11/25/2009 08:50 am ET Updated May 25, 2011

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.