What kind of (watch) dogs are CSOs supposed to be?

September 28, 2014

In a week where New York has been bombarded with thousands of civil society representatives eager to participate in the United Nations (UN) General Assembly, where severe security checks and NYPD officers are everywhere, and civil society organisations (CSOs) have to wait for hours to receive their UN grounds passes, ironically, Action for Global Health organized an event on the meaningful participation of civil society in health policy dialogues. Although the added value of ensuring the meaningful engagement of CSOs has been shown time and again, they are still not seen as an equal partner around the table. Not even in this city of power: the Big Apple.

Back then, CSOs contributed to policy making, to thedevelopment of public-private partnerships and to exploring innovativesolutions, yet today, CSOs are still not fully recognized as a formal actorwithin health-policy development.

Dr. Joan Awunyo-Akaba, CSO representative on the GAVIBoard, questioned; "Are CSOs really seen as watch dogs or rather as street dogsthat need to be kept outside?"

Civil society is not yet seen as an equal partner withequal votes. Being involved in the policy process is seen as a favour, not aright. As a member of the GAVI Board, an important CSO engagement mechanism,Dr. Awunyo-Akaba knows that it is not enough, and more is needed. Civil societydeserves not only to be recognized but to be fully involved.

Christopher Benn, current Director of ExternalRelations at the Global Fund, but once the first CSO representative on itsBoard, also remembers how difficult it was in the past to ensure CSOs had anequal voice on the Board when they were only allowed to speak when allgovernments had finished their speeches.

"A successful Global Fund Replenishment withoutincluding CSOs is simply unimaginable," Benn stressed. Civil society plays a crucialrole advocating for attention for vulnerable groups and key populations, aswell as community-system strengthening."

The European Commission (EC) representative Jean-PaulHarkin explained that this is why the EC developed EU CSO roadmaps that strengthenthe crucial partnership between civil society and EU delegations in-country.

To ensure an equal seat at the table, good governanceis needed, which goes beyond accountability. Openness and transparency arecritical for CSOs to meaningfully engage.

"We need CSOs to construct global governance forhealth," insisted Professor Lawrence. Dr. Awunyo-Akaba agreed. "But weneed to be cautious," she continued. "Universal Health Coverage will not becomea reality if we only build hospitals and forget about equality. We simplycannot have a unified global framework of health development, like UHC, unlesswe engage communities."

Action for Global Health has been advocating stronglyduring the past months and years to demonstrate that Universal Health Coveragerequires specific attention to marginalized and vulnerable populations, as wellas civil society and community involvement to ensure the right to health forall.

This debate in New York re-emphasized that a commonagreement on the need for CSOs to be an equal part of the policy dialogue seemsto be there, but how this can be done is less clear. Civil society engagementcan't simply be a 'tick-the-box' exercise and will therefore need broad supportof high-level representatives within the UN and governments, who reallyunderstand the added value.

So what kind of dogs do CSOs need to be? Let'sremember, it is better to be the head of a dog than the tail of a lion!

Emilie Peeters is EU Policy Advisor at Stop AIDS Alliance, a partner of Action for Global Health