Governance Area: Policy accountability
Health and disability rights: using legal frameworks
The Foundation recently convened learning exchanges with civil society leaders working on health and disability rights—particularly the rights of vulnerable populations who have been ‘left behind’. The participants, who hailed from 11 Commonwealth countries and had each received support from our grants programme, shared strategies and approaches to realise these rights by making governments more accountable; this is the third in a series of blogs profiling the case studies our partners shared.
The evidence is unambiguous: vulnerable and marginalised groups—including women and girls, the poor, and persons with disabilities (PwDs)—are very far from achieving the promise of universal health coverage. And much remains to be done before we come close to realising the globally agreed Sustainable Development Goal of ensuring healthy lives and wellbeing for all. It is significant that the estimated one billion PwDs in the world continue to be denied equitable participation in society due to prevailing material and attitudinal barriers. They face higher rates of multidimensional poverty, lower educational attainment and rates of employment, and poorer health outcomes. The COVID-19 pandemic has exacerbated these inequalities.
Civil society plays a critical role in promoting and protecting health and disability rights. Civil society groups can, for example, hold their governments to account in respect of rights enshrined in national legislation and the constitution. International treaties can also provide a valuable framework for advocating for improved protection of rights including through changes to domestic law and policy.
Alternative reports to the international treaty bodies
The Shanta Memorial Rehabilitation Centre (SMRC) has been gathering grassroots data on disability for years in partnership with civil society organisations throughout India. Their data is consistent with the UN’s findings: women with disabilities face more obstacles than their male counterparts and struggle to access ‘adequate housing, health, education, vocational training and employment’.
In 2019, SMRC and its partners submitted an alternative report to the UN Committee on the Rights of Persons with Disabilities (CRPD). This is a process which enables civil society to provide an alternative point of view to the official reports submitted by governments under international treaties. The report, which was presented by a group of women with disabilities, contained 33 recommendations. It detailed what they were seeing on the ground in relation to Article 6 of the Convention on Persons with Disabilities, which relates specifically to women. They also included data on 15 other articles that intersect with Article 6, on the Right to Life, Access to Justice, Education, Health and Employment, and Freedom from Violence.
Their data identified nine major barriers faced by women with disabilities including discriminatory attitudes and low standards in service provision, challenging the Indian Government’s data on this point. Many of the report’s findings and recommendations were cited when the CRPD reported back to the Indian Government at the conclusion of the review process.
The report, along with the remarks of the committee, were later disseminated to communities and disabled persons organisations in India. SMRC provided training on how to use the documents for advocacy purposes, thereby helping to create a groundswell of grassroots campaigning. Hundreds of people with disabilities are now reaching out to officials in their own states and pressing for change. Some trainees have even approached the courts where they feel government action is either not forthcoming or too slow.
Review and reform
Research that took place in 2012-13 found that mental health legislation in the Seychelles and Botswana was outdated and ignored advances in care and treatment, denying those living with mental health problems their basic rights. The Commonwealth Nurses and Midwives Federation and its partners established a National Mental Health Advisory Committee (NMHAC) in each country that involved civil society representatives and government officials. The job of these committees was to review existing legislation, prepare guidelines for law reform, and educate stakeholders and the public on mental health issues.
‘the central mental health law was focussed on keeping the mentally ill in custody and excluding them from society’
In the Seychelles, the government had ratified the Convention on Persons with Disabilities (CRPD). The job of the newly-formed Committee was, therefore, to help ensure domestic legislation was up to the new standard agreed to by the government through its ratification of the treaty. The Committee’s review revealed substantial gaps and weaknesses and it confirmed that new domestic legislation was required. A new mental health act went before Parliament in 2018 and was enacted into law in the National Assembly in May 2020.
Unlike the Seychelles, Botswana has not become party to the CRPD. However, Botswana’s constitution affirms the right to life, to personal liberty and freedom, as well as freedom from inhumane treatment and discrimination. The National Mental Health Advisory Committee’s analysis identified numerous violations of these fundamental rights. Because the central mental health law was focussed on keeping the mentally ill in custody and excluding them from society, the Committee decided that it could not be reconciled with a rights-based approach. In response, and using drafting instructions provided by the Committee, the Attorney General drafted a new mental health bill that will soon go before Parliament.
