Towards a Strategy for Reorienting Technical Cooperation in the five Priority Countries

1. Towards a Strategy for Reorienting Technical Cooperation in the fivePriority Countries Office of the Director of Program Management Washington D.C. February 2004

2. Elements of the Strategy • Redefining the nature of technical cooperation with the priority countries. II. Articulating PAHO/WHO’s technical cooperation with the broader agenda of international technical and financial cooperation III. Translating the reorientation into the Planning, Monitoring and Evaluation process (CCS,AMPES) and new managerial practices IV. Assessing the level of resources, both regular and extra-budgetary, that are needed for reorienting technical cooperation V. Determining the staffing and staff development needs for advancing the reoriented strategies VI. Building alliances and partnerships and mobilizing resources to support the intensified cooperation with priority countries.

3. Elements of the Strategy • Redefining the nature of technical cooperation with the priority countries. II. Articulating PAHO/WHO’s technical cooperation with the broader agenda of international technical and financial cooperation III. Translating the reorientation into the Planning, Monitoring and Evaluation process (CCS,AMPES) and new managerial practices IV. Assessing the level of resources, both regular and extra-budgetary, that are needed for reorienting technical cooperation V. Determining the staffing and staff development needs for advancing the reoriented strategies VI. Building alliances and partnerships and mobilizing resources to support the intensified cooperation with priority countries.

4. REDEFINING THE NATURE OF TECHNICAL COOPERATION • Centered in intensified support to National Health Development • Emphasis in the strengthening of processes that can contribute to the attainment of the MDGs, specially the health related MDGs • Driven by the need of building institutional capacity at country level

5. REDEFINING THE NATURE OF TECHNICAL COOPERATION • Inspired by the pursuit of reducing inequities in health status and in access to health care • Anchored in a renewed vision of HFA and PHC • Guided by the defense of human rights, the building of citizenship and the extension of social protection in health • Linked to poverty reduction initiatives

6. MDGs and NHD • National health development goes beyond the MDGs. • However, MDGs are important milestones of progress in terms of human development as well as relevant indicators of the effectiveness of the health system in addressing key health problems that are amenable to intervention

7. MDGs and NHD • The relevance of the health related MDGs depends on the level of national health development in the country: if the baseline of the indicators is low a reduction by 2/3 in 2015 is virtually impossible or extremely costly.

8. MDGs and NHD • Work on the health related MDGs cannot be reduced to an exercise of monitoring of indicators done by the Agencies of United Nations. • It has to be a process that has a high degree of ownership on the part of the countries.

9. MDGs and NHD • The monitoring of the MDGs should strengthen the national capabilities of generation of information, of situation analyses, and of formulation and evaluation of social and health policies and not only be an endogamous exercise of reports of the Agencies of United Nations.

10. MDGs and NHD • The perspective of equity should be present in the analysis and monitoring of the actions necessary for attaining the MDGs.

11. MDGs and NHD • The goals are referred to national averages. We should highlight , among national actors and international development partners, the need for disaggregating the indicators so geographical areas and neglected social groups that should be targeted for special interventions can be identified.

12. MDGs and NHD • We have to address other issues in addition to the monitoring of the health related MDGs, such as: • the nature and cost of the interventions that countries need to put in place for attaining the health related MDGs • the necessary scaling up of health systems for carrying out the interventions as well as the economies of scale of scaling up • the internal and external investment flows that are required and the process for mobilizing them

13. The “missing middle” • Strengthening Public Health Infrastructure • Extending social protection in health • Developing the health workforce • Developing the operative capacity of health services

14. Elements of the Strategy • Redefining the nature of technical cooperation with the priority countries. II. Articulating PAHO/WHO’s technical cooperation with the broader agenda of international technical and financial cooperation III. Translating the reorientation into the Planning, Monitoring and Evaluation process (CCS,AMPES) and new managerial practices IV. Assessing the level of resources, both regular and extra-budgetary, that are needed for reorienting technical cooperation V. Determining the staffing and staff development needs for advancing the reoriented strategies VI. Building alliances and partnerships and mobilizing resources to support the intensified cooperation with priority countries.

