This was an NGO/CSO Regional Consultation on Governance in Africa, published in 1997. UNDP and ECA shared responsibility under the UNSSIA for improving coordination in the areas of capacity building, peace-building, conflict resolution and national reconciliation, and strengthening civil society for development, all linked to the governance agenda. Effective good governance and sustainable development is predicated on efficient public sector management systems and practices; establishment of appropriate legal frameworks that guarantee the rule of law; instalment of systems that ensure both economic and financial accountability; and ensure transparency. The consultation noted both the state and non-state sectors must reach a consensus on a common definition, priority agenda and practical modalities for popular participation in governance. It also noted that defining the nexus between popular participation, governance, peace, and development must invariably include the collaborative initiatives of various actors including ECA, UNDP, and the OAU on one hand and representative African governments, African NGOs and other civic organizations in the continent.
Governance and participation in health
This book talks about the changing relations between and roles of development NGOs and donor governmental agencies, based on case studies of 22 western countries, EU and the World Bank.
Twenty years ago, a group of activists came together to demand access to treatment for all people living with HIV. The introduction of highly effective combination antiretroviral (ARV) therapy offered hope. Yet their high price meant that they were entirely unavailable in the public health system and out of reach for millions of people. In 1998, ARVs cost US$10 000 per year. Demanding access to treatments, activists from the Treatment Action Campaign (TAC), Médecins Sans Frontières (MSF) and the AIDS Law Project, later incorporated as SECTION27 helped to spur a global movement that radically reduced the prices of HIV medicines. Using skilled legal advocacy, high-quality research, social mobilisation, and public education, these activists transformed the global conversation on drug pricing, making it possible for millions of people to access treatment. Yet despite the remarkable success in increasing access to HIV medicines, this paper notes that systemic problems remain entrenched. New medicines to treat drug-resistant TB, cancers, and many other conditions remain far too expensive. As South Africa develops its intellectual property framework, they argue that it is worth revisiting the strategies, successes, and shortcomings of the access to medicines movement for the insights they may offer. The authors observe that a battle that began nearly twenty years ago engaging pharmaceutical giants and recalcitrant governments continues today. This interactive website showcases their story.
According to CIVICUS, in 2011, the existing institutions of global governance failed to provide people-centred responses to the current global economic, social, political and environmental crises. Too often in key multilateral meetings and processes, the narrow national interests of states prevailed. The Durban climate change summit of 2011 (COP17) fell short of the decisive action required, as did the 2011 G20 meeting of the world’s most powerful economies. On the positive side was the launch of the new United Nations body, UN Women, as well as the Busan High-Level Forum on Aid Effectiveness, and many of the stances adopted by the UN Human Rights Council in Geneva, particularly during the Universal Periodic Review, its peer-reviewed assessment of human rights in UN member states. In Busan and in Geneva, the space guaranteed to civil society enhanced the credibility and quality of the process, and these procedures should be regarded as minimal standards that should be extended to other arenas. A predicament for both states and civil society alike is the fact that disconnected summits purport to address intertwined issues such as economic growth, development effectiveness, climate change and human rights in silos. Civil society organisations must combine to advocate for a multilateral system that has the reach and ambition to tackle connected challenges and the imagination to put global interests first.
This report evaluates South Africa’s compliance with twelve selected African Union (AU) instruments to which it is a signatory. Eight of these twelve instruments are treaties while four are strategies, resolutions or plans of action. While treaties are legally binding on States Parties, resolutions are not. Seven of the treaties are already in force. Two await the required instruments of ratification to become effective and have not yet been signed or ratified by South Africa. Several health instruments are covered, including the Africa Health Strategy 2007-2015 (AHS), the Abuja Call for Accelerated Action towards Universal Access to HIV and AIDS, Tuberculosis and Malaria Services in Africa by 2010, and the Maputo Plan of Action for the Operationalisation of the Continental Sexual and Reproductive Health and Rights Policy Framework 2007-2010 (MPA). The audit of compliance indicates that South Africa has made significant strides to comply with the selected AU instruments, though much remains to be done. For example, in terms of the Abuja call, the country has a solid HIV and AIDS programme in place and is making progress towards treating tuberculosis and malaria, but the report points to lack of political will, lack of financial resources, and lack of public involvement and well-trained medical staff as factors impeding compliance with the AHS and the MPA. Many health workers are noted to not know about these health instruments because the government has failed to popularise them.
