ICTs, Transparency and Health Institutions

Transparency is often considered a prerequisite for democratic accountability, and can be conceptualized as “the extent to which individuals who may be significantly affected by a decision are able to learn about the decision-making process, including its existence, subject matter, structure and current status” (Dingwerth, 2007: 30). [1] Many global institutions offer online information for their members and interested stakeholders. This post discusses online access to information in some health global governance institutions. This analysis will enable to determine if marginalized actors, including civil society and LDCs, have gained additional capacity thanks to take part in global governance arrangements.

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).

All institutions examined here offer a broad access to information for their members and interested stakeholders. This means that marginalized actors have access to five types of information: (1) information about the organization, its governance structure, mission, and main activities; (2) a newsroom with various levels of complexity and media proposed; (3) a publication section with various search functionalities; (4) information to prepare and attend future meetings; and (5) information on the latest decisions and outcomes (meeting decisions, standards, grant decisions for instance). Some organizations offer more in depth, detailed information than others. Also, some institutions have an open-data policy and open their data to interested audiences. This is a minority among all organizations though. As follows, some specific examples to illustrate the use of ICTs to provide access to information by health institutions. As stated previously, all organizations offer access to these five types of information. The examples cited below aim to represent the most iconic illustration of the access provided online, and therefore the increased capacity it implies for marginalized actors.

Codex Alimentarius offers a one stop shop with all documentations needed for delegations to attend meetings. Due to its paperless policy, delegations can obtain all documentation from the Codex website prior to a Codex session and should bring copies of documents to the meeting as working papers are distributed exclusively via the Codex website and not printed at meetings – with the exception of Conference Room Documents. These documents include circular letters, the invitation and provisional agenda, working papers and information documents. After meetings, the report is distributed electronically. Reports, final texts and publications are available on the Codex website in at least three official United Nations languages.[2] Since 1990s, every Codex standard is created and stored digitally and made publicly available on the Codex website in multiple languages as soon as it is adopted by the Commission. All standards, guidelines, codes of practice and advisory texts that compose the Alimentarius, the numerical Codex standards for food additives, veterinary drugs maximum residue levels and pesticide maximum residue levels; and thematic compilations of Codex texts can be are available online. [3]

Gavi website offers a very comprehensive online library and news section that is fully searchable. It offers various options and contains news, including press releases, statements, return on investment stories and features; Gavi documents, pneumococcal Advance Market Commitment (AMC) documents, independent evaluation studies and policy papers; Gavi Publications, including the Annual Progress Report, Evidence Base and Fact sheets and white papers. [4] News are shown either in various formats, including written, videos, audio, presentation and infographics. This section also contains a blog that reports from the field by Gavi and partner staff members, illustrating the impact ‘on the ground’ of the Vaccine Alliance’s mission to increase access to immunization in developing countries.[5]

The Global Fund operates with a high degree of transparency. Information about each individual grant, for example, is available on the relevant country’s page, but, in addition, raw data about the grant portfolio can be accessed and downloaded through a Web API (Application Programming Interface).[6] This enables existing supported organizations and potential ones to have more information about where the Global Fund works. It also includes the six Eligibility Requirements (ERs) with which Country Coordinating Mechanisms (CCMs) must comply in order to be eligible for funding. Eligibility Requirements embody good governance practices with which all CCMs must comply. To help CCM prepare their application, some documents are available online including guidelines, implementing partners and some case studies.[7]

The Institutional Repository for Information Sharing (IRIS) is the digital library of WHO’s published material and technical information in full text produced since 1948. Its content is freely accessible and searchable in the six official languages (Arabic, Chinese, English, French, Russian & Spanish). This global digital library provides online access to WHO published material. [8] It is possible to browse per Issue Date, Author, Title, Subject, Communities and Collections, and to refine the search by issue date, author or subject (among others Organization and Administration, Budgets, Interinstitutional Relations, Meeting Abstracts, Regional Health Planning and National Health Programs Governing Board, Malaria, Health Policy or Health Planning). Two other similar applications exist but for specific regions: the Institutional Repository of the Pan American Health Organization (PAHO/WHO)[9] and the Western Pacific’s Institutional Repository for Information Sharing (WPRO IRIS).[10]

WHO set up Hinari Programme together with major publishers to enable low- and middle- income countries to gain access to one of the world’s largest collections of biomedical and health literature. Up to 15,000 journals (in 30 different languages), up to 47,000 e-books, up to 100 other information resources are now available to health institutions in more than 100 countries, areas and territories benefiting many thousands of health workers and researchers, and in turn, contributing to improve world health.[11] The Global Index Medicus (GIM) provides worldwide access to biomedical and public health literature produced by and within low- and middle- income countries. The main objective is to increase the visibility and usability of this important set of resources. The material is collated and aggregated by WHO Regional Office Libraries on a central search platform allowing retrieval of bibliographical and full text information.[12]

WHO website also proposes a distinctive application dedicated to the election of the next Director General. Members can find on this application Key documents (Governing bodies documents, Rules of Procedure of the Health Assembly and the Executive Board, and other relevant documents); Code of Conduct for the Election of the Director-General of the World Health Organization; Roadmap for the election of the Director-General of the World Health Organization; Web forum; Candidates’ forum and some additional information on the next 140th session of the Executive Board and Seventieth session of the World Health Assembly.[13] The Web Forum is open for Members only via a specific login.

As discussed in this post, ICTs allow some international health institutions to provide a broad access to information. All organizations  examined here offer access to five types of information and the examples cited above illustrate how marginalized actors gained new access to information that was once restricted to western diplomacies and most powerful states.

[1] Dingwerth, K. (2014). Global democracy and the democratic minimum: Why a procedural account alone is insufficient. European Journal of International Relations, 20(4), 1124–1147. https://doi.org/10.1177/1354066113509116, p.10

[2] Codex website: http://www.fao.org/fao-who-codexalimentarius/meetings-reports/information-for-delegates/en/

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

[4] Codex website : http://www.gavi.org/library/

[5] Codex website: http://www.gavi.org/library/news/gavi-blogs/

[6] Global Fund website: http://theglobalfund.org/en/portfolio/

[7] Global Fund website: http://theglobalfund.org/en/ccm/#related-resources

[8] WHO website: http://apps.who.int/iris/

[9] WHO website : http://iris.paho.org/xmlui/

[10] WHO website : http://iris.wpro.who.int

[11] WHO website : http://www.who.int/hinari/en/

[12] WHO website : http://www.globalhealthlibrary.net/php/index.php

[13] WHO website : http://apps.who.int/gb/ep/