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Category: Knowledge Hub

Johannesburg waste pickers organise to defend their livelihoods

Posted on by Vanessa Pillay

Four months ago, WIEGO’s project with the Commonwealth Foundation Waste integration South Africa (WISA) took an unplanned turn as Johannesburg’s waste-pickers were faced with a major challenge to their livelihood.

The city’s official waste management service provider, Pikitup, signed contracts with private recycling companies to expand Pikitup’s Separation at Source programme.  Separation at Source diverts recyclable waste away from landfills and encourages residents to separate their waste at home. In this way, according to Pikitup, recyclables remain clean and can be resold more easily.  Effectively, however, this would exclude waste-pickers from the recycling service they have provided for decades at no cost to the city and negatively affect the income that they earn from selling recyclable material.

WIEGO has been working with the waste-pickers of Johannesburg who collect, sort, separate and recycle the City’s waste from the main landfills as well as from the street sides.  There are 6,000 to 10,000 people in Johannesburg who depend on waste-picking work.  Unemployment in South Africa has reached a record 27.7 percent, so excluding wastepickers will create additional hardship.  By giving recycling contracts to private companies, the city is opting for a private system, when a less costly, more socially responsible and environmentally–friendly solid waste management programme, including waste-pickers, is possible.

Listen to a radio interview with waste picker representatives, Eva Mokoena and Steven Leeuw from Johannesburg about the  impact of  this troubling development.

Aware of the potential introduction of the Separation at Source programme, WIEGO and waste-pickers have been asking Pikitup and the City to disclose and discuss the contracts since September last year, but to no avail.  As a result, an Interim Johannesburg Reclaimers Committee (IJRC) was set up and in July waste pickers from seven regions of the City marched to protest outside Pikitup’s offices.  Eva Mokoena from the IJRC presented a Memorandum of Demands to the Managing Director of Pikitup on behalf of the Committee.  See a video of the protest on Facebook.

As a result of the campaign, Pikitup put a halt to signing any new contracts and acknowledged wastepickers as principle stakeholders in Johannesburg’s waste economy. Pikitup says that it is requiring the companies to include reclaimers, but it is leaving it up to companies that have no experience in integrating them to figure out how to do this and have not consulted with wastepickers on how they should be included. However, dialogue has now been opened up between Pikitup, the City of Joburg and the wastepickers, which is very much welcomed.

For waste pickers, the four key pillars of integration are: recognition as workers providing public and environmental services for which they should be paid; inclusion in the current and future solid waste management system; consultation on all decisions affecting their livelihoods; and, all of the above to begin with the registration of all waste pickers in a centralised database to ensure that the integration process is well planned, fair, transparent and able to be properly monitored. 

Negotiations to develop a framework of how the integration process will be implemented have been underway for the past three months.

See the WIEGO site for further information.

Vanessa Pillay is the WIEGO Organisation and Representation Programme Officer, Johannesburg

 

Mental health policy reform: time to decolonise our minds

Posted on by Vijay Krishnarayan

Mental health legislation in 20 per cent of Commonwealth countries was passed before 1960.

The term “idiot” remains on the statutes of 10 Commonwealth countries. The law in many Commonwealth countries is in conflict with contemporary international human rights obligations towards people with mental illness. The roots of mental health legislation can often be traced to a bygone era. It’s time we de-colonised our minds.

‘The roots of mental health legislation can often be traced to a bygone era.’

The Commonwealth Foundation is not a mental health focussed organisation but we are committed to strengthening civic voice in policy reform. We funded a review of mental health laws across the Commonwealth five years ago. The final report – produced by the Commonwealth Health Professions Alliance (CHPA) and written by Dr Soumitra Pathare and Dr Jaya Sagade of the Indian Centre for Mental Health Law and Policy highlighted the dichotomy between existing laws and human rights. The CMNF identified two countries where policy reform was being considered. They applied to the Commonwealth Foundation for a grant to help make change happen and were successful.