Strategic litigation
Where collaboration and dialogue do not work, civil society may use litigation to ensure governments implement their legal commitments. In 2015, the Kenyan government issued a Presidential directive for district education departments to collect the names of HIV positive school children and their guardians. Although the Directive was aimed at delivering more effective care, it exposed children to potential discrimination that could cause real hardship and adversely affect educational outcomes.
‘it exposed children to potential discrimination that could cause real hardship and adversely affect educational outcomes’
Community representatives wanted safeguards to be put in place to protect individuals from having their HIV status known in this way. Efforts to lobby the government to change the Directive were unsuccessful. The Kenya Ethical Legal Issues Network on HIV and AIDS (KELIN), alongside a child rights agency and the families of two children living with HIV, brought a case against the government arguing that the Directive violated fundamental rights and freedoms in contravention of the Kenyan constitution.
The High Court of Kenya ruled that the Directive did indeed breach the right to privacy and was in violation of the overarching guiding principle of the ‘best interests of the child’. It ordered all data to be anonymised so a person’s name could not be linked to their HIV status. In partnership with community leadership, KELIN continues to advocate for legal compliance with the court ruling, providing awareness-raising for schools and supporting schools’ efforts to help children living with HIV.
Next month in our blog series on health and disability rights accountability, we look at how our partners build multi-stakeholder coalitions to achieve their advocacy goals.
Dr Shobha Das is a former Director of Programmes at Minority Rights Group International and Gillian Cooper is the Programme Manager of Knowledge, Learning, and Communications at the Commonwealth Foundation.
Health and disability rights: building coalitions
The Foundation recently convened learning exchanges with civil society leaders working on health and disability rights—particularly the rights of vulnerable populations who have been ‘left behind’. The participants, who hailed from 11 Commonwealth countries and had each received support from our grants programme, shared strategies and approaches to realise these rights by making governments more accountable; this is the second in a series of blogs profiling the case studies our partners shared.
The evidence is unambiguous: vulnerable and marginalised groups—including women and girls, the poor, and persons with disabilities (PwDs)—are very far from achieving the promise of universal health coverage or the Sustainable Development Goal of ensuring healthy lives and wellbeing for all. Further, the estimated one billion PwDs in the world are denied equitable participation in society due to prevailing material and attitudinal barriers. They face higher rates of multidimensional poverty, lower educational attainment and rates of employment, and poorer health outcomes. The COVID-19 pandemic has made these inequalities starker.
Coalition building can be a powerful force for change, not least because coalitions of like-minded organisations working towards a common purpose provide greater visibility for a cause by engaging groups across society. As the following case studies demonstrate, those within a coalition also share information and pool their skills, vastly increasing their potential to create and sustain change.
Two case studies from Kenya
Action Network for the Disabled (ANDY) is a Disabled Persons Organisation (DPO) in Kenya. They are working in partnership with Able Child Africa to realise the rights of children and young people with disabilities.
ANDY builds coalitions at both the national and community levels in Kenya.
The National Disability Coalition brings together disability rights activists with other civil society groups working on related issues such as education, health, and employment. The coalition builds relationships with decision-makers. It also establishes nationwide policy priorities, key messages, and raises awareness of disability rights issues.
At the community level, ANDY identifies informal groups that are organising around an issue. For instance, the Sagana Disabled Self-Help Group in Kirinyaga county is an informal collection of businesspeople with disabilities who are looking for ways to make the business environment more disability-friendly, including through seeking exemptions from business fees. Such groups, which ANDY calls disabled people’s groups, have a detailed understanding of the local needs of people with disabilities but often lack the capacity to engage government on matters of policy. ANDY and other civil society organisations in the network build their partners’ skills in advocacy, fundraising, and collecting evidence. They then connect the disabled people’s groups with the relevant decision-makers in the network.
This strategy has proven effective. For example, a disabled people’s group in Machakos county worked with a number of formal organisations in the network to improve the accessibility of local buildings and, together, they managed to successfully lobby the county government to pass the necessary legislation. In another example, in Kirinyaga county, ANDY connected a disabled persons group working to protect children with disabilities from abuse to the government’s local children’s officer. They now work regularly together to resolve cases.
Using Community Champions
KELIN’s mission is to improve the quality of life for people living with HIV by making sure the government meets its commitment to protect their health and wellbeing. A fundamental part of their strategy is to build the capacity of people living with HIV to collaborate.
