CHOGM fails its citizens with its woeful record on health

Both the UK and Australian Governments’ review of their aid this year found the Commonwealth Secretariat to be weak and ineffective. Commonwealth Secretariat

CHOGM: As the leaders of Commonwealth nations gather in Perth this week, The Conversation is examining the role of the biennial Commonwealth Heads of Government (CHOGM) Meeting.

In our latest piece in this series, Kate Taylor from the Nossal Institute for Global Health argues the Commonwealth Secretariat is ineffective and must change or perish.

Commonwealth countries have some of the worst states of health in the world. And the Commonwealth Secretariat’s meetings don’t look like they can offer to make things any better.

I don’t know if republicans are more or less favourably disposed to CHOGM meetings than monarchists, but let me open by disclosing my republican yearning for Australia’s future, just in case.

Nevertheless, I’m sure I’m not alone in thinking that the Commonwealth concept – like many empires that came before – has lost its glow and its meaning.

The United Kingdom’s Department for International Development (DFID) in March of this year looked at all of the multilateral organisations it funds and ranked the Commonwealth Secretariat as the weakest in terms of organisation and as the second-worst contributor to the UK’s development priorities.

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Earlier this year, the Australian Government’s Independent Review of Aid Effectiveness found the Commonwealth Secretariat’s effectiveness is “hindered by its broad and loosely–defined mandate”.

It concluded that future funding would be “contingent on a demonstrated increase in effectiveness”.

This is a pity, because Commonwealth countries overall could use more support judging by a raft of health measures:

  • All three of the countries in the world that have HIV prevalences of more than 20% of the adult populations – Botswana, Lesotho, and Swaziland – are in the Commonwealth.

Of the 30+ million people infected with HIV, one in five lives in the Commonwealth countries of Botswana and South Africa and the former member Zimbabwe.

With India, Nigeria and other members, the Commonwealth is home to roughly 60% of the world’s HIV positive people.

  • The Commonwealth is also home to polio: just four countries in the world have failed to control the spread of polio – Commonwealth members India, Nigeria and Pakistan and Commonwealth-eligible Afghanistan.

  • For tuberculosis (TB) India and China comprise 40% of the global burden. China has halved its prevalence over the last few years and reduced deaths from TB by 80%.

In contrast, India continues to struggle – as do its eight other Commonwealth peers and the Commonwealth “lost children” of Afghanistan, Myanmar, and Zimbabwe.

In other words, the Commonwealth potentially comprises 12 of the remaining 22 countries that host 80% of the TB in the world.

  • The Commonwealth does somewhat better on the measure of maternal mortality – representing “just” seven of the 14 countries where mothers fare the worst, where the risk of death in pregnancy and childbirth exceeds 1 in 100.

There are plenty of other examples – including current ones from malaria in health to education or women’s rights to own land as well as looming ones like the non-communicable diseases epidemics.

Former high court justice Michael Kirby has highlighted the lack of protection from discrimination for same sex relationships, with three quarters of Commonwealth countries still criminalising same sex activities.

But despite the efforts of former justice Kirby and the other people who served on the Eminent Persons Group (EPG), there seems to be little prospect of meaningful change.

Indeed, the fact that CHOGM neither releases its meeting agenda, let alone the EPG’s recommendations, doesn’t speak well for a commitment to transparency or accountability.

Certainly, it’s the opposite of the lessons in global health that increasing demand multilateral organisations – whether the World Health Organization, The Global Fund to Fight AIDS, Tuberculosis and Malaria, or the Bill and Melinda Gates Foundation – open up, share their data and be responsible for results, both good and bad.

DFID closed its review of the Commonwealth Secretariat by assessing the likelihood of positive change as “uncertain”. A wonderful British, bureaucratic word.

While the old methods of the elite and closed conversations by parties whose self-interest is the status quo prevail, we shouldn’t expect any significant progress on fundamentally democratic issues – including health, human rights or climate change – to come out of Commonwealth meetings.

But the two billion people of the Commonwealth should look to and demand future-looking organisations that address their needs – that may well include a setting sun for the CHOGM flag.

Read more:

Our complex relationship with India

That sinking feeling: will the Pacific be heard at CHOGM 2011?

Can CHOGM take the reins in the face of NCD disaster?