Civil Society, its organizations and global health governance

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Civil Society, its organizations and global
health governance
Dr. David McCoy Centre for International Health
and Development, University College
London Co-Managing Editor of Global Health
Watch Steering Committee Peoples Health Movement
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Global Health Governance

• Loosely defined as the structures, systems, rules
  and processes at the global level for
• making decisions about health-policy and
  priority-setting
• financing and implementing global health
  initiatives, programmes and plans
• ensuring appropriate and effective systems of
  accountability.

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The rise of the CSO

• First registered international NGO - the
  Anti-Slavery Society -formed in 1839
• Number of international NGOs grew from about
  1,000 in 1914 to about 37,000 in 2000
• Clear evidence exists of their impact
• Alma Ata
• International Code
• FCTC
• Landmines
• Doha Declaration
• AIDS treatment

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What do we mean by civil society organisations
and how do they relate to each other and to other
actors?

• CSOs are usually described in terms of a
  framework of three distinct sectors
• Some UN bodies describe businesses as being
  non-governmental

Government
Civil society
Business
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Types of CSO

• NGOs
• Community based organisations
• Universities
• Think-tanks
• Professional associations and trade unions
• Private foundations
• Social movements
• Patient groups

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GONGOs
Government
Civil society
PINGOs
Business
BONGOs
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IGOs
Foundations
GHPs
Civil society
G8, OECD
Business
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Differences within civil society

• By funding source and relationship to other
  actors
• By size
• By geography and wealth
• According to their legitimacy
• According to what they do
• According to their politics, views and
  orientation

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CSOs by politics and orientation

• PHC orientation
• Proximal or Distal determinants
• Scholte 1999
• Conform
• Reform
• Transform

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How CSOs engage in GHG

• working within GHG institutions

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• Through formally constituted advisory or
  technical committees or by being incorporated
  into decision-making structures
• In one overview of 23 GHPs, out of a total of 298
  Board seats, 23 per cent and five per cent were
  occupied by academic and NGO representatives
  respectively
• The Global Fund has three seats allocated to NGOs
  amongst its twenty voting members on its Board of
  Governors (one for a developed country NGO one
  for a developing country NGO and one for
  communities affected by the diseases).
• But 23 of governing board seats were occupied by
  the private (corporate) sector

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How CSOs engage with or participate in GHG

• working within GHG institutions
• lobbying and campaigning from the outside
• playing a watchdog role
• working with or through other actors
• opposing and resisting

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C6 Oil extraction and health in the Niger Delta
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The struggle of indigenous peoples to hang on to
their lands and cultures
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The successful struggle against water
privatisation in Cochabamba (Bolivia) followed
days of street protests and police retaliation
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Conclusion

• A complex and complicated issue
• Is there good enough accountability?
• Is there enough transparency? Who is being
  co-opted by whom?
• Is there a fair hearing of all voices?
• Do we need more independent funding