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The IDA Health Window Is Gaining Traction: Four Responses to the Proposal
I recently proposed an IDA Health Window as the future of multilateral global health financing. The proposal is beginning to gain traction. It has received interest (mostly positive, but always with good, constructive challenges) from colleagues associated with the Accra Reset; Africa CDC and the African High-Level Ministerial Committee on Global Health Architecture Reform; low- and middle-income country health and finance officials; key high-income donors including the UK, France, Germany, and Norway; the World Bank and the Asian Development Bank; the World Health Organization, Wellcome Trust, and civil society.
Towards a responsive health system and equitable access to quality RMNCAH services
Indonesia’s vast geography and sociocultural diversity shape the delivery of reproductive, maternal, newborn, child and adolescent health (RMNCAH) services in ways that are both enabling and challenging. Across provinces, significant variation has been observed in how services are planned, resourced, and delivered. These variations in service standards and quality are felt daily in the lives of women, newborns and adolescents. Despite these challenges, progress is visible. National estimates show a drop in maternal mortality ratio, from 331 to 140 per 100 000 live births since 2000, signaling improvements in care quality and access. Fertility has stabilised and contraceptive use has grown, yet unmet reproductive health needs persist, and adolescent pregnancies continue to reflect early marriage and limited access to youth-friendly services.To better understand how Indonesia’s health system has evolved under decentralisation, the Ministry of Health, supported by World Health Organization (WHO), United Nations Population Fund (UNFPA), the United Nations Children’s Fund (UNICEF), IPAS and the Asian Development Bank (ADB), conducted a joint external review of RMNCAH programmes. This review draws on multiple sources of evidence, including existing literature, policy documents, national health system data, as well as field visits to six selected provinces to represent Indonesia’s geographic and administrative diversity. During the field visits, review teams observed service delivery in health facilities, spoke with health workers and local leaders and met mothers and families to understand how RMNCAH policies are operationalised. One of the challenges identified was the management of low birthweight (LBW) infants, a major contributor to neonatal deaths, under resource constraints. One midwife described a severe case of extremely LBW twins, one stillborn and the other died after three days of care. She recalled how the surviving infant struggled to swallow and may not have received breast milk, while simultaneous emergencies required the team’s attention, affecting the care provided to the infant.A subsequent review of the case by the district health office revealed insufficient antenatal care, fragmented maternal medical history due to population mobility, referral delays, limited provider capacity in neonatal intravenous access and a heavy workload that constrained proper newborn monitoring. These insights informed recommendations to strengthen both system-wide and service-level responses. Since the early 2000s, Indonesia’s decentralisation initiative has given much of the responsibility for funding, staffing and managing health services to regional governments. While the Ministry of Health sets national clinical standards, daily management of public health facilities falls under regional authorities through the Ministry of Internal Affairs. While this arrangement allows services to be tailored to local needs, it also depends heavily on local capacity for planning, budgeting and management. Health facilities and district health offices are better positioned to translate national priorities into local action when they have access to consistent technical support, helping health workers manage resource constraints and infrastructure gaps.The complexity of Indonesia’s health system governance is no easy feat to navigate. Understanding these dynamics is essential to strengthening policy, improving coordination and ensuring more equitable access to services across Indonesia. Under the leadership of Ministry of Health, recommendations from this exercise will be key in guiding the nation’s roadmap to an equitable and quality health system for RMNCAH.Written by Edit Oktavia Manuama, National Professional Officer (Maternal, Newborn, and Child Health), and Jessie Yunus, National Professional Officer (Gender, Rights, Equity, and Disability Inclusion)
Forum on harnessing Artificial Intelligence for health equity
Register to this forumOver the past decade, artificial intelligence (AI) has significantly evolved in complexity, performance, and utility. Its integration across a wide range of industrial sectors has accelerated, with healthcare emerging as one of the most transformative sectors. In this sector, AI has enabled high-impact applications – from enhancing the speed and accuracy of disease diagnosis and supporting clinical decision-making, to strengthening public health initiatives such as disease surveillance and workforce optimization. Moreover, AI holds immense potential to empower individuals, enabling them to take greater control of their personal health and well-being. Yet the central question remains: Who benefits, who is at risk, and do these innovations close or widen health inequities? While the potential of AI-enabled applications is substantial, many countries have approached their adoption with caution. This hesitancy stems from concerns about risks and benefits, including model bias, data breaches, privacy violations, and the erosion of professional skills due to over-reliance on AI. Additional barriers include inadequate data infrastructure and a lack of robust evidence on the most effective forms and interfaces of AI to enhance service delivery and system performance. Moreover, the rapid rise of Generative AI has introduced a heightened urgency for the development of comprehensive governance and ethical frameworks. The Asian Development Bank (ADB) Health Practice Team and Digital Sector, in collaboration with the World Health Organization (WHO) Regional Office for the Western Pacific, are convening the Forum on Harnessing AI for Health Equity on 25–26 March at ADB Headquarters. Senior health officials from 16 developing member countries (DMCs), alongside leading researchers, innovators, and policymakers from across Asia and the Pacific, will engage in discussions on how AI can be governed, financed, and scaled to deliver healthier lives for all. The forum is funded through the High-Level Technology Fund with support from the Government of Japan. Objectives The two-day forum aims to:Identify high-impact, evidence-based health AI use cases suitable for resource-constrained settings and map out a pipeline for potential supportIntroduce and validate the WHO's policy guidance on minimum necessary ecosystem for countries and institutions to self-assess readiness for AI adoptionObtain initial commitment from participating stakeholders to join a pilot regional initiative focused on data/model sharing for a priority health challengeEndorse a prioritized set of actionable policy recommendations focusing on governance, regulation, and sustainable financing necessary to scale high-impact health AI use cases in resource-constrained settings Target participants The forum will convene participants from 16 ADB DMCs including Bangladesh, Bhutan, Cambodia, Cook Islands, Fiji, Indonesia, Lao People's Democratic Republic, Mongolia, Nepal, Palau, Papua New Guinea, Philippines, Sri Lanka, Thailand, Uzbekistan, and Viet Nam. In addition, health system leaders and practitioners, private sector technologists, academic experts, representatives from civil society organizations, development partners, and philanthropic institutions engaged in AI for Health from Australia, the People’s Republic of China, Japan, Malaysia, New Zealand, Singapore, and the Republic of Korea will also be invited. SessionsDay 1 (25 March)Session 1: AI Use Cases for the Care Continuum: Improving Access and QualitySession 2: Adopting a risk-based approach for AI use case prioritizationSession 3: Establishing the Minimum Ecosystem for Implementation Risk ManagementSession 4: Future-Ready Health Workforce: Building Competency for Human-AI CollaborationDay 2 (26 March)Session 5: The Political Economy of AI in Health: Understanding Stakeholder Interests and their Impact on EquitySession 6: AI and Health Financing: Supporting Fair Coverage and ProtectionSession 7: AI Regulation and Oversight: Pathways for Different RealitiesSession 8: The Way Forward – Building Alliances and Regional Partnership How to registerThe forum will be held in a hybrid format. In-person attendance is by invitation only, while livestreaming of the forum will be available to the public. To register, please complete this form on or before 24 March 2026.Event organizers / partnersAsian Development Bank (ADB)WHO Regional Office for the Western Pacific High-Level Technology Fund (HLTF)ContactAkihito WatabeHealth Specialist, SD3-HSDawatabe@adb.org Jae Kyoun KimHealth Specialist, SD3-HSDjkkim@adb.org