KELIN use a two-step process. First, they identify all relevant non-government stakeholders in an area—this includes people living with HIV, communities affected by HIV, health providers, civil society organisations, community-based organisations, and media with an interest in health issues. They then bring the groups together for a two-day training and networking session. Those involved are provided with information on the rights of people living with HIV and how decisions are made by government. They then develop work plans based on the priorities they agree on, as well as the most appropriate methods for engaging relevant decision-makers.
At the end of the event, the group selects a sub-group of Community Champions who meet on a quarterly basis. Community Champions continue to identify and prioritise the most important issues throughout the year to ensure the coalitions’ advocacy strategy is responsive to evolving needs. For example, Community Champions in Mombasa noticed that women with HIV or TB were being detained in a health facility after giving birth, due to non-payment of hospital charges. The coalition met formally with officials at the facility to point out that the practice of detainment was not in line with the government’s stated commitment to free maternal services. This led to the head of the health facility working with their team to eliminate the practice.
KELIN has found that building coalitions in this way leads to sustainable change. For example, involving journalists in the coalition results in coverage and raised public awareness. Community Champions gradually develop the confidence and know-how for independent advocacy. And the government also begins to see the value in regular community feedback. This is well illustrated in Mombasa, where local officials now invite Community Champions to join regular working groups so they can provide input on policy and practice.
Dr Shobha Das is a former Director of Programmes at Minority Rights Group International and Gillian Cooper is the Programme Manager of Knowledge, Learning, and Communications at the Commonwealth Foundation.
Health and disability rights: gathering citizens’ voices
The Foundation recently convened learning exchanges with civil society leaders working on health and disability rights—particularly the rights of vulnerable populations who have been ‘left behind’. The participants, who hailed from 11 Commonwealth countries and had each received support from our grants programme, shared ways to realise these rights by making governments more accountable. This is the first in a series of blogs profiling the approaches our partners have taken.
Existing research is unambiguous: vulnerable and marginalised groups—including women and girls, the poor, and persons with disabilities (PwDs)—are very far from achieving the promise of Universal Health Coverage (UHC) or the Sustainable Development Goal of ensuring healthy lives and wellbeing for all. Further, the estimated one billion PwDs in the world are denied equitable participation in society due to prevailing material and attitudinal barriers, facing higher rates of multidimensional poverty, lower educational attainment, lower rates of employment, and poorer health outcomes. The COVID-19 pandemic has made these inequalities starker.
If you want to ensure a government remains accountable to a community, gathering data directly from that community is a vital first step. Decision makers rarely seek citizen data automatically and voluntarily, and disadvantaged communities may not readily have the capacity to know when, how, and where to provide it in order to influence decisions. The media, civil society organisations (CSOs), and research groups play a key role in the collection, synthesis, and communication of citizen data. Many Commonwealth Foundation partners fulfil this intermediary role. The key to their success has been to fully involve the communities they are trying to help in the process—ensuring it is both credible and sustainable.
Here are two examples of how this has been done effectively:
Community scorecards, Jadabpur Union Council, Bangladesh
Beneficiaries under the Bangladesh government’s Vulnerable Group Development (VGD) scheme are entitled to 30kgs of rice each month—this is a safety net to provide food security for the poorest and most vulnerable citizens. Government officials believed that the scheme was satisfactorily reaching all those in need, but Access Bangladesh Foundation found that many persons with disabilities (PwDs) living in poverty were not accessing the scheme due to lack of awareness, gender discrimination, and nepotistic and non-transparent beneficiary selection.
‘The scores revealed a gulf between the perceptions of PwDs and government officials.’
In order to hold the government accountable to its promises, Access Bangladesh first needed to find an effective way to demonstrate the gulf between PwD’s and the government’s perceptions of the scheme. For this, they designed a community scorecard for the Jadabpur Union council. Through focus groups and individual meetings with PwDs and government officials, they identified the most relevant performance criteria on VGD schemes including the beneficiary selection process, the attitudes of staff providing the service which affected how PwDs felt, and the quality and quantity of items. The scores revealed a gulf between the perceptions of PwDs and government officials. For instance, government officials scored themselves highly on the quality of information provided to PwDs before beneficiary selection, as well as on beneficiary selection itself—PwDs gave the government low marks for both.
