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Theme: Health and disabilities

Seasonal message from the Director-General

Posted on by Commonwealth Foundation

Excellencies, colleagues, partners, and friends of the Commonwealth Foundation,

The festive season is a time to pause and reflect on our changing world. One event that loomed large for the Foundation in 2022 was the passing of Her Majesty Queen Elizabeth II, who, as head of the Commonwealth, dedicated her life to serving its people. We pay tribute to her steadfast and devoted service.

‘COP27 in Egypt presented a valuable opportunity to advance our strategic agenda on climate change and the interests of the Commonwealth’s small and vulnerable states.’

In terms of our own work, the past year has been an exciting one, with a major highlight being our hosting of the Commonwealth People’s Forum in partnership with the Government of Rwanda. We were thrilled with the level and quality of engagement: over 250 delegates from across the Commonwealth were involved, including civil society leaders, government officials, lawyers, journalists, academics, and activists. The Foundation team developed a short outcome video that was shown to Foreign Ministers in Kigali. You can watch it here. We are already planning for the next People’s Forum that will be held in Samoa in 2024: looking at ways that the Foundation can bring the people of the Commonwealth together (in person and online) to discuss and debate the issues that matter most to them.

The Commonwealth Short Story Prize has continued to grow this year, attracting new writers from more Commonwealth Member States. The 2022 prize was won by Ntsika Kota for his story ‘and the earth drank deep’. Ntsika is the first writer from Eswatini to be shortlisted for the prize, and the second overall winner from Africa. In a record year for entries, he saw off competition from 6,729 entrants worldwide to take the £5,000 prize. A hitherto unpublished author with extraordinary talent, Ntsika’s success reminds us of the power of the prize to unearth world-beating literary talent in all corners of our Commonwealth.

Finally, COP27 in Egypt presented a valuable opportunity to advance our strategic agenda on climate change and the interests of the Commonwealth’s small and vulnerable states. The Foundation hosted three online events as part of our Critical Conversations series in the lead-up to—and immediately after—COP27. These events—which brought together a wide range of activists and decision-makers—considered how to advance the needs and interests of those most affected by climate change. We were delighted that over 7000 people registered to attend online.

‘The issues that are at the heart of our work: climate, health and freedom of expression, continue to require urgent attention.’

The Foundation also hosted two in-person events at COP27: bringing together the President of Vanuatu, the Prime Minister of the Bahamas, the Commonwealth Secretary-General, and leading figures in international law and climate advocacy to consider how the tools of international law can be used to secure climate justice for some of the Commonwealth’s smallest and most climate-vulnerable countries. Attendance at both events was at full capacity and drew widespread media attention ahead of the historic agreement to establish a funding mechanism for loss and damage.

The issues that are at the heart of our work: climate, health and freedom of expression, continue to require urgent attention and the Foundation has begun planning in earnest for the year ahead. We were delighted to receive a record number of applications to our open grants call. Much work has gone into simplifying our grant-making to improve access and we are confident that these changes will help ensure that smaller civil society organisations in smaller Commonwealth countries benefit from this funding stream. We are also in no doubt that, among the thousands of submissions made to the 2023 Commonwealth Short Story Prize, a new cohort of world-beating writers will emerge to claim the regional and overall prizes that will be announced mid-year.

‘Member-State commitment to the Charter is critical if the Commonwealth is to survive and thrive.’

The Foundation is also gearing up to celebrate the tenth anniversary of the Commonwealth Charter: a bold and forward-looking statement of Commonwealth values and principles. Member-State commitment to the Charter is critical if the Commonwealth is to survive and thrive. The Foundation will be doing its bit to bring the voice of Commonwealth civil society into anniversary celebrations for the Charter. Please sign up to our mailing list to receive updates on these plans.

Once again, thank you to all those who have contributed to our work, most especially our governors and the Foundation’s expanding network of partners. I look forward to working with you in the coming year as we join forces to advance the principles and values of our Commonwealth.

Dr Anne T. Gallagher AO is Director-General of the Commonwealth Foundation. 

Power to the People: the Commonwealth Foundation at CHOGM 2022

Posted on by Anne Therese Gallagher

After two years of delay and postponement, of anticipation and frustration, the Commonwealth Heads of Government meetings (CHOGM) finally took place in Kigali in late June.

For the Foundation, this was the culmination of years of preparation and planning, most especially for the People’s Forum—the largest gathering of civil society in the Commonwealth system that has been a fixture of the CHOGM calendar for almost two decades.

