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.
Governance and participation in health
The flip side to Bill Gates’ charity billions
Bowman A: New Internationalist Magazine 451, 1 April 2012
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.
Citizens’ agenda for Africa’s development
African Monitor: 2010
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.
Civil society organisations: Perspectives and priorities
Action Group for Health, Human Rights and HIV/AIDS: January 2011
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).
Report on Tenth Meeting of the States Parties to the Mine Ban Treaty: 29 November to 3 December 2010
International Campaign to Ban Landmines: December 2010
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.
The potential roles of African Union Mechanisms in aid accountability and effectiveness
Amadasun AB: Reality of Aid Network, 2010
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.
Distinguishing between civil society groups is divisive and will weaken cohesion among different sectors: An interview with Lewis Mwape of the Zambia Council for Social Development
CIVICUS: 20 December 2012
If implemented, new provisions governing the registration of civil society organisations (CSOs) and non-governmental organisations (NGOs) under Zambia’s NGO Act will be extremely problematic, according to Lewis Mwape of the Zambia Council for Social Development. Under the law CSOs and NGOs must re-register every five years, creating a major administrative workload. Prior to registering, they must explicitly state their sources of funding and proposed activities, which Mwape regards as impractical. The NGO Act also greatly narrows the definitions of CSOs and NGOs, no longer recognising labour unions, faith-based organisations and professional groups. Distinguishing between civil society groups is divisive and will weaken cohesion among different sectors, says Mwape. Advocacy and human rights organisations can also be subjected to arbitrary and/or discriminatory application of the law, and the law gives the Minister too much discretionary power. Zambian civil society has initiated a campaign calling for the amendment of the law but they are facing major difficulties in accessing and mobilising the hundreds of NGOs and CSOs based in less accessible areas to engage in the campaign to re-evaluate the law.
Online Civil Society Consultation on the Global health Theme of the Post-2015 UN Agenda
Global Health South (The Alliance of Southern CS in Global Health)/CHESTRAD in partnership with Campaign 2015+ and the Call for Action on Universal Health Coverage With Support from the Health Thematic Group, Post 2015 UN Agenda: January 2013
From the 9th of December 2012 to 11th January 2013, an online consultation on global health Theme in the Post-2015 UN Agenda was conducted. Researchers targeted a total of 785 institutions across partner organisations and networks and attracted participation from over 180 organisations active across 48 countries, notably community based and regional organisations in Africa, which constituted 69.5% of all participants. A number of key messages emerged. 1. There is no strong support for one health goal framed around Universal Health Care. 2. There is a very clear emphasis given to prioritising the needs of women and children. 3. There are strong calls to broaden the focus of the goals towards health systems strengthening and away from disease- and issue-specific interventions. 4. Strong support is given to the importance of a multisectoral action for health, alongside recognition of the need to address the socio-economic determinants and the rapidly evolving economic realities between countries. 5. The health-related post-2015 development goals should take into account the context in which action will be taken, and must be founded on guiding principles that are adaptable at the national level, and flexible for local implementation. They should also be based on shared, coherent understanding that enables global level solidarity and differentiated accountable action where necessary and appropriate.
Further details: /newsletter/id/37581
Project Matchstick
HDI Youth Marketers: January 2013
In this 2012 survey, the opinions on their social conditions of 1,360 young South Africans from various backgrounds of the country were gathered. Individuals across age groups (kids, teens and young adults) from Gauteng, KwaZulu Natal and the Western Cape responded to the survey and expressed their opinions on numerous issues and attributes relevant to South African society. Generally, respondents expressed high levels of nostalgia towards the country’s previous leaders, specifically Nelson Mandela, and were critical of the current leadership. Across all the regions, crime was ranked as the country’s biggest problem, and education was cited repeatedly as being crucial to ensure the future success of young South Africans. Freedom of expression was highlighted as a key issue throughout the interviews, yet many young people felt they were not given the opportunity to be heard. Many respondents argued that relying on the government to bring about change is not good enough, and expressed a desire for youth to play a greater role.