In this interview, CIVICUS Secretary General, Dhananjayan Sriskandarajah argues that civil society has the potential to find solutions to our greatest global challenges based on equity, participation and sustainability. Civil society participation is now of greater significance as the development paradigm is changing faster than the key players realise. Official aid flows are becoming less important, new actors such as China and India are blurring the boundaries between development and business, and Big Business has moved in to take advantage of potential profits to be made from the 'aid industry'. He identifies two key mechanisms for responding to these changes and to ensuring progress on the development agenda: global commitments that involve all key actors and set real targets, and local action that finds new ways of involving citizens in shaping the development process. He also criticises current multilateral processes where the negotiating positions taken by diplomats do not reflect the wishes of their citizens. At these meetings, principles of human rights, democracy and environmental sustainability disappear from the agenda and narrow interests emerge that do not arise out of any popular mandate. He calls for new ways of holding governments to account for the positions they take on the international stage.
Governance and participation in health
Despite being some of the most taxed citizens of the world, Kenyans have so far had little say in how their economy is managed. The Constitution of Kenya (2010) has, however, given much impetus to ordinary citizens participate in the management and decision-making process in governance socially, economically and politically. Participatory budgeting is a mechanism that civil society can use to decide how to allocate part of a municipal or public budget. In collaboration with Fahamu, in September 2012, the Kwale community engaged in a needs assessment process after which the priority areas were identified before electing budget delegates at the ward level. Kwale County currently has 20 wards following the recent boundary demarcations by the Andrew Ligale-led Interim Independent Boundaries Commission. The 20 wards are in Matuga, Msambweni, Kinango and the newly created Lunga-Lunga constituencies. The ward delegates are charged with developing specific spending proposals which will later be presented to the community for validation. If the community approves of the proposals, the same are to be forwarded to the county government for consideration of implementation. If implemented, participatory budgeting is expected to raise the social and economic well-being of the two counties. Areas that are expected to benefit significantly include education, health, agriculture, roads and energy sectors.
The aim of the “Open for Development” campaign – and the global petition – is to persuade the High-Level Panel on the post-2015 Millennium Development Goals to ensure that openness forms the basis of the next global development framework. In this petition, ONE is calling for three things: 1. Openness in the design of the post-2015 framework to ensure that the post-2015 goals reflect people’s needs and priorities. 2. Openness in the monitoring of investments and outcomes so both funding and recipient governments collect information about what they spend and what they achieve in pursuit of the goals. 3. Openness in terms of making that information widely available and accessible so citizens, parliaments and the media can use it hold governments to account. The global petition urges world leaders to make sure the plan to end extreme poverty is specific, measurable and accountable.
The author raises questions in this paper about the operations of the Gates Foundation in public health and the impact of its work. These relate to the mechanisms for accountability and the considerable power in shaping health policy priorities and intellectual norms, in a context of a significant focus on technocratic solutions for the world’s health challenges and a demand for greater private sector influence in global health policy. Many health rights campaigners argue in contrast for a loosening of private interests, such as in intellectual property laws to increase access to technologies such as medicines - both in lowering prices through generic competition and in enabling innovation outside patent-hoarding companies.
Oxfam is calling for a fundamental overhaul of World Bank lending to financial markets actors, following the publication of an Ombudsman audit that revealed the International Finance Corporation (IFC), the Bank’s private lending arm, “knows very little” about the environmental or social impacts of its financial market lending. Oxfam is calling on the IFC to improve transparency and ensure its loans do not put poor people at risk of land grabs. The fact that many projects technically meet IFC policies ignores the finding that the policies themselves are fundamentally and fatally flawed, the article says, calling for a commitment by the IFC to review its approach to lending to the financial market. The audit shows that the World Bank must not adopt the IFC model, which fosters a culture of client self-monitoring, self-assessment and zero oversight. This would leave communities and the environment vulnerable to harm. The CAO audit also reveals that IFC policies are not industry best practice and that IFC is not above using legal loopholes in financial intermediary policies that other financiers would consider ethically dubious.
of the major challenges with regard to the World Health Organisation’s (WHO) engagement with non-state actors is maintaining the independence and intergovernmental nature of the WHO by protecting it from the influence of vested interests. This proved to be one of the major issues raised at the 132nd WHO Executive Board (EB) session held from 21-29 January in Geneva, Switzerland. Participants called for a more flexible accreditation mechanism to authorise non-state actor participation in WHO meetings and argued that WHO’s policy of engagement should be driven by its own interests and needs, and limited to those entities with which mutually beneficial cooperation is possible. Some countries called for a single policy of engagement, while others preferred two separate policies for NGOs and private commercial entities respectively. WHO’s Secretary General supported the single policy option. Participants called for further analysis, particularly concerning the implications of differentiation, a procedure that is perceived to risk exclusion. The Executive Board requested that the director-general conduct public web-based consultations, and convene two separate consultations - one with member states and NGOs, and the other one with member states and the private commercial sector - to support the development of the respective draft policies.