15. Articulating with the broader agenda of international and financial cooperation • Greater profile of health in the PRSPs • HIPIC and Debt restructuring • CCA-UNDAF • Subregional and Regional Integration processes • SWAPs, Budget Support or Sector Support by multiple partners • Governance, democracy, human rights and social cohesion • National action plans to fight HIV-AIDS (multisectoral) • Policy dialogue and lending operations of IFIs and other bilateral and multilateral partners • GFATM projects

16. HLF on Health MDGs (January 2004) • Countries should have a single process leading to one “MDG-responsive” PRSP. • In order to facilitate this process, countries should be encouraged to prepare health sector strategies with investment plans based on well-documented needs and costing scenarios. • Members of the HLF will ask the next Development Committee to request that the World Bank and IMF incorporate into their joint assessments of PRSPs explicit reference to and review of progress toward MDGs. • The UN Secretary-General will be asked by the Millennium Project to endorse this recommendation to the Development Committee

17. Elements of the Strategy • Redefining the nature of technical cooperation with the priority countries. II. Articulating PAHO/WHO’s technical cooperation with the broader agenda of international technical and financial cooperation III. Translating the reorientation into the Planning, Monitoring and Evaluation process (CCS,AMPES) and new managerial practices IV. Assessing the level of resources, both regular and extra-budgetary, that are needed for reorienting technical cooperation V. Determining the staffing and staff development needs for advancing the reoriented strategies VI. Building alliances and partnerships and mobilizing resources to support the intensified cooperation with priority countries.

18. Translating into PME process and new managerial practices • Country based and regionally driven CCS process • CCS focused on the key issues and main bottlenecks derived from the reoriented nature of technical cooperation • CCS properly followed by changes in existing BPBs, formulation of new BPBs, managerial practices, staffing patterns and staff development actions

19. Translating into PME process and new managerial practices • “One single” country program budget • Clear identification of the backstopping functions of centers , regional units and HQ units in support to the Priority Countries Strategy, CCSs and program budgets ( not only money or visits). • Defining the organization-wide and country program specific managerial realignments necessary for advancing the strategy

20. Elements of the Strategy • Redefining the nature of technical cooperation with the priority countries. II. Articulating PAHO/WHO’s technical cooperation with the broader agenda of international technical and financial cooperation III. Translating the reorientation into the Planning, Monitoring and Evaluation process (CCS,AMPES) and new managerial practices IV. Assessing the level of resources, both regular and extra-budgetary, that are needed for reorienting technical cooperation V. Determining the staffing and staff development needs for advancing the reoriented strategies VI. Building alliances and partnerships and mobilizing resources to support the intensified cooperation with priority countries.

21. Assessing level of resources • Priority Countries and reallocation of regular resources (Regional Budget Policy) • Allocation of extra budgetary resources • Mobilized by PAHO • Mobilized by WHO • Absorptive capacity

22. Elements of the Strategy • Redefining the nature of technical cooperation with the priority countries. II. Articulating PAHO/WHO’s technical cooperation with the broader agenda of international technical and financial cooperation III. Translating the reorientation into the Planning, Monitoring and Evaluation process (CCS,AMPES) and new managerial practices IV. Assessing the level of resources, both regular and extra-budgetary, that are needed for reorienting technical cooperation V. Determining the staffing and staff development needs for advancing the reoriented strategies VI. Building alliances and partnerships and mobilizing resources to support the intensified cooperation with priority countries.

23. Staffing and staff development needs • Mapping of competencies and staffing pattern required at country level • Identification of the necessary personnel management issues that need to be addressed to attain the desired pattern of competencies and staff profiles • Definition of intensified staff development needs instrumental for the advancement of the strategy.

24. Elements of the Strategy • Redefining the nature of technical cooperation with the priority countries. II. Articulating PAHO/WHO’s technical cooperation with the broader agenda of international technical and financial cooperation III. Translating the reorientation into the Planning, Monitoring and Evaluation process (CCS,AMPES) and new managerial practices IV. Assessing the level of resources, both regular and extra-budgetary, that are needed for reorienting technical cooperation V. Determining the staffing and staff development needs for advancing the reoriented strategies VI.Building alliances and partnerships and mobilizing resources to support the intensified cooperation with priority countries.

25. Alliances, partnerships and resource mobilization • Aid effectiveness and harmonization • Strengthening of resource mobilization and partnerships efforts at country level (decentralization of ODA) • Interagency coordinating committees for national health development • PRSPs and related operations • Regional and country coordination with IFIs operations

26. Alliances, partnerships and resource mobilization • UNICEF-UNFPA -PAHO joint action • UNDG guidance to country teams • UN mechanisms and MDGs • UNAIDS mechanism and processes • Support to CCMs and preparation and execution of GFATM projects

27. CODA • This strategy is an expression of the Country Focus Initiative developments of WHO and contributes to its furthering • Concerted action at regional and country level is necessary. It is not only a redefinition of the Country’s BPB. • We need to identify the specificity for each country and draw an aaction plan with clear milestones for the next two biennia.