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Governance Area: Policy and legislative reform

Advocating for better health for people living with HIV and people who use drugs

Issue

The prevalence of Human Immunodeficiency Virus (HIV) amongst the adult population in Mauritius is estimated at 0.9 per cent, approximately 9,200 people, a large proportion of HIV transmissions were due to the sharing of contaminated needles. By 2014 this percentage had reduced from 68 per cent to 31 per cent thanks to successful harm reduction programmes. However, amongst new cases detected in 2015, there has been an increase in the prevalence rate of people who use drugs.

Project

Prevention Information Lutte contre le SIDA (PILS) is facilitating access to HIV health services for People Who Use Drugs (PWUDs) by promoting a better understanding of drug policies which can be used as a means of preventing HIV transmission among PWUDs and contribute to a reduction in HIV prevalence in general.

PILS is engaging in dialogue with policy and decision makers including members of parliament, prison officers, police departments and religious leaders to advocate for changes to legislation and policies on drug use and HIV that can better contribute to reducing HIV transmission and prevalence. They are also raising communities’ awareness of drug policies and their impact among on People Living with HIV and AIDS (PLHIV), at risk populations, and village councillors by organising and training a group of Community Health Advocates (CHAs) to lead awareness raising activities in their communities.

By the end of the project, it is estimated that over 7,000 people in the communities would have been reached by CHAs and that CHAs will have the necessary knowledge and expertise to continue to raise awareness among their communities once the project ends. It is also expected that by the end of the project a greater awareness about drug and HIV policies, and how they can be used to contribute to the reduction of HIV transmission and prevalence would have been generated. In addition, the project is likely to influence discussions on policy and legislation change on HIV and drug use during its duration.

Prevention Information Lutte Contre le Sida

PILS is the leading organisation working on HIV in Mauritius. It works in close collaboration with six national NGOs, reaching out to all relevant key affected populations. The main areas of work of the organisation are: provision of health care through its own health clinic; awareness raising on HIV prevention with most at risk populations; advocacy on HIV prevention with various stakeholders and capacity building of local and regional NGOs which work with key affected populations. It has been the civil society principal recipient for the Global Fund since 2012.

Strengthening legislation and policy development on natural resource management

Issue

Papua New Guinea has several pieces of vital legislation around the use and management of natural resources, but customary landowners often lack awareness or a clear understanding of the legislation and polices that protect their rights.

Project

The Centre for Environmental Law and Community Rights (CELCOR) is engaging government agencies to deliver changes to legislation and policies that govern the use and management of natural resources, including the Land Act (1996), the Environment Act (2000) and the Climate Change Management Act (2015), so that they better reflect customary land owner’s rights. This involves raising awareness among community based organisations (CBOs), conducting a detailed review and analysis of existing policies and legislation, and working with government agencies directly to present and propose changes to the First Legislative Counsel and advocate with Parliamentarians for these changes to be adopted.

By the end of the project, it is expected that some pieces of legislation will be revised to more strongly reflect support for customary land rights.

Photo Credit: Flickr CC Stefan Krasowski

Centre for Environmental Law and Community Rights (CELCOR)

The Centre for Environmental Law and Community Rights is an environmental and conservation NGOnot for profit public interest firm that promotes sustainable management of natural resources in Papua New Guinea. The objectives of the organisation are to carry out policy research on national development issues and management of the environment and to use the research findings to advocate for change of policies and relevant legislation. Their activities include legal advice and assistance to communities, policy research, advocacy, as well as education and awareness programs on environmental issues, development, land and resource rights of customary landowners.

A new policy for civil society in Nigeria

Posted on by Oyebisi Babatunde Oluseyi

The recent debate in Nigeria on Bill HB585 provided an unexpected opportunity for The Nigeria Network of NGOs’ to advance its efforts to strengthen the regulatory framework surrounding the civil society sector.

Last year, when The Nigerian House of Representatives considered Bill HB585, to regulate the activities of nonprofits in the country, many within the sector felt, quite rightly, that the Bill, if passed, could limit freedoms for civil society.

