ICTs, Decisional and non-Decisional processes, and Health Institutions

This Wednesday, March 11, 2015 photo shows the World Health Organization (WHO) headquarters building in Geneva, Switzerland. In a delay that some say may have cost lives, the World Health Organization resisted calling the Ebola outbreak in West Africa a public health emergency until the summer of 2014, two months after staff raised the possibility and long after a senior manager called for a drastic change in strategy, The Associated Press has learned. (AP Photo/Raphael Satter)

The most important impact that ICTs may have is in the increasing openness and possibility for mass collaboration and participation, which in turn is expected to gradually change governance models. [1] Thanks to ICTs, openness of governance systems and integration of policy making mechanisms can harness collective intelligence, building on the knowledge, experience, and competence of various actors. [2] In this post, participation is understood as taking part in decisional and non-decisional processes, ranging from commenting on ongoing working papers and standards, to influencing the agenda of the next General Assembly or the organization’s next working plan via an open debate on an eForum.

The international health institutions examined here comprise of Codex Alimentarius; Gavi; the Global Fund to Fight AIDS, Tuberculosis and Malaria; Good Agricultural Practice (G.A.P.); International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH); International Medical Device Regulators Forum (IMDRF); and World Health Organization (WHO).

Participation is increasingly requested by members and external stakeholders as a proof of transparency and efficiency. Although to include stakeholders in any decisional and non-decisional process requires dedicated financial and human resources, it is remarkable to notice that all organizations examined here offer the possibility to participate in such process. These institutions use ICTs to support commenting online on working papers, standards, or implementing programs; discussing online via electronic working groups on specific issues; and applying for a grant and check for its status. Most organizations also offer the possibility to join the organization online either via a form to fill in and email, or via a web portal. Furthermore, all organizations offer members, observers and the general public to engage with them via social media. The most common social media channels used are Twitter, LinkedIn, Facebook and YouTube. As follows, some specific examples to illustrate the use of ICTs by these health institutions.

All Codex Members and observers are encouraged to participate in the process to develop Codex texts, through sending written comments and attendance at meetings. Through an online login (or dashboard),[3] members and observers are encouraged to participate to the meetings to discuss and adopt the new standards, but prior to these meetings, ICTs offer possibilities to collaborate. Members and observers can comment on various preparatory documents including circular letters (each is available online in three languages with a commenting deadline). [4] Members also have the possibility to join Electronic Working Groups (eWG) that each Codex Committee establishes when deciding to develop work between sessions.

In 2015 Codex introduced a new Online Commenting System (OCS) for draft standards. [5] The system, called PleaseReview, enables Codex members and observers to share and submit comments on draft standards online at the click of a button. It will lead to “Improved consultation and work management: Codex contact points will find it much easier to draft, share and submit comments on Codex texts and the OCS will allow the Codex secretariat to manage consultation processes by automating notifications, compiling comments in an easy and efficient manner, and providing data for analysis.”[6]

Gavi’s new online country portal ensures that each country has quick and easy access to up-to-date information about its portfolio of Gavi support.[7] Countries can apply for new funding support, and from March 2016, report on their performance and provide key data for renewals. The portal improves how Vaccine Alliance partners can assess performance, pinpoint areas of need, and address challenges to strengthening immunization.

The Global Fund’s Grant Management Platform is a tool that allows implementing countries and the Global Fund to manage their grants online. It is accessible to Country Coordinating Mechanisms and other applicants, Principal Recipients, Local Fund Agents and Global Fund staff, who can sign on using the user name and password they have been given by the Global Fund.[8] The Global Fund’s e-Forum is an integral part of this extensive consultation process. Borderless, open to all, and in multiple languages, it engages all sectors of society in an inclusive and participatory way to collectively shape the future work of the Global Fund over a 10-week period. All stakeholders are invited to discuss the nine high-level strategic thematic areas of the Global Fund. It is moderated simultaneously in four languages, English, French, Russian and Spanish. The e-Forum 2015 is an opportunity to help shape the strategy and ensure the Global Fund’s increasing impact for the three diseases and global health.[9]

IMDRF offers on its website the possibility for send comments on documents.  The section contains open and closed consultations, with each the consultation item, working group, coordinator, and closing date. Each consultation item has a specific dedicated page with the document available to download and the contact person (working group chair).

WHO’s ePanel is an electronic system to process nominations, extensions and terminations of membership of experts to the WHO expert advisory panels. Proposed or existing experts can access the system using a unique URL and username and password provided by email.[10]
WHO Secretariat also produces proposals for electronic consultation open for comments from Member States.[11] WHO offers also a wide array of social media channels members, observers or anyone to follow and interact with the organization. They include Facebook, instragram, Google +, Twitter, Youtube. Many regional offices and programs have their own social media channels. WHO offers as well various applications as mentioned previously.

As discussed in this section, ICTs allow some international health institutions to enable stakeholders to participate in numerous decisional and non-decisional processes. The examples cited above illustrate how marginalized actors gained additional capacity to participate in decisional and non-decisional processes and therefore to shape global arrangements. However, these health institutions did not digitalize all processes. For instance, the election of the next Director General or Secretary General is not possible online. Traditional participation of stakeholders in meetings at headquarters or regional offices continue to be the favored option for specific types of decisions, mainly for privacy issues. Members still need to go to a physical location to vote and express their opinion. In many cases, they receive financial support to do so.

[1] Misuraca, G., Broster, D., & Centeno, C. (2012). Digital Europe 2030: Designing scenarios for ICT in future governance and policy making. Government Information Quarterly, 29(SUPPL. 1), S121–S131. https://doi.org/10.1016/j.giq.2011.08.006, p.126

[2] Misuraca, G., Broster, D., & Centeno, C. (2012). Digital Europe 2030: Designing scenarios for ICT in future governance and policy making. Government Information Quarterly, 29(SUPPL. 1), S121–S131. https://doi.org/10.1016/j.giq.2011.08.006, p.126

[3] Codex website : http://www.fao.org/fao-who-codexalimentarius/login/en/

[4] Codex website: http://www.fao.org/fao-who-codexalimentarius/circular-letters/en/

[5] Codex Alimentarius, Codex to use new online commenting system for draft standards, at http://www.codexalimentarius.org/roster/detail/en/c/358584/.

[6] Codex website: http://www.fao.org/fao-who-codexalimentarius/roster/detail/en/c/358584/

[7] Gavi website: http://www.gavi.org/support/process/country-portal/

[8] Global Fund website : http://www.theglobalfund.org/en/gmp/

[9] Global Fund website: http://theglobalfund-eforum.org/consultation

[10] WHO website : http://www.who.int/about/collaborations/epanel/en/

[11] WHO website : http://www.who.int/about/collaborations/non-state-actors/en/