Governance and participation in health

Just Governance for the World We Need: A critical cornerstone for an equitable and human rights-centred sustainable development agenda post-2015
Beyond 2015: February 2013

As debate intensifies on the future of the post-2015 sustainable development agenda, participating organisations in Beyond 2015 came together to develop this joint position paper to advance the concept of just governance. Just governance in the post-2015 era would first require a reconception of sustainable development goals not as needs and services but as rights accessible to all. Just governance likewise implies that the framework that replaces the Millennium Development Goals must include an explicit focus on equality and equity across all development goals, geared towards ensuring that those who are most marginalised participate in the benefits of development. Finally, just governance implies accountable governance for all relevant actors at all levels, based on a clear mandate regarding who is responsible for what post-2015 commitments.

Open For Development: Achieving Greater Post-2015 Results through an Open Design Process, Monitoring System and Data Portals
ONE, the Centre for Transparency and Accountability in Liberia (CENTAL), Development Initiatives, Fundar (Mexico), Global Witness, Global Movement for Budget Transparency, Accountability and Participation, Integrity Action et al: 2013

To further accelerate progress in the run-up to the Millennium Development Goal (MDG) deadline in 2015, and to ensure sustained progress beyond this date, civil society argues in this report that openness – especially transparency, accountability and public participation – must be at the heart of the post-2015 development framework. They call on the High-level Panel of Eminent Persons (HLP) to pioneer a high-impact agenda through a series of concrete recommendations to the UN Secretary-General. The recommendations should be guided by the promotion of: (1) an open process for soliciting and responding to the priorities and concerns of the world’s poorest people; (2) open, comprehensive and timely reporting on investments and outcomes in pursuit of the agreed development goals and targets, along with enhanced opportunities for citizen participation; and (3) the establishment of open data platforms to ensure that progress can be transparently tracked, lessons can be learned on a real-time basis and all stakeholders can be held accountable.

UN conference hears resounding call for human rights-based governance post-2015
Holland L: Centre for Economic and Social Rights, 4 March 2013

At the final meeting of the United Nations Thematic Consultation on Governance and the Post-2015 Framework, held in Johannesburg at the end of February 2013, participants argued that human rights and accountability must be placed at the heart of governance at the national and global levels. A high point of the meeting was the address by High Level Panel member Graça Machel, who spoke of the panel´s commitment to ensuring that issues of governance, human rights and inequality were central to the new post-2015 framework. There was wide consensus at the meeting that weak and unaccountable governance, including at the global level, is one of the key issues that must be addressed in a future framework, and that democratic governance must be predicated on respect for the full range of human rights. Ultimately, it will be up to the international community to decide the parameters of the successor framework when it gathers for the Millennium Development Goal Review Summit in New York in September 2013. In this article, the author calls on global civil society to promote rights-based governance in the run up to this important event, which is likely to prove pivotal for the future of international development.

CIVICUS World Assembly Report 2012: Montreal Civil Society Commitments for a New Social Contract
Delegates of the Eleventh CIVICUS World Assembly: November 2012

At the end of the Eleventh CIVICUS World Assembly, held in September 2012, the various recommendations made by delegates were analysed and distilled into 15 key commitments for civil society to implement as it seeks to work more effectively to promote equity and to challenge and change the rules of engagement between citizens, the state and other holders of power. Some of these commitments call for greater networking and smarter partnerships between formal civil society organisations and new social movements and social media technologies. The significance of encouraging local and voluntary participation, maintaining community connections and addressing marginalisation was highlighted. Other commitments argued for work within an equity and human rights based framework that includes sustainability and demands accountability to citizens, not external funders. Civil society also needs to be less dependent on governments and seek alternative financing models, like social and crowd-sourced funding. The commitments further call for civil society organisations (CSOs) to be innovative, strategic and have an assets-based approach, develop a better understanding of private sector involvement as well as develop CSO capacities for negotiation and analysis of power.

Civil society has the potential of finding new solutions to global challenges which are based on the principles of equity, participation and sustainability: An Interview with CIVICUS Secretary General, Dhananjayan Sriskandarajah
CIVICUS: 11 February 2013

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.

Constitution empowers Kenyans to take part in budgeting
Jaramba G and Changani S: Pambazuka News 615, 7 February 2013

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.

ONE launches campaign for transparency in post-2015 framework
ONE: February 2013

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 flip side to Bill Gates’ charity billions
Bowman A: New Internationalist Magazine 451, 1 April 2012

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.

The World Bank’s private sector financing arm doesn’t know the environmental and social impacts of nearly half its portfolio
Oxfam: 8 February 2013

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.

WHO’s engagement with non-state actors: the challenge of maintaining integrity and independence
Sangiorgio M: Health Diplomacy Monitor 4(1): 6-8

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.

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