This article has been written by Christie Johnson Satti (@ChristieSatti).
Global health governance is put to the test in the era of Ebola. The patchwork framework that coordinates governance for health, globally, is under tremendous strain, with deadly consequences for directly effected countries. In this context, at an intimate gathering in the German Federal Foreign Office, an assortment of experts, policy practitioners, and stakeholders from civil society discussed how Germany and France, two of the most powerful influencers of global health policy, can work more efficiently on shared goals. This year, the World Health Summit, the leading civil society platform bringing together global health expertise in Germany welcomed a new contributor to the debate, the Centre Virchow-Villermé for Public Health Paris-Berlin, an academic bridge between the Sorbonne Paris Citéand the Charité–Universitätsmedizin Berlin—one which hints at the developing productivity their respective nations have found addressing common challenges together. The Centre Virchow-Villerméhosted two stakeholder dialogues on global health governance at the 2014 World Health Summit in Berlin. Another two workshops about a French-German comparison in Global Health strategies are scheduled for May and July 2015.
In a session aptly titled National Agendas of Global Health, emphasis was given to Germany and France’s similar approach to governance—strengthening the World Health Organization as the guiding and coordinating organization in global health policy. The discussion, fr amed by shared national interests at the WHO, UN, and G7, provided a rare look into policymaking processes. Ilona Kickbusch, director of the Global Health Program at the Graduate Institute in Geneva, opened the session: “Did you ever think that 20 years ago this would be possible?”—referring to the two diplomats among the panelists, as well as the recent diplomatic turn global health policy has taken. There is now an Ambassador coordinating the German Ebola Task Force headquartered in the Foreign office. Global health’s new home is less a symbolic shift, rather a measurable transformation of State responsibilities. States must, and increasingly do, invoke the right of participation by its citizens in policy, and enact policies that are grounded in a human rights framework.
Panel speaker Dagmar Reitenbach, head of the Multilateral Cooperation in the Field of Health at the German Federal Ministry of Health, recounted the atypical process by which global health informed policymaking in Germany: “At the beginning…there was a lack of comprehensive knowledge of German contributions to global health…with no clear public German profile.” In 2009 Germany acted on a trend, embracing global health as a key organizing principle for cross ministerial collaboration. By 2011 the ministries of Health, Development and Foreign affairs were engaged in two public consultations with civil society —a first for Germany. In 2012, led by the Federal Ministry of Health, the strategy was adopted by the German cabinet, also a rarity outside the leadership of Foreign Affairs. In 2013 Germany joined the handful of nations with a global health strategy. The coordinated response to Ebola is an early accomplishment of the comprehensive approach to global health, suggests Reitenbach.
France released its global health strategy in 2011 and maintains an active civil society consulting body. Jeanine Pommier, the deputy director of the Department of Human and Social Sciences and Health Behaviour at the EHESP School of Public Health in France, emphasized the commitment France has placed on dialogue and connecting state and non-state stakeholders across global policy arenas. President Hollande in 2012 established a national financing mechanism for global health, with broad public support.
While global health itself is difficult to define —in 2010, the European Commission on Global Health communication that was adopted by the EU member states did not even include a definition of the term—Canice Nolan, Senior Coordinator for Global Health at the European Commission, explained that the strategic approach has been extremely helpful. The internal communication informs the day-to-day governing of the EU response to Ebola. For Canice Nolan, increasing the participation of civil society in Brussels remains a challenge.
At the close of the session, several unanswered questions lingered uneasily in the air ripe for debate. How could stakeholders be better involved in governance for global health? Who participates? Even as civil society plays a larger role in driving the discourse, calling to task governments to address the gaps and creating spaces for solutions, along with opportunities for solidarity—if we are to be prepared for pandemics like Ebola, more intimate gatherings like this are needed.
About the author :
Christie Johnson Satti is an American born researcher based in Berlin passionate about pursuing solutions for sustainable universal health care for all persons, globally. She has an MPH in Global Health from Yale University and has worked in Germany alongside Dr. Peter Tinnemann of the Institute for Social Medicine, Epidemiology and Health Economics Charitéto establish global learning and teaching programs between health professionals in German and Sub-Saharan based institutions. Christie Satti is pursuing her research at the CharitéUniversitätsmedizin Berlin where she explores the governance mechanisms that influence global health strategy development at the national context.
Centre Virchow-Villermé Berlin
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Centre Virchow-Villermé Paris
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