the meeting. You have the floor.

Thank you very much, and that was perfect. Excellencies, distinguished delegates, ladies and gentlemen, it is a great pleasure for me to join you at this seventh annual ministerial meeting of the Group of Friends of Universal Health Coverage and Global Health. At the outset, allow me to thank Japan and Georgia, my esteemed fellow co-chairs, as well as all our partners from WHO, UHC 2030, the UN Foundation, and our distinguished panelists for their contributions. The theme of our meeting, Accelerating Universal Health Coverage for a More Resilient World, is both timely and appropriate. it reminds us that the UHC journey is a continuity. It does not end once universal health is achieved. Attaining UHC is only the beginning. We must accelerate our efforts to sustain UHC and continue to drive it forward. In this connection, I have three points to make. First, we must ensure that UHC is truly equitable. Service coverage must provide access to services in accordance with the people's needs. It must also remove barriers that cause significant unmet needs, barriers such as distance, cost, limited availability, lack of health workers, or gaps in information and digital access. One appropriate solution is monitoring and evaluation, or M&E. Through effective M&E, along with reliable data, we can identify gaps which can be addressed for a more equitable UHC. Accurate information and data can inform our decision making on the procurement of medicines to suit local needs, ways to ensure appropriate distribution of health and care workers and tend to their welfare. and the utilization of digital technologies to support more targeted service delivery. Second, we must ensure that UHC is sustained, and this requires sustainable financing. This means health financing that allows UHC to effectively respond to evolving health needs. Thailand employs the SAFE, or safe approach to health financing, with the initial standing for sustainable, adequate, fair, and efficient. It is a practical means for advancing UHC to ensure that available resources are allocated fairly, used efficiently, and directed towards the needs of our people. Based on the safe approach, Thailand is pursuing reforms across our three public health insurance schemes. The first scheme focuses on civil servants health insurance with the aim to improve management of budgets and benefits. The second scheme is universal coverage where we focus on advancing value-based healthcare approaches. And the last scheme is the social security scheme, where we place an emphasis on strengthening payment and financing arrangements. My third point is that UHC must ultimately remain people-centered. Multi-sectoral and social participation have always been at the core of Thailand's UHC governance. A whole of government and whole of society approach allows us to better understand the needs of our people and reflect their perspectives in policy formulation and implementation. This also means recognizing the important role of the private sector as a partner in delivering UHC. Thailand has engaged private hospitals, pharmacies, and community-based providers in delivering health services. we have been working to move beyond hospital-based services towards community-based health promotion and disease prevention, building on existing primary health care and the support of village health volunteers. Excellencies, in the face of wide-ranging global uncertainties, we must strive for a more equitable, sustainably financed, and people-centered UHC which will be more resilient in these challenging times. As we move towards the high-level meeting in 2027, let us take this moment to renew our commitment, build on the progress we have made, and accelerate our action towards UHC for all. I thank you.

Thank you. Thank you very much, Honourable Minister, Mr. Thank you. Thank you for your kind words and for sharing the experiences and the learnings you are having in Thailand, which I think, as we heard from Georgia and from Japan, are really inspiring and bring lessons for other countries to assess whether it is adequate for the context or not. So we are now moving to listen to the honorable Dr. Bruce. Dr. Bruce Aylward from the World Health Organization. He is the Assistant Director General for Health Promotion, Disease Prevention and Care, and he will set the scene for today's discussion. Bruce.

