Honesty, Persistency and Engagement

Sometimes, we are attracted and tempted by the smooth, clean and easy surface of things – and narratives. 2018 was again a year with many such temptations: The “partnership”, “multi-stakeholder” and “global movement” discourse of the UN Sustainable Development Goals, taken over and amplified by the new leadership of the World Health Organization, pretends that we can achieve everything (sustainable development or Universal Health Coverage) if we just do it together. The mainstream narratives on “leaving no-one behind”, “pro-poor policies”, “gender transformation” – to throw a few of the buzzwords of the past year(s) on the table – make us believe that there are easy answers to complicated realities.

And sometimes it is awkward to be the ones who challenge the easy answers, ask the critical questions, enquire about the making of an apparent consensus, and insist on blind spots or shortcomings of an analysis or strategy. But sometimes just asking the right question is as relevant as giving the answers, and most of the time, it is more honest to ask the question first…

In 2018, in its own events and statements and contributions to global meetings and working groups, the Medicus Mundi International Network continued to ask “difficult” questions such as the following:

  • In the year of celebrating the jubilee of the 1978 Alma-Ata Declaration: How to translate “Health for All” into the present and future?
  • How to make sure that development cooperation contributes to strengthening and not weakening national health policies and systems?
  • How to ensure better transparency and inclusiveness in the making of “joint civil society statements”? Can civil society, in global political processes, really “speak with one voice”?
  • How to address the root causes of sexual harassment and exploitation in the context of aid?
  • How to make sure that digital health, eHealth, mHealth become a real breakthrough for public health and do not create new dependency?

You see the diversity of the topics and levels, and you might see the related challenge: If we take our Network’s culture of honesty, sincerity and persistence serious, asking the right question and insisting on them can only be the first step. We also need to find or create ourselves spaces for honest debates in view of achieving a better analysis and finding some answers, even accepting that these answers cannot be easy ones.

The Annual Report 2018 of the MMI Network will lead you to all the questions above and to more of them, to the processes they relate to and to our Network’s engagement in these processes.

The report is structured along the two main fields of activities as outlined in the MMI Network Strategy 2016-20: We continued in 2018 to engage our members and partners in a conversation on how to move health cooperation “beyond aid”. And we continued to successfully play our role as both a critical civil society voice at the World Health Organization, its governing bodies and processes, and as a convenor and facilitator of civil society networking and advocacy in the field of global health and health governance. In our approach of linking practice with evidence and the local and national with the global level, the MMI Network and its members deal with these fields of work not just as separate tracks, but as a holistic one.

Message by the President

Dear Members and Partners,

Technological advances have allowed us to reach unprecedented life expectancy and to improve our life quality. Nevertheless, a big part of world’s population is still excluded from “healthy lives and well-being for all”. As an example, the huge existing gap between and within countries and populations in terms of maternal or child mortality cannot be explained by any genetic or biological reason. The real problem lies in the inequalities in both living conditions and access to health care.

At the same time, global issues become more and more relevant for the health status of individuals, communities and populations and for national health

policies and systems. “Global health” does not only relate to political issues such as access to medicines or the governance of global health institutions, but includes the broader determinants of health and health policies such as climate change, the economic crisis, food preservation and renewable energy that cannot be resolved at a national level alone. All these issues must indeed be considered when we aim at more equality and “health for all”.

In order to cope with today’s challenges and to fulfil its mission, the Network Medicus Mundi International (MMI) has structured its work plan in two interrelated fields of work. On the one hand, many Network members strive to improve communities’ and people’s health conditions by means of actions and projects on the ground, directed to the most disadvantaged people. To support this action, the MMI Network and its working group on Effective Health Cooperation provide a space for joint reflection on how to do this best. On the other hand, MMI tries to influence global health policies and governance through own inputs and as a convener of civil society advocacy. The activities falling under each field of work are built on contributions by Network members coming from different world regions and belonging to different areas (NGOs, national networks, academia) and are supported by our secretariat.

Two main elements of MMI Network action in the past year are worth to be highlighted: The first one is our participation in events and initiatives aimed are triggering a global process of critical reflection and debate on the right to health for all. In this regard, the Network has officially taken part in the most important meetings and conferences throughout 2018: The 71st World Health Assembly in Geneva, the Global Conference on Primary Health Care in Astana, and the Fourth People’s Health Assembly in Dhaka are some of the events where MMI had an active and vocal role in 2018.

The second element is directly linked to the Network members’ benefits. MMI is conceived for letting members share their experiences, for promoting their work and good practices, for amplifying their voices and developing common projects. This is based on the demand and contributions by members, and we had two outstanding experiences in the past year: the symposium on “The State as health duty bearer – challenges and threats” organized by Medicus Mundi Bizkaia in February in Bilbao, and the symposium “’Health for All’ by 2030: On the Right Track, or on the Verge of Failing?” of Medicus Mundi Switzerland that took place in Basel in November. MMI contributed actively to these two great occasions to gather many relevant actors among and beyond our Network(s) and to shine a light on our members’ positions and work.

2019 will be another crucial year for Medicus Mundi International to follow this double track: Continuing and further deepening our work in the fields of effective health cooperation and global health governance will not only consolidate our role, but also help these fields to be mutually strengthened. The perspectives are promising.

That’s why I think that it is important to keep thinking big and aiming high, reaching the most important institutions and actors with our analysis and input, at the same working hard, with the resources available at the Network members and secretariat, without ever losing sight of the realities and ambitions of the institutions we intend to bring together, nor of the people we want to serve.

Thanks to all who contributed to another successful year!

Carlos Mediano

Contents of the MMI Annual Report 2018

  • Message by the President
  • A year of renewed attention to Primary Health Care
  • “Health cooperation beyond aid” …and beyond the MMI discussion paper
  • Global Health Policy and Governance: Difficult questions, difficult processes
  • Short stories by Network members
  • Network members

Network members: Short stories

In addition to the institutional report, we have again received great contributions by MMI Network members. Their “short stories” provide a good picture of realities and challenges in the field of international health cooperation and global health policy and governance.