Health

From Historic Breakthrough to Colossal Breakdown

White Ribbon Alliance's Betsy McCallon on the barriers to citizen engagement in global health.

“Whatever we do, we must always remember the people.” – Dr. Margaret Chan, Director General, World Health Organization, at the 2015 World Health Assembly

One year later, those words ring hollow.

In global health we talk a lot about the inclusion of marginalized groups. We speak of equity. Participation. We encourage governments to create health strategies that reach all people. But the reality is there are tremendous barriers to citizen engagement and participatory accountability at all levels.

Commitments have been made to ensure citizen involvement and accountability in health systems. Global bodies, including the WHO, have championed giving citizens a true voice in the health policies that impact their lives, and the involvement of citizens has been recognized in the updated Global Strategy for Women’s, Children’s and Adolescent’s health.

However, it’s time global leaders turn their words into action and make these commitments a reality. Only one year after the first ever Global Citizens Dialogue on reproductive, maternal, newborn, child and adolescent health, deemed a ‘historic breakthrough’ and held during the World Health Assembly in 2015 – the forum through which the WHO is governed and the world’s highest health policy setting body – we failed to secure an official spot for the citizen’s dialogue in 2016. This was more than a great disappointment; it was a colossal breakdown.

First, our application as an official side event inside the Palais was rejected on the grounds that something similar was held last year. Then representatives from Sierra Leone, Mali, and Kenya who had prepared testimony resulting from hundreds of citizens’ hearings, were denied visas. The system broke down at the most critical moment, failing to show support and validation that citizen views and experiences should be heard in this forum.

While organized by a core group of NGOs, the movement for a Global Dialogue represents tens of thousands of citizens and hundreds of grassroots organizations that have been involved around the world. Beyond allowing for direct dialogue between a government and its people, the Global Dialogue also serves to act as an important arena to discuss how citizens’ voices can be included within formal accountability mechanisms at the national level and at the global level regarding health‐related Sustainable Development Goals.

Global leaders must break down barriers, not construct them.

Global leaders must break down barriers, not construct them. Not just because it is the right thing to do, but because it will accelerate progress to achieve our shared health goals.

One of the recommendations to come out last year’s Citizens’ Hearing in Mymensigh, Bangladesh came from the testimony of a woman who bravely talked about traveling to a health facility for her baby’s vaccinations. She had to wait for hours, and during her wait, she was not able to breastfeed her baby. Despite the fact that the Bangladesh Government advocates strongly for breastfeeding and its many benefits, many health facilities do not have a private area for mothers to breastfeed, more than a nicety but a necessity for mothers in Bangladesh who seek medical services. Following this profound discovery, it became a priority, and today, all the Government facilities in that district now have a designated corner for breastfeeding. That is the power of citizen input.

Accountability must be more than a buzz word making its way around global health circles. It is our duty to demand meaningful accountability and insist that the World Health Assembly itself be a democratic and open platform which supports citizen participation and input, each and every year.

Join us in calling for the World Health Assembly to designate an official time and place for citizen engagement with health ministers. In the words of Dr. Margaret Chan, “whatever we do, we must remember the people.”

Tweet this:  #CitizensVoices must be heard each and every year! Demand @WHO commit to a #GlobalCitizensDialogue for #WHA70 & beyond.

Betsy McCallon is CEO of White Ribbon Alliance (WRA). WRA, together with the Governments of Bangladesh, Sweden and Zambia, International Planned Parenthood Federation, Save the Children, World Vision International, the Partnership for Maternal, Newborn and Child Health (PMNCH) and Board Members of the NGOs Constituency Group of PMNCH representing approximately 400 NGOs, organized the second Global Dialogue for Citizen-led accountability for Women’s, Children’s and Adolescents’ Health at the World Health Assembly 2016.

Image: World Health Assembly, 27 May 2016. WHO Photo.

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