The Foundation also took the lead in convening a half-day of roundtable discussions between Foreign Ministers and members of Commonwealth civil society. An outcome video of the Forum, which was broadcast at the official CHOGM Foreign Ministers Meeting, and also played at the Roundtable itself, can be accessed here.

‘What role could—or should—the Commonwealth of Nations play in these vital steps towards a better world for all its people?’

The People’s Forum 2022: Our Health, Our Planet, Our Future

The People’s Forum 2022 set itself the ambitious task of asking—and trying to answer—the biggest and most important questions of our age: how do we harness the best of humanity—the forces of love, compassion, equality and justice­—to advance our common future and protect our planet? How do we work together to build or re-fashion our institutions so that they support a world that leaves no one behind? And what role could—or should—the Commonwealth of Nations play in these vital steps towards a better world for all its people?

Along with our partners at the Rwanda Governance Board, the Foundation took advantage of the two-year delay to shape a strong and streamlined programme that focused on what is front and centre for so many people of the Commonwealth: health, climate and freedom of expression. The Critical Conversations online event series, launched by the Foundation in 2020 after the first CHOGM postponement, proved to be a gamechanger: giving us experience and confidence in new formats and approaches and expanding our network of activists and leaders across all Commonwealth regions.

‘In a time of growing debt burdens, especially across low and middle-income countries, who should be paying for better primary health care and the other elements of UHC?’

In relation to developing the Forum sessions on climate for example, the Foundation was able to draw on several different events  organised as part of the Critical Conversations series, including one on small states and climate justice held in September 2021 just before COP26, and another on the difficult issue of reparations for climate damage, held in February of this year. Our main climate session at the People’s Forum was explicitly practical: looking ahead to COP27 in November and to what the Commonwealth could and should be doing to advance the interests of those most affected.  Leaders and advocates from the Commonwealth’s small island developing states left the Forum in no doubt about the urgency of the challenge and the moral duty of the Commonwealth, its member countries and its institutions, to demonstrate genuine solidarity through concrete commitments.

The Forum’s sessions on health also benefited from multiple Critical Conversations events the Foundation has convened since early 2020 which shed a bright light on the parlous state of so many national health systems and the apparent incapacity of international systems and institutions (including, disappointingly, the Commonwealth itself) to deliver practical support. At the Forum, the issue of universal health coverage (UHC)—the guarantee that people can access quality health services without facing financial hardship—was front and centre, with panellists interrogating the role that civil society might play in pushing for UHC and the strong, resilient, and equitable health systems that must be at its heart.

Any useful discussion around health and climate must address the thorny question of finance: how do we get the money needed to fund desperately overdue measures aimed at protecting countries and communities from the worst effects of climate change? In a time of growing debt burdens, especially across low and middle-income countries, who should be paying for better primary health care and the other elements of UHC? In the case of climate, Forum participants strongly took up the cause of the Commonwealth’s smaller and more vulnerable Member States, for whom the loss and damage caused by climate change is presenting unique—and in some cases existential—challenges. Across both issues participants were united in their conviction that the Commonwealth has a unique role to play in bringing together those who hold the power to deliver support, relieve debt burdens, and provide restitution. A failure to take up that role with determination would be, in the eyes of Commonwealth civil society, a clear rejection of the very ideas that the Commonwealth stands for.

‘a vibrant and principled Commonwealth is critical to the future of its citizens’

The Commonwealth Charter affirms that freedom of expression—including media freedom—is essential to the flourishing of democratic societies and a basic condition for development. Sadly, this is an area where too many Commonwealth countries are slipping behind. Building on a previous Critical Conversations event, the Forum engaged in a vigorous, at times tense discussion of freedom of expression: why does it matter and how can it be protected? What can the Commonwealth, its member states and institutions, do to support and advance free and responsible media? There was clear agreement that no country can afford to be complacent: direct threats to journalists and freedom of expression are real and growing. Civil society has an important role to play in championing the proposed Commonwealth Principles on Freedom of Expression that could help shore up freedom of expression and break the culture of silence that provides cover for its steady erosion.

The final session of the Forum, ‘A Commonwealth for All’, set itself the ambitious goal of provoking deep discussion and personal reflection about where we are now, and how the Commonwealth—its Member States, its institutions, and its people—can help inspire real and meaningful change. It was aimed at all those who care about the Commonwealth; those who have a perspective on its past; and those who have a stake in its future. The Forum Chair participated in the event alongside the Commonwealth Secretary-General. Both were asked to comment on a provocative video of highlights from the Foundation’s three-part mini-series on the future of the Commonwealth. The passion and conviction of speakers at this final event—and of the many participants who contributed to the discussion—left no doubt that a vibrant and principled Commonwealth is critical to the future of its citizens. The ten-year anniversary of the Charter, which will be commemorated next year, was singled out by many as an opportunity to galvanise action for a reinvigorated Commonwealth.

