CSO Advocacy Framework and proposed toolkit

1. CSO Advocacy Framework and proposed toolkit GAVI CSO Constituency Steering Committee Meeting 12 November 2011 Dhaka, Bangladesh Special Thanks to: RESULTS UK, CHPI, AFGH, ACTION, Oxfam Ghana, and steering committee member, formerly known as the Advocacy Strategy WG

2. Principles and Values GAVI CSO framework still will still hold the principles and values that guide the reason why providing this tool is important: Health Systems strengthening: GAVI CSO’s believe in universal access to comprehensive immunization and health care services on the premise of cost effectiveness, equity and social justice. Our focus is towards the impoverished and the marginalized societies of the world. Solidarity within CS Coalitions: GAVI CSOs believe in building coalitions that strive to balance the common and diverse needs of each of the members; to respect their\ individual values, uniqueness and roles; and to continually ensure that the focus of all our collective activities is to benefit the health of children, mothers and all. Commitments among our membership: GAVI CSOs endeavour to establish a commitment from members that reflects their individual needs, while maintaining balance with the organizational strategic needs in order to sustain GAVI as a vibrant, evolving and responsive alliance.

3. From CSO GAVI Constituency Advocacy Strategy to CSO Advocacy Framework and toolkit • Coordinate advocacy work between such a diverse group of actors is to develop an advocacy framework and an associated toolkit. • The rationale behind an advocacy framework is to allow CSOs the flexibility to work towards specific advocacy objectives that are relevant to their comparative advantages, internal priorities, and country locations. • At the same time keeping in tune with the core objectives of GAVI and the Constituency as a whole. • A high-level global framework will serve as a common starting point for best practice and coordination. • The framework should also facilitate the development of a flexible advocacy toolkit that can be used by CSOs from both developing and industrialised countries.

4. Shared Advocacy Priorities It is important that the GAVI CSO constituency does not miss this opportunity To frame Its messages , profile and Policy “asks” around the existing GAVI Alliance Strategic Goals. Equity of Access Comprehensive Country Ownership Resource Mobilisation and Funds Dispersal Affordable Vaccines Representative Governance Research and Development for New and Better vaccines

5. Operating methods GAVI CSO Constituency operate at various levels of advocacy; local, national, regional (AU, EU, ASEAN, SAARC, OAS (GCC)) and international. These reflect differing priorities. CSOs also have differing abilities to engage at these levels depending on time, organisational focus and the relevance of such processes to the contexts in which they work. • When complete, this document will outline how these different levels of engagement most naturally map onto the differing Constituency priorities outlined in Section 1 and suggest how such priorities can be operationalized by the members of Constituency. • It will outline how advocacy at the local, national, regional, and international level can be coordinated and combined to maximise the Constituency’s potential to achieve its core objectives/goals. • In all our work we should take into account the core Paris Principles from the Paris Declaration on Aid Effectiveness on ownership; alignment; harmonisation; results; and mutual accountability and the updated guidance within the Accra Agenda for Action, specifically on: Inclusive partnerships: All partners - including donors in the OECD Development Assistance Committee and developing countries, as well as other donors, foundations and civil society - participate fully; delivering results: Aid is focused on real and measurable impact on development; and Capacity development - to build the ability of countries to manage their own future

6. Outputs • Outputs can only be broadly defined at this framework level unless specific policy positions have been agreed by the broader constituency. For example, “Getting Cheaper Vaccines” is a measurable output for the goal of “Affordable Vaccines”, but exactly what price for what vaccine in what context is somewhat beyond the scope of this document. • It may be difficult to include useful specific outputs in this framework document, and these may need to be more fully fleshed out in subsequent conversations by those within the Constituency. • It is important, just as in the previous Section 2 on the Operating Methods, that the Outputs are appropriate based on the CSO itself, its context, and the forain which it works, similar to the below table. • The full framework document could include a policy and evidence section where we outline sources for the above priorities to give Constituency members the opportunity to read about each priority in more detail.