Access Bangladesh then facilitated discussions between the two parties during which the scores were revealed. PwDs explained how the government could improve the scheme’s uptake, while government representatives explained their constraints. Through dialogue, both parties agreed on how to improve access to the support schemes. This exercise produced reliable citizen data, initiated a sustained dialogue among service users and providers, increased the trust PwDs held in government because they were listened to, and led to more-inclusive service delivery. For example, women with disabilities were given priority in future beneficiary selection because their additional vulnerability was recognised. In addition, PwDs became more aware of the scheme and the numbers of users increased. In particular, the vulnerability of women with disabilities was recognised and they were given priority in future beneficiary selection. The success of the project was driven by each party working together before, during, and after the meeting in a manner that ensured equal participation. The exercise also improved the confidence and problem-solving skills of the PwDs involved, who are currently following through on the scorecard exercise to ensure that promises are being delivered on.
Social audits, India
During their work in India, Carers Worldwide (CW) found anecdotal evidence that many PwDs in remote, rural and tribal areas were not counted in government disability data, or were miscategorised as having low-level disability and were not in receipt of adequate support. Upon investigation, the assessment process was found to be deeply flawed: camps were only held once per year at locations in each district shown to have poor accessibility. PwDs who couldn’t attend these camps did not get disability certificates and received no government support as a result.
‘They entered the discussion armed with a powerful combination of clear data, a call to action, and the presence of PwDs and their families’
CW brought this to the attention of government officials and other decision makers with the help of a local organisation called SPREAD. A year passed without progress and so CW, alongside local partners and PwDs, decided a new strategy was required. They conducted a large-scale social audit to ascertain data on disabilities and government support. The audit was implemented by PwDs and carers in two villages as pilots before it was scaled up to 34 villages. The data showed the extent of the problem: hundreds of PwDs in this small area were not registered and not claiming government support. Poor community knowledge on accessing support and an inadequate understanding of what counted as a disability had profound impacts with mental illness, stroke, and accident-acquired disabilities too often going undeclared. Perhaps the most striking finding was that 80% of persons with severe disabilities had been wrongly categorised as having ‘minor disabilities’—leading them to claim far less government support than they were entitled to.
A coalition of CW, local partners, PwDs, and carers presented these results to local government officials during a face-to-face meeting. They entered the discussion armed with a powerful combination of clear data, a call to action, and the presence of PwDs and their families. This combination attracted the attention and empathy of government officials who took swift action. As a result, assessment camps are now held three times a year in several locations and involve increased numbers of staff and attendant PwDs. Additionally, hundreds of PwDs have been registered as disabled or re-categorised to reflect their actual level of disability and are now in receipt of the government support they are entitled to.
Next month in our blog series on health and disability rights accountability, we will share case studies that demonstrate the importance of coalition building and leveraging networks.
Dr Shobha Das is a former Director of Programmes at Minority Rights Group International and Gillian Cooper is the Programme Manager of Knowledge, Learning, and Communications at the Commonwealth Foundation.
Caribbean island states and COVID-19: re-building resilience
Caribbean Island States are characterised by, among many other things, small but growing populations, limited resources, remoteness, susceptibility to natural disasters, vulnerability to external shocks, excessive dependence on international trade, and fragile natural environments. For many Caribbean countries, a new year signals the start of a series of established annual events—from the respective country carnivals of exceptional revelry to the end of a flourishing tourist season that coincides with the winter season in North America and Europe. Such is the Caribbean reality to which many have grown accustomed.
The year 2020 beckons a different Caribbean truth. The entire region is grappling with COVID-19 and some unique challenges loom. Commodity-dependent islands such as Trinidad and Tobago and Guyana are reeling from the shock of oil prices that have plummeted beyond their wildest imagination. Given that the pandemic began to shut down global travel as early as December 2019, tourism-dependent islands did not have the kind of winter tourist season and revenue to which they’ve grown accustomed. Add to these novel challenges those that are not new: the imminent hurricane season that starts in June (the devastation of earlier years from which some Caribbean countries are still trying to recover), and the perennial social and economic challenges in the region—high levels of debt, poverty, unemployment, and crime.
‘It is well known that the poor suffer the most in times of disaster due to fewer—if any—safety nets.’
