Mapping the future of global health governance: Insights from the Lusaka Agenda

The global health landscape continues to evolve, with pressing challenges requiring innovative solutions and coordinated efforts. The Lusaka Agenda of December 2023 marked a pivotal moment, outlining five critical shifts in health systems to achieve universal health coverage (UHC) and strengthen primary health care (PHC). In response to this agenda, hera undertook a project that mapped potential pathways for advancing these priorities, offering actionable insights for global health policy reform.

hera’s engagement involved synthesizing primary and secondary data to guide the global community on the next steps post-Lusaka Agenda. The study aimed to:  

• Identify platforms capable of driving coordination, advocacy, and accountability.  

• Align recommendations with health system strengthening and UHC goals.  

• Evaluate partnerships to understand their strengths, risks, and limitations in implementing the Lusaka Agenda’s shifts. 

The final report, published by Norad, serves as a foundation for dialogue and decision-making on global health governance reforms.  

Understanding the Lusaka Agenda 

At its core, the Lusaka Agenda sets out five key shifts for the global health system: 

1. Expanding Universal Health Coverage (UHC): Ensuring health services are accessible and affordable for everyone, everywhere. 

2. Strengthening Primary Health Care (PHC): Making primary healthcare the foundation of health systems, promoting preventive care, and improving access to essential services. 

3. Improving Global Health Partnerships: Strengthening collaboration among governments, donors, global health initiatives (GHIs), and civil society. 

4. Advocacy and Accountability: Promoting transparency, ensuring global commitments are met, and holding stakeholders accountable. 

5. Health Systems Strengthening (HSS): Addressing the systemic challenges that hinder effective healthcare delivery. 

The challenge now is to translate these broad goals into actionable strategies that can drive meaningful change across all levels of health systems.

hera’s multifaceted approach to advancing the Lusaka Agenda

The Lusaka Agenda’s five shifts aim to redefine global health priorities. hera’s analysis provides a roadmap for translating these shifts into tangible outcomes, ensuring alignment with UHC and PHC objectives. The recommendations emphasize the need for adaptive and inclusive platforms that foster collaboration, accountability, and equity. hera’s methodology combined rigorous data collection, stakeholder engagement, and strategic analysis to produce actionable recommendations:  

1. Stakeholder Consultations: Through interviews with 20 global health informants—including representatives from governments, global health initiatives, donors, and regional bodies—hera captured diverse perspectives. This informed the evaluation of current platforms and the formulation of forward-looking options.

2. Thematic Analysis: By examining critical issues and lessons from past reform processes, hera identified key success factors and challenges. The analysis emphasized operational coherence, country ownership, and accountability as essential elements for progress.

3. Strategic Recommendations: The report outlines a “mix and match” approach, presenting pathways for stakeholder engagement at global, regional, and country levels. Concrete strategies for improving partner alignment, addressing global health initiative (GHI) behaviors, and strengthening country ownership were central to the findings. 

Explore the full report here: Stewardship of the post-Lusaka Agenda: Issues and Options.