One of the project’s countries is Seychelles and I was privileged to see for myself the way they are going about the process of reform. Seychelles was identified because of the willingness of lawmakers, and civil society (mental health and allied professionals and people with mental illness) to work together to address the policy challenge. The inclusion of people with mental illness in the process speaks to the Foundation’s core purpose of strengthening less heard voices.

Civil society has provided the impetus for reform but it has drawn strength from the support of the Minister for Health who impressed upon me the need for civic-state dialogue to make health services responsive to contemporary demands. The need for change is evident. The existing law is the Mental Health Act of 2006. Although relatively recent the legislation was passed before Seychelles signed the UN Convention on the Rights of Persons with Disabilities. I heard from mental health professionals that the law emphasises retaining people with mental illness in institutions rather than the treatment and rehabilitation of patients. As one mental health professional critiqued it’s about protecting “us” from “them.”

‘the law can help to either re-inforce or deconstruct social attitudes.’

A Mental Health Advisory Committee was established to steer the project in-country. It is chaired by the Chief Medical Officer and it brings together health professionals, policy specialists and service consumers. The Committee is supported by the CMNF and Dr Pathare and during my stay I sat in on their discussions. I heard how hard it is for people with mental illness to enjoy rights that we take for granted – to gain employment or to get insurance. I also heard how easy it is for people with mental illness to be incarcerated or restrained. The particular challenge of the stigma associated with mental illness in a small state was never far from the surface and it was recognised that the law can help to either re-inforce or deconstruct social attitudes.

Essential to the process of reform was the engagement of the Attorney-General’s office. I had the chance to meet with the newly appointed Attorney General and I was struck by his recognition of the importance of bringing his office nearer to people. His representative sat with the Committee as they pored over the new draft Act, line by line. The draft Act was then presented at an open meeting at the Seychelles Hospital. About forty people from all walks of life gathered: patients, politicians, police and practitioners. They attested to the need for change, called for more and targeted dialogue with particularly affected parts of society like young people. They want to see the Act passed and fully implemented. They want to see the new law make a difference and all were optimistic about the chances of the Act going before Parliament by next April.

Our colleagues on the Advisory Committee – public officials and civil society alike are committed to change. They agreed that there was no point in trying to change elements of the existing 2006 Act and are developing a national policy that will provide a framework for the new Act. They recognised that the spirit of the existing law was a ghost from a time long past. This was a time when administrators wrote laws to suit themselves and when it was presumed that people with mental illness were objects of charity rather than agents of their own destiny.

Colonial institutions are not just fine buildings that are well preserved but they are laws and practices that have also endured. While I’ve been here, discussions with Ministers, senior officials and civil society have all touched on the continuing relevance of the Commonwealth. In Seychelles they’ve taken a problem left behind by empire and addressed it using the empathy and solidarity that are the hallmark of the People’s Commonwealth.

Image credit: Flickr CC darkday

Through a different lens

Posted on by Emma D'Costa

Despite extensive planning, when Commonwealth Writers start work on a creative project, we don’t always know the exact course it will take or what unexpected results it will achieve.

In 2012 we launched a capacity building scheme to give emerging writer-directors the opportunity to make a film on the theme of relationships. Five filmmakers – from Bahamas, Barbados, Canada, Kenya and New Zealand – made short films which highlighted issues affecting them and their communities.

The subject of one of these short films, Passage, by Bahamian filmmaker Kareem Mortimer, is now an award-winning feature film, Cargo, which won the Amnesty International Human Rights Award at the Trinidad+Tobago Film Festival recently. The Award recognises the importance of film as a vehicle for raising awareness about human rights issues and advancing inclusion and social justice. Films such as Passage and Cargo tell the personal story and human cost of illegal migration, putting dangers and suffering under the spotlight, and giving the viewers a different perspective.

