This article has been written by Ms. Aninditha Gandhe, a 2nd year student of Symbiosis Law School, Hyderabad.
Abstract
This research paper explores the pivotal role of Civil Society Organizations (CSOs) in shaping and advocating for global health resolutions. Positioned between state institutions and profit-driven entities, CSOs, including NGOs, community groups, and faith-based organizations, play a crucial intermediary role in championing health-related causes at local and international levels. The paper delves into the multifaceted engagement of CSOs, extending beyond traditional health service delivery to encompass advocacy, policy influence, and resource mobilization.
Over recent decades, CSOs have emerged as influential actors in addressing health disparities, influencing policy decisions, and promoting public awareness. The intricate interactions between CSOs, governments, and international bodies have become integral to developing and implementing global health resolutions. The research emphasizes the diverse functions of CSOs, addressing gaps in health service provision, raising public awareness, and advocating for regulatory measures.
The paper underscores the significant contributions of CSOs to human security, including personal, health, and economic security. It discusses the adaptability of CSOs during the pandemic and raises concerns about proposed changes limiting civil society participation in global health meetings. The research concludes by highlighting the indispensable role of CSOs in shaping and advancing global health resolutions, urging the recognition and preservation of their unique contributions for the benefit of populations worldwide.
Introduction
The pivotal role of Civil Society Organizations (CSOs) in shaping and advocating for global health resolutions is a testament to the dynamic influence these entities wield in public health. Situated between state institutions and profit-driven organizations, CSOs, including NGOs, community groups, and faith-based organizations, play a crucial intermediary role in championing health-related causes on both local and international fronts. Their multifaceted engagement extends beyond traditional health service delivery, encompassing advocacy, policy influence, and resource mobilization.
In recent decades, CSOs have emerged as influential actors in addressing health disparities, influencing policy decisions, and promoting public awareness. The intricate web of interactions between CSOs, governments, and international bodies has become integral to developing and implementing global health resolutions. This introduction sets the stage to delve into the diverse functions and impactful contributions of Civil Society Organizations, highlighting their essential role in shaping the global health landscape and advancing resolutions prioritising the well-being of populations worldwide.
Civil Society
Civil Society Organizations (CSOs) are delineated as entities distinct from state institutions and market-driven organizations. The World Health Organization (WHO) characterizes CSOs as entities existing within the social sphere between the state and the citizen, yet independent of state apparatus and profit-oriented sectors. A parallel definition by the World Bank encompasses a broad spectrum of non-governmental and not-for-profit organizations actively participating in public life. CSOs, as per this definition, encompass a diverse array of entities, including community groups, non-governmental organizations (NGOs), labour unions, indigenous groups, charitable organizations, faith-based organizations, professional associations, and foundations.
In his address during the High-level event on supporting Civil Society on September 23, 2013, UN Secretary-General Ban Ki-moon emphasized the critical importance of leaders heeding the concerns of their constituents. He underscored that failure to do so could result in expressions of discontent, whether through public protests in streets and squares or, regrettably, on the battlefield. Secretary-General Ban advocated a more constructive approach, emphasizing increased participation, democracy, and engagement. He called for greater openness and maximum allowance for civil society to play a pivotal role in shaping policies and decisions.
Civil society encompasses diverse actors engaged in advancing human rights and addressing critical societal issues. This includes human rights defenders, online activists, NGOs, victim-support groups, coalitions, and networks focused on various rights, such as women’s, children’s, and environmental rights. It also involves persons with disabilities, community-based groups, faith-based organizations, unions, social movements, and professionals like lawyers and doctors. These entities are crucial in tackling challenges such as poverty, corruption, and economic inequality, responding to humanitarian crises, promoting the rule of law, advocating for public freedoms, ensuring government transparency, protecting the environment, and empowering marginalized groups. Additionally, civil society is instrumental in combatting discrimination, supporting crime prevention, promoting corporate social responsibility, addressing human trafficking, empowering women and youth, advancing social justice, and ensuring consumer protection through social services. Civil society contributes significantly to fostering a just and accountable society through multifaceted efforts.