Thank you very much, Madam Chair, Excellencies, ladies and gentlemen. It's a great pleasure to join everyone today on behalf of our Director General, Dr. Tedros. And first and foremost, we really just want to thank our co-chairs of the group of friends for bringing us together today, a year ahead of the march that we're all on now toward the next high-level meeting on UHC. It's a pivotal moment, and thank you for bringing us together. Madam Chair, you started the discussion today by thanking all of us for prioritizing UHC and indeed at the World Health Organization, this is our ultimate goal, health for all and achieving that through universal health coverage. But in that regard, of course, the world is off track and I think everyone here knows the numbers. Nobody has said the numbers so far, but 4.6 billion people at least on this planet don't have access to the most essential of services. And those who do try to access services find themselves in financial hardship, 2 billion people or more in that regard. And this striking, of course, those most vulnerable. And while things are difficult already and we already have a challenge, we are now, as we head into the march to the high-level meeting, in an even more challenging environment, of course. I don't need to tell the foreign ministers about the geopolitical challenges we face, of course. This is your day-to-day business. But in addition, we have, of course, the financial challenges. And again, we haven't used the numbers, but with a 40% decline in overseas development assistance for health, I mean, it's hard to get your head around what a staggering number that is, the impact it's having, and the people who are feeling that impact worse, of course, aren't those of us in the room today, but those that we seek to get access to with universal health coverage. As we look forward, the challenge is becoming even more frequent, with the frequent shocks that the world is feeling, which, of course, bring us together on Friday with the high-level meeting on pandemic prevention, preparedness and response. These increasingly frequent and unpredictable shocks are, of course, one more of the challenges on the road to UHC. In the face of all that, it is easy, Madam Chair, to despair, but, as we have just heard from the three ministers, There are solutions, countries are implementing those solutions, and countries are putting UHC in place when that political will is there, and that's being matched with the partnerships and the other elements, the financing needed to make it happen. And we're going to hear from a great panel today about some of those solutions and the actions that can make a difference. As we look forward to the high-level meeting next year, WHO is really emphasizing three priorities, and the ministers, our member state ministers, have made the job easy because they've already highlighted those priorities. But I'm going to reemphasize them, if I might take a moment to do that. First and most important, of course, is investing in primary health care, but also essential public health functions, as truly the foundations for what is the title of today's, right up on the screen there, a more resilient health systems and, as a result, more resilient world. In that regard, I just want to remind that UHC and health security, we always talk about how these are inextricably connected, inextricably linked, yet too often they are planned, financed and implemented separately. And if we want a resilient world, we have to bring these two pieces together. And the ministers have spoken to that point already. We can't achieve UHC if countries are continually buffeted by emergencies. We can't achieve health security unless we have resilient systems. These have to come together. But secondly, and again, everyone has spoken to this, we have got to advance more progressive, equitable and sustainable financing for health of course, fiscal pressures are growing everywhere. We've been speaking to that. External assistance is declining, the numbers I just mentioned, and countries now heavily dependent, so many communities, on out-of-pocket spending, which, of course, again, we heard there are solutions to that, as the Minister of Thailand and our Minister from Georgia already spoke to. But as we look forward, this is as much about spending better as well, and as we look forward, I also wanted to highlight in the context of the financing piece. There was a wonderful statement Dr. Tedros used yesterday in one of the panels he was on. He talked about a strategy or a plan without financing committed right up front is already a promise broken. And I think that's the way we have to think as we move forward with UHC. We have to do this with intention, ensuring that health is prioritized in public budgets and that spending is done in a way that actually reduces financial hardship, but especially the inequity that some of our panelists have spoken. The third big priority after the PHC, after the finance, of course, is accelerating the digital transformation and harnessing AI and these other technologies that we now have. These can be extraordinary assets to extend services, improve system performance, and ensure the most underserved are actually reached with better, more responsive people-centered care. But it's not going to happen by accident. Governments have an incredibly important role to play as we roll out these technologies to ensure robust governance, regulatory frameworks, etc. So with those three priorities, excellencies, thank you again to the group of friends for bringing us together. We have 12 months to ensure that we have a meaningful outcome of the HLM in 2027 and that we really start making real progress and moving from the ambition of UHC to the actual reality. Thank you.

Thank you, Dr. Bruce, the Assistant Director General for Health Promotion, Disease Prevention and Care at the WHO. Thank you for grounding our discussions and the shared priorities for advancing UHC and building resilient health systems in a world that is increasingly disrupted, but we are learning to navigate the disruption. I would like now to invite Member States who are here with us this afternoon to share their experiences and initiatives in moving the UHC agenda forward. And I would like to start with the Honorable Minister of Health of Spain, Monica Garcia Gomez. Please, you have the floor.

