Wednesday, June 17, 2009

Health-Eight Meet in Seattle

Sandi Doughton of the Seattle Times lifts the lid a bit on one of the more exclusive clubs in global health--the Health-8 or H8--meeting this week in Seattle.

Her report documents one more step in the ongoing privatization of global health as power and influence drain away from public groups--like the World Health Organization--to private foundations and non-profit organizations.

Given the reactions in Doughton's article, folks don't seem too concerned about the lack of transparency. After all, it's not like Hilary Clinton having secret talks about health care during her husband's administration or Dick Cheney chatting about energy policy with petroleum execs--right?

Related Post:
Who are the Health 8 (or H8)?


Dev Varma said...

Oligopolies have always had problems with transparency. I think that's kinda the point in their setup, though. They work under the principles of consent without consent, the idea that "mother knows best". Of course in this case "mother" is 8 of the largest players in the Global Health world. As I see it, the H8 have established themselves as a collusive oligopoly, an intelligent minority, a group of men and women who have claimed the bulk of the world's health burden for themselves. And if their technocratic insulation means a lack of transparency; and if that very lack of transparency means that something wicked this way comes, then we must break up the oligopoly. So the true problem, as I see it, isn't simply a lack of transparency. It's oligopoly. And it's solution isn't simply holding them accountable (I hate to say it, but whistle-blowing only affects policy if there are people to do it constantly, and only if they're willing to lose their breath over it). The solution lies in taking power away from the powerful. How we do that, I have no idea.

Laura said...

Or perhaps this "collusion" is the result of these agencies understanding perfectly well that they do not having any real authority to speak for the entire global health community, while knowing it would be foolish not to come to the table when invited. Perhaps the broader array of global health organizations, including community-based organizations, need to devise a means of establishing a body of health organizations that legitimately represent a diversity of interests as well as expertise. Do we think that is possible?

Dev Varma said...

It is slowly becoming the case that many of the UN organizations at this meeting are slowly losing their "power" in the global health world. The Lancet recently published a report outlining recent trends in global health funding and activity. But I'm not sure how replacing one group of health organizations with another will make much difference.Plus, I think organizations like the WHO, the World Bank, and UNICEF are the sources of expertise in the global health world. They have been around the longest and have served as a vital bridge between the science/technology community and governments worldwide.

Christine Gorman said...

There are issues of scale, as well. If decision-making involves too many people in the room, any real action simply dissipates.

Also interesting how, in many ways, these are issues of governance--whether public or private entitites are involved.

When you are acting on behalf of others--which must happen on some level because of the scale issues--how do you demonstrate accountability to the folks you are supposed to be helping?

Dev Varma said...

I think that is a question that no one has answered sufficiently. How many times have people complained about government's lack of transperancy? It seems that the only check on government is through the media. If the media makes a big enough fuss about something, it seems to kickstart the masses, sometimes. So I wonder if the only check for the H8 is global health reporting. And even then, how effective can it be?

Christine Gorman said...

Better to light a lamp than curse the darkness.

Dev Varma said...

Only if people are willing to open their eyes.