• Media engagement —–> Investigative reporting and putting a human face to campaign (testimonies/personal stories by patients) – UGANDA
• Engagement with government  and collaboration with other CSOs active in the field + mobilisation of communities – ZIMBABWE
• Pill-check week campaign – Data from public/ public pressure/ applying human face to campaign – KENYA
• Using opportune moments —-> Election period (targeting local politicians, making health issues campaign issues, 367 aspiring candidates signed a pledge/ Using patnerships/ using general approach – broader issues (medicines for all not just stockouts) – MALAWI
• Engagement with officials in the government —-> alliance building with key officials – ZAMBIA
• Follow-up activities with members of parliament —-> Budget analysis/ meetings with parliamentary committees/ alliance building using core group of MPs that signed the pledge to reach out to those who had not signed/ “Health Swap” review meetings (compare government reports with alternative CSOs reports – MALAWI

GROUP 4 GROUP LEADER: ROSEMARY KAMBEWA – MALAWI.

CHALLENGE

• To make Parliamentarians go beyond signing the pledge cards and make the pledge have impact at local level.
• To continue the momentum started during the campaign period at local level to continue.

PROPOSED STRATEGIES

1. Health Budgetary Analysis – Conduct an analysis of the health budget to ensure government has allocated 15% or more.

1. Budget Tracking – Track the budget from national to health facility (community level)

• • This should allow for social audit including social audit by the local communities.
•  
  • Interface activities : The budget analysis and tracking should be followed by interface activities such as Meetings with Parliamentary committees on health, HIV and AIDS and Finance committees parliamentary Committees to discuss issues identified from the analysis and tracking. The interface activities should go down up to community level.

1. On going capacity building to the following;

•  
  • Members of the civil society – for them to continue with the activities of the campaign.
  • Parliamentary Committees on Health, HIV and AIDS and Finance – for them to ensure allocated budgets meet the 15% Abuja Declaration.
  • Local Communities – for them to demand their right to drugs at local level.

1. “Name and shame” –Exposing discrepancies in the budget and drug availability and utilisation.
2. Public Pressure- Build on existing partnerships with civil society groups and continue with awareness campaigns and empower communities to know and demand their rights.

1. Litigition – The signing of the pledge cards has a social accountability and not a legal accountability so there is need to put back the legal recall of Parliamentarians.

1. Strengthening the health facility advisory committee to be able to monitor drugs delivered at the health and usage at health facilities.

Caroline  A Mubaira

Southern  Sun Hotel, Lusaka.   Zambia

7  December to 11 December  2009

Working  with Parliaments- CWGH  Experience

• The  CWGH is a network of Civic/Community Based  Organisations

• Formed  in 1998 to take up health issues  of common concern

• Aims to  be a leader in the achievement of  equity and accessibility in health through  empowered communities

• Builds  on the principles of community participation  in health 

• Motto  “ Health is your  Right and your Responsibility”

Parliamentary Portfolio  Committees

    The  CWGH has engaged the parliament through  the PPCH with the following outcomes; 

• •  
    • Increase  in resource allocation towards prevention &  control of diseasese

• • • General  increase in the health budget allocations

•  
  •  
    • Increased  space for Civil Society in budget monitoring 

•  
  •  
    • Improved  resource  utilisation for health

•  
  • Include  the Right to Health in the new Zimbabwe  constitution

•  
  • Building  the health system from the base –  up, with prevention, promotion- in schools,  media, homes

•  
  • Allocating  public resources to: 
    • Rebuild, strengthen and support environments and infrastructures for health
    • Fairly resource health systems
    • Invest in Non-financial incentives to return health workers

• Collecting  information 
  • Carried out Health basket research
  • Research on Primary Health Care state of services in communities
  • Write report with people
  • Write position paper to Parliament based on report from the people
  • Meeting with Parliament Portfolio Committee on Health (PPHC)
  • Field visit for Parliamentarians to meet with communities

•  
  • National  conference with
    • PPCH
    • PPC Finance
    • Ministry of Health and Child Welfare
    • Minister of Finance
    • Community Members
    • Other NGOs and CBOs