Thank you. Thank you very much, excellencies, colleagues. When we talk about universal health coverage, it's to speak about the right to health and the kind of society that want to build, a society that's able to protect from illness and from inequality, protect people from illness and inequality regardless of their background and their income. And for Spain, this conviction is part of our own democratic history. This year, we are marking 40 years of the General Health Act, is one of the greatest milestones of our democracy. And four decades ago, Spain decided to build a public, universal and equitable national health system on the premise that access to health care cannot depend on a person's background, income or social situation. And that principle still guides our policies today. In recent years, we have strengthened the guarantees of access to the national health system for foreign nationals. including those in irregular administrative situation, we have promoted a common vaccination strategy for migrants and refugees. We have expanded our public oral health package, and we have advanced equity in screening and prevention programs. All these measures point in the same direction, which is to ensure that the right to health generally reaches everyone. Universal health care gives us healthier societies, but yet the international reality remains deeply unequal. Around 4.0 billion people still lack full access to essential health services, and close to 2 billion face health care costs that can push their families into poverty. This is why the 2027 high-level meeting must serve to turn the commitments already made into concrete progress. It has to be the moment of really delivering. We also know that universal health coverage is part of our health security. The fight against pandemics begin long before the first outbreak appears, with strong public systems, strong primary healthcare, investment in prevention and surveillance, and a healthcare workforce that is sufficient. It is crucial. Our capacity to prevent and detect and respond to future emergency also depends that no one is left outside the health system. We need financing and resolve and sustained investment. Every state has a fundamental responsibility for the health of its citizens. We also need strong international cooperation and financing mechanisms that allow countries with fewer resources to make progress. Spain will continue to defend public and universal healthcare as one of the pillars of our democracy and our welfare state. 40 years ago, we decided that the right to health had to reach everyone in our country. Today, our commitment is to keep broadening it and to help it reach everyone in every country, leaving no one behind. Thank you very much.

Thank you. Yes, it should not just be in Spain, but around the world. Everyone needs good quality health. Thank you, Honorable Minister Monica Garcia Gomez. It is now my pleasure to introduce someone whom I don't know whether I'm chasing him or he's chasing me. Since yesterday, we have been, this is the third event we are together since yesterday. And I'm talking about the Honourable Minister of Health from Guyana, Honourable Dr. Frank Anthony. And before I give you the floor, I want to thank you for your leadership. as co-facilitator of the previous high-level meeting on UHC in 2023. Thank you for that, and we look forward to an even greater meeting next year. You have the floor.

Thank you very much, Madam Chair. First of all, allow me to congratulate Thailand, Japan, and Georgia for spearheading this initiative here. And for us, UHC, I think, is what the world should have. And we are far away from that because the stats have shown that, as was said, 4.6 billion people is still without that coverage. And a lot more people suffer because they don't have the financing. We should not let that deter us, however. We need to push on because this is a noble job that we have to do. And unless people can have access to good health, then the world would not be a better place. So we just need to make sure that we are able to do this. Dr. Bruce mentioned that there are three priority areas. We still have to maintain that focus on primary health care. you have to find the money to make sure that not only are we providing primary healthcare, but if necessary, secondary and tertiary care. And the new technologies that are available to us now in terms of digital technologies, AI and so forth, can help us to build more resilient systems and improve efficiency. And perhaps some of the savings that we get there can help us to, you know, put it into creating more health for people. In Guyana, we have been working on this strategy. And I'm proud to say that as a country, a small country, we have about a million persons, that we have been offering public healthcare free of cost to our population. And we have been expanding it, improving its quality, and making sure that more people can have access to that type of care. Over the last three years, we have added six new hospitals, 35 new health centers, and we have added actually about 4,000 new healthcare workers to help us to deliver quality care. And we have embraced digital transformation because we see that this can actually become more meaningful and help us. So one of the ways that we've been doing this is to use AI in imaging interpretation, such as X-rays, and that has been very successful because we just don't have enough radiologists. And so there are ways in which we can embrace the technology to help us to improve. And I think if a small country like Guyana can do this, then I'm sure other countries can do similar things. We're not perfect. We still have challenges, but we are working on those challenges. And I think by 2027, it would be a good place for us to assess where we are. And hopefully, we can move in a very strong way to 2030, when we can say that we have made great accomplishments in terms of UHC. Thank you.

Thank you, Dr. Frank Anthony. Your million precious people deserve all the efforts and dedication, commitments that your government is putting to protect their health. So Like you said, if Guyana can do it, other countries can do it. And we shouldn't think that small countries don't have complexities. Sometimes it's even more difficult to manage small countries. So I come from a small country. I know what I'm talking about. Thank you for pushing that. Who knows, maybe you'll be one of the countries that will have achieved universal health coverage by the time we get to 2030. Thank you for sharing your experience. I would like now to invite the Honourable Minister of the Republic of Armenia, Ms. Anahit Avanessian, to share her experiences with us. Honourable.

