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Joint learning and sharing best practices in Nagasaki: Building resilient health systems for communities and the world

• Dr.Kono, His Excellency Mr. Zahid Maleque from Bangladesh, His Excellency Dr. Lo Veasnakiry from Cambodia, distinguished guests, esteemed colleagues, it is my honour to deliver the keynote speech on behalf of the World Bank Group at this joint symposium with Nagasaki University. 
• We would like to express our appreciation to Dr. Kono, the president of Nagasaki University, and faculty members for their exceptional collaboration throughout the preparation process. 
• We would also like to extend the World Bank¡¯s gratitude to the Government of Japan, Nagasaki Prefecture, and Nagasaki City for supporting this event, which follows the G7 Health Ministers' Meeting convened here over the past two days.
• Yesterday, the G7 Health Ministers' Communique was announced, with Japan leading as the chair of the G7 Health Track. Japan has always been a strong advocate for Universal Health Coverage or UHC. We are very pleased to observe the continued commitment to UHC at the G7 meeting as we head towards the UN General Assembly High-Level Meeting in September. The communique emphasizes that in order to make tangible progress towards achieving UHC, implementation needs to be tailored to each country¡¯s circumstances and capacity to embed health in all policies.  It also notes that it is necessary to promote UHC initiatives based on the concrete needs and resources and scientific data of each country. We are encouraged by this statement as it aligns with the World Bank Group¡¯s efforts to support health systems strengthening, including through our Flagship Course and Joint Learning Network over the past two decades.
• Å·ÃÀÈÕb´óƬ Group is the largest investor in health systems in the world. We have a portfolio worth 34 billion US dollars that spans more than 200 projects across over 100 countries, but we need to do more. It is critical that we continue to invest in health systems that will advance UHC. The impacts of the pandemic on world economies, ongoing conflicts, rising inflation, and extreme weather events mean that many people still experience worsening health outcomes and struggle to access quality and affordable health care. Our experience with COVID-19 has taught us that the best way to prepare for and prevent any health emergency, including the next pandemic, is through strengthening health systems.
• In addition to investing in health systems strengthening, the World Bank is committed to advancing and sharing knowledge about health systems in coordination with partners. This joint symposium with Nagasaki University and the Flagship Course over the next three days exemplifies the World Bank's role in shaping knowledge and fostering partnerships.
• When the Flagship course was originally conceived by the World Bank, the World Bank, in its wisdom did not see it as a vehicle for our corporate priorities in health. Instead, the World Bank¡¯s health team reached out to experts in academia to develop a coherent framework that drew on the best global evidence on the performance and reforms of health systems. As a doctoral student at Harvard at the time the Flagship course was being developed, I well remember the fierce debates even amongst Harvard faculty and World Bank colleagues about key concepts that led to the Flagship framework. I still remember sitting outside Professor Michael Reich¡¯s office for my appointment with him, overhearing one such  debate between him and the other authors on some critical point in the book. I believed I missed my next class waiting for him to finish.  In the 17 years I have been working for the World Bank in health, I have grown to appreciate the value and continued relevance of the Framework to the challenges we face today. 
• Over the years, the Flagship course has contributed to strengthening health leadership around the world. It remains highly sought after by national governments and development partners. I would like to take this opportunity to thank the Government of Japan for their continuous support and welcome Nagasaki University as our partner in the course this week.
• The Flagship seeks to strengthen the technical capacity of health policymakers and promote a strategic and systematic approach to planning health system reforms that will support progress towards UHC. The Flagship courses draw from real-life examples, teaching participants how to think about health system reform in a systematic and practical way.? 
• The value of this course is that it considers the reality each country faces - its cultural, political, and ethical contexts - as well as its capabilities, and constraints in pursuing health system reform. The course does not offer a silver bullet, as no such solution exists, but it does offer stakeholders a framework for thinking critically about the challenges they face so they can apply global best practices in their own context.  
• With nearly three decades of successful Flagship teaching, there are thousands of alumni whose capacity to undertake health systems reform and improve performance was enhanced by the Flagship course.
• Today, we are proud to be hosting the Flagship minicourse here in Nagasaki, with more than 50 senior decision makers from over 14 countries including 9 Pacific islands, and 20 colleagues from Japan.  
• In this course you will learn how to take a broader health systems approach to policymaking, discuss health financing fundamentals, talk about domestic resources mobilization, and share experiences on how to make health systems more resilient. We will also explore opportunities to collaborate and learn from each other.
• Å·ÃÀÈÕb´óƬ is also a strong partner of the Joint Learning Network for Universal Health Coverage. This global network is country-led and country-driven, and for 13 years has brought together policymakers and practitioners from 36 countries - primarily low- and middle-income countries in Asia and Africa - to improve health system performance. The Network is a valuable platform for sharing lessons learned while implementing actual reform processes in dozens of countries worldwide. 
• Although we cannot simply transplant the success of one country to another, this joint learning process is one of the best assets we have accumulated over the past two decades. One that becomes even more critical as we approach the Sustainable Development Goals (SDGs) in 2030.
• The Network also has a long-standing partnership with the Global Financing Facility for Women, Children, and Adolescents, or GFF, where members from Africa and Asia deliberate on the shared challenges to domestic resource mobilization for health.  
• The Flagship and the Joint Learning Network are the two main learning programs offered by the World Bank in health systems strengthening. The Flagship focuses on foundational courses, policy dialogue opportunities, and capacity building, while the Joint Learning Network promotes peer-to-peer learning and problem-solving among countries as they start applying knowledge to real-world challenges. 
• Today¡¯s gathering, in the wake of the G7 Health Ministers¡¯ Meeting, and at an important center of learning on health systems, Nagasaki University, is testament to our common commitment to support global health initiatives. Our achievements would not have been possible without the continuous political and financial support from the Government of Japan. We have just witnessed the G7's renewed commitment to Health System Strengthening towards UHC, as expressed in their Communique. Å·ÃÀÈÕb´óƬ Group will continue to fully align with Japanese leadership on the Global Health agenda and look forward to fostering this newly established partnership with Nagasaki University. 
• Lastly, while it may not be customary to express gratitude to my colleagues at the World Bank during this speech, I cannot help but extend special thanks and appreciation to the World Bank¡¯s Tokyo representative, Mr. Yoneyama, and his colleagues. Behind the scenes, Mr. Yoneyama and his team have been instrumental in preparing for this event. 
• In conclusion, the World Bank Group remains dedicated to supporting countries in strengthening their health systems, achieving Universal Health Coverage, and addressing global health challenges such as pandemics and climate change. Through our partnerships with esteemed institutions like Nagasaki University and the Joint Learning Network, we aim to foster knowledge exchange and innovation that will lead to improved health outcomes worldwide.
• As we embark on this symposium and the Flagship Course, let us renew our commitment to building resilient, equitable, and sustainable health systems that serve the needs of all people, especially the most vulnerable. Together, we can make tangible progress towards achieving the health-related Sustainable Development Goals by 2030.
• Thank you for your attention, and I wish you all a fruitful and inspiring symposium.
   

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