Weaving together all Forum sessions was the idea of participatory governance: the idea that the involvement of people in their governance is critical to democracy and democratic legitimacy; the idea that citizens have a central role to play in helping to shape policies and decisions that affect their lives. Forum participants acknowledged that participatory governance is a work in progress right across the Commonwealth. We can learn from examples of innovation that have delivered tangible results. But we must be brave in pushing for more meaningful involvement of citizens across every area of public life.

‘How can we measure progress? And how can we push for meaningful action as global economic headwinds turn against us?’

Civil Society and the Foreign Ministers’ Roundtable

The roundtable between participants of the People’s Forum and Foreign Ministers is now an established fixture on the CHOGM calendar: a powerful embodiment of the Commonwealth identity as an organisation of people—and not just of states. For the Foundation, it is an unambiguous exercise in participatory governance—the unifying thread of the People’s Forum.

The 2022 Roundtable was widely proclaimed to be a huge success with the largest-ever number of Ministers in attendance, including a substantial contingent of Foreign Ministers and excellent representation from Commonwealth civil society and accredited organisations. The event was Chaired by the Rwanda Foreign Minister and moderated by me. The seating arrangement, large round tables where government and civil society sat together, and the moderator’s insistence that each take turns in contributing, guaranteed a lively and at times passionate debate. Among the wide range of matters discussed, gender equality and freedom of expression stood out as issues that everyone in the room—government and civil society alike—cared deeply about.

Towards the Future

On the current schedule, we now have less than two years to go until CHOGM 2024. While our future is uncertain, we must brace ourselves for the likelihood that many of the challenges discussed in Kigali will be unresolved. How can we measure progress? And how can we push for meaningful action as global economic headwinds turn against us?

The CHOGM communique—which sets out a bold and ambitious plan of action—should be front and centre. However, many participants in the Forum pointed out the danger of the Communique becoming irrelevant unless Member States commit to measuring their actions against the goals they have set before reporting to CHOGM 2024. Our analysis of the sentiment coming out from the Forum indicates that progress on climate could be usefully measured by the practical steps that Commonwealth countries and institutions take to protect small island developing countries. Progress on freedom of expression is even easier to measure: the Commonwealth must take the final step to adopt a robust set of principles on media freedom that comply with current international human rights standards and put in place mechanisms to monitor implementation. Progress on health requires concerted action to break the debt deadlock that is strangling efforts to deliver universal health care in so many of the Commonwealth’s low and middle-income countries.

So much more could and should be done. But we must start somewhere if the Commonwealth is to hold its head high. Let us decide to hold ourselves—and each other—to account. The people of the Commonwealth deserve no less.

Dr Anne T. Gallagher AO is Director-General of the Commonwealth Foundation.

Patently necessary: taking health into our own hands

Posted on by Achal Prabhala

At long last, the World Trade Organization is slated to open formal discussions on intellectual property waivers to help developing countries in the fight against Covid-19.

This pragmatic and humane idea was first proposed 18 months ago at the height of the pandemic. The proposals have since been woefully diluted: indeed—in their current form—it would seem the WTO has finally achieved the consensus it was looking for, since, apparently, everyone hates them. Hidden in the folds of this fiasco, however, is an important lesson for the developing world.

From the very beginning of the pandemic, monopolies on the production of tests and medicines were a part of the problem of surviving it. We went from a situation in 2020 during which tests and treatments were in short supply to a situation in 2021 in which vaccines were being made in far smaller quantities than was possible. This led to shamefully unequal access to these essential tools of survival. While vaccine access generally improved towards the end of 2021, there are still glaring disparities. To date, 93% of all contracted mRNA vaccines from Moderna, Pfizer and BioNtech have gone to rich countries, according to data from Airfinity, a health analytics company. Promising new treatments such as Pfizer’s Paxlovid which are now standard treatments in rich countries are almost completely unavailable in poor countries.

‘Promising new treatments such as Pfizer’s Paxlovid which are now standard treatments in rich countries are almost completely unavailable in poor countries.’

The TRIPs waiver—named after an obscure but powerful rule that obligates WTO member countries to uphold pharmaceutical monopolies—was meant to solve this problem. As the initial proposal was deflected, objected to, or just outright blocked by rich countries over a period of 18 months, people around the world suffered and died. The international community should be ashamed of this failure. Nevertheless, we find ourselves where we are, on the eve of discussions regarding proposals that have been dramatically watered down. What are we to make of this moment?