The debate on whether Bill HB585 should pass or not took place via traditional and social media platforms. What we heard loudly from the public both online and offline was that the bill could pose a threat to citizens’ rights of free association and assembly. However, a quiet but nonetheless large number of voices that supported the bill had genuine concerns about a lack of transparency in the sector.

‘Amidst the growing call for strengthening sector accountability and regulations, a relationship with the regulators on how best to address these issues has matured for action’

Those that argue for the bill say there is no regulatory framework guiding the work of non-profits in Nigeria. However, there are 7 regulatory frameworks in place that can be strengthened and reformed. This is the work that my organisation, Nigeria Network of NGOs is leading, thanks to support from the Commonwealth Foundation.

This assertion that no regulatory framework exists confirms the gaps in the understanding of legislation governing the operational environment of the third sector space and the sector’s ways of working. These gaps must be bridged as full knowledge of the sector’s modus operandi by all stakeholders will go a long way in easing the rush to over-regulate. Efforts to this end will require a combination of awareness raising activities, evidence-based analysis of the sectors and a level headed evaluation of the positive and negative impacts of red tape.

‘this moment provided an opportunity to remind government of the importance of civic space and the equity that must come to play within the attainment of the Sustainable Development Goals’

Our engagement with regulators since 2012 and the multiyear support received in 2016 from the Commonwealth Foundation has meant that the Nigeria Network of NGOs has been able to review regulations and suggest constructive changes. Ongoing engagement with our regulatory authorities remains an imperative. Amidst the growing call for strengthening sector accountability and regulations, a relationship with the regulators on how best to address these issues has matured for action. Through a detailed review of the laws guiding the operations of the sector, targeted advocacy efforts and meetings with regulators, Nigeria Network of NGOs found it easier to engage regulators and suggest evidence based solutions.

For instance, suggested changes to the Part C of the Companies and Allied Matters Act (the law guiding the operations of nonprofits in Nigeria) were generated from discussions and outcomes from conferences and workshops with regulators, sector wide consultations, experience, evidence and lessons learnt from our work and peers in other parts of the world.

The Government’s ease of doing business order in addition to its ongoing efforts at reducing red tape, has helped ensure that the civil society sector is not left behind. As the country aims to improve its ranking on the ease of doing business index, this moment provided an opportunity to remind government of the importance of civic space and the equity that must come to play within the attainment of the Sustainable Development Goals.

Oyebisi Babatunde Oluseyi is Executive Director of the Nigeria Network of NGOs. Photo credit: NNNGO

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

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.

Commonwealth Health Ministers Meeting: Civil Society Forum 2017

Posted on by Commonwealth Foundation

With support from the Commonwealth Foundation, the Civil Society Forum was jointly hosted by the Commonwealth Health Professionals Alliance, International Community of Women Living with HIV Eastern Africa (ICWEA) and Third World Network, and took place on 20 May 2017 prior to the World Health Assembly and in conjunction with the Commonwealth Health Ministers’ Meeting (CHMM).

Objectives: to present the Commonwealth civil society position on issues discussed at the Commonwealth Health Ministerial Meeting 2017, and produce a policy statement that will be heard by Ministers attending the  CHMM 2017.

Methodology: The forum followed the format of a policy dialogue bringing together civil society representatives and policy makers.  It included a presentation of policy briefs that are the result of a consultation process in which civil society voices throughout the Commonwealth were reflected.

The policy briefs presented to ministers can be downloaded below:

Regional multi-stakeholder dialogue on gender equality

Posted on by Commonwealth Foundation

Convened by EASSI, the multi-stakeholder dialogue intended to present and discuss the findings of the pilot implementation of the EAC Gender Barometer and to lay the foundation and build partnerships for an evidence based advocacy tool for promoting gender equality in the East African Community (EAC). The Commonwealth Foundation supported the dialogue, which was held in Kampala in May 2017.

