Uniting partners to accelerate Pakistan’s progress towards health-related SDGs

Pakistan signed the UHC2030 Global Compact in 2018, committing itself to advancing universal health coverage (UHC) as part of the country’s efforts to achieve health-related Sustainable Development Goals (SDGs).

The Government of Pakistan recognizes the fundamental role of primary health care (PHC) in achieving UHC. Considering the dire need for PHC reforms and the Government’s recent commitments, international partners came together to agree on the Global Action Plan for Healthy Lives and Wellbeing for All (GAP) agenda. Pakistan has been prioritized by SDG3+ GAP for intensified support under accelerator themes one and two which relate to PHC and sustainable financing for health [1].

How did Pakistan do it, and how did the WHO Secretariat support Pakistan?

Considering the Government of Pakistan’s commitment towards SDGs and UHC, the WHO Country Office in Pakistan took the lead in establishing the SDG3+ GAP Coordination Committee to enhance and harmonize coordination among partners engaged in the health sector. Further, two technical working groups for PHC and sustainable health financing were established to provide technical support to the Committee.

Members of the SDG3+ GAP Coordination Committee in Pakistan are comprised of WHO (Chair and Secretariat), the United Nations Children’s Fund (UNICEF), the United Nations Population Fund (UNFPA), the World Bank Group, the Joint United Nations Programme on HIV/AIDS (UNAIDS), the Global Financing Facility (GFF), Gavi, the Vaccine Alliance (Gavi), and the Global Fund to Fight AIDS, TB and Malaria (GFATM). The SDG3+ GAP Coordination Committee and related technical working groups convene regular meetings to align and accelerate their support, monitor progress, and exchange information on recent initiatives. During the last meeting of the Coordination Committee, partners acknowledged that the committee is providing a useful forum to exchange information for alignment and committed to remain engaged for provision of coordinated support to the government.

The WHO Country Office in Pakistan is leading SDG3+ GAP coordination at country level. WHO organized a high-level PHC4UHC mission which united eight SDG3+ GAP partners in Pakistan from 1-5 March 2021 to review the status of PHC and sustainable health financing and advise on a model of care to ensure effective implementation of the UHC-Benefit Package. The mission was led by the Director of Universal Health Coverage and Health Systems, WHO Regional Office for the Eastern Mediterranean. The mission concluded with a high-level national “PHC4UHC” Forum, where representatives from federal and provincial levels as well as the eight GAP partners signed a Joint statement in support of enhancing PHC towards UHC in Pakistan.

After endorsement of the UHC-Benefit Package/Essential Package of Health Services (EPHS) in October 2020, SDG3+ GAP partners supported the government in the development of provincial/area specific essential package of health services documents. Three provinces have already endorsed the packages and the remaining provinces are expected to endorse it soon.

WHO is providing technical and financial support to the Government of Pakistan through a Canadian PHC grant for piloting a PHC-Oriented Model of Care in two districts for implementing the UHC-Benefit Package. The project support is envisaged to be provided over a four-year period in a phased manner. The first phase, for 14 months (1 April 2021-31 May 2022), is under implementation in Islamabad Capital Territory and Charsadda. This phase primarily focusses on integrating a holistic health approach and inter-sectoral collaboration to optimize all health interventions while addressing social determinants of health. All SDG3+ GAP partners and government stakeholders were engaged in brainstorming the key elements of the proposed Model of Care and WHO is regularly exchanging progress with partners in technical working group meetings convened periodically.

Successful implementation of the Model of Care will present an example which can be replicated in other districts for implementation of the UHC-Benefit Package to expand UHC coverage in the country. Given the size of the Pakistani population of around 230 million, success of the model in general and UHC expansion, in particular, is crucial in helping to achieve one billion more people benefiting from UHC globally. 

 [1] GAP Accelerator One addresses the theme of PHC. Effective and sustainable PHC is a cornerstone for achieving the health-related SDG targets and progress on the other accelerator themes. It provides a platform for accessible, affordable, equitable, integrated, quality primary care and public health services for all, near where people live and work, linked to higher levels of care.

GAP Accelerator Two deals with the theme of sustainable financing for health. Sustainable financing enables countries to reduce unmet need for services and financial hardship arising from out-of-pocket payments by establishing and progressively strengthening systems to mobilize adequate resources for health and to spend them better to deliver more health for the money.