While global health diplomacy (GHD) has attracted growing attention, accompanied by hopes of its potential to progress global health and/or foreign policy goals, the concept remains imprecise. This paper finds the term has largely been used normatively to describe its expected purpose rather than distinct features. This paper distinguishes between traditional and “new diplomacy”, with the latter defined by its global context, diverse actors and innovative processes. The authors point to need to strengthen the evidence base in this rapidly evolving area.
Governance and participation in health
What is ‘global health diplomacy’? A conceptual review
Lee K and Smith R: Global Health Governance V(1) (Fall 2011), 21 November 2011
A systematic review of the literature for evidence on health facility committees in low- and middle-income countries
McCoy D, Hall J and Ridge M: Health Policy and Planning December 8, 2011
This paper presents the findings of a systematic literature review of: (a) the evidence of HFCs' effectiveness, and (b) the factors that influence the performance and effectiveness of HFCs. Four electronic databases and the websites of eight key organizations were searched. Out of 341 potentially relevant publications, only four provided reasonable evidence of the effectiveness of HFCs. A further 37 papers were selected and used to draw out data on the factors that influence the functioning of HFCs. The review found some evidence that HFCs can be effective in terms of improving the quality and coverage of health care, as well as impacting on health outcomes. However, the external validity of these studies is inevitably limited. Given the different potential roles and functions of HFCs and the complex and multiple set of factors influencing their functioning, the authors argue that there is no ‘one size fits all’ approach to CPH via HFCs, nor to the evaluation of HFCs. However, there are plenty of experiences and lessons in the literature which decision makers and managers can use to optimize HFCs.
A ‘New Deal’ for engagement in fragile states
International Dialogue on Peace-building and State-building: Organisation for Economic Co-operation and Development, December 2011
On 1 December 2012, the final day of the Fourth High-level Forum for Aid Effectiveness held in Korea, the International Dialogue on Peace-building and State-building – consisting of the G7+ group of 19 fragile and conflict-affected countries, development partners and international organisations – signed a ‘New Deal’ of development architecture for fragile states. It builds on vision and principles from a range of international agreements, including the Paris Declaration on Aid Effectiveness, the Accra Agenda for Action and the Millennium Development Goals, and will be implemented in a trial period from 2012 to 2015. Signatories have agreed to use five peace-building and state-building goals (PSGs): foster inclusive political settlements and conflict resolution, establish and strengthen people’s security, address injustices and increase people’s access to justice, generate employment and improve livelihoods, and manage revenue and build capacity for accountable and fair service delivery. They further commit to support inclusive country-led and country-owned transitions out of fragility, using the PSGs to monitor progress, and to support inclusive and participatory political dialogue. Mutual trust will be fostered by providing reliable external funding, managing resources more effectively and transparently, and aligning resources for results.
Daily lives and corruption: Public opinion in Mozambique
Transparency International: November 2011
Between 26 April and 5 May 2011, 1,000 people were surveyed in Mozambique by Transparency International. The data were weighted by age, gender and region to represent the population of 5,852,280 Mozambicans. The study found that 68% of people reported having paid a bribe in the past year. Fifty-six percent of respondents believed that corruption had got worse, with the remainder evenly divided in their perceptions of corruption having improved or remained the same. More than a third of those using health services or education reported that they had to pay a bribe in the 12 months before the survey was conducted. Of these about 60% had to pay a bribe to ‘speed things up’, 20% had to pay a bribe to avoid problems with authorities, and the remainder had to pay to receive a service to which they were already entitled. Thirty-seven percent paid a bribie less than US$30, while 42% paid a bribe between $30-99. The minimum annual wage ranges from $54 for farm workers to $173 for financial sector employees.
Donor transparency and aid allocation
Faust J: German Development Institute, December 2011
In recent years, the transparency of foreign aid has received substantial attention among aid practitioners. This analysis shows the impact of political transparency in donor countries on those countries’ formal promotion of aid transparency and on their concrete aid allocation patterns. Political transparency as measured by standard corruption indices not only impacts on the engagement of bilateral external funders (donors) in the International Aid Transparency Initiative. Differences in political transparency in donor countries also explain a large part of their varying aid selectivity patterns. External funders with higher levels of political transparency allocate aid more according to recipients’ neediness and institutional performance.
