The Role of Civil Society in Global Health Activities

1
The Role of Civil Society in Global Health
Activities

• Milton B. Amayun, MD, MPH
• Sr. Technical Advisor, The Hope Initiative
• World Vision International
• CCIH Annual Conference
• May 27, 2007

2
Civil Society - Definition

• Organized activity that acts at the interface
  between government and the general population
• Civic action not sponsored by the state
• Organizations created and run by the people for
  the people
• Separate from both government and commercial
  sector

3
Usual processes

• Voluntary
• Self-governed
• Self-sustained
• Follows democratic processes
• Usually citizen-led, service-oriented, nonprofit
• Outside state control

4
What civil society includes

• NGOs, CBOs
• FBOs, including the Church
• Professional associations
• Trade unions
• Communities affected by targeted conditions,
  e.g., AIDS, TB, Malaria, disability

5
Why civil society?

• Normally not dependent on political changes
• Reaches marginalized populations much better than
  government institutions
• Outside the government bureaucracy can be more
  efficient
• Church more sustainable than government
• Promotes diversity
• Encourages accountability

6
Weaknesses of civil society

• Issues driven many do not last long
• Often fragmented coordination needed
• Uneven levels of transparency and management
  expertise
• Technical expertise varies
• Financial sustainability always at risk
• Can be entangled in politics

7
Civil society participation in the Global Fund to
fight ATM

• Fundamental to GFATMs new public-private
  paradigm
• Required in proposal preparation and Country
  Coordination Mechanisms governance
• Represented in GFATM Board by 3 members
• Basic element of accountability
• Adds different (citizen-driven, non-governmental)
  perspectives to programs

8
Examples of civil society involvement in GFATM

• Fiduciary control Principal Recipient in many
  countries
• Service delivery Implementor or sub-recipient
  for projects
• Member of civil society delegation to the Board
• Advocate for funding
• Participant in M E, e.g., on high-level global
  commitments

9
Recommendations, 1

• FBOs must recognize their role as civil society
  participants, especially their value add
  contributions to technical, financial,
  management, and ethical areas of programs and
  projects
• Special leadership areas to be built Advocacy,
  ME and Skills Transfer
• Common manuals for training in above areas should
  be developed early
• Ideal A global network of FBOs building on each
  others uniqueness and strengths
• Common purpose Collaborate on issues that
  advance the health and poverty agenda
• Joint evaluations to ensure cross-learning

10
Recommendations, 2

• Networks for shared information and resources,
  but differences in adaptation allowed to surface
• Networks could be national, geographic or based
  on functional leadership or a combination of
  both.
• Mechanism for continuous interaction should be
  designed point persons designated as hubs for
  information-sharing
• Bi-annual meetings a minimum
• Other possibilities to look at listserves,
  registries
• Networks should not be limited to technical NGOs
  larger development- or health-focused NGOs must
  be part of the mix

11
Specific Roles of FBOs in Global Fund Processes
at Country Level

• Proposal writers, consortium leaders/members
• Data-gatherers and providers
• Implementors/Sub-recipients
• Country Coordinating Mechanism members
• Civil society delegation members
• Principal Recipients (for FBOs with experience in
  handling large amounts of foreign currency)
• Technical Consultants
• Evaluators