The first thing to understand is that critics of the current proposals are right: the ideas first put forward 18 months ago were more comprehensive and would have enabled us to turn the tide on the pandemic far sooner. The original proposals asked for intellectual property rights on all crucial aspects of our survival—namely tests, treatments and vaccines—to be waived for the whole course of the pandemic. These demands would have covered our immediate need to ramp up testing and would have delivered far greater quantities of treatments to those in need much faster. Consider the case of Bangladesh, where Pfizer’s patent on Paxlovid does not extend. Beximco—a pharmaceutical company based there—was able to manufacture and deliver the drug a mere ten days after the US Food and Drug Administration approved it, saving thousands of lives.

‘By limiting the waiving of patents to vaccines, rich countries have ensured the WTO plan will have a limited effect on the availability of treatments and tests that are so desperately needed.’

But, alas, the revised waiver proposal now under discussion at the WTO covers vaccines alone. This is perverse. By limiting the waiving of patents to vaccines, rich countries have ensured the WTO plan will have a limited effect on the availability of treatments and tests that are so desperately needed.

No matter how flawed the revised TRIPS wavier proposal is, the potential it holds to prompt a wider discussion among WTO member countries is probably a good thing. For the first time in eighteen long months, there has been a measure of agreement, however inadequate, between key WTO players to move forward: an essential prerequisite for the WTO to move the proposal into formal multilateral discussions. So far, discussions on potential waivers have been bilateral, or between groups of similarly-inclined countries, which is to say they have been unproductive and unaccountable to the international community.

The outcome at the WTO next week is almost certain to disappoint public health activists. Some rich countries are intent on further watering down the proposals and perhaps suppressing them altogether. A wide section of international civil society believes the proposal at the WTO has no value, even as a starting point. They argue that the WTO is in effect supporting a global protection racket: formal permission from the world’s richest countries to the rest of the world to allow them—without fear of reprisals—to do what they are in fact legally entitled to in order to survive an emergency.

‘But it’s also vital that we—those living in developing countries, the majority—begin to understand and use our own sovereignty to arrive at solutions.’

So, what if a decision could be taken at the level of the nation-state to simply roll back or even temporarily suspend patents, regardless of what’s decided at the international level? This would bring the immediate relief that developing countries need and arguably increase their bargaining power at the WTO. In September 2021, one country did exactly that: Brazil passed a law that went beyond even what the original TRIPs waiver proposal had asked for, and it did so with an overwhelming domestic majority and cross-party support. Even though the law was ultimately diluted by a Presidential veto, it remains in effect today and is perfectly permissible under the WTO’s own rules. This option, to create a legislative framework that supports increased supplies of tests, treatments and vaccines, and moreover, encourages their manufacture everywhere, is one that is open to all developing countries today.

Through this pandemic, we have heard much of the unfair way a majority of the world is being treated by a much smaller and wealthier minority. This situation deserves our outrage and attention. But it’s also vital that we—those living in developing countries, the majority—begin to understand and use our own sovereignty to arrive at solutions. The mRNA vaccine technology of today will define the future of global health. Many in the developing world understand that suspending pharmaceutical monopolies is an integral part of securing our present and future wellbeing. But what is less widely understood is that developing countries can do a lot to fix these problems on their own—or better still in concert with others—without having to wait endlessly for permission to do so.

Achal Prabhala is the coordinator of the AccessIBSA project which campaigns for access to medicines in India, Brazil and South Africa.

A Commonwealth of the People: Time for Urgent Reform

Commonwealth Heads of Government decided to create an Eminent Persons Group (EPG) to advise them on reform of the association at their meeting in Port-of-Spain in 2009.

This decision by Heads of Government was taken at a time when the world was – as it now still is – in the midst of an economic crisis. The old order of economic power was changing. Climate change showed signs of endangering global economic activity and the safety and livelihood of millions of people. It posed threats to the very existence of a number of countries. Terrorism, too, threatened the security of states and presented a serious challenge to international peace.

Heads of Government decided that in such a world, it was important to build a stronger, more resilient and progressive Commonwealth and to make it more relevant to its times and to its people in the future. They made it clear that they wanted the Commonwealth to continue to be an important player in the world, drawing on its rich diversity to help build global consensus around the Commonwealth’s core values including peace, democracy, the rule of law, human rights, gender equality, economic development, and freedom of expression.

Download the report