New working group to investigate transparency in CSOs and NGOs
International Aid Transparency Initiative: 29 November 2011
The International Aid Transparency Initiative (IATI) Steering Committee has approved the creation of a CSO-led working group to discuss application of the IATI standard to the work of civil society organisations (CSOs) and non-governmental organisations (NGOs) or not-for-profit organisations. Building on the Accra Agenda for Action and IATI outcomes to date, the working group will examine the IATI standard in the light of existing CSO and NGO accountability frameworks and self-regulatory mechanisms. It will take into account the particular characteristics of CSOs and NGOs as development and humanitarian assistance actors, as well as the different operating environments that shape CSO responses to demands for greater accountability and transparency. The working group’s primary objective is to encourage the participation of civil society and not-for-profit actors in IATI by developing practical proposals on guidelines and tools to assist CSOs who wish to publish IATI-compatible data. Early priorities include the identification of information that is already being shared or could be reported by CSOs in the short- and medium-term and the development of protocols for exclusions of data where appropriate on privacy or security grounds.
Questioning old certainties: Challenges for Africa-EU relations in 2012
Mackie J, Goertz S and de Roquefeuil Q: ECDPM Policy and Management Insights Series 3, 2011
With a range of new development actors at hand, such as China and Brazil, Africa’s position has been strengthened, according to this paper. Africans must decide which partner can best serve their various interests. The authors argue that the European Union (EU) is a good candidate to support capacity in financial administration, regional integration, good governance, and peace and security. To be recognised as such, the EU should stand by its partnership approach and avoid unilateral initiatives towards the continent. However, Africans may perceive EU support as coming at too high a price in terms of values conditionality. In that case, it may choose other partners to rely on. Some applaud an EU move to increase conditionality in its overseas development assistance (ODA). The depth of the euro crisis suggests that after a decade of rising European ODA, the world is now entering a period in which EU ODA will stagnate, though some member states may still manage increases. Further details regarding the Green Climate Fund to cover the costs of climate change also need to be clarified. At some stage Europe, along with other developed parts of the world, will need to meet that obligation. Funding requirements for environmental and other global public goods remains high, but the EU is unlikely to be able to contribute as much as in the past. Old certainties therefore are changing and those who have relied on European support will have little choice but to look elsewhere.
The WHO Global Code of Practice on the International Recruitment of Health Personnel: The evolution of of Global Health Diplomacy
Taylor A and Dhillon I: Global Health Governance, Vol. V, Issue 1, 2011
The May 2010 adoption of the World Health Organization Global Code of Practice on the International Recruitment of Health Personnel created a global architecture, including ethical norms and institutional and legal arrangements, to guide international cooperation and serve as a platform for continuing dialogue on the critical problem of health worker migration. Highlighting the contribution of non-binding instruments to global health governance, this article describes the Code negotiation process from its early stages to the formal adoption of the final text of the Code. Detailed are the vigorous negotiations amongst key stakeholders, including the active role of non-governmental organizations. The article emphasizes the importance of political leadership, appropriate sequencing, and support for capacity building of developing countries¹ negotiating skills to successful global health negotiations. It also reflects on how the dynamics of the Code negotiation process is evidence of an evolution in global health negotiations amongst the WHO Secretariat, civil society, and WHO Member States.
Assessing community perspectives of the community based education and service model at Makerere University, Uganda: a qualitative evaluation
Mbalinda SN, Plover CM, Burnham G, Kaye D, Mwanika A, Oria H et al: BMC International Health and Human Rights 11(Suppl 1): S6, 9 March 2011
The authors of this study evaluated community-based education and service (COBES) programmes at Makerere University College, Uganda, from a community perspective. A stratified random sample of eleven COBES sites was selected to examine the community’s perception of the programmes. Key informant interviews were held with 11 site tutors and 33 community members. Communities reported that the university students consistently engaged with them with culturally appropriate behavior and rated the student’s communication as very good even though translators were frequently needed. They also reported positive changes in health and health-seeking behaviours but remarked that some programmes were not financially sustainable. The major challenges from the community included community fatigue, and poor motivation of community leaders to continue to take in students without any form of compensation.
At G20 Summit, civil society demands 'People First, Not Finance'
Fatoorehchi C: Inter Press Services, 4 November 2011
Led by the slogan ‘People First, Not Finance’, the People’s Forum held in November raised that the G20’s ‘cosmetic’ economic solutions to the global recession in 2008 would do little to ease the cyclical problems of the financial system, adding that much deeper, structural changes were required to address global inequity. It argued that the G20 will only increase the ‘financialisation’ of this world, instead of fundamentally changing it. The forum raised that social movements ranging from the ‘Occupy’ protests in Wall Street in the United States to the ongoing demonstrations in Tahrir Square need to ‘coordinate, exchange views' towards this deeper structural change.