Next Steps
Ensuring the meaningful involvement of communities and civil society within governance structures across the global health architecture is vital. Permanent representation and voting rights accompanied by funding and strong support mechanisms amongst others mentioned throughout the aforementioned Principles, will enable constituencies to play a more significant and impactful role in decision making-processes.
Communities and civil society representatives are experts in their fields and this should be reflected in their permanent seats and voting rights which take them beyond mere consultative stakeholders into more influential actors whose lived experience and expertise informs and guides decisions on a continual as opposed to sporadic basis.
For these Principles to be meaningful, accountability mechanisms should be developed to hold institutions accountable to the Principles and to ensure they are integrated at all levels. Similarly to Y+ Global scorecards for organisations1 scorecards should be developed on the meaningful involvement of civil society and communities across the different Global Health Institutions to showcase examples of best practice and encourage stronger accountability across the global health architecture. These scorecards can act as an accountability framework to track the implementation of the Principles in practice.
The Secretariats of Global Health Institutions should accelerate this discussion to scope the potential for KPIs in their respective institutions on meaningful involvement of civil society (both at a global and national level) so that the level of engagement can be more concretely measured and consequently held to account.
Finally, the aim of the process of developing these principles has been to ensure the global health architecture is more inclusive and in order for them to be sustainable and reflective of the current reality in global health. As a result, the Principles will be open to feedback and updated as needed. This will be facilitated through the online feedback mechanism which has been developed on the website and an annual review of the Principles based on feedback received and on a process of review by an agreed representative body.
Commentary
These principles are being launched at a time of great upheaval and rapid transformation. Having only just emerged from a global pandemic which led to a dramatic shift in global health focus to pandemic prevention, preparedness, and response (PPPR) but which also served to further emphasise the systemic failures of the architecture in relation to addressing inequality. This ran parallel to and was co-influenced by the Black Lives Matter movement, the Me Too movement, the decoloniality movement and some other big shifts in society – all of which have catapulted awareness and acceptance of the need for individual and systemic review and reform. All of these community-originated challenges to existing power structures amplify the pursuit of the 17 Sustainable Development Goals, the climate emergency and the fight for a human rights-based approach to development, health, and socioeconomic equity.
Building on all these insights and looking forward to the needs of the post-2030 agenda, there are several processes within global health and broader development co-operation and finance that are seeking to identify and discuss possible solutions that might support the realisation of achieving the various global targets which have been set. Some of the global health-focused processes include, but are not limited to: The Future of Global Health Initiatives; Global Action Plan; and the Pandemic Accords. These Principles should be incorporated into their outputs and be the answer to some of the questions they pose. There are also already some big ideas out there that are gaining significant traction and support in which the principles feature. One of those is the concept of Global Public Investment (GPI), which is singled out here for its important focus on the inclusion principle of “All Decide” in global multilateral fund governance.
Acknowledgements
In 2022, STOPAIDS received some funding from Love Alliance to support the work led by consultant Sally Shackleton who led on the consultations which took place in 2022 and whose report has been intertwined into this document and the overview of consultations section. These principles were subsequently authored by a taskforce of civil society and community constituency representatives from the governance boards of various global health institutions. Thank you to those who took the time to engage and provide valuable feedback throughout the consultations in 2022 and in 2023 consultations. The feedback provided via the survey, IAS event and consultation webinars have been invaluable in shaping these principles but there is evidently a need for further and ongoing conversations to continue to strengthen this set of principles over time.
The recommendations outlined in this report are not intended to be static as the intention of the taskforce is for these to be living principles which can adapt overtime as the global health architecture evolves and with it civil society and communities engagement in it. Again, ongoing feedback and suggestions is welcomed and encouraged through the website both on how these can be strengthened as well as what new examples others may be aware of in global health which demonstrate good or poor practice of meaningful involvement. All feedback or questions can be submitted at any time via the portal on the principles website.