As seen around the world, local outbreaks of the coronavirus result in illness, quarantine, and in many cases, government-imposed ‘stay at home’ measures; these all affect hours worked and productivity. Public health services are at the forefront of the COVID-19 response but most countries in the region have little fiscal space to increase spending to the health sector and simultaneously support households. Islands that have weak public health infrastructure and large elderly populations are particularly at risk. The United Nations Economic Commission for Latin America and the Caribbean has predicted that ‘The effects of COVID-19 will cause the biggest recession that the region has suffered since 1914 and 1930.’
Caribbean countries need to begin contemplating what their development trajectory with COVID-19 looks like. It is well known that the poor suffer the most in times of disaster due to fewer—if any—safety nets. Women and children are also more at risk, especially in developing countries since they comprise a larger proportion of those living in poverty. Building multidimensional resilience should be a priority at this time; resilience, in this sense, is understood as a country’s (or individual’s) capacity to adapt and maintain an acceptable level of functioning when exposed to hazards.
‘This challenge should not be left solely to Governments, though they have a pivotal role to play’
COVID-19 is exposing many of the fault lines that could compromise sustainable development in this part of the world. Loss of jobs and slower economic activity could push more people into poverty; health care systems, which are under unimaginable strain at this time, may not be able to support the general health and wellness of the population, particularly the most vulnerable; and, while many schools have closed and lessons have moved online, inequities and inequalities in education might be exacerbated due to unequal digital access.
The road ahead in rebuilding Caribbean island states will be challenging. I see it as a marathon as opposed to a sprint—it will be achieved over the medium to long-term. This challenge should not be left solely to Governments, though they have a pivotal role to play in terms of ensuring the availability of, and access to, public goods and services. Caribbean community-based and non-governmental organisations are vital allies in the process of recovery and resilience-building since they are closer to the pulse on the ground and can identify where interventions might be most effective. To ensure we do not rebuild our vulnerabilities and that we embed resilience—now, more than ever—Caribbean civil society should be integral to policy-making and planning.
Dr Marlene Attzs is an economist and a Civil Society Advisory Governor on the Foundation’s Board.
Shielding democracy from COVID-19
Across the world, COVID-19 has unleashed a tidal wave of state power. What can we do to ensure that the great pandemic of 2020 is not remembered for an unravelling of democratic values, a disintegration of the rule of law; an irreversible erosion of hard-won rights and freedoms?
The risk is very real. Authoritarianism, the enemy of personal freedom, dines richly on fear and uncertainty. As a former UK Chief Justice recently remarked, we often give up our freedom voluntarily in return for promised protection from some external threat. Accepting this aspect of our humanity leads us to understand that passivity is dangerous. Today, more so than ever, the long-term well-being of our societies requires us to engage our leaders: to support them, yes, but also to question and challenge.
‘Emergency measures that come without an expiry or review date should always raise a red flag.’
The first step is to be absolutely clear about what is acceptable during a time of crisis and what is not. All political systems recognise the need for extraordinary action in extraordinary times. Even in liberal democracies, additional powers can be granted and certain can be suspended during a health or other public emergency ‘which threatens the life of the nation’. The rationale is straightforward. When things go terribly wrong, our leaders need the space and capacity to respond swiftly and effectively. As citizens, we agree to make a temporary sacrifice in order to secure our longer-term freedom and prosperity.
In the real world, things are never that simple. Too often, the rights and freedoms we sacrifice in extraordinary times are permanently damaged. In the aftermath of the 2001 US terrorist attacks, for example, ‘temporary’ powers that infringed on basic rights to privacy and security were granted to national security agencies. Many of these laws are still with us, now routinely used for non-terrorism purposes: from migration control to suppression of the media.
How do we distinguish between a legitimate response to an extreme threat on the one hand and a dangerous overreach on the other? In some cases, the answer seems straightforward. In Cambodia for example, the recently passed COVID-19 emergency law grants an already dictatorial and unchallenged government vast new powers: from property seizure to media controls. Hungary is on the verge of an indefinite state of emergency that will allow its Prime Minister to rule without reference to Parliament until he decides the emergency is over. And the Philippines’ response has quickly morphed from lockdown to crackdown.
‘An informed, engaged and questioning citizenry is the best defence we have.’
Fortunately, such instances of shameless power-grabbing remain the exception, at least for now. But the trend is clear, with Oxford University’s COVID-19 government response tracker confirming that governments of every political stripe are granting themselves sweeping new powers to forcibly detain individuals; close schools; shut borders; restrict internal movement; limit free speech; impose curfews and ban public gatherings. Whether by executive fiat or via parliaments, these laws are being rushed through without the attention and scrutiny that much less-important legislation routinely receives.