In 2001, the World Health Organization (WHO) inaugurated a Civil Society Initiative (CSI) to conduct a comprehensive assessment of the established and informal interactions between WHO and Civil Society Organizations (CSOs). The primary objective was to formulate an updated policy to enhance collaborative efforts, facilitate improved information exchange, and foster constructive dialogue with CSOs. Additionally, the initiative sought to refine the support provided by WHO to its Member States in their engagements with Non-Governmental Organizations (NGOs) and CSOs.
CSOs have traditionally concentrated their efforts on health service delivery in health development, particularly in low and middle-income countries. Notably, since the 1980s, the landscape of health-related CSOs has witnessed a proliferation in terms of type, quantity, and functions performed a phenomenon generally regarded positively. When governments have fallen short in providing essential health services, CSOs have intervened through state or donor contracts or by actively engaging in charitable initiatives. Additionally, when the state or market has marginalized certain population groups, CSOs have undertaken advocacy efforts to influence policy prioritization on their behalf.
The multifaceted roles of CSOs in recent decades include addressing gaps in health service provision, influencing policy decisions, raising public awareness, mobilizing resources in the absence of adequate funding, and advocating for regulatory measures in response to adverse corporate impacts on population health. There has been a discernible surge in CSO activity, accompanied by a diversification in the scope of functions they perform.
Role of Civil Society
The human security framework was explicitly designed to emphasize the significance of nonmilitary and nontraditional security challenges, including diseases and health-related issues. Therefore, there is no need to overemphasize the importance of good health to human security.
Following this line of reasoning, it can be confidently asserted that Civil Society Organizations (CSOs) advocating for good health also contribute significantly to human security.
Civil Society Organizations are groups of citizens that operate on a nonprofit and voluntary basis. These organizations focus on specific issues at the local, national, or international levels, undertaking various services and humanitarian functions. They play a crucial role in drawing citizens’ attention to government activities, monitoring policies, promoting community participation, and offering analysis and expertise. Through the provision of medical and healthcare services, the promotion of awareness regarding health-related issues, safeguarding the privacy and human rights of individuals facing diseases, and offering financial and legal assistance to affected individuals and families, CSOs play an instrumental role in reducing premature death and upholding human dignity (personal security).
Additionally, their efforts contribute to improving the performance of healthcare systems (health security), lowering medical care costs, and mitigating their adverse impact on household spending on nonfood items (economic security). Furthermore, CSOs sustain access to food by protecting the health of breadwinners, thereby contributing to food security. In summary, CSOs, through their multifaceted initiatives, actively contribute to various dimensions of human security.
Civil society, particularly international non-governmental organizations (NGOs), is crucial in defining and achieving health targets. They are instrumental in holding governments accountable, offering technical expertise, and representing diverse communities. Proposed changes in the current framework could significantly impact the valuable contributions of civil society groups, a vital constituency dedicated to enhancing global health and well-being.
Before the pandemic, civil society organizations actively participated in Executive Board (EB) meetings, leading grassroots mobilization efforts, disseminating technical guidelines, advocating for marginalized groups and neglected issues, and contributing to essential knowledge generation. However, the emergence of the pandemic disrupted civil society’s involvement as the United Nations (UN) and the World Health Organization (WHO) had to adapt to restrictions, shifting to a virtual format that excluded civil society participation.
Human rights establish a normative framework that allows civil society organizations to mobilize, strengthen community agency, and provide a method to challenge the perceived limitations imposed by globalization. Starting in the 1980s, coalitions of individuals affected by HIV and CSOs initiated advocacy efforts, focusing on various human rights concerns. These initiatives encompassed campaigns against AIDS-related stigma and discrimination, along with endeavours to enhance the accessibility of medicines.