‘Cargo examines the world’s refugee crisis from a very local perspective’

Kareem has described Cargo as the ‘feature version of (his) short film Passage’, feeling that ‘there was a great deal more to be said about human smuggling.’ Passage tells the story of a young Haitian woman and her brother fighting for survival while being smuggled into the United States on a dilapidated fishing boat. With over fifty screenings to date, including showings in New Zealand, Nigeria, Europe, the Caribbean and the US, Passage has also won a number of awards including the Best Diaspora Short Film at the Africa Movie Academy Awards 2014. It also made Kareem the first Bahamian filmmaker to show a film in Havana, Cuba, at the International Festival of New Latin American Cinema.

Inspired by true events, Cargo examines the world’s refugee crisis from a very local perspective. When his income, further eroded by his gambling addiction, proves insufficient to cover his son’s school fees, an American exile living in the Bahamas turns to human smuggling in order to raise desperately needed funds. He finds that he is good at this dangerous yet profitable enterprise —good enough to trust himself with smuggling his own girlfriend and her son to the US. But when faced with having to abandon refugees at sea far from Miami shores, he is suddenly forced to reassess his responsibilities.

The largest Bahamian film project to date, this latest feature from Mortimer is, as described by the Miami Film Festival where it premiered in March 2017, ‘a thrilling, vital call for empathy in troubled times.’ As Mortimer has said, he hopes the film ‘sparks conversations …. We live with this and have been living with this for the better part of 30 years. It’s time to address it. Bodies wash up on shore a couple of times a year.’ As well as portraying the human cost of illegal migration, the feature film shines a light on Bahamian culture, something rarely seen in films where the islands are more often simply an exotic backdrop.

‘The last scenes are gutting, yet your heart is left pounding for unexpected possibilities for survival and opportunity.’

One of the judges for the Amnesty Award, Trinidadian writer, activist and scholar Gabrielle Hosein, said that Cargo, ‘presents real life for many Caribbean people in layer after layer of devastating, intimate and disturbingly beautiful detail. The story-telling is deeply personal, yet feels global. You visually connect to the land and seascape of the Bahamas, where Mortimer’s film is based, but cannot help but think about such experiences cross-cutting our blue planet. The film follows multiple vulnerabilities and imperfections as experienced by Jamaican migrant workers, Haitians seeking a better life and middle-class deportees. It also explores the difficulties of family as they intersect love, sex and the global economy, and their complex inequities. While focus is on the disempowering effects of illegal migration, trafficking in persons, the drug trade, and domestic and retail sector workers’ low-status and informal labour, you are left gasping for breath … The last scenes are gutting, yet your heart is left pounding for unexpected possibilities for survival and opportunity.’

Four films from Commonwealth Writers’ latest film project, Commonwealth Shorts: Pacific Voices, are about to be premiered at the Hawaii International Film Festival on 10 and 11 November.

Six writer/directors from Tonga and Papua New Guinea attended script development workshops with local script editors before developing their own scripts and shooting their own films, with the assistance of BSAG Productions in New Zealand. Like the original Commonwealth Shorts, all the films highlight stories and issues which affect their communities, as well as shedding new light on Pacific culture and opening the world’s eyes to talented filmmakers.

Emma D’Costa is Senior Programme Officer for Commonwealth Writers, the cultural initiative of the Commonwealth Foundation.

SDGs: it’s NOT just about data

Posted on by Myn Garcia

It has been buzzing in development circles. But it seems stronger now in certain places. It’s the buzz on the data revolution.

And there is also a lot of talk about the need for people in the margins to participate in the monitoring the Sustainable Development Goals (SDGs). But what does the data revolution mean? And what would it take for citizens to be interested in monitoring the SDGs?

The Participate Initiative’s Policy Brief, Using knowledge from the margins to meet the SDGs: the real data revolution says that ‘the ultimate success or failure of the SDGs depends, in large part, on inclusion.’ Indeed, inclusion is key. But what does inclusion look like? What does it take for the SDG process to be genuinely inclusive in a governance context? SDG 16 is regarded as the goal that would ‘unlock’ the SDG framework and fulfil the ‘ambition to leave no one behind.’ But how?