Many of these responses are raising hard questions. For example, is it appropriate for governments to use surveillance technology that is normally deployed against enemies of the state to track the movements of their own citizens? And how far should that go: what if, for example, these new rules turn out to support biometric surveillance? What if new laws and regulations have a disproportionately negative impact on certain social or ethnic groups? What if they are deployed to silence protest—to effectively outlaw criticism of state policy in this or other areas? And even if we presume that strong measures might be necessary, how can citizens pass judgement on the actions of their leaders during this critical time when governments across the world, 47 at last count, are postponing national and local elections?
Deciding what constitutes a reasonable law is tricky. It might even be impossible until after the fog has lifted. At this stage, the best question we can ask is whether the authorities are demonstrating that their reaction to COVID-19 passes the two-fold test of being necessary and proportionate to the threat as it is currently understood. That involves weighing a myriad of factors, not least the underlying democratic health of the country: a government that is generally responsible and answerable to its people deserves to be trusted much more than one which is unaccountable.
On top of the general tests, we must be alert to the classic warning signs of overreach. Emergency measures that come without an expiry or review date should always raise a red flag. Laws that fail to specify their objective—and to relate the application of new powers solely to securing that objective—should raise another. Laws that erode basic democratic protections—for example by exempting their application from judicial or parliamentary scrutiny—are also to be treated with great caution. And in this situation, as in all others, we must be highly wary of emergency-related restrictions on those fundamental rights that serve to protect all others: freedom of speech, expression and information. This is the time for radical transparency: any attempt to suppress information, debate and dissent should be robustly challenged.
The COVID-19 pandemic has expanded the reach and power of the state to a degree that is unprecedented in the living memory of most modern democracies. The consequent loss of rights and freedoms may well turn out to be necessary. But history teaches a harsh lesson: sacrificing liberties is a dangerous game with a highly uncertain outcome. An informed, engaged and questioning citizenry is the best defence we have.
Dr Anne T. Gallagher AO is Director-General of the Commonwealth Foundation.
Gender Analysis Guidance Tool
This Gender Analysis Guidance Tool has been developed to help civil society organisations in the Caribbean understand the connections between gender and climate change, as well as develop gender-sensitive policies and programmes for adapting to climate change.
Download the Gender Analysis Guidance ToolStrengthening advocacy for better implementation of the Prevention of Atrocities Act
From commitment to action: inclusion of women’s voices in Commonwealth priorities for gender equality
Women from across the Commonwealth met in advance of the 12 Women’s Affairs Ministers Meeting (12WAMM) on 16 and 17 September to discuss policy recommendations to accelerate national, regional, and global action to implement the Commonwealth commitments on gender equality in support of Beijing+25 Platform for Action. The Commonwealth Foundation offered a platform to 50 women’s rights and women-led organisations from across the Commonwealth.
Delegates to the civil society roundtable in advance of 12WAMM called on member countries of the Commonwealth to support four priorities: ending violence against women and girls, women in leadership, women’s economic empowerment, and women’s land rights and climate change. These priorities reinforce the commitments made in Beijing 25 years ago, which despite progress remain unfinished business globally. The discussion also included an interrogation of the intersectionality of gender and how it is finding its way (or not) to the analysis of policy, particularly with regard to commitments made in Beijing on gender equality and women’s rights.
‘We call on #Commonwealth member countries to allocate at least 15% of all sectoral budgets to women’s economic empowerment’ – Anne Pakoa just delivered the #CivilSociety statement at #WAMM.
Thanks to hosts @PSYGKenya.
— Commonwealth Fdn (@commonwealthorg) September 20, 2019
One of the things that the Foundation has been committed to in the last seven years is to promote ways by which civic voices are able to not only access spaces of policy making, but meaningfully engage with policy makers in the Commonwealth and beyond. The efforts have had uneven results. But on 18 September 2019 in Nairobi, the Foundation and its partners celebrated the inclusion of civic voices in the Senior Officials Meeting of 12WAMM, a milestone for the Commonwealth.
