The Kigali Summit, held in May 2018 in Kigali, Rwanda, brought together global health leaders, policymakers, practitioners, and advocates. Participants discussed future health opportunities and challenges while sharing innovations in public health to promote human well-being. It specifically addressed health policy in different fields, such as communicable and noncommunicable diseases, and the importance and practice of public health in low- and middle-income countries. This commentary reviews the policy impact of Kigali, exploring how the summit’s deliberations are influencing global health policies. Specifically, it examines the pathways related to discussions and outlines the directions for the next steps in global health programming. In doing so, we highlight the key themes that emerged during the summit and their implications for future policy initiatives. Ultimately, this analysis aims to provide a clearer understanding of how the outcomes from Kigali can shape global health efforts moving forward.
Overview of the Kigali Summit
The Kigali Summit was held to address our most critical global health issues, including malaria, vaccination efforts, and health system strengthening. This gathering aimed to foster collaboration among global health leaders and identify innovative solutions to enhance health outcomes worldwide. In addition to strengthening international cooperation, the summit aimed to increase health financing and promote new and innovative approaches to improve health around the world.
Notable features of the summit included:
- High-Level Panels and Discussions: The summit featured keynote addresses and discussions led by prominent heads of global health organizations, focusing on strategies against major infectious diseases, other health problems, and necessary health system reforms. Moreover, these discussions provided a platform for sharing insights and best practices.
- Commitments and Resolutions: In a flurry of high-profile commitments, delegates pledged greater funding for health initiatives, improved access to healthcare, and enhanced health equity. Consequently, these resolutions aim to create a more inclusive and effective health system.
- Innovation and Technology: Furthermore, innovation and technology were central topics of discussion, highlighting how new tools and approaches can effectively address pressing health problems. Participants explored various ways to leverage these advancements, thereby improving health outcomes on a global scale.
Key Changes in Global Health Strategies Post-Summit
1. Enhanced International Collaboration
One of the chief accomplishments of the summit was reaffirming the importance of international cooperation. The summit highlighted the need to cooperate internationally to work on global health concerns. This has resulted in:
- Widened Partnerships: The past decade has seen a spike in collaborations between countries, international organizations, and nongovernmental organizations (NGOs) that seek to harness resources, knowledge, and joint health efforts.
- Global Health Networks: New global health networks and coalitions have been created with specific health challenges in mind (eg, vaccination distribution and disease eradication), facilitating information exchange and coordinated action.
2. Increased Funding and Resource Allocation
The key issue of funding was top of the agenda in Kigali and was soon to precipitate big changes in how a large part of global health funding operates.
- Increased Funding: Most countries and organizations are committed to increasing funding for global health, including money for health programs and contributions to international health funds.
- Innovative Financing Mechanisms: The summit presented innovative financing mechanisms as a way to finance health, including, for example, the use of blended finance and public-private partnerships, which mobilize private investment through different mechanisms (including capital markets, funding stability, or reducing policy and regulatory barriers) to complement public funding.
3. Focus on Health Equity and Access
The idea of health equity became a driving force at the summit, shaping new policy and strategy:
- Equitable health solutions: Greater emphasis on developing health solutions that are equitable and available to all people across all populations (eg, marginalized and underserved) and developing strategies for mitigating disparities in healthcare access and outcomes.
- Strengthening health systems is vital, especially in low- and middle-income countries. Efforts to improve health infrastructure, enhance supply chains, and build healthcare workforce capacity have gained recognition and support.
4. Emphasis on Innovation and Technology
The summit’s call to action emphasizes that the 2018 Summit aims to build on the momentum from the first Summit by harnessing the power of innovation and technology to accelerate global health.
- Technology-driven solutions focus on developing digital health tools and telemedicine to dramatically improve health service delivery and expand access to healthcare. Governments and other organizations have invested in the area of technology-driven solutions for enhancing health systems.
- Research and Development: Priorities include increasing funding and promoting the development of research towards advanced health technologies. Participants desired to see new vaccines, treatments, diagnostic tools, and technologies developed to solve new emerging health challenges.
5. Commitment to Sustainable Development Goals (SDGs)
Directives to place health strategies more in sync with the Sustainable Development Goals (SDGs) were paramount at the summit:
- SDG alignment: Health targets are being more closely integrated with broader SDG goals, particularly those related to health and wellbeing, poverty reduction, and education, to ensure that health efforts are supporting overall sustainable development.
- Monitoring and Accountability: The summit emphasized their commitment to tracking progress toward the health-related SDGs and holding themselves and their peers more accountable for meeting those commitments. Enhanced tracking and reporting mechanisms are being rolled out to increase transparency and accountability.
Case Studies of Policy Changes Influenced by the Kigali Summit
Case Study 1: Vaccine Distribution in Africa
In the years since the Kigali Summit, several African nations have improved vaccine access. There has been a shift toward regional distribution networks with services that take into account the variable distance of many people from health centers, as well as the continuous engagement with rural communities to achieve the best vaccine coverage. Moreover, vaccine-preventable diseases, in developing countries, are diminishing.
Case Study 2: Health System Strengthening in Low-Income Countries
This commitment to HSS has led to billions of dollars invested in HIS in low-income countries. These investments have funded new health infrastructure, expanded and upgraded existing facilities, upskilled the health workforce, improved health information systems, and established better infrastructure for medical product supply chains and distribution systems. They have also enhanced vaccines, blood services, data, and decision support, and ensured commodity security and emergency preparedness and response, among many other activities. For instance, [Country] is implementing a national health system strengthening program that is enabling widened access by: building new healthcare facilities; training healthcare workers; expanding supply chains; and improving the delivery of quality healthcare services.
Case Study 3: Public-Private Partnerships for Health Innovation
This focus on innovation and technology has fuelled a series of public-private partnerships towards health innovation to foster the development of technology in [Country]. An alliance between the government and private sector has encouraged the launch of a digital health platform that utilizes multiple mobile phone applications for telemedicine services and health information to improve access to care, as well as remote diagnosis and treatment for the underserved.
Challenges and Future Directions
While the Kigali Summit triggered a fundamental shift in global health-policy initiatives, some of the challenges still face us:
- Continuity of Effort: Convincing all parties to remain committed to the ideas raised at the summit will be key to making this process work. That means ensuring that finances pledged and policy changes translate into real gains in health outcomes.
- Closing Implementation Gaps: The hard part of realizing global commitments is the ‘execution’ element. It’s easy to say that we want to leave no one behind. But how can governments and international organizations turn these global commitments into day-to-day decision-making by frontline workers in the Philippines and Zimbabwe? This is where implementation gaps occur – the distance between global agendas and the communities tasked with executing those agendas.
- Politics and Economics: Politics, the political process, and the economy are other stakeholders in the equation and can critically affect how new strategies for health are put in place. Here, it is necessary to navigate the constraints, particularly for highlighting the health priorities and making them stay at the forefront of the decision-making process in the face of other competing priorities.
One of the reasons the Kigali Summit mattered and still matters was because it shifted the trajectory and direction of so much about global health strategies: international and domestic funding, commitments to health equity, strategies for innovation, and overall alignment with the national and international commitments laid out in the Sustainable Development Goals. In the years since the Kigali Summit, its resolution has set the course for future global health policy agendas. At the summit, leaders outlined ambitious, comprehensive goals and are actively pursuing them. They are committed to ensuring that every country’s biomedical and health system develops evenly, so no nation faces a crisis without the chance to overcome it.