‘Arguably, localisation is about taking the SDG agenda back to its roots, where the difference matters and where it actually matters most.’

Domestication and localisation of the SDGs is an effort that is currently underway in many countries. Dissecting how it works allows us to understand facets of inclusion. To say localisation gives one the impression that the process now should be driven from the top to the ground after a set of global goals have been agreed. Lest we forget, the goals were arrived at after civil society, community-based organisations and NGOs were consulted (perhaps over consulted) in developing the architecture for the Post 2015 Development Agenda. Arguably, localisation is about taking the SDG agenda back to its roots, where the difference matters and where it actually matters most.

One of the tasks at hand for the sustainable agenda “unanimously adopted by 193 UN members” is to ensure the domestication of the agenda into national development plans and / or poverty reduction strategies of countries and that these are informed and influenced by local development plans developed through processes that are participatory, formal and informal.

‘Inclusion in governance undeniably requires political will and is complex, embedded in a system.’

A decentralised structure of governance allows for people’s participation at the local level with citizens engaging with local authorities and councils. Conversations with civil society, local authorities and local councils in some Commonwealth countries raised the challenges to decentralisation. But they also pointed to some of the enabling processes:

  1. Formal, institutional spaces designed for citizen to engage and have the authority to input in or influence decision-making processes such as local planning and budgeting. This may come in the form of membership in local councils and service delivery committees, among others
  2. Informal engagements such as citizen led mobilisation, advocacy campaigns and community-based dialogues on issues that policy makers would be able to consider for the agenda of both the executive and legislative council, for example
  3. Raising awareness of citizens’ rights in areas that matter to them such as delivery of services; enabling citizens to engage more constructively and confidently
  4. Citizen-generated and evidence based data which includes citizen scorecard and gender barometer and individual or collective stories and testimonials which would facilitate dialogues and other inclusive processes between government and citizens
  5. Citizens access to information and protection of fundamental freedoms
  6. Collective action and social movements that connect people in the margins to people in power- in government, civil society and wider society including the media, donours and the private sector

Inclusion in governance undeniably requires political will and is complex, embedded in a system. Inclusion engenders accountability which should be understood within a system characterised by the nature of power and economic, cultural and social contexts. It requires an integrated approach at different levels in a web of interconnections. It certainly can’t work through ‘one-off processes of consultation or narrow citizen-monitoring mechanisms‘. It is definitely not just about data.

Myn Garcia is the Deputy Director-General of the Commonwealth Foundation. Image credit: Flickr CC Judson Weinsheimer

Realising rights to health care

Posted on by Timothy Wafula

Article 43(1)a of the Constitution of Kenya guarantees the right to the highest attainable standard of health, which includes the right to health care services, including reproductive health care.

The realization of this right is fundamental to the physical and mental wellbeing of all individuals and is a necessary condition for the exercise of other human rights. In the implementation of the right to health care, State officers are bound by Article 10’s constitutional principles of transparency and accountability.

The Kenya Legal and Ethical Issues Network on HIV and AIDS (KELIN) is a human rights non-government organization that advocates for the full enjoyment of the right to health by all, including vulnerable, marginalized, and excluded populations.

‘The project adopts a capacity building approach for communities and the media to demand increased transparency and accountability in service delivery and health-budgetary spending’

Starting this October KELIN, with support from the Commonwealth Foundation, will commence implementation of a project titled: Protection of right to health of the vulnerable through transparency and accountability. This project, which will be implemented in the regions of Mombasa, Nairobi, Kakamega and Kisumu, seeks to ensure that resources allocated to the health sector are utilized in an accountable and transparent manner. KELIN will work with community based organisations (CBOs), civil society organisations (CSOs), the media and communities of persons living with and affected by HIV and TB to monitor implementation of the right to health.