Thank you so much, Honourable Chair, dear colleagues, Excellencies. First of all, just to let me comment our co-chairs, WHO, and all the colleagues for commitment to this very important clause. And we see that the numbers shows us that we cannot stop and we need to go forward in global progress. And as we see here, big countries, small countries, if there is a political will and desire to change the system, to bring equity to our population, it is possible. I'm glad to share that Armenia is fully committed to 2030 year progress and this 2016 2026 was a pivotal year for us. We have provided a large benefit package to more than 60% of our population from the first year, and we are willing to continue the enrollment program. In two years, we will cover the whole population with this enlarged benefit package. Of course, all our strategies are addressing these core three pillars that Bruce shared and emphasized once more, and want to add that, of course, the first thing is the financing. And we are willing to change the systematic restructuring public health expenditures to directly relieve household out-of-pocket burdens, because as we see that in all countries, Globally, the cost of health is going up, and we need to do everything to ensure that people who need very essential medical services have this accessibility. Second, we need to cement primary health care as our non-negotiable anchor. True resilience begins at the community level. We are heavily investing in upgrading PHC infrastructure, ensuring that preventative screenings, chronic disease management, and essential diagnostics are available, accessible, and trusted by every citizen in every region. And third, we need to leverage digital innovation, AI, or service integration. We see that if we work together, we can maximize the efficiency and transparency, but it will not be by itself. So we all need to put a lot of effort to make this technological development, not vice versa for equity, but to help us to bring equity to all people. And of course, we invest a lot for building a nationwide healthcare ecosystem, where this platform streamlines patient pathways, optimizes resource tracking, and empowers clinicians with real-time data, cutting administrative waste and ensuring that public funds are directed precisely where care is needed. Dear colleagues, We believe that global frameworks and political declarations provide the map, but the domestic execution builds the road. So Armenia remains deeply committed to sharing our lessons learned, learning from our experiences, and working hand in hand with WHO, UHC2030, and all global partners. Let us use this road to 2027 to ensure that our health systems are not just surviving crisis, but reliably serving our people every single day, in times of calm and in times of shock. Thank you so much.

Thank you, Honourable Minister, for sharing your experience in Armenia and how you are positioning your country to achieve universal health coverage. Ladies and gentlemen, we have listened to experiences from six countries, Thailand, Japan, Georgia. Spain, Guyana, and Armenia. We are now moving into a segment of this afternoon conversation to listen to our esteemed panelists that are going to bring us to a lively discussion on how we can navigate the interconnected challenges we are faced with today and use the 2027 UHC high-level meeting to deliver strong commitments for accelerated action. Joining us today, we have Dr. John Honey, Rottingen, the CEO of Welcome Trust. Dr. Vanessa Kerry, WHO DG Special Envoy for Health Resilience and CEO of Seed Global Health, congratulations on your appointment. Dr. Cecilia Mondaca Shah, Vice President of Global Health Strategy and Foundation. Ms. Kathy Dane, CEO of the NCD Alliance, representative of the Coalition of Partnerships for UHC and Global Health. Ms. Yolanda Grace Tembo, UNICEF Youth Advocate. I would like to kindly and respectfully request that you use the minimum possible time. I know you have been given three to four minutes. If you can make it to within two to three minutes, then we can open the floor and then listen to a couple of other people before we call it a meeting. I will start with the CEO of Welcome Trust, Jon Honey.