The urgency of controlling the pandemic led to a hiatus in civil society’s engagement. The UN and WHO swiftly implemented virtual formats due to pandemic-induced restrictions, resulting in the exclusion of civil society from last year’s World Health Assembly and the UN General Assembly, both focused on addressing COVID-19. This absence of civil society voices on the virtual floor represents a notable shift from their active role.
Civil society, not confined to governmental ministries or divisions, possesses the flexibility to forge partnerships without limitations. Noteworthy is the example of tobacco control advocates who extended beyond public health alliances. They engaged with the food and hospitality sector, urging the prohibition of smoking in restaurants and bars. Collaboration with transport ministries was instrumental in implementing smoking bans on planes. Furthermore, these advocates successfully persuaded other Civil Society Organizations to decline funding from tobacco companies.
Malaysian CSOs, exemplified by the Malaysian Cancer Society, demonstrated effective advocacy during negotiations concerning the Trans-Pacific Partnership Trade Agreement. Their efforts led to the proposal of a ‘tobacco carve-out,’ aiming to prevent tobacco corporations from utilizing investor-state dispute mechanisms to undermine public health measures.
Since 2011, civil society organizations dedicated to addressing climate change have joined forces to establish the Global Climate and Health Alliance (GCHA). Since then, GCHA and the World Health Organization (WHO) have joined hands to organize a yearly Global Climate and Health Summit concurrent with the Conference of the Parties (COP). In addition to these annual events, there has been continuous communication between the two entities, with the shared objective of enhancing global health sector initiatives.
The democratic shortfall in global health governance can be addressed by actively involving Civil Society Organizations (CSOs), which can enhance institutional legitimacy. A case in point is the Global Fund’s commitment to including community representatives in every national Country Coordinating Mechanism and ensuring the presence of affected communities in its governance board. CSOs possess a distinct advantage over government agencies in service provision and advocacy. This advantage lies in their capacity to effectively reach and represent the often overlooked and marginalized groups. These groups, typically more vulnerable to the adverse effects of health problems, benefit from the specialized attention and advocacy efforts extended by CSOs.
The upcoming changes are scheduled to undergo testing during the 74th World Health Assembly (WHA74) in May of this year. The proposed adjustments suggest scheduling informal civil society events in advance, weeks or months before the central meetings. This would create a distinct, parallel process that prevents civil society from participating in or organizing events concurrently with the meetings attended by heads of state and other officials.
Traditionally, events on the sidelines of the WHA are arranged outside of formal sessions, offering a valuable opportunity for Member States and civil society to engage in discussions regarding various issues. It is noteworthy that, even prior to these proposed changes, official civil society statements during crucial global health meetings were constrained. Often, these statements were relegated towards the end of the program due to time constraints, and in some cases, they needed to be read.
Conclusion
In conclusion, the indispensable role of Civil Society Organizations (CSOs) in shaping and advocating for global health resolutions is incontrovertible. Situated between governmental bodies and profit-driven entities, CSOs serve as crucial intermediaries, championing health causes on both local and international stages. Their multifaceted engagement spans advocacy, policy influence, resource mobilization, and beyond, significantly addressing health disparities and promoting public awareness.
Over recent decades, CSOs have evolved into influential actors, pivotal in health service provision, policy decisions, and resource mobilization, particularly in low and middle-income countries. Their diverse functions include addressing gaps in health services, raising public awareness, and advocating for regulatory measures. In the context of human security, CSOs contribute significantly to personal, health, and economic security, actively enhancing global health and well-being.
The recent disruption caused by the pandemic highlighted the adaptability of CSOs, albeit with a temporary hiatus in their active involvement. The proposed changes in the format of global health meetings, though aimed at enhancing efficiency, raise concerns about limiting civil society participation. CSOs, with their flexibility and advocacy prowess, remain pivotal in addressing global health challenges. As we approach the 74th World Health Assembly, it is imperative to recognize and preserve the unique contributions of CSOs, ensuring their continued involvement in shaping and advancing global health resolutions for the benefit of populations worldwide.
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