Reflections from a key Civil Society Organisation (CSO) meeting on Global Health and Universal Health Coverage (UHC), organised in Dakar, 17-19 February, by Action for Global Health and REPAOC.

CSO group pic

As Coordinator of the European network Action for Global Health, the opportunity to gather health activists from 23 different countries around the table, interact with them and listen to their experiences, was both inspiring and vital.

Most participants came from countries across East, West and Southern Africa, Latin-America and Asia. On a daily basis, each of them interacts with populations and communities seeking assistance in access to health, but in very different contexts.

They work closely with governments and public health institutes – whether as partners or advisors, to improve the design and implementation of services – or as watchdogs, to advocate towards those who deny or obstruct positive change towards realising the right to health for all.

It was refreshing, in many ways, to collectively go beyond the rhetoric expressed at public meetings, and to share amongst peers the challenges faced, as well as to express increased hopes for change.  Participants expressed awe at the courageous and inspiring roles of CSOs. In the dramatic case of a decrease or denial of the right to health, often combined with CSO repression, participants conveyed solidarity.

The case of Zimbabwe certainly spoke to the imagination. Not just for the fact that the once prosperous country no longer has a national currency of its own, but also because the dramatic health statistics are now putting a country with so many resources on a par with a war-torn country such as Afghanistan.  A situation made even more upsetting by the knowledge that Zimbabwe keeps qualified nurses and health personnel unemployed due to a ‘freeze’ in public spending on health. At the same time, CSO efforts in Zimbabwe were inspiring, using the constitutional reform to obtain  legal recognition of the Right to Health for all.

CSO colleagues shared many stories of hope as well. They inspired one another by the strength of mobilised community workers, presented through testimonies of BRAC volunteers in Bangladesh, ASHA workers in India, or community leaders in many of the African countries.  Overall, hope for improvement and change, as well as a willingness to continue the struggle prevailed.

The discussions on what should be prioritised in shaping the future of health, through UHC, raised differences between colleagues from low-income developing countries and CSOs working in (high) & middle-income countries. Participants illustrated differences in context and expectations, with regards to risks in the fragmentation of services, versus getting any services at all.

Acknowledging the differences in national contexts and interests, all participants firmly rejected the notion of a “minimum floor”, instead calling for 100% targets – on universal access to health services.  This applies both to reforms or negotiations at national level, as to the global discussions and upcoming negotiations on post-2015.  Minimums should not be set as goals. As civil society we should not to be ‘lured’ by the minimum standards imposed by existing public and governmental commitments towards the right to health, such as those captured within the MDGs; IHP+ and ICPD.

In this regard, the final résumé of the meeting stated: ‘full funding of UHC is achievable and the resources required are not beyond the means of the global community, however, we need political will, and partnerships based on global solidarity to prioritise the health of citizens’.

Action for Global Health, together with a range of national and regional organisations, concluded the meeting by agreeing to explore various advocacy opportunities ahead, and to investigate further collaboration. Indignation about unacceptable inequities, waste of resources and peoples’ capacities, drives each of us to continue to challenge decision-makers, and to seek change.  Personally, I have been inspired by the expression of hope by my colleagues and peers to achieve the right to health, for all, in every single one of our countries and communities.


Tim Roosen

Coordinator Action for Global Health

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