“Our mission has always been to watch the GF. It never crossed our mind that we would be PR. We wanted to keep the GF on its toes. Once you are hungry and somebody waves a plate of food who are you not to take a bite?” said Felix Mwanza, a representative from Zambia’s TALC: a group that advocates for better access to health services on behalf of people living with HIV.
If this provocative analogy, shared during the two-day workshop hosted by Aidspan in Nairobi for watchdogs, civil servants and technical partners from around East Africa, elicited titters and giggles from the more than 50 assembled participants, it also provoked somber reflection about some of the concerns expressed by those same advocates for accountability and transparency. Where do they fit within the Global Fund ecology, and how do they remain true to their independent watching and listening, while also relying on the Fund for financial support?
Finding financial support for independent watchdogging is a perennial challenge confronting all of the organizations.
“Most development partners are most focused on organizations that do health service delivery. They are not interested in watchdogs, so it is difficult to convince them.” said Mercy Bosha of Citizens Health Watch in Zimbabwe: a position echoed by her colleague, Sammey Jessie Fernanda.
“We depend on calls for proposal, and even then the funding is short term,” said Fernanda, from the Cameroon-based For Impact in Social Health. “When the money stops, everything stops. So it’s hard for us to evaluate our impact and ensure continuity.”
How to ensure a human rights approach to health program implementation has been identified as a key priority for many donors. In this sence, one participant suggested that watchdogs must step into the breach and present themselves as viable recipients of support – secure in the knowledge that access to health services should be an inalienable right for all people.
“They don’t see health as human rights but as a social issue,” said Bosha.
The challenge of finding funding has pushed many groups into the arms of the Global Fund, as recipients or sub-recipients of national or regional grants. This, too, has raised concerns both internally and externally about how to manage the conflicts of interest that could arise.
“We won’t stop barking. But we won’t forget who we are,” said Mwanza. “We’ll have to watch out before we open our mouth to make sure we are first doing a good job. But there’s a huge gain because now we’ll be directly involved in the action rather than observing.”
Over the course of two days of often intense discussions, recommendations were also made to ensure that watchdog work would continue, through the mentoring of other organizations and the cultivating of other interested parties in ensuring accountability and transparency in spending and operations at the community and country levels.
“We need a clear policy on conflict of interest so that stakeholders understand our position,” added Mwanza.
Others insisted that just because they had crossed to the other side, it wasn’t all bad: on the contrary. Becoming a recipient of Global Fund money means having a window of insight from the inside and more leverage to respond to the daily challenges confronting implementing partners of Global Fund programs.
Etienne Michaud, senior strategy and policy manager for the Office of the Inspector General, said that the Fund is absolutely interested in collaborating with local groups whose primary aim is to ensure transparency, even if it means that they will lose vital independent voices in countries to sound the alarm about potential irregularities.