Launch of NGO Code of Conduct to support public health systems

A group of leading service and advocacy organizations today (Thursday 29 May) announced the launch of an “NGO Code of Conduct for Health Systems Strengthening” at the Global Health Council Annual Meeting.

The initial group of 22 signatories will ask international health and development organizations to join them in signing the Code, which encourages non-government organizations (NGOs) to change their practices as they operate in developing countries.

Organizers of the Code said they were motivated to draft their document because development aid, while helpful in the short term, can sometimes do damage to health systems in the long term. “We are worried,” said spokesperson Dr. Wendy Johnson, “that high NGO salaries in low-income countries can lure qualified people out of the Ministries of Health and into the private sector. While this helps the private NGOs accomplish their objectives, it undermines the ability of the government to maintain strong health systems.”

In recent years, international NGOs have attempted to fill gaps left by under-funded public health systems. “Tremendous growth in NGOs has led to a multitude of different projects and approaches across the developing world,” said Donna Barry from Partners in Health, who helped draft the Code. “NGOs can quickly hire more staff at higher salaries, acquire specialized equipment or create idealized projects serving one 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 can’t get a cesarean sections; where one district has a state of the art hospital while the next district has only an empty cement-block building without running water or electricity."

"For this reason, we have consistently aimed at strengthening government supported public health clinics in all countries in which we work, leading to sustained and more equitable care,” she added.

Drafters of the Code included a group of health-focused NGOs, including ActionAid, Health GAP, Partners in Health, Oxfam UK, Equinet, African Medical and Research Foundation (AMREF), Physicians for Human Rights, Health Alliance International and others. They held two open meetings with invited NGOs to revise the content over the last several months, one in Washington DC and one during the First Global Forum on Human resources for Health in Kampala, Uganda, hosted by GHWA in March 2008.

Vivian Cherue, with the Liberian Ministry of Health, attended the Kampala meeting to revise the Code, where she said, “We’ve had lots of problems with NGOs, such as that they locate themselves unevenly across the country, for example there are none in the Southeast, or they pull out abruptly, as they have no real obligation to be there. When I looked at this Code, I thought our Minister of Health would love this.”

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