Under EASSI’s leadership the dialogue provided a space for civil society, government representatives from Kenya, Rwanda, Tanzania and Uganda as well as women’s rights activists to interact on the findings of the EAC Gender Barometer.  Some of the highlights from the pilot:

  • Need for bold steps to address gender redistributive justice, and to reorient entitlements of women and men. All governments achieved low scores in this regard
  • Gender-based violence:  need for issue based conscientization campaign and the need for accountability channels, where currently none exist.
  • Sexual and reproductive health and HIV/AIDS: there has been a reversal of gains in countries like Uganda; social responses need to be strengthened.
  • Rwanda taking the lead in institutionalising gender budgeting. Macro economic frameworks still largely impervious to gender and equity concerns
  • Good progress made on legislation; challenge is in implementation.

At the dialogue a government representative from South Africa offered the SADC experience on the use of the barometer in the Southern Africa region and spoke of how important the collaborative partnership to advance gender equality is.

In addition, five policy briefs based on identified gender priority issues were developed to include targeted policy recommendations on realisation of gender equality in the EAC.

Priorities for the way forward: 1) Popularising the Gender Bill nationally, 2) National ratification, 3) application of the Gender Barometer

The Commonwealth theme for 2017: all we are saying…

Posted on by Vijay Krishnarayan

It is right that the Commonwealth’s theme for 2017 “A Peace-building Commonwealth,” follows from last year’s “An Inclusive Commonwealth.” The explicit and logical connection between inclusion and peace is important.

It takes on the notion that peace might be threatened by diversity and compels us to understand the relationship between pluralism and peace. It also encourages us to acknowledge the importance of governance in creating an environment for peace. Institutions that are not able to engage with the people they purport to serve are increasingly likely to get a loud wake up call.

The events of 2016 put peace back on the agenda. The Global Peace Index published its tenth anniversary report last year analysing the main trends. It charted the continuing deterioration in the overall global levels of peace. Among the 163 countries mapped, it found a widening gap between the most and the least peaceful. Of the index’s chosen indicators “the impact of terrorism” and “political instability” showed the sharpest decline. The report attributes the global deterioration to conflicts in the Middle East and North Africa and the associated international repercussions. The number of refugees and displaced persons doubled between 2007 and 2015 to nearly 60 million, accounting for more than 10% of the population in nine countries.

What these global figures do not document is the heightened exposure to the fallout from conflict and instability, experienced by specific sections of society including women, young people, minority ethnic peoples and sexual minorities. Between 2008 and 2014, the homicide rate in developing countries was twice that in the developed world, and further increased in the least developed countries.

Multilateral institutions, including the Commonwealth, have their part to play in addressing this prevailing climate but they should proceed with humility and caution. Multilateral institutions come with moral baggage that also needs to be handled. The Commonwealth has a colonial history, which is relevant to its role as an agency for peace-building. This is acknowledged in the seminal publication “Civil Paths to Peace – the report of the Commonwealth Commission on Respect and Understanding,” which reminds us that “The history of the world matters to contemporary problems, since the effects of past maltreatment and humiliation can last for a very long time.” The colonial legacy should not prevent the Commonwealth from being an active agent for peace, but it must be one of the elements that informs our work in this field.

The Commonwealth consistently flags the importance of civil society in peace-building. This gives the Commonwealth Foundation – the Commonwealth’s agency for civil society – a place to stand. The Foundation’s Vision is for a world where every person is able to fully participate in and contribute to the sustainable development of a peaceful and equitable society. We recognise the opportunity provided by the globally agreed Sustainable Development Goals to place peace in the context of development. When they met in Malta in 2015, Heads of Government noted the consonance between the Commonwealth Foundation’s mission and Sustainable Development Goal 16 with its emphasis on peaceful and inclusive societies and building effective, accountable institutions at all levels. How does the Commonwealth Foundation turn this mandate into practical action?

