Accountability matters: Civil Society and Parliamentarians push for MAF implementation
Updated: May 6
2 December 2021 -- The Global TB Caucus coordinates with at least one Civil Society Organisation (CSO) in each country where a Member of Parliament (MP) is committed. These CSO representatives are referred to as Focal Points (FP), primary contacts for the Caucus in a country.
While our endeavours to engage FPs has resulted in an extensive reach and strong network, a recent survey showed that the relationship between MPs and FPs in some countries are either relatively distant, or non-existent.
In an effort to strengthen MP connections with Focal Points, the Caucus launched the Platform of Experts (PoE). Facilitated primarily via webinars, the PoE launched with the aim of sharing expertise between MPs and CSOs across regions, as well as exchanging ideas that accelerate progress towards the 2018 UN High Level Meeting TB targets and the Sustainable Development Goals. These insights will prove to be particularly helpful in countries with a high TB burden, and inform Caucus agendas and activities.
This was also the PoE's first global gathering, as it was previously divided into different regions. The new format allowed for a more unified and comprehensive perspective to be brought into the discussion.
To this effect, the second PoE event was held on the 2nd of December, 2021, and centred on the need to implement the Multi-sectoral Accountability Framework (MAF). A custom framework developed for MPs, its checklist aids in assessing parliamentary engagement and informs how they can further orient themselves within the accountability process. The MP checklist, developed by the Global TB Caucus in partnership with WHO Europe, has notably already been piloted in the Eastern Europe and Central Asia regions.
Michael Macharia (Conference of Catholic Bishops, Kenya) was among those who presented and shared some keen insights on the MAF implementation within Kenya:
Firstly, he noted that the MAF fosters collaboration and mutual accountability to end TB within (and beyond) the health sector in Kenya, which facilitates an all-inclusive approach: ending TB needs a united spirit in work. He also discussed four key elements in the fight against TB:
Manufacturing- National/local manufacturing of TB-related drugs and commodities can mitigate limited stock issues, as well as reduce costs incurred from importation.
Food and nutritional security- Ensuring food and nutrition security will facilitate the availability of good nutrition for the (approximately) 50% of TB patients suffering from malnutrition, thus preventing loss of lives associated with poor nutrition.
Health- Universal health coverage will help mitigate the costs associated with TB care, preventing impoverishment of households as well as improving access to essential aspects of care.
Housing- Good and affordable housing will lead to decongestion of informal settlements, thus aiding the prevention of TB.
And lastly, some lessons learnt from his experience: firstly, patience is key as government processes cannot be rushed. Macharia also emphasised the importance of planning; how timing and sufficient notice to stakeholders is critical. Then he discussed important aspects for any team working on the MAF: Commitment and Diversity, where the former ensures the process moves forward, and the wealth of ideas and solutions from the latter enriches execution. Lastly, he discussed how it is essential to align with National TB Program teams and key health ministry officials, while noting that the MAF is a continuous process which one should keep constantly engaged.
Dr Syed Karam Shah (Stop TB Partnership Pakistan) gave a presentation on the MAF at a district level in Pakistan, which provided some much-needed context on how the MAF must be flexible to meet the systems of different countries: after Pakistan decentralised health to the provincial level in 2011, the Sindh province subsequently abolished provincial programs; and districts became the hub of health activity. Following a consultative process, the MAF was launched in the Badin District of Sindh in 2019. Dr. Shah stressed the importance of establishing similar structures at a provincial level to bring social sectors closer together in united action, in the pursuit of the SDG 2030 targets (including TB elimination).
The rest of the panellist presentations (which can be accessed here) gave insight into each of their countries’ current implementation of the MAF; their respective regional and national experiences, raising the significance of cooperation with the Caucus on the MPs’ checklist implementation:
Ms. Natalia Krishtafovich (Republican public association - Defeat Tuberculosis Together, Belarus, EECA region) on the experience of her organisation in the implementation of the MAF-TB in Belarus.
Gisèle Takeléa (DRAF TB, Francophone region) on the experience of Côte d'Ivoire on the implementation of the multi sectoral accountability framework to achieve the UN HLM targets.
Dr. Erzio Tavora (StopTB Partnership Brazil) on the implementation of the MAF-TB in Brazil’s National TB Plan.
Global partners of the Caucus, which include the Global Fund, WHO representatives and other donors, were also present and expressed that the insights helped them build a bigger, broader picture of global activities combating tuberculosis.
Moving forward, the outcomes from discussion are to be reported and further discussed at larger meetings with Heads and members of National TB Caucuses. This is in line with the Caucus’ spirit of collaboration, which presents these valuable experiences and best practices to Global TB Caucus’ members and Heads of National TB Caucuses, allowing them to better identify gaps in TB responses, while building capacity and strengthening opportunities through these connections.
The next meeting of the Platform of Experts is expected to be held in June of this year, 2022; details to follow.