• Resolutions  adopted at the people’s conference
• Presented to chair of committee to table it Parliament.
• Ministry of Health announce had adopted our Primary Health Care strategy
  • It was people centered
  • Report covered many districts
  • Report was from the people

Services and intellectual properties

- Counterfeit – fake

-Trade mark- comes from hp.  Its up to you to believe. Trust a source

 -IP – don’t check quality

Uganda re-enforced Intellectual properties

Legislative efforts

Participants of the Access to medicines conference in Lusaka, Zambia

Sisule:

- What is problem with existing laws

- Are there gaps

- Can we fill gap instead of coming up with anti-counterfeit laws

Recommendation for Advocacy

WHO IMPACT INITIATIVE

• International
• Medical
• Product
• Against
• Counterfeiting
• Taskforce

Kenya: Peter

Toward 1990s Kenya.

Having provisions interpreted wrongly.

2007 bill published on anti- counterfeit

2008 bill resurfaced

Cso put workshop to inform media

There was a noticeable change that it was not dealing with batteries only

CSO sought to engage Parliament Committee on Health

They sought more information.

Parliamentary on Health raised with committee on Trade.  They entertained issues.  asked CSO to draft an amendment.  Some coincidence occurred. Day PPCH parliament was discussing constitutional amendments.  CSO was invited to meet Minister whom they found sitting with industry

In another meeting realized minute taker was industry. It was a rubber stamping method.  Government considered and imported WHO definition.  The definition does not include diagnostic. 

Law was enacted.  President signed.  He also signed a law guarding media.  It also impeded freedom of speech.  They could not be reported.  Another meeting was convened to clarify what law meant.  No one knew.  The generic manufacturers were afraid that they would be labeled criminal.  CSO realized lobbying works before law is passed.

Kenya has no RTH in constitution.  June 2009 lobbying started with support from OSI.  Law would commence by notice by Minister.  Government had no money to implement.  Expectation was 2009-2010 law would be enacted.  A suit was filed

A notice was published by Minister with a day before the suit.   The government not offered a response

Strategy

Court has to decide if RT life includes health and environment

If case is worn would be good.  If lost it would be a win.  It would mean medicines are left out.

Questions and comments

Is there evidence of corruption?

It was the PP Trade. When CSO came up with a draft to PPH.  Elections was an issue.  Various constitutional amendments were to be made. Opportunity not present draft was not available.

In terms of corruption you can see all signs but not possible to tell.

What is the specific law trying to change?

The nature of Kenya rules one has to challenge section by section.  Once a section is removed it means it has to go to court.  We are challenging counterfeit definition, one can possess for personal consumption.  This is section being challenged.

The current law has WHO definition.  Part of the reason is it had support with pharmacy.  CSO had proposed trade make infringement and copyright.

If Kenya CSOs could do one thing different, what would you do differently? 

• Refuse as there are other mechanism
• Remove what is offending
• To highlight home from an international perspective.  Kenya was first and no one knew how it would come out
• Sue government, but not possible for a law not yet enacted
• More advocacy strategies

Uganda

No one knew this was happening till the Kenya issues.

• Bill being brought
• Introduce of new agency that took powers of National Council of medicine
• Process, bill going through Ministry of Trade.  It had gone through and thrown back

Media is reporting the other side?  How strategic are you channeling information?  It’s easy to look to the obvious?

Whose interests are IMPACT serving?

What happens if boarder measures are removed?

Realise we can not stop governments from enacting the law, so how are other countries going to act…the trend is obvious.

Saiti Chikwapulo, a participant from Malawi

Opportunities: 

- The  AFRO meeting opened its doors to civil  society and we can see if we can  influence its agenda for next year

- EALS is part of a team that is undertaking the drafting of the regional HIV bill on request from the EALA.

- EACSO Forum as the recommendations from this forum are formally

- The synchronization of the pre budgetary hearings and budget readings in EA partner states is helpful in budget tracking

- An analysis of the EAC to map out where the greatest impact of the campaigns would be felt and have the greatest impact

- Training of civil society on procurement and supply in order to allow them to come to the table with a solution to the problems

- Trainings which are being offered at the universities on IP

- The AU level. Litigation at the ACHPR

Media: 

- We  need the media as they are part of  Civil Society. We must work with media to ensure that there is information to the general public as well as public debate on the issues in order to ensure ownership of the issues.