There are around 11.5 million children worldwide still thought to be working illegally. In South Asia there is an increasing willingness to address their plight. With Commonwealth Foundation support, Global March has been working with partner organisations to build on the experiences of Bangladesh’s Shishu Adhikar Forum, India’s Bachpan Bachao Andolan, and Pakistan’s Grassroots Organisation for Human Development to raise awareness, advocate for policy change and build the capacity of civil society, government and law enforcement agencies to work together against child domestic labour. The project has supported the development of national intervention plans with guidance for those working to address the causes of violence against children as well as secure fair and sensitive judicial processes. There have been compilations of legislative literature, expansive regional and national consultations, and extensive analysis of existing structures – all aimed at enhancing advocacy for stronger policies that will contribute to a peaceful childhood for millions. We were delighted when the Chair of Global March, Kailash Satyarthi was awarded the Nobel Peace Prize (jointly with Malala Yousef Sai) in 2014 for his work in this field.

Port Harcourt has grown rapidly over the past forty years and is now one of five Nigerian cities with a population of over a million. It is estimated that between 20 and 40 per cent of the people in Port Harcourt live in self-built waterfront settlements. With Commonwealth Foundation support the Stakeholder Democracy Network and its partner Human City Media Advocacy is encouraging communities to exchange experiences and engage with the State authorities as plans for the redevelopment of their city are made. This new project will develop the ability of young people to use art forms such as music to express their vision for their city. Radio programmes will be produced, shows and performances will be staged and public discussions convened all with the aim of bringing people and institutions together on the future of Port Harcourt.

These two examples articulate the Commonwealth Foundation’s approach to peace-building, which emphasises the importance of civic voice and agency. They illustrate the centrality of young people to peace-building and show how creative expression can provide the means to express a desire for peace and inclusion. Other Commonwealth Foundation programmes show how those previously side-lined can come to play a leading role in making the case for peace – most notably women.

Abuse, threat and grievance fuel and sustain instability, conflict and violence. It’s easy to see how these can compromise social and economic progress and this underscores the importance of a Sustainable Development Goal that focuses on peace. The Global Peace Index estimated that in 2015, violence cost 13.3% of global GDP and pointed out that the economic loss from conflict far outweighs investment in peace-building and peace keeping.

The Commonwealth Foundation seeks to help create and support an environment where people who are not heard can engage effectively in the processes that shape their lives. We believe engagement of this kind has the power to shape a peaceful existence for all. The Foundation’s programmes highlight the importance of human dignity for all, as both a requirement for and characteristic of a peaceful society. It’s a timeless theme that resonates particularly loudly in 2017.

A full length version of this article features in the Commonwealth Ministers’ Reference Book 2017. Find out more about this year’s Commonwealth theme at the Commonwealth Secretariat’s website. Photo credit: Flickr CC ResoluteSupportMedia

Strengthening statutory regulation for civil society organisations

Issue

The regulatory framework for Nigerian civil society organisations (CSOs) is derived from a series of laws which cover registration, supervision and regulation of CSOs activities. These laws need to be amended to reflect the realities of the CSO sector in Nigeria.

Project

The Nigeria Network of NGOs (NNNGO) is engaging with government on the need to revise legislation and work with CSOs to improve compliance. The project is holding consultations with civil society organisations to develop recommendations for a law that directly supports the effectiveness of CSOs in Nigeria  The project will be undertaken in close collaboration with regulatory bodies, in order to review the current legislation and present draft amendments for discussion. NNNGO is also promoting understanding of the regulatory requirements among CSOs.

It is hoped that by the end of the project, revised legislation that improves the operating environment for civil society organisations and promotes effectiveness and accountability would have been adopted.

Endorsed project title: Strengthening statutory regulation for civil society organisations in Nigeria

Photo: Mark Fischer, Abuja Street Portrait, Flickr CC

Nigeria Network of NGOs

Nigeria Network for NGOs is the first generic membership body umbrella membership body for civil society organisations in Nigeria. It is comprised of over 2,000 organisations across all the states in Nigeria, ranging from small organisations working at the local level, to larger networks at the national level. Its mission includes protecting the environment within which NGOs operate, coordinating the voice of civil society organisations in Nigeria and facilitating advocacy on issues of sustainable development.