The project adopts a capacity building approach for communities and the media to demand increased transparency and accountability in service delivery and health-budgetary spending:

“The Constitution of Kenya provides for public participation in governance, health-governance included. Public participation is a powerful accountability tool that citizens can use to monitor formulation and implementation of laws, policies and guidelines by governments. This project will provide communities and the media with information, knowledge, and platforms to demand for accountability and transparency in the health sector.” – Allan Maleche, KELIN Executive Director.

An estimated 26% of the total health expenditure in Kenya is derived from development assistance. Relatedly, 72% of the total expenditure for HIV is from development partners or aid. Lack of transparency and accountability can have dire consequences, and impact negatively on realization of health rights. For instance, the United States Agency for International Development (USAID) recently suspended direct assistance to the Ministry of Health. Among the reasons cited for the suspension included lack of accountability.

‘An estimated 26% of the total health expenditure in Kenya is derived from development assistance’

This new project builds on a previous one named “Enhanced Protection of PLHIV Rights through Participatory Governance” which was implemented from 2013 to 2016, with support from the Commonwealth Foundation. The project enhanced and strengthened the knowledge and capacity of CSOs, PLHIV, and CBOs on participatory approaches in governance; and promoted active participation in the legislation process.

In preparation for the project, as KELIN’s Program Officer I joined the Commonwealth Foundation and other grantees, from 3-6 October 2017 at a workshop on monitoring, assessment and learning. The Workshop, held in London, brought together 14 organizations receiving support from the Commonwealth Foundation to implement projects in Commonwealth countries including Papua New Guinea, Tonga, Sri Lanka, India, Pakistan, Nigeria, Mauritius, and Kenya. The workshop equipped us with knowledge on developing, monitoring and assessment plans that would ensure projects achieve their intended purposes.

KELIN will use the current project to give communities the knowledge and voice to demand for transparent and accountable implementation of the right to health.

To contribute to the discussion and for live updates you can find KELIN on Twitter @KELINkenya and Facebook: http://www.facebook.com/kelinkenya. Image Credit: KELIN Kenya

Non-binary approaches to climate change: time is up for the politics of them and us

Posted on by Vijay Krishnarayan

It has taken two category five hurricanes to bring the Caribbean and climate change on to the world’s front pages.

The nature of news is such that as we try to fathom the devastation wrought by Irma and Maria, the loss of life and livelihoods caused by the recent flooding in South Asia seem dim and distant. The scale of the damage is hard to grasp: 41 million affected by floods in Bangladesh, India and Nepal; a third of Bangladesh under water; £230 million to repair Barbuda alone; and 90% of Dominica’s buildings damaged. All of this on top of the immeasurable trauma and loss of life.

Will these facts move the international community beyond the standard reactions and urgings to adapt to new climate realities? The Commonwealth and like-minded institutions could play an important role in identifying the need for responses that take their lead from the people most directly affected – most of whom would argue that they have not been listened to so far. The President of Kiribati brought the plight of his Pacific island state to the attention of the UN General Assembly in 2004. He had to wait another three years before there was anything like a global consensus on the nature of the problem.

Aware that established international ways and means were not getting the message across, cultural activists in the Caribbean used song, poetry and performance as part of the 1.5 to Stay Alive campaign in support of the region’s position at COP21 in Paris two years ago. This called for a legally binding agreement, applicable to all, and ensuring that greenhouse gas emissions stop at levels that limit the global average temperature increase to well below 1.5° Celsius by 2100.

‘Whether they are Presidents or Poets those unheard voices tell us that change is needed.’

Whether they are Presidents or Poets those unheard voices tell us that change is needed. This means getting at the root causes of storms and floods, the likes of which we’ve never seen. The principle of “common but differentiated responsibilities” has been a rallying cry for the Global South since 1992 and if the argument in favour of calling to account those doing the most damage needed further support it can surely be found in the events of the last month.

People affected tell of the need for space in global discussions on climate change that takes account of local realities. This means real engagement and involvement in the details of making a global agreement stick. They point to the need for joined up and collaborative approaches to natural resource management that work across national borders as well as locally in the interests of people whose livelihoods depend on those very resources, which include rivers, forests, mangroves and reefs.