- We  must re-strategise on how the messages  are packaged, this campaign must be bigger  than HIV as the issue of stock outs  affects various essential drugs

- Media  engagement has been a major issue with  all the country groups

- Engaging media practitioners to help training of CSOs on their media advocacy campaigns

- We should tap into international media as they have a wider readership

- We should also link with community media as they have their ear to the ground and have the attention of the masses

- We must cultivate relationships with those journalists who have a specialized interest in the issues

• Ensure Disbursements  of the money allocated to health
• Minimize/ stop diversions of medicines in the Black market
• Have a mechanism of communicating with Rural District Health Centres
• Supply chain
• Improve collection of evidence

Raise awareness 

• Baseline survey-  HAI to assist in five districts
  • Over time
  • Once off
• Pill check week
  • Photocopy slips with o/s
  • Human stories
• Community meetings
• Advocacy at National level
  •  
    • Disbursements

Raise awareness 

• Media 
  • SW radio, Cape Town
  • Voice of America
  • Standard Paper
  • Etc
• IEC materials
  • Posters
  • Pamphlets

Raise awareness 
 

• TAXI tunes with  issues, contact numbers
• Road shows
• World Health Day 2010

Main Issues 

• Corruption 
• Lack of awareness of the community
• HCC not actively involved

• Actions 
• Continuous monitoring mechanism by communities
• Revive HCC committees to monitor the medicine flow- need a lot of resources
• Mechanism of HCC to provide feed back to communities and government
• SMS for sending information

• Working with PPCH,  MOHCW
• Policies, EDLIZ list
• Resource issue
• Clinics run by government
• Government to disburse the money to health
• Lack of transport- donors
• Bad infrastructure- roads

Key people  

• MOHCW Minister
• Minister of Finance
• Parliament Portifolio Committee on Health
• Prime Minister
• Minister of State in Prime Minister office
• WHO- Director
• UNICEF
• MSF
• RBZ??????

Key people  

• Donor Health Cluster
• Use of media
• SABC – political issues but regional strategy to help
• Voice of America
• Oxfam

Contacts  

• Zimbabweans in  diaspora
• Voice of America
• Citizen Journalism in Africa- Tapiwa, GAPWUZ
• MISA
• SW Radio

Websites 

• New Zimbabwe
• Kubatana
• SAFAIDS

• UGANDA – Media engagement —–> Investigative reporting and putting a human face to campaign (testimonies/personal stories by patients) 
• ZIMBABWE – Engagement with government  and collaboration with other CSOs active in the field + mobilisation of communities 
• KENYA - Pill-check week campaign – Data from public/ public pressure/ applying human face to campaign 
• MALAWI – Using opportune moments —-> Election period (targeting local politicians, making health issues campaign issues, 367 aspiring candidates signed a pledge/ Using patnerships/ using general approach – broader issues (medicines for all not just stockouts) 
• ZAMBIA – Engagement with officials in the government —-> alliance building with key officials 
• MALAWI - Follow-up activities with members of parliament —-> Budget analysis/ meetings with parliamentary committees/ alliance building using core group of MPs that signed the pledge to reach out to those who had not signed/ “Health Swap” review meetings (compare government reports with alternative CSOs reports 

1. Uganda: 

- Success in engaging /educating the media. Message in the media filtered through to decision makers, thanks to strong reporting. This lead to policy changes including the establishment of Drug Monitoring Unit

2. Zimbabwe: 

- Focus on resources >>> Adoption of Abuja commitments in health budget

3. Kenya:

- Positive response from government >>>> from denial to appreciation/recognition of challenges vis a vis procurement and supply chain management

4. Malawi: 

- Use of opportune moment to push access to medicines agenda in election campaigns >>> incorporation of access to medicines issues into political debates during election campaigns

5. Zambia: 

- Close collaboration with government, recognition and support from government departments/officials. 

- Findings from the campaign led to commitments by the government to review drug supply chain management