A group of current and former African finance ministers discussed ways to improve the management of public health systems at an early October roundtable convened by Harvard School of Public Health (HSPH) and the African Development Bank. Fifteen ministers met in Washington, D.C.—where they were also attending the annual meetings of the World Bank Group and the International Monetary Fund—as a follow-up to discussions begun last April through HSPH’s Ministerial Forum for Ministers of Finance, part of the Ministerial Leadership in Health (MLIH) program.

The MLIH program, a joint initiative of HSPH and Harvard Kennedy School, aims to recognize and promote transformational leadership among health ministers. The goal is to strengthen health systems, improve health care delivery, and boost health outcomes. The Ministerial Forum for Ministers of Finance extends the MLIH program by focusing on innovative thinking in health financing and on advancing the notion of health as a key component of national economic development.

Participants at the roundtable discussed how public health systems have suffered over the past two decades because of low levels of national investment; how health systems are prone to inefficiency, waste, and corruption; and the importance of boosting public health systems so that African countries can achieve universal access to public health services, ensure affordability of care, and achieve sustainable health financing. A healthy nation is more productive, the ministers agreed—and increasing productivity is key to economic development.

The ministers discussed a variety of strategies that might improve health systems, including:

• Streamlining supply systems management by using the same technology that stores like Walmart use to keep their shelves fully stocked

• Centralizing drug and equipment procurement to reduce costs and improve control

• Instituting pay-for-performance to improve productivity and accountability among health workers

Michael Sinclair, MLIH executive director, said the goal of the Ministerial Forum for Ministers of Finance is to encourage the ministers to improve efficiency and value in the health and social sector, thus potentially making it easier to justify increased national investment in these areas. “Finance ministers can play a crucial role in shaping public policy,” he said.

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