Those voices are calling for more ambitious climate targets and joined up thinking on economic and development policies. Fundamentally, they have identified inequality between nations and within nations as a major barrier to addressing the causes and consequences of climate change. The humanitarian crises that follow the passage of these storms are a damning indictment on the lack of agency and urgency in addressing the challenge.

‘Senior officials arguing the case for small states in climate change discussions are strengthened by the advocacy undertaken by their counterparts from civil society.’

Of the many startling vignettes revealed by the recent storms, the testimony from Dominica’s Prime Minister Roosevelt Skerrit as he recalled his experience of taking cover under a mattress as the roof of his house was torn off by Hurricane Maria was powerful. In that moment there was no distinction made between government and non-governmental. This binary divide prevents us from building the coalitions and alliances needed to make marginalised voices heard. The political leaders and senior officials arguing the case for small states in climate change discussions are strengthened by the advocacy undertaken by their counterparts from civil society.

The Commonwealth and other institutions that are committed to global equity can play a role in helping to convey a sense of urgency and by bringing seemingly disparate governments, politicians, officials, organisations and individuals together. The demand is there and manifests itself in the powerful solidarity between sister member states. To see Antigua and Barbuda reach out to Dominica with an offer of support in the aftermath of Hurricane Maria was humbling.

The platform that the Commonwealth provides for its 30 small states is well documented and has achieved real impact. There is more to do. The floods in South Asia and the drought in Southern Africa tell us that climate change is not solely a small state issue and the Commonwealth provides a platform to identify common cause and foster collaboration across its membership. The Commonwealth Foundation is prepared to play its part – in the first instance by supporting dialogue between affected civil society and their colleagues in government to develop a common agenda.

Next year’s Commonwealth Summit, hosted by the United Kingdom takes place under the theme “Towards a Common Future” and it will feature discussions on sustainability and climate change. In addition to taking stock of the outcomes of COP23 in Bonn this November, the Summit will provide a moment to forge and consolidate a community for advocacy – one that brings together big and small, government and non-government, north and south. It’s a good opportunity to articulate “non-binary” positions that draw on the common concerns of diverse partners. As the Summit’s theme suggests, climate change responses call for social justice as much as disaster relief. It also acknowledges that there is work to do in order to achieve this.

Image credit: Flickr CC Cayobo

The full picture: the Partner’s Learning Exchange 2017

Posted on by Commonwealth Foundation

As part of capacity development support to the South African Alliance on Youth Employment (SAAYE), the Commonwealth Foundation brokered a learning exchange with Citizens UK, trialling a new model of support. This multimedia story explores the techniques used in the exchange to help civil society to better organise.

‘It taught me to celebrate people’s identities, stories and history’

Posted on by Yasmin Aktar

‘I came to South Africa eager to learn from the young leaders of SAAYE and what I ended up finding out had a huge impact on me.’

I have been working as a community organiser with Citizens UK for 4 years in one of the most diverse boroughs in London – Tower Hamlets, where over 55 languages are spoken.

My colleague, Emmanuel Gotora and I were the main facilitators for the recent Learning Exchange between Citizens UK and SAAYE. I came to South Africa eager to learn from the young leaders of SAAYE and what I ended up finding out had a huge impact on me. I saw politically engaged young people and individuals working together to create social change in the world. They had hope despite the huge challenge of youth unemployment and the slow progress or seeming in-action of their governments to address it. I also saw young people rooted in their history and culture, who readily shared their different identities.

Social change has been a part of their day-to-day lives. It has shaped who they are and made them proud of their country. Music and dance were a regular feature of our workshop energisers. This was a stark difference from the leaders that I work with in the UK. I attribute this difference to the heightened political awareness of the participants and a strong identity shaped by recent history, that of the liberation struggle. Social change has been a part of their day-to-day lives. It has shaped who they are and made them proud of their country.

