The Expanding Function of NGOs in Global Health

Public Health Preparedness and ODA The Growing Role of NGOs in Global Health Jamie Drummond February, 2004 Focus on NGOs as Advocates • NGOs increased role on two fronts: • Advocacy • Service delivery • Much interplay. Connection with those programs on the ground which pilot then advocate new approaches (Paul Farmer, MSF) and target most marginalized communities (church groups, Oxfam) which give NGOs credibility when doing developing country advocacy. • Create demand-pull pressure on government services, not replace them. • But for the sake of this presentation will split the two and focus on advocacy. 1 1. Jubilee / Debt Campaign • Debt cancellation to provide more resources to fight poverty and especially improve healthcare. De facto more like a systems approach through PRSPs. Debt cancellation as justice issue – origins of many of the debts. Global movement present in developed and developing countries; multilateral and bilateral. • • Results of Jubilee/Debt Campaign Freeing about $1bn a year in debt service which is being redirected towards poverty alleviation. Through PRSPs this has leveraged more poverty-focused social expenditures from developing country budgets and social sector spending has doubled since Jubilee campaign. • 500,000 children immunized in Mozambique • Elimination of primary school fees Tanzania • National HIV/AIDS plan in Uganda 2 2. Global AIDS Advocacy • • • • Partly modeled on Jubilee approach, partly more human rights- based approach. Domestic AIDS campaigns, PLWA, brought a different background and set of experiences. Treatment access campaign brilliantly focused the debate. Vertical approach to health? Hope that the debate has now moved on such that when triaging with AIDS you need both vertical and horizontal. Concerns about PEPFAR, GFATM, WHO 3 x 05. • Results of Global AIDS Advocacy • $6 billion spent on Global AIDS in 2004 • President Bush’s announcement during the State of the Union 2003 • $15 billion commitment • President’s Emergency Plan for AIDS Relief • Global Fund • $5.9 billion pledged thus far by donors • $3.1 billion committed to 127 countries • $900 million disbursed • WHO 3x5 Initiative (inc PEPFAR, GFATM, other) • Currently 700,000 on ARV treatment 3 3. ONE Campaign Global Call to Action Against Poverty • • Launched last May and growing in strength. Focused on AIDS emergency but also deals with broad challenges of poverty, the conditions in which AIDS thrives and gets out of control: Debt, ODA, Trade, Corruption. Sister efforts in G7 nations, OECD nations and most developing countries. • Aims of ONE Campaign • Aims to educate Americans that less than 0.5% of the US federal budget goes towards overseas development and an increase of 1% toward effective programs would result in massive reductions in poverty in the developing world, so long as this is part of a coordinated global effort – ultimately in support of the Millennium Development Goals. • DATA is part of this, and has a particular focus on Africa, the region furthest from achieving the Millennium Goals. 4 Note on Faith-Based Advocacy • Jubilee had origins in faith-based approach. When applied to health policy this has implications. • AIDS services delivery: need to use churchbased capacity in developing countries. Need to work with their affiliates in developed countries; Catholic and Anglican and other denominations. • US-based faith-based advocacy: must work with Christian community. Educate about good public health policy. Improve dialogue. 5