Save the Children UK. Consultation on Principles Guiding Joint Programming and a Funding Platform for Health System Strengthening. Recognising the limitations of disease-specific approaches and the shortcomings of a fragmented international architecture for health, Save the Children UK welcomes the process of harmonisation among the World Bank, the Global Fund and the GAVI Alliance of their support to health systems strengthening programmes and activities. Save the Children supports the establishment of a joint funding and programming platform for health system strengthening by the three financiers of international health in line with the principles of the International Health Partnership and related initiatives (IHP+). In order to make the new joint mechanism completely aligned to the IHP+ principles, Save the Children recommends that: · the new entity operates in full transparency and openness, with a governance structure open to civil society at both global and country level; · in addition to striving for harmonisation among funding agencies, the new platform explicitly adopts the objective of better alignment to national needs. In order to achieve true alignment with national priorities, Save the Children endorses the recommendations recently published in the Lancet on the desirable features of a global fund for health systems and the health MDGs. Grounding our policy position in the framework of the Convention for the Rights of the Child, Save the Children calls for the adoption of a rights-based approach by the global health community, and especially its main financiers. In some low-income countries translating this vision into a reality requires challenging the model of national financial autonomy and short-term financial sustainability of health programmes, principles incompatible with achieving the health MDGs and which have in the past been pre-conditions to secure World Bank grants and loans. The new funding platform should therefore have these characteristics: 1. Focus on measurable improvements in health outcomes, with performance evaluation framework that looks at coverage with services relating to reproductive, maternal, newborn, and child health, HIV, malaria and tuberculosis, other infectious and non-communicable chronic diseases, quality of care, and fairness of financial contribution to the health system. 2. Clear mandate and funding criteria that address key bottlenecks in health systems (including long-term predictable support for recurrent costs, such as salaries for health workers, medical supplies, and infrastructure maintenance). 3. Rights-based approach to health supported by new model of globally shared financial sustainability, explicitly rejecting the principles of fiscal space as a pre-condition to deliver development assistance for health. 4. Capacity to disburse resources beyond public system and beyond health sector when this represents appropriate and cost-effective approach to improve health outcomes. 5. Governance and accountability structure open to civil society at global and country levels. 6. Flexibility to provide support to public sector on-budget or off -budget, in form of grants and not loans, unconstrained by financial ceilings. 7. Independent mechanism that judges proposals exclusively on technical grounds. In addition Save the Children recommends that, while the three agencies work together on the establishment of a joint platform that leverages their respective comparative advantages, the leadership of the World Health Organisation in providing guidance and technical assistance on health policy and health systems is incorporated into the bylaws and structure of the new platform. The World Health Organisation has over the years consistently championed the causes of primary health care, sustainable development in health, and adopted an evidence-based perspective in its recommendations. Its involvement is therefore necessary in brokering knowledge and in providing guidance and impartial technical advice at the global and country level on the establishment and then the implementation of the new funding platform for health systems. Save the Children welcomes this positive and exciting development in aid architecture for health, and commits to engaging constructively in the next stages of the consultation.