What was even more remarkable was the speed at which SAAYE members grasped, challenged and understood the concepts, teachings and universals that we were delivering. Their ability to challenge and question what was being presented showed us that they were reflecting upon it within their own contexts. They were definitely the right people for the task. I could see light bulb moments within each one of them.

We adapted the trainings based on the needs and experiences of the participants, but the training proved to me that the universals that we teach in community organising are truly universal. SAAYE members were able to grasp the concept of understanding power and how to build relational power as if it was natural to them. I saw this from the first day, during our Athenian-Melian role play. Irene, who had assumed a lead role, refused to leave the negotiation table when Emmanuel asked her to leave[1]. Instead, she stayed throughout the negotiations acknowledging that what mattered at this moment was the deal on the table because it concerned her future.

As a facilitator, we are trained not only to teach the content of our training but to adapt it according to the context of the room. This can be challenging at times but because SAAYE members were clear on adapting Citizens UK’s experiences to their own, it became natural and easy. One of the main case studies that we shared was Citizens UK’s Good Jobs Campaign that focuses on creating employment opportunities for young people. Based on participant’s reflections and drawing on the experience of Good Jobs Campaign, I introduced an issue based organising model – an adaptation of the broad based organsing model, which also brings together principle partners from the state, market and civil society to meet the needs of people at grassroots levels.

The Learning Exchange with SAAYE provided me with a lot of learning about Southern Africa and for myself as a community organiser. It taught me the value of understanding the context in the room and it made me realise that I need to do more at Citizens UK to celebrate people’s identities, stories and history.

[1] During the Athenian-Melian role play, in order to change the dynamics of the negotiations and get the actors to think on their feet, the facilitators often create an intervening scenario. In Irene’s case, she was called to an important meeting, but then refused to go.

Read the full multimedia story on the learning exchange here

Healthy discussion: but will Ministers listen?

Posted on by Vijay Krishnarayan

Anton Kerr, former Director of HIV/AIDS alliance and chairman of Commonwealth Health Professions Alliance, makes the case for increased spending on health. Photo credit: Leo Kiss

But will Ministers listen? That was the thought that nagged away throughout the short flight from London to Geneva as I travelled to attend this year’s Commonwealth Heath Minister’s meeting. They meet in the wings of the World Health Assembly and we work to bring civic voices to that Commonwealth ministerial gathering. Naturally civil society organisations across the Commonwealth have an interest in trying to influence the outcomes of the ministerial meeting. To do this we convened a policy dialogue at the Commonwealth Civil Society Forum that addressed the themes that would come up in the Commonwealth Health Ministers Meeting, which met under the banner “Sustainable Financing of Universal Health Coverage as an Essential Component for Global Security Including the Reduction of All Forms of Violence. But would they listen?

I came away from Geneva understanding that I had been asking the wrong question. It’s not a question of getting ministers to listen – rather the challenge is getting ministers, officials and civil society to talk with each other in order to find workable solutions to the health challenges we face. The approach we took this year was two-fold.

Firstly, we broadened the debate so that a wider cross section of civil society was able to participate in the discussion. Not only did this bring a Commonwealth agenda to a new audience – it also provided an opportunity for voices less heard to be given a platform. We convened a working group comprising the Commonwealth Health Professionals Alliance, Third World Network and the International Community of Women Living with HIV in Eastern Africa so that civil society organisations were designing and steering the process. They also delivered the three policy papers that formed the basis of the discussions at the civil society forum. Those papers included policy asks of Commonwealth Ministers. Those policy asks drew on the inputs of more than 100 other civic voices from across the Commonwealth through a survey. The process also drew in new stakeholders.

Secondly we deepened the discussion so that Ministers were provided with perspectives from civil society that they might not have considered or previously been exposed to. The three papers explored each of the strands on the Ministerial agenda: adding a gender equality dimension; exploring the utility of the concept of well-being; and provoking a discussion on the financing of universal healthcare.

