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

This post was originally found on Action for Global Health by Emilie Peeters, EU Policy Advisor at Stop AIDS Alliance, a partner of Action for Global Health.

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.

Action for Global Health organized the event in collaboration with Global Health Council. Professor Lawrence Gostin, from the O’Neill Global Health Institute at Georgetown University, led the lively and interactive debate ; “We tend to forget what the pre-AIDS era was like and how brave CSO voices changed the world by realizing social mobilization and articulating what they didn’t agree on.”

Back then, CSOs contributed to policy making, to the development of public-private partnerships and to exploring innovative solutions, yet today, CSOs are still not fully recognized as a formal actor within health-policy development.

Dr. Joan Awunyo-Akaba, CSO representative on the GAVI Board, questioned; “Are CSOs really seen as watch dogs or rather as street dogs that need to be kept outside?”

Civil society is not yet seen as an equal partner with equal votes. Being involved in the policy process is seen as a favour, not a right. 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 society deserves not only to be recognized but to be fully involved.

Christopher Benn, current Director of External Relations at the Global Fund, but once the first CSO representative on its Board, also remembers how difficult it was in the past to ensure CSOs had an equal voice on the Board when they were only allowed to speak when all governments had finished their speeches.

“A successful Global Fund Replenishment without including CSOs is simply unimaginable,” Benn stressed. Civil society plays a crucial role advocating for attention for vulnerable groups and key populations, as well as community-system strengthening.”

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

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

“We need CSOs to construct global governance for health,” insisted Professor Lawrence. Dr. Awunyo-Akaba agreed.  “But we need to be cautious,” she continued. “Universal Health Coverage will not become a reality if we only build hospitals and forget about equality. We simply cannot have a unified global framework of health development, like UHC, unless we engage communities.”

Action for Global Health has been advocating strongly during the past months and years to demonstrate that Universal Health Coverage requires specific attention to marginalized and vulnerable populations, as well as civil society and community involvement to ensure the right to health for all.

This debate in New York re-emphasized that a common agreement on the need for CSOs to be an equal part of the policy dialogue seems to be there, but how this can be done is less clear. Civil society engagement can’t simply be a ‘tick-the-box’ exercise and will therefore need broad support of high-level representatives within the UN and governments, who really understand the added value.

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