Thank you, Madam Chair. Thank you all. Enable health systems. Insufficient domestic health investment not only constrains country ownership and health sovereignty at the national level, but also undermines countries' agency in the global health ecosystem and their progress to UHC. And I would say a lack of adequately designed mechanisms to build domestic financing capacity and plan for a responsible transition from external financing in a difficult time of reduction in aid is a key gap in our current global ecosystem. And this is exacerbated by the macro financial constraints, debts, illicit financial flows, inequitable borrowing costs for developing countries. So country ownership cannot simply mean asking countries to raise more revenue within the existing system. The wider financing architecture also needs to change so that countries have access to support that reflects their priorities and wider circumstances. That means differentiated external support with grant funding available for humanitarian settings and low-income countries, and then transition funding for middle-income countries moving towards sustainable self-financing. It also means moving away from multiple parallel funding streams and instead really align financing behind a single national plan, channeled through country systems and on budget. We heard it recently. as mentioned by the chair from the Accra Reset and said in Lusaka Agenda, Paris Agreement, and Paris Effective AIDS Agenda, and so forth. So for us at Wellcome, the broader question is not simply how we raise more domestic revenue, but how we can build a more coherent global health financing system that gives countries greater control over the resources and better enables them to finance their own health systems. And this will enable more countries to achieve UHC. However, on the street and in corridors in this week, we hear that UHC and PHC, primary health care, is not selling, and if I may, it's not sexy. We hear that it's not about maternal health or child survival. It's not about preventing, treating, or controlling infectious diseases. It's not about the new additional burden of NCDs emerging in also low-income country settings, and it's not about mental health and the need to support well-being of adolescents around all other countries. And that is, of course, not true. Because it's all about, it's about all of this, and it's about delivering that effectively, efficiently, and equitably with improved health outcomes for everyone. And we've heard this from the countries today. So thanks to Georgia, thanks to Thailand and Japan, and the broader Friends group. for leading us in understanding how we can achieve health for all. We hope that the high-level meeting next year can challenge this and actually make a change also in the global ecosystem and not only make individual countries responsible. Thank you.

Thank you. Thank you, Jonny, for giving us some great ideas on how we could strategize and make sure that health financing conversations around UHC could not only go beyond the traditional things we talk about, but then put into action for the strategic objectives. I would like now to turn to Dr. Vanessa Kerry. Again, congratulations on your recent appointment as DG Special Envoy for Health Resilience. If we expand the financing envelope, The next question is how to make those resources work better for countries. How can we achieve greater coherence and alignment across domestic and international financing?

Thank you, Honorable Chair and distinguished excellencies. And I want to thank Thailand, Japan, Georgia, and all the Friends Group for the extraordinary leadership on a critically important topic. Dr. Aylward mentioned at the beginning the 4.6 billion that do not have access to, you know, that are being left behind in this argument for having essential coverage. It's worth noting that number has essentially stayed the same every year that we have mentioned it for about 10 years. There's a fundamental piece that we have to realize that we are not making progress. And for me, the question is the how as much as just the what. We all know there needs to be more money, and we're doing, we're asking for more money at time where there is less money available on the table. 40% in one year, but 60% total since 2022 levels for health financing. And so the question isn't how much do we just raise more money, but it's how we are using the existing money and how we're bringing it together, both domestically and internationally. And I want to be very clear, there does need to be support, especially to lower income countries at this point. We cannot just walk away and say domestic financing is going to do this alone. But how we close that gap is going to be critically important. And it cannot be disease by disease, and it cannot be crisis by crisis, because that is where we have found that we're keeping that number the same, and we're continuing to not stand up to shocks. Health resilience is a question of how a health system delivers care every day, and also the system can hold at a time of emergency or crisis. We have not yet achieved that. And the question is not just who pays, but it is how. And so that means investing in health resilience is investing in shared foundations that allow health systems to deliver across existing burdens. When a woman dies in childbirth, it is a failure of a system. It is a failure to have the skilled midwife who's adequately trained, the blood in the blood bank, the surveillance system that did antenatal care. It is a failure of the whole piece and the financing that goes there, and so these are the markers that we should use about how we're making progress. At Seed Global Health, we've seen this concretely through our partnerships with governments, where we've been partnering towards national priorities to train health workers. And in a place like Uganda, for example, which has established a national health compact around government-defined priorities and is working to get external donors to give on to that budget, we are seeing that what sounds very procedural actually translates into lives saved. They had seven imported cases of Ebola with one of the second largest Ebola crisis in our history. And that's because they had the workforce, the systems, the investment, the national plan that built resilience that allowed them to respond adequately. Country ownership must move from just a discussion to a core operating model. And that means setting the priorities, but making sure that in addition to one national plan that we're working towards, that we are, when we're putting budget, all of our funding should go on budget to priorities. That doesn't have to necessarily be directly into the government coffer, but it does need to be with equal transparency and visibility, and governments need the ability to allocate, and we need one shared metric system of mutual accountability for donors and for the governments themselves. And that system of mutual accountability shouldn't just be looking at lives saved, but jobs created, economic growth and well-being, pathways in education, a larger sectoral impact, because that actually creates the narrative and the case for investment that's going to mobilize all of us or all those that aren't in this room with us and believe on this cause to understand the core value of UHC. for resilience of a nation, its security, its economic growth, its well-being, its future. And that's part of the argument that we are missing. So if we get this right, we are going to see that investments in UHC, PHC, and resilience are ultimately reinforcing an argument, meeting the ability to deal with NCDs, to deal with pandemics, to deal with maternal health, but coming from a systems and a horizontal lens first, because it's the same health worker, the same supply chain, the surveillance system that responds to all of those. It's time to stop triple counting each of those independent needs and see it from a health system as a single investment instead. Thank you.