The papers stimulated discussion in different ways. The paper by Saamah Abdallah on the Politics of Wellbeing challenged conventional metrics of development. It posited wellbeing as a sustainable condition that enables the individual to develop and thrive. Its holistic approach encourages ministries and agencies to collaborate. In data collected to date it seems there is a correlation between high levels of wellbeing in a population and “good” governance. The paper on structural violence and its impact on women’s health was powerfully delivered by Lillian Mworeko. She cited instances of forced sterilisation of women living with HIV. She made the point that when institutions visit this violence on women they foster discrimination and stigma and this despite progressive laws and policies. Tony Nelson presented on financing Universal Health Care. The provocative thesis suggested that spending more on health care doesn’t always result in better health outcomes and that greater accountability is needed on way that resources are allocated and spent.

But would Ministers listen? The chances of giving the issues raised by civic voices a proper airing is constrained by the format of the Ministerial Meeting so we invited policy makers to sit with civil society at the Forum and respond to the policy changes being suggested. The Minister of Health for Barbados, Hon. John Boyce provided new insights on the potential of alliances between civil society and Ministries of Health. He described moves to address sugar in soft drinks in Barbados, where collaboration had worked well. Dr Jabbin Mulwanda, the Permanent Secretary for Health Services in Zambia affirmed how helpful civic inputs were for civil servants charged with finding solutions to public health challenges. Their willingness to engage at the Forum helped to achieve our objective of dialogue. Without them the Forum would have been one more civic gathering and there are plenty of spaces where civil society can talk to itself. I know colleagues from governments valued the exposure and I dare say we enhanced their Commonwealth Health Ministerial Meeting experience.

We provided a Commonwealth space that encouraged the co-creation of new policy thinking in a collegial and informal setting. We went some way to making room for less heard voices and south-south exchange. The process worked well and everyone got a boost from the attendance and participation of the Commonwealth Secretary-General, Hon. Patricia Scotland QC. It was the first time that an SG had actively listened to what civil society had to say about the Health Ministers’ agenda and her assurance that the policy asks made would be given proper consideration was widely appreciated.

But did Ministers listen? The crude indicator in these matters is the final statement that Ministers issue at the end of their meeting. These statements are brief and summarise the main points. In the Commonwealth system they generally serve to signal intent rather than bind governments to specific commitments. Last year the Ministers’ statement included the line: “we note the civil society participation and contribution to discussions on sustainable financing and encourage their ongoing participation in health policy.” This was a disappointing result and perhaps responsible for that nagging refrain that wouldn’t go away – “Will Ministers listen?”

I looked at this year’s statement with hope restored. In paragraph 12: “Ministers noted the report from the Civil Society Forum Policy Dialogue which highlighted the need for a universal health system that provides basic minimum package of services to all as a key priority; emphasised well-being as core to health policy and being more than just absence of disease; and, raised the issue of structural inequalities and violence and their impact on the utilisation of healthcare.” This year it seems, at least the substance provided by civil society at its Forum had been registered.

Yes, Ministers of Health did listen to what civil society organisations had to say but now I was left with a new concern. If the priorities in the Ministers’ statement are going to be implemented – the position of Health Ministers in national administrations needs to be strengthened. My new question was “Does anyone listen to what Ministers of Health have to say?” Surely dialogue and alliances between health ministries and civil society for a common cause can only improve the chances.

What next for peacebuilding in Africa?

Posted on by Commonwealth Foundation

At Wilton Park’s third meeting on ‘Peacebuilding in Africa’ series, participants were asked about the biggest opportunities or hindrances to sustainable civil society engagement in the African peacebuilding process.

Myn Garcia, The Commonwealth Foundation’s Deputy Director, spoke about the importance of localised civil society action to peaceful development and the need to acknowledge the multitude of national and local perspectives in the African context.

Previous events in Wilton Park’s ‘African perspectives on peacebuilding’ series have assessed the development of African approaches to peacebuilding in response to the changing dynamics of conflict and emergence of new conflict actors on the continent.

For more details explore Wilton Park’s website.