PIH presents vision for comprehensive delivery strategies to achieve UHC in Astana

Author: Maia Olsen, NCD Synergies
November 1, 2018

On Wednesday October 24th 2018, Partners In Health hosted a one-day side meeting “Health Systems and Delivery Strategies to Achieve Universal Health Coverage,” on the sidelines of the Global Conference on Primary Health Care in Astana, Kazakhstan which was held later in the week in honor of the 40th Anniversary of the Declaration of Alma-Ata.

At this ambitious and wide-ranging meeting covering a number of topics related to the delivery of universal health coverage (UHC), PIH looked to push the global conversation around UHC to better focus on pathways to expand quality care delivery. The discussion, at various points, delved into how to best encourage donors and support governments to invest in health systems strengthening across all levels of the health system, rather than only committing to a more minimal primary care package.

Askar Yedilbayev / Partners In Health
Dr. Gene Bukhman discusses the challenges of funding an NCDI Poverty agenda in a high-level plenary session on health financing, which also featured Dr. Joia Mukherjee (moderator), Dr. Mariam Claeson from the World Bank, Dr. Marijike Wijnroks from the Global Fund, and Dr. Angela Kichaga from the Financing Alliance for Health. 

On behalf of the NCD Synergies team and the Program on Global NCDs and Social Change at Harvard Medical School, Dr. Gene Bukhman presented twice in the meeting. During a high-level plenary session on “Health Financing: Success Stories and Strategies for the Way Forward on Achieving SDG3”, Dr. Bukhman followed presentations from the World Bank’s Dr. Mariam Claeson, Director of the Global Financing Facility (GFF), and Dr. Marijike Wijnroks, Chief of Staff at the Global Fund, by presenting gaps in financing for NCDs and injuries among the very poorest and posing critical questions around how best to integrate NCDI conditions into existing financing mechanisms like the Global Financing Facility.

Maia Olsen / Partners In Health
Dr. Reginald Fils-Aime from PIH Haiti discusses the importance of including mental health within UHC strategies on a panel with NCD Synergies director Dr. Gene Bukhman and Dr. Isabelle Citron from the Program on Global Surgery and Social Change at Harvard Medical School, moderated by Dr. Joel Mubiligi, Executive Director of PIH Rwanda. 

Later in the day, Dr. Bukhman was part of a breakout session panel moderated by Dr. Joel Mubiligi on “Integrating NCDs and Mental Health into Comprehensive Healthcare Delivery”, alongside Dr. Reginald Fils-Aime, a mental health specialist from PIH/Zanmi Lasante in Haiti, and Dr. Isabelle Citron from the Program on Global Surgery and Social Change at Harvard Medical School. All three panelists made strong calls to action around ensuring that it is well understood within the global community that NCDs, injuries, mental health, and the full spectrum of surgically-amenable conditions need to be a well-integrated part of efforts to achieve UHC, well beyond primary care.

In Dr. Bukhman’s comments, he also emphasized leading priority-setting efforts with severity and equity and that the work of integrated care teams at 1st level hospitals will be essential to achieving an expansion of care for NCDs and injuries among poorest populations. Dr. Fils-Aime and Dr. Citron concluded the session powerfully by emphasizing that like NCDs, interventions within mental health and surgery can also address significant gaps in the disease burden and results in care delivery can be achieved even in settings with minimal resources.

Partners In Health Kazakhstan
PIH colleagues visiting from Rwanda, Mexico, Haiti, Liberia, Sierra Leone, Navajo Nation, and a number of clinical programs meet with clinicians from the PIH Kazakhstan team and Astana City TB Dispensary during an October 2018 site visit in Astana, Kazakhstan.

Joel Mubiligi / Partners In Health
At the invitation of the Astana City TB Dispensary, visiting teams from across Partners In Health’s global programs prepare to visit with patients undergoing treatment for multi-drug resistant tuberculosis during an October 2018 site visit in Astana, Kazakhstan.

Maia Olsen / Partners In Health
Dr. Askar Yedilbayev and colleagues from the Astana City TB Dispensary present progress in TB care supported by the government of Kazakhstan and partners like PIH Kazakhstan to a delegation of visiting teams.








On Thursday 25th 2018, while some of our colleagues represented Partners In Health at the Global Conference on Primary Care, the NCD Synergies team was able to take part in site visits of the government of Kazakhstan’s multi-drug resistant tuberculosis efforts with our PIH Kazakhstan colleagues in Astana and Almaty. Getting a chance to better understand the progress that the government of Kazakhstan and our colleagues have exhibited over the last twenty years was an inspiring close to an enriching week – much can be learned from Kazakhstan’s leadership to support patients struggling with a challenging and neglected disease like MDR-TB.