7. What is the proposed toolkit The GAVI CSO Advocacy Toolkit  has been developed to assist civil society, NGOs, communities and country networks as leaders in advocating for immunizations and children’s issues. The toolkit contains 12. The toolkit provides helpful tips and tools related to several advocacy topics, such as: • The Policy Process • Building Coalitions • Communicating with Policymakers • Media Advocacy • Community Engagement Each section of the toolkit serves as a “mini primer” on the topic with reference to helpful samples and tolls listed in the appendices. Users may find it helpful to skip directly to section in which they are particularly interested. The toolkit and the attachments listed in the appendices are available online at the following: http://www.xxxxxx.org.

8. Policy areas in which to focus Equity of Access • Advocating for the universal right to immunisation as an entitlement and obligation which all countries have committed to. This may include using laws and justice systems to challenge failure to ensure this entitlement. It may look for universal action to increase immunisation for those currently excluded. • Provision of immunisation is a core function of health services and inequities reflect the unequal distribution of healthcare. Linking advocacy with immunisation with advocacy for health systems which reach the poor. The children who are missing out on immunisation are also missing out on basic health services. Policy implications to ensure universal access to healthcare will include removing obstacles which exclude the poor such as out-of-pocket expenditure. • Conduct advocacy to ensure that the funding window for cash based programmes remains open and is increased. Such programmes should, where possible, be embedded within a broader health systems strengthening and community systems strengthening framework rather than narrowly focussing on the creation of vertical vaccine delivery systems.

9. Comprehensive country ownership • Supporting the principle that national governments should identify which vaccines to include in basic immunisation activities. GAVI support for the introduction of new vaccines and the expansion of access should respect the importance of country ownership. Donations and temporary price reductions should not take precedence over considerations of sustainability. • Immunisation should rarely be a vertical programme but should be integrated into the national health system. Advocacy may call for better integration and that immunisation activities should support the national plans for health. • Advocate for, build and support strong CSO and community voices, enabling participation in comprehensive, country-led national vaccine strategic planning and implementation processes. • Ensure that the voice of recipient countries is powerful in GAVI and donor considerations and that GAVI’s approach is driven by recipient country needs, not the needs of donors.

10. Resource Mobilization and Funding Dispersals • Identify and maximise opportunities in developing countries to leverage domestic resources according to the country context to ensure sustainable increased in access to new and existing vaccines. • Monitor donors who have made pledges, and ensure that pledges translate into genuine dispersal within the agreed timelines. • Ensure that aid is being given free of conditions. • Remain vigilant in identifying new opportunities for resource mobilisation and advocating for these as they are identified. Affordable Vaccines • What is our benchmark for ‘affordability’? • Advocate for full transparency in pricing within GAVI, and take forceful action to use competition to get a better deal. • Ensure that GAVI supports alternative suppliers to enter the market in order to ensure competition between suppliers. • Ensure that mechanisms to bring new products are appropriately planned so as to avoid creating a monopoly. • The CSO Constituency has a unique and special role in seeking ways to positively shape vaccine markets using creative and innovative mechanisms that do not rely solely on competition and market dynamics, particularly in emerging markets.

11. Representative Governance • The governance of GAVI is weighted to ensure that developing countries are able to drive GAVI’s policies and that these should take precedence over the interests of donors. • Advocate for strong conflict of interest management processes and thorough transparency in decision-making. • Call for a full review of the board structure to determine how well its make up represents the full set of stakeholders involved in GAVIs work and the vaccines community. Research and Development for New and Better Vaccines • A balanced approach to the way that R&D companies profit from their developments, ensuring their ability to recoup investment but ensuring that new products can be produced by a range of suppliers as soon as possible to develop a genuine and lower market price. • Advocate for appropriate and catalytic investments to be made by the donor community to fund the development of new vaccines from initial research through to deployment in the field. • Clinical trials are an essential part of the near term landscape for the development of vaccines. What should be the Constituency’s advocacy priorities for in this area?

12. Donor support which is well-targeted at developing new and improved vaccines which are needed by poor countries. Mechanisms such as AMCs should have clear policies to ensure multiple suppliers including provision for technology transfer.Advocate for operational research that could contribute to effective distribution processes in developing country contexts.. Strong ethical controls for trials of new products to ensure that participants are fully respected and informed and that in-country research capacity is enhanced.

13. THANK YOU FOR THE ENTIRE ADVOCACY WORKING GROUP QUESTIONS? HOW TO MOVE FORWARD?