Delegates of the roundtable called on member countries to take action as follows:
- commit to ensuring that women and gender affairs ministries track compliance to international commitments and accelerate implementation at the national level
- invest in research to collect disaggregated data relating to the four pillars to ensure better planning, effective implementation, monitoring and evaluation
- address gender-based violence for the promotion of social and economic justice for women and girls, and document all women’s rights violations
- allocate significant funds: 15% of all sectoral budgets to women’s economic empowerment and 30% of national budgets to women machineries, in support of women, girls, and vulnerable groups in the margins
- allocate 50% of parliamentary seats for women leaders
- address the gender impact of climate change through meaningful international climate financing and prioritisation of mitigation, adaptation, and loss and damage strategies in the most vulnerable countries in the global south, particularly in the small island developing states and the large ocean nations.
Anne Pakoa, Founder and CEO of the Human Rights Coalition of Vanuatu and Founder of Vanuatu Young Women for Change, addressed the Senior Officials Meeting in the days following the roundtable. She concluded her delivery of the core messages from civil society with these words:
‘We hope that as you return to your respective countries, you will continue with the same spirit of constructively engaging with women’s rights and women-led organisations in support of the Commonwealth priorities for the advancement of the Beijing +25 Platform for Action.’
Indeed, accelerating the implementation of the Commonwealth’s priorities in support of the Beijing+25 Platform for Action requires national action. The key to accelerating these commitments lies at the national level. That’s one of the lessons the Millennium Development Goals gave us. Let’s take heed.
Myn Garcia is a former Deputy Director-General of the Commonwealth Foundation.
Patently helpful: medicines and trade
Cancer, dementia, diabetes, tuberculosis, and heart and lung disease, accounted for 31 million of the 56 million deaths worldwide in 2016. Eighty percent of these deaths occurred in developing and low income countries; the truth is many people died because the drugs they needed were too expensive to buy. The good news is—Third World Network (TWN) Malaysia are showing there is something we can do.
Developing and low income countries share a bigger burden of these deaths because their public health systems are often under-funded and unable to make the imported drugs available at an affordable price. This is partly because of the exorbitant costs and the long-term nature of the treatments required. As a consequence, sick patients go untreated leading to their debilitation and death. Both government and patients do not see a way out of the problem because the drugs produced by big pharmaceutical companies, usually based overseas, are bound by patents that are locked into trade deals.
‘Companies often extend their product patents by tweaking the chemical make-up of the drugs to maintain their monopoly of production and sale’
Pharmaceutical companies fix the prices of drugs they produce and also license these drugs to ensure that no one else can use the same combination of chemicals. These licenses can run for as long as 20 years, during which time the companies have a monopoly of production and sale. Pharmaceutical companies argue that the protection afforded them by the licence is necessary to recoup research and development costs, but profits have been shown to far outstrip these. Moreover, companies often extend their product patents by tweaking the chemical make-up of the drugs to maintain their monopoly of production and sale.
It is customary for countries to sign trade agreements to improve trading flows and boost the economy. The benefits of trade agreements can be widespread but some clauses can close the door on the possibility of countries making essential drugs themselves, while ensuring overseas companies continue to monopolise supply. These agreements substantially reduce the ability of countries to make laws that promote the local production of essential drugs, while government officials in different ministries often do not appear to know or fully understand the technical implications of some of the agreements that former or current governments have signed.
‘It is estimated that over 450,000 Malaysians are infected with Hepatitis C, and that the new treatment plan will make it possible for Malaysia to eliminate the disease by 2025’
However, special agreements made at the World Trade Organisation (WTO) give governments the legal right to prioritise the health of their citizens and so produce drugs in their own countries—even if they have subsisting trade agreements that might otherwise prevent them from doing so. Nonetheless, government awareness of the WTO agreements remains low, and those that are aware often do not know how to activate its provisions, nor do they have the required drug manufacturing capabilities and resources for research and development.
TWN Malaysia is implementing a project to tackle these factors, with support from the Commonwealth Foundation and the cooperation of the Malaysian Government. In particular, TWN Malaysia has worked with other civil society partners to provide technical and legal input to overcome the license barrier for Sofosbuvira—a drug used for treating Hepatitis C. Due to these efforts, the price of a three-month supply has now dropped from US$10,000 to US$100. This has allowed the Malaysian Government to roll out free treatment in 21 public hospitals. It is estimated that over 450,000 Malaysians are infected with Hepatitis C, and that the new treatment plan will make it possible for Malaysia to eliminate the disease by 2025.
You can read more about Third World Network’s project here.
