July 24, 2008
UW professors coordinate NGO code of conduct
rural clinic in Mozambique, where patients wait for comprehensive care, including AIDS treatment.
By Bobbi Nodell
News & Community Relations
More than 25 nongovernmental organizations (NGOs) have pledged to pursue practices that bolster public health practices in the countries in which they work, as part of an international nongovernmental organization code of conduct developed by UW professors working for Health Alliance International in Seattle.
“Nongovernmental organizations do life-saving work in developing nations but inadvertently their actions, fuelled by the pressure for quick results, can be detrimental to public-health systems,” The Lancet wrote June 28.
The code, officially launched May 28 at the Global Health Council conference in Washington, D.C., was developed by a handful of NGOs, including Health Alliance International, Physicians for Human Rights, African Medical and Research Foundation, Oxfam UK and Partners in Health.
The NGOs held monthly meetings and sought feedback from a wide group of people, including faith-based organizations and members of the ministries of health in Africa, said Amy Hagopian, acting assistant professor of health services.
A Web site was created to track signatories and offer a forum for discussion (www.ngocodeofconduct.org). Any organization can sign the code by going to the Web site. The code was developed out of frustration of seeing parallel systems of health care develop in Africa with pockets of shiny new clinics for HIV/AIDS patients next to outdated clinics for pregnant mothers.
“We want to maximize the effectiveness of aid,” said Hagopian. “Right now NGOs are accountable to no one and sometimes can do more harm than good.”
Ideally, NGOs working abroad would adopt practices that would help the government improve its health system. One such practice is for an NGO to send its staff to work for the ministry of health or at least not hire away staff from the government, thereby creating an internal brain drain. “We are worried that high NGO salaries in low-income countries can lure qualified people out of ministries of health and into the private sector,” said Dr. Wendy Johnson, UW clinical assistant professor of health services.
While most NGOs don’t intend to undermine a country’s human resource system it’s often an unintended consequence, she said.
Donna Barry with Partners in Health said tremendous growth in NGOs has led to a multitude of different projects and approaches across the developing world. She said well-funded NGOs can create idealized projects serving a limited population in a small geographic area.
“The result is a fragmented and inequitable health system where we can count HIV viral loads but a woman dying in childbirth cannot get a Cesarean section,” she said.
Vivian Cherue with the Liberian Ministry of Health said her country has had a lot of problems with NGOs locating themselves unevenly across the country or pulling out abruptly.
“When I looked at this code, I thought our minister of health would love this,” she said.
Health Alliance International (HAI) based in Seattle has more than 800 employees in Mozambique, Timor-Leste, Cote d’Ivoire and Sudan working to strengthen the provision of essential services by ministries of health. HAI is led by Dr. Stephen Gloyd and Mary Anne Mercer, pioneers of global health at UW who focus their work on improving structures that lead to health disparities.
