Civil society, meet global vaccinations

A recent posting on this blog remarked on the need for greater civil society involvement and for them to use their voice to make demands.  So it’s promising to see that the message has been heard. For the first time ever, the activist voice of civil society was present and pressing for action in ways never before seen at the GAVI Board’s most recent meeting in VietNam.  During the Board’s meeting, representatives of civil society openly applauded the members that supported their position with public comments and withheld applause from those who didn’t.

In the interests of making demands, the civil society members who attended the GAVI partners meeting went even further by demanding the Board increase their involvement by dedicating an additional seat to a civil society representative.  Note, that this might not be an unreasonable expectation.  The Global Fund for AIDS, TB, and malaria has 3 seats for civil society, while the GAVI Alliance board has only one.

It seems reasonable to expect that this is a trend that will last into 2010.  What makes me think so?  First, the GAVI leadership appears more receptive than ever. The new deputy CEO of GAVI, Helen Evans, comes from the Global Fund, with its greater involvement of civil society.  Add to that the Board chair, Mary Robinson, former President of Ireland, is a well-known advocate for a rights-based approach to health and a vocal supporter of cervical cancer vaccines, perhaps the vaccine with the best-organized civil society backing today.

Faced with a major financing challenge, a difficult fundraising environment and competing priorities for donor attention, the future of the GAVI Alliance and child survival may rest on the way in which civil society plays its role.  Civil society can contribute in several important ways.  With an effective and active role of civil society, it is possible to elevate global vaccinations and child survival from a technical issue of interest to specialists to a cause or a movement with interest from the general public.  This is what happened with AIDS and a large part of why that disease eclipses all others in its attention, funding, and political will.

Civil society can demand more from all parties – donors, countries, industry, and the Alliance itself.  It’s easy pickings to shout at industry as the sole party needing to do more.  While there is indeed more that industry can do, it would be naïve to think that there isn’t more that we can demand from the other parties as well.  Donors can give more and countries can do more to implement their vaccinations equitably and the Alliance can be held accountable for doing its part. 

Success will also mean using the voice wisely and using the right voices.  Because civil society stands to benefit directly from some of the decisions that it influences, it needs to be wise in its approach.  For example, the Global Fund currently gives ~25% of its funding to civil society organizations while GAVI gives nearly all of its money to governments so a move to greater funding from GAVI to civil society might be a good one but it is also in their self-interest.  When civil society finds the voices of the affected communities themselves, it will also have its most significant impact.  If it brings in only its Geneva and DC-based advocacy champions, it will have less of the authenticity that makes it a compelling force in so many discussions. If all this happens, we may look forward to 2010 as the year that civil society emerged as a major force in global vaccinations.