Equity in health is a long stated policy goal in Southern Africa, and some significant advances were made often through joint and complimentary action between the public health sector and communities. However, the health and health care gap between communities is still wide or widening, with differences based on gender, geographical area, income, access to public or private services, education and other factors. More recently,the combined impact of AIDS, structural adjustment, and real reductions in the health budget and in household incomes, has reversed many health gains. The quality of health care has declined and health workers and their clients have become demoralised. While these issues demand technical responses, reversing inequities depends in the main on social and political factors. This goes beyond the fact that social networking is important for service outreach and health seeking behaviour, and that social exclusion as a dimension of deprivation or poverty affects health outcomes. What we argue is that unless people affected by ill health have greater control over the resources needed for health care or to be healthy, equity goals will remain a dream. Equity without this socio-political dimension is not equity. What is the level of community control in health and health care? From our experience, we have found that participation of communities remains higher in an implementation role than in decision making, and health services are still weak in its responsive to community inputs. In part this is due to the lack of a sustained institutional framework for participation and inadequate investment in the capacities and systems needed to support it. Unfortunately as public health systems have themselves become weaker this too has undermined the possibility for meaningful participation. Declining primary health care, falling access to primary care services might generate more demand, but weakens the voice needed to direct resources towards these levels and to underserved communities. Individual fee charging approaches are also less effective in building collective participation than collective financing approaches, like taxes, insurance or even community pre-payment schemes managed at local level. Local communities have little control over budgets and planning, and decision making in health makes relatively weak and unsystematic use of local evidence, especially evidence on community preferences and priorities. Health workers often lack the communication, management, negotiation, facilitation skills to support participatory mechanisms. This situation is one of the motivations for the Community Working Group on Health, which covers 28 national civic organisations in Zimbabwe. It was formed as a network to add weight to our input into health policy negotiations and maximise the effect of our joint actions in the health sector. Since 1998 CWGH has been able to give voice to community health demands, to lobby, discuss and liaise with health providers, parliament and local government and make public policy more accountable to communities and build community action in health. In this way civil society has been promoted as a key player in health, with a regular presence in the deliberations of the parliamentary committee on health, and wit invitations to input into the health budget, and participate in new health policies. d Increased attention has thus been given to issues raised through the civics, like primary health care, the role of village health workers, accountability in public health funds and so on. We have begun work to set up or revitalise health centre committees to ensure that communities have a say in planning and management of their health services and to ensure civic participation in district and national decision making structures. The question we face, and posed by EQUINET more widely is, “Does participation by communities make any difference to the allocation of resources to and responsiveness of services to community priorities?” In Zimbabwe we are investigating whether community mechanisms such as health centre committees make any difference to equity,resource allocation to health centre and community level and to health system performance as indicated by availability of drugs, staff and inclusion of community priorities. More widely, the Equinet Governance and Equity Research Network (GovERN) co-ordinated through TARSC (Zimbabwe) and Chessore (Zambia) aims to assess the impact of participation in governance mechanisms for health on resource mobilisation, integration of community preferences in health planning and equitable resource allocation. The research will be used to identify common positive features of governance systems that enhance participation, effective tools for integrating community evidence and preferances into health planning, and assess their impact on resource flows within the health sector and communities towards public health priorities. Although Zimbabwe faces serious problems in health and health care exacerbated by a massive food crisis, serious decline in health services, rising poverty, political polarisation and social instability, the basic issue remains that people and civil society groups that organise them are the root of the solution.