Thank you. Thank you, Dr. Carey. Now, let's move to a little bit of reflection on our opportunity to leverage political processes. And I wanted to invite Dr. Shah to help us with that reflection. The PPR political declaration explicitly anchors preparedness infrastructure into universal health coverage and primary health care. How can the 2027 meeting on EHC high level meeting carry that integration from language into practice, particularly so that health workforce and surveillance assets can be planned and financed.

Thank you, Dr. Robel, and thank you so much for your leadership and for gathering us today. It is really an honor to be here. And I think we heard from Dr. Bruce earlier about how often people talk about UHC and PPR as two sides of the same coin. But what does it really mean when you say in practice, right? When we have health ministers really trying to deal with how they manage siloed budget lines for both service delivery and preparedness efforts, and how do they make that investment case for their finance ministers actually to continue investing on them? And what does it really mean for health workers? And I think we've heard before, I worked in Peru for many years on that frontline where you actually are the link between a community and your health system. And I think what we really need to think about is that in practice, it means by recognizing what we heard before, and I really want to emphasize, is that we spent so many, many years building, instead of ministries of health, ministers of diseases. And I think until we recognize that the workforce and surveillance and lab networks and primary care clinics that deliver essential services are the same ones that are the backbone for our emergency response. So we're not talking about UHC infrastructure, we're not talking about PPR infrastructure, we're talking about one system to build for both. And yet the reality, as we heard, is that many countries are still budgeting, planning and reporting this separately. And as we all know, in this financing landscape and with the budget really tightening, this approach is not going to work. And so for us and for countries to actually meet their population's needs and avoid disruptions and get the best return investment, really preparedness needs to be built on the foundations of primary health care. And so the political declaration on PPR is actually recognizing this, right? UHC and primary care really as fundamental, you know, to be able to create this resilient health systems that we all require day-to-day. But I think what we've also seen year after year is that this can just stay as a policy statement and really never become a reality. And what we actually have to show up is it has to be present in the way we plan, in the way we finance, in the way we measure health systems, in budget lines, legal mandates, and reporting structures. So I think the first step is really to make these gaps visible, because if we don't see them, and if we don't recognize actually how much we're investing on these capacities, we're not going to be able to identify and prioritize and actually be able to get the commitment that we need to advance this. So this accountability is especially important during this volatile finance and governance environment. And initiatives that we heard, Lusaka Agenda, the Accra Reset, are already pointing towards that country ownership that we really need with more effective global collaboration to bring decision making and resources closer to those who need them and we intend to serve. So 2027. And I'm going to end with that is, you know, on this high level meeting with UHC, we're all going to work and support and work towards is an opportunity to convert this momentum that we're living through in like actually long term action and to scale up these core capacities that are required for a health system to make smarter investments and to actually walk the talk on policy solutions that bring UHC and global health security under one umbrella. Thank you.

Thank you. Thank you. And talking about umbrella, UHC is often referred to as the umbrella because it serves an overarching framework that brings together distinct health initiatives and disease programs. Ms. Katidain, I would like to hear your perspective. What lessons can we take from disease specific programs to build more integrated people centered health systems that remain responsive to people's specific health needs across the life course.