Innovation in biomedicine is a global enterprise in which 'Rising Power' states (emerging states) figure prominently, and which undoubtedly will re-shape health systems and health economies globally, the authors of this paper argue. Against this background, they present an overview of a range of approaches that have potential for advancing understanding of governance of global life science and biomedical innovation, with special reference to the 'Rising Powers'. The authors’ analysis indicates significant convergences and complementarities between the approaches discussed, concluding that the role of the national state itself has become relatively neglected in much of the relevant literature. They call for a new approach that enables innovation and governance to be seen as 'co-producing' each other in a multi-level, global ecology of innovation, taking account of the particular, differing characteristics of different emerging scientific fields and technologies.
At least 750,000 people are stateless in West Africa, according to the UN Refugee Agency (UNHCR), which is calling for governments to do more to give or restore the nationality of stateless individuals, and improve national laws to prevent statelessness. Many in the region are both stateless and refugees, said Emmanuelle Mitte, senior protection officer on statelessness with UNHCR in Dakar, but the overwhelming majority of stateless persons in West Africa are stateless within their own country, lacking proof of the criteria required to guarantee their nationality. Statelessness can block people’s ability to access health care, education or any form of social security. In the case of children who are separated from their families during emergencies, the lack of official documentation makes it much harder to reunite them, says the UN Children’s Fund (UNICEF). Lack of official identification documents can mean a child enters into marriage, the labour market, or is conscripted into the armed forces, before the legal age. Statelessness can also render people void of protection from abuse. Denied the right to work or move, they risk moving into the invisible underclass, said UNHCR’s West Africa protection officer, Kavita Brahmbhatt, who gave the example of a group of stranded non-documented Sierra Leonean migrants living in the slums of Liberia’s capital, Monrovia, selling charcoal as they were too poor to do anything else, and too scared to return home for fear of being punished. “They became a member of Monrovia’s underclass,” she said. “Birth registration is more than just a right. It’s how societies first recognize and acknowledge a child’s identity and existence,” said Geeta Rao Gupta, UNICEF deputy executive director in a late 2013 communique launching the report Every Child’s Birth Right: Inequities and trends in birth registration.
In this open letter, civil society groups across Africa argue that the Alliance for a Green Revolution in Africa (AGRA) is failing in Africa, as it benefits relatively few farmers, often at the expense of the majority. AGRA-promoted technologies, like genetically modified crops, produce concentration of land ownership, increasing economies of scale and a declining number of food-producing households in a context of limited other livelihood options. Opening markets and creating space for multinationals to secure profits lie at the heart of the G8 and AGRA interventions, they argue. They also fear that the intellectual property of many plant types may be transferred to large multinational corporations as part of AGRA practices. As a solution, they call for differentiated agricultural strategies that recognise and vigorously support local and informal markets, proven low-input and ecologically sustainable agricultural techniques including intercropping, on-farm compost production, mixed farming systems (livestock, crops and trees), on-farm biofuel production and use, and intermediate processing and storage technologies. The International Assessment of Agricultural Knowledge, Science and Technology for Development (IAASTD) provides detailed and scientifically sound proposals in this regard.
This study attempts to distil lessons learned by a handful of African civil society coalitions on the dynamics of demanding improved governance of governments that are often averse to governance reform. The project admittedly tackles an ambitiously formidable subject, largely due to the dearth of compelling, contemporary African examples of civil society leading noteworthy policy or social change. Governance and policy reform in several African countries continues to be driven by African governments, through initiatives such as the African Peer Review Mechanism (APRM), as the South African Institute of International Affairs’ (SAIIA) six years of research into the APRM suggests. As such, the study broaches a subject starved of compelling material. However, it creates an accessible set of lessons from civil society activists, academics, diplomats, representatives of donor agencies and civil society experts that have played leading roles in a few – but notable – episodes of civil society-led policy reform.
Accountability refers to the processes by which those with power in the health sector engage with, and are answerable to, those who make demands on it, and enforce disciplinary action on those in the health sector who do not perform effectively. This paper reviews the practice of accountability to citizens on gender and health, assesses gaps, and recommends strategies. Four kinds of accountability mechanisms have been used by citizens to press for accountability on gender and health. These include international human rights instruments, legislation, governance structures, and other tools, some of which are relevant to all public sector services, some to the health sector alone, some to gender issues alone, and some to gender-specific health concerns of women. However, there are few instances wherein private health sector and donors have been held accountable. Rarely have accountability processes reduced gender inequalities in health, or addressed 'low priority' gender-specific health needs of women. Accountability with respect to implementation and to marginalized groups has remained weak. This paper recommends that: (1) the four kinds of accountability mechanisms be extended to the private health sector and donors; (2) health accountability mechanisms be engendered, and gender accountability mechanisms be made health-specific; (3) resources be earmarked to enable government to respond to gender-specific health demands; (4) mechanisms for enforcement of such policies be improved; and (5) democratic spaces and participation of marginalised groups be strengthened.