Civil society organizations and the functions of global health governance: what role within intergovernmental organizations?

Amid discussion of how global health governance (GHG) should and could be strengthened, the potential role of civil society organisations (CSOs) has been frequently raised. This paper considers the role of CSOs in four health governance instruments under the auspices of the WHO, and maps the functions they have contributed to.

The examined case studies indicate that:

• CSOs have contributed to diverse functions across the four health governance instruments.
• CSOs have played a supplementary role where government institutions have been weak or non existent.
  
• CSOs are playing a critical watchdog role, ensuring that governmental institutions fulfill their responsibilities appropriately, and keeping a watchful eye on corporate actors engaging in health harming activities.
• CSOs have played the biggest roles in initiating, formulating and implementing formal rules in GHG.
• however, CSOs have not been given formal authority to make and enforce policy decisions.
  

The paper draws the following conclusions about the opportunities and limitations CSOs represent for strengthening GHG:

• although the formal authority of CSOs participating in GHG remains limited, informal participation can be highly effective.
• governments can enhance the policy process by broadening the scope for involvement by CSOs through improved consultation, granting of observer status, and provision of resources to participate in specific functions.
• yet, there are certain functions that require fulfillment by state institutions to ensure GHG instruments are effective.
• more detailed understanding of the respective roles of state, market and civil society actors is needed in terms of specific functions, and across different GHG institutions and instruments.
• understanding how meaningfully CSOs have been involved in their partnerships would be an important step towards ensuring appropriate balances in a system of GHG.