Thank you first to the group of friends for convening this important event. As others have already said, health systems and vertical approaches to health no longer match the reality of health today or tomorrow. We're obviously facing a huge tsunami of NCDs and mental health. as well as the challenge of multimorbidity essentially being the norm rather than the exception. Yet, health systems have not really caught up to this reality. People are navigating fragmented, uncoordinated systems and services for different conditions, with varying quality of services across them. For some, it is free, while others are pushed into poverty due to out-of-pocket expenditure. That makes no sense. Drawing from the NCD response and the lessons that we have learned over the years, I would say there are four key messages for the high-level meeting next year on UHC. First and foremost, as others have highlighted, really strengthening primary healthcare is the foundation for integrated service delivery. It's very much the entry point for most people into the health system, and it can be the cornerstone for really preventing early, diagnosing early, and delivering much of the day-to-day management required for NCDs as well as many other health conditions. I think what's really clear is that disease-specific programs have demonstrated the value of community-based delivery and outreach, prioritizing prevention as well as health promotion. and shifting from specialised care to primary healthcare clinics with a one-stop shop approach, with screening, treatment and management of HIV, women and children's health and NCDs all under one roof. And as budgets become tighter for health, the imperative is even clearer for integrated approaches from an economic perspective, from a systems perspective in terms of leveraging the infrastructure, the health workforce for multiple conditions, as well as from a people perspective. Second, and linked to that first one, is that countries absolutely need to expand service coverage for NCD treatment and care. This is almost the kind of final frontier of universal health coverage, if you like. The WHO Global Monitoring Report on Universal Health Coverage from 2025 highlighted that in most countries, service coverage for NCDs is lagging behind the furthest. And so if we're really serious about making progress towards the UHC targets, countries will need to essentially progressively expand the UHC benefit packages to include aspects of NCDs, and we know what works in terms of the interventions and the treatment that's required. Thirdly, financing and financial risk protection. From an NCD perspective, this is a real challenge. Out-of-pocket payments are dominant and the main way that people and patients are having to pay, pushing whole families into poverty. Another important aspect of the financing side of things is shifting financing from the verticals to aligning financing around integrated primary healthcare investments that work for all. Finally, as Thailand highlighted in its intervention, we need to put people and communities at the centre of all this. We often talk about people-centred care, but but unless we are really engaging people and communities in shaping and co-designing policies, reforms and services, we will get nowhere. It is proven to ground services in the reality of communities and the challenges of people, ensuring that services are tailored to the greatest need and that they are really appropriate and reach the communities where they are, as well as really tackling inequities around the world. Social participation inclusive participatory governance and policy making for UHC and health. So I think the challenge is no longer defining what needs to be done. The task now ahead of the UHC high level meeting is much more about doubling down to fast track action and implementation to achieve health for all. So thank you.

Thank you. Thank you, Ms. Tain. I'm now moving to Miss Yolanda Tembo. And you are not last by design. You are last purposefully. You have heard from the people who are managing, building, thinking. the health systems we have now, but you belong to a generation that will need to carry this forward. UHC is, in addition to being technical, strategic, is a governance issue and a political issue. If we look at the education system, same problems. The population grew in such a way that services couldn't catch up. doesn't explain everything, but it's part of the problem. So from your perspective, what would you do with what you are going to inherit from us?

I believe when designing health systems, we should not design them for young people, but design them with young people. As young people, we are already using technology to find information, make content, learn and speak up. Let's use the same energy to make healthcare more accessible, trusted and human, because technology can connect us, but being heard is what builds trust. So my call to action is simple. Don't just invite us on the table. Give us a seat, give us a voice, and give us a part to shape solutions. Because we are not just the future of health. We are part of the transformation today. And as we have had these important conversations, I think we also need to ask ourselves what happens after this meeting ends. leaders, my fellow young people, we have spoken, we have heard, and we have gathered around the same table many times. Now we need to turn those conversations into action. The UHC cannot be transformed by words. alone. It requires commitment, implementation, accountability, and communities at the center of the solutions. Let us not measure progress by how many people are in the room, but by how many lives are going to change when we leave it. Because young people do not need to be invited into conversations. We need to see the conversations become actions in our communities. Thank you.

Thank you very much, Ms. Tembo. Nothing about us without us. We need to make sure that young people are not just at the table, but contribute to the decisions that are made. Thank you, the panelists, for your great contributions in addition to the country experiences. Now I have a big, big, big dilemma. We have only three minutes before the end of this meeting. It's true we started late, not a reason for us to finish late, but still I want to open the floor for contributions, questions, and suggestions as well. We have received a few expressions of interest already, and I would start with that. And I promise you with that list, then the three minutes will be largely exhausted. Therefore, I would like to kindly invite everyone to use just half a minute. Leave the background and the introduction, go straight to the point so that we can hear from as many people as possible. Is that okay? Can I go to India? Ms. Punya Srivastava, Vice Minister, Ministry of Health and Family Welfare.