Five years remain for the achievement of the Millennium Development Goals (MDGs) and more needs to be done in Africa to meet the goals for governance and economic and social development. This document reports grassroots opinions from across Africa for shaping the policy agenda for the forthcoming decade, 2011–2020. African Monitor argues that the current development paradigm is exclusionary and does not reach the intended beneficiaries, hence their minimal access to basic services such as health, education, water and sanitation. The report provides a number of recommendations, proposing a values-based and sustainable development ideal to replace the current one and arguing that the MDGs need to be spelt out properly for the African and Western public, with the emphasis on public benefits. African governments should operate with financial transparency and civil society, professional associations, social movements and business entrepreneurs should be catalysts for engendering accountability. Agriculture, food security and the informal sector should also be prioritised by African governments and those who support Africa’s development.
This report documents perspectives from civil society organisations (CSOs) on the performance of the health sector in Uganda, against the background of the government’s Health Sector Strategic and Investment Plan III (HSSIP). Researchers found that most priority areas are in the integrated health systems, including health workforce development, increasing production and equitable deployment of health workers, increasing financial resources, strengthening the role of civil society in monitoring and accountability, and ensuring reliable access to medicines and health supplies. They call for the Ministry of Health to demonstrate its leadership, stewardship, and political will to push forward the recommendations not only elucidated in this report, but also in the HSSIP. Specific critical areas of intervention are also highlighted, including mental health and non-communicable diseases (including cancer and sickle cell disease), malaria, HIV and AIDS, health promotion and human rights. The authors recommend critical interventions in health financing, human resources for health, essential medicines and health supplies, and delivery of the Uganda Minimum Health Care Package (UMHCP).
From 29 November to 3 December 2010, the Tenth Meeting of the States Parties to the Mine Ban Treaty took place in Geneva, Switzerland, to discuss implementation of the global Mine Ban Treaty of 1997. Twenty-three states parties with significant numbers of landmine survivors presented their activities and the challenges faced so far in implementing the victim assistance actions of the Cartagena Action Plan (CAP), which is the plan devised to help countries implement the requirements of the Ban Treaty. The CAP stresses the need to improve quality of and access to services – including health and rehabilitation services – by disabled people. Reports indicated that, by the end of 2009, most survivors had not experienced significant overall improvements in quality or access to a range of necessary services, while nearly as many countries reported a decline in services, due mostly to deteriorating security and the downturn in the global economy. A number of east, central and southern African countries participated in the meeting. Uganda reported that its victim assistance plans had been revised or redrafted according to CAP principles, while the Democratic Republic of Congo reported drafting victim assistance plans that were pending adoption and also noted establishing a national commission for the rehabilitation of survivors. Mozambique reported that survivors are assisted through the national disability framework but failed to describe its efforts to assist persons with disabilities in any detail.
Amadasun reviews several of the important international mechanisms which channel aid to Africa, finding that the many instruments developed outside Africa are ineffective because they have design, accountability and ownership flaws. These criticisms apply to International Monetary Fund (IMF) programmes, debt relief and also budget support. Despite some changes in the way that the IMF and other international agencies operate – for example linking their interventions to Poverty Reduction Strategies – their fundamental way of working remains to pressure governments to take certain actions even at the expense of citizens’ views. Amadasun suggests that new mechanisms that originate in Africa, for Africa, stand a better chance of enabling decisions that empower and support large numbers of impoverished people. These mechanisms include the Pan-African Parliament (PAP) and the African Peer Review Mechanism (APRM). However these institutions are nascent and have yet to fulfill their full potential. To reach their potential these African bodies must develop authority to scrutinise the interventions of the international financial institutions (IFIs). These bodies will have to overcome several challenges. These include improving who is selected to represent African citizens, increasing public awareness and discussion of the bodies, and developing an independent source of financing for their own operations. If they overcome these challenges the PAP and APRM may be able to prevent international agencies from imposing policies and pressures from outside the region and enable a flourishing of democracy from below.