Civil society organisations were yesterday urged to place emphasis on advocacy in addressing public health threats while at the same time remaining independent of the government in their operations.
Sir Trevor Hassell, President of the Healthy Caribbean Coalition, gave the advice during a health symposium on non-communicable diseases (NCDs) and their burdens on society, held yesterday at the Guyana International Convention Center.
Hassell, in his address, emphasised the importance of civil society in bringing about change in a nation. “Civil society has the role to support but also pressure the government…to encourage them to do the right things,” Hassell said. He added, “Civil society is independent of the government and should be independent of the government.”
According to Hassell, this independence allows organisations the tools of advocacy, service provision and evidence provision while being a watchdog for the people. Though Hassell believed all of the roles were important, he pointed out that advocacy played the greatest part.
“This [advocacy] is the most important role of civil society. Advocacy is trying to bring about positive change,” he said. He went on, “Advocacy really paves to change an existing unfavorable situation by applying pressure to those who control the situation. So, it’s about changing minds and driving change; it’s the effort to influence people, primarily policy makers and decision-makers but most importantly, advocacy is about empowering people,” he finished.
Hassell further said that advocacy allowed for the deepening of the democratic process as well as the educating of the public. Hassell reiterated that public health problems could be solved through the application of advocacy, whether it be in the form of activism, collaborations or confrontations.
Despite his calls for independence, Hassell nonetheless said that advocacy should not exist in isolation. “Advocacy and the role of civil society do not exist within a vacuum; civil society needs to function together with government which has a legislative and a regulatory role,” Hassell opined. He continued, “Because whatever civil society will do, you really cannot determine policies and laws or undertake taxations. That’s what the government does.”
He further stated that civil society must work closely with the business sector, which holds a large portion of the product power. However, he said, effective advocacy is an issue not only in Guyana but throughout the Caribbean. “In the Caribbean, there is not a strong position on advocacy by civil society in general so very often these civil society organisations are unaware of the value of advocacy.”
Hassell admitted that civil society faced its own share of challenges, including a lack in its capacity to contribute effectively due to weak governments or weak management of financial structures. He added that non-governmental organisations (NGOs) also consider themselves to be on the periphery of policy making.
“What is now needed is for the major public health institutions in the region…and also the political directorates…with their professional and technical staff, to put in place mechanisms and platforms to allow major, regional decision makers to respond to the voice of civil society,” Hassell opined. He further said, “Also, platforms and mechanisms that will allow civil society to engage with them at the institutional level as all sectors seek to respond to public health and in particular NCDs threats.”
Nevertheless, Hassell said, “it is important to appreciate that national civil society organisations – that is health and non-health – have continued to enhance, broaden and increase their roles in contributing to the chronic disease response.”
The symposium afforded room for discussion and comments were made by a number of persons include Rudolph Cummings, head of the Health Desk, Caricom. Cummings opined that Guyana is behind many of its Caribbean counterparts in its advocacy. He also believed that though there are civil society and non-governmental organisations, many of them “do not have the same flavor” as those of other countries.
Minister of Health Bheri Ramsaran agreed that civil society and NGOs must remain autonomous and Hassell reiterated the importance of independence. “Civil society organisations and NGOs…should not be receiving funds from government,” he said. “The reason why is that civil society needs to be in a position to hold governments accountable. If the governments are funding civil society organisations then frankly it’s difficult for the organisations to hold the government of the day accountable. This is a fundamental principle,” he continued.
Burdens on Society
NCDs can lead to the loss of hundreds of millions of dollars by cutting the life of its workforce by a number of years.
The proclamation was made by Anselm Hennis, Director of the NCD/Mental Health division for the PAHO/HQ who shared with the health symposium that NCDs lead to earlier deaths. This, in turn, can lead to the loss of US$270M or 9% of Guyana’s gross domestic product (GDP), he said.
According to Hennis, NCDs also account for over 60% of deaths amongst males and over 70% of deaths amongst females in 2009 and led to numerous burdens on society, including loss of productivity as well as high costs to the health care system.
“So NCDs, in sum, impact on economies, on health systems, and on households,” he said. He further said that NCDs negatively affected productivity and competitiveness while causing financial pressures at the national level. He also believed that NCDs deepened poverty and the loss of opportunities.
Globally, the loss of income can run into the trillions, Hennis said. This burden, he added, will primarily affect poorer nations. “The burden will be particularly heard in lower and middle income countries such as the Caribbean region,” he said.
Hennis also revealed that a number of targets set by a number of countries, including Guyana, to reduce NCDs globally by 2025. These targets include reducing premature mortality by 25%, alcohol consumption and physical inactivity by 10% and salt intake and tobacco use by 30%.
During discussions, Cummings pointed out that there is too much talking and little activity and suggested that more training should be on the agenda in fighting NCDs. Cummings further said that there should be better partnership between training institutions and the health care system.
During the interactive session, nutrition and research were also noted as being missing from the minds of many nations and it was opined that there ought to be tougher legislation on fast food places.