Thank you for convening this forum. So India, the solution that India, or the approach that India has adopted is that we have over 180,000 primary health centers, which we call health and wellness centers. So we are focusing both on reproductive child health, but also in CDs, also mental health, and elderly and palliative care requirements. We are also trying to ensure that they all comply by our national quality assurance standards. I would also like to bring to your notice that we have the world's largest health assurance or insurance scheme. It's publicly funded. The bottom 40% of the population get support of over $5,000 annually for hospitalization expenditure. We have free drugs and diagnostic service initiative. Our Prime Minister's National Dialysis Program has brought about a significant dip in the out-of-pocket expenditure. But I would like to emphasize that tracking each person is important, and for that, we have our interoperable digital health ecosystem, and over 900 million citizens have their unique health identities. We have health facility registries and health professionals registries, which helps us develop longitudinal health records as well as provide continuum of care. We would like to offer solutions like our telemedicine and teleconsultation network, which has served over 497 million people and this combined with teleradiology, IAI enabled x-rays, our mobile health units, we are trying to reach each and every corner of the country.

Thank you.

So that's how we go about it.

Thank you. Thank you very much for sharing that. We know that NJ's and there is a lot you have to share with us. World UHC Day is coming and that is an opportunity for us to hear more from you, but thank you for sharing that experience. Hungary, Dr. Lakatos, Deputy State Secretary for International Cooperation. Less than a minute, please.

Thank you very much, Madam Chair. I just would like to make two points because of the time concern. I think the first, we need resilient health system built around strong primary health care and prevention. Universal health care coverage must mean more than formal entitlement. Prevention, early diagnosis, and treatment must actually reach people, regardless of their social or geographical circumstances. Hungary's strong childhood immunization system provides a solid foundation, while we continue working to improve screening and reduce inequalities in access. And the second point I would like to make, that a resilient health system requires sustainable foundations. adequate financing, a strong health workforce, and access to safe water, sanitation, and hygiene in healthcare facilities. And Hungary has made WASH a particular priority of our international engagement. Together with the Philippines and the WHO, we initiated the UN General Assembly resolution on sustainable, safe, and universal water, sanitation, hygiene, waste, and electricity service in healthcare facilities. Thank you very much.

Fabulous. Below one minute. Thank you. Thank you very much. Norwegian Ministry of Health and Care Services, Dr. Lene Vold, Director General, Department of Public Health.

I'll be quick as well. Just a couple of points. Universal health coverage with a focus on prevention and primary health care is a priority for Norway. And sexual and reproductive health and rights, as well as gender equality, must be fully integrated wherever relevant. Strong health systems are also essential for effective national and international health emergency preparedness, and universal health coverage must be built on robust primary health care and sustained investment in national health systems. And this requires increased domestic public financing, including through effective and equitable taxation. Where external financing is needed, donors and global health initiatives must align their support with national health plans, priorities, and budgets. We must avoid fragmented, duplicative, and parallel efforts. Norway has advanced this agenda through our engagement in the future of global health initiatives process and the Lusaka agenda. A central objective has been to ensure that global health initiatives support country priorities and national pathways to UHC. We must redefine roles, functions, and financing within an increasingly fragmented global health architecture. The WHO should emerge stronger and remain firmly at the center of a reformed global health architecture. Ultimately, we need a strong and coherent global health ecosystem that support national priorities, strengthens integrated and resilient health systems, enables a sustainable transition towards domestic financing, and safeguards the global public goods for health on which we all depend. And this is in the interest of us all. Thank you.

Thank you. Thank you very much. Unfortunately, we'll need to stop here because The room needs to be prepared for the next session. And I want to thank everyone for coming and staying committed, demonstrating how committed we are to UHC. I want to thank the co-chairs for their consistent support, WHO, Thank you very much, ladies and gentlemen. We are preparing for the celebration of UHC Day, and we will be reaching out to you for your participation on the way, on the roadmap to the high-level meeting next year. Thank you very much for your contributions.

My name is Luciana Carlos, I am the General.

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