Future of Global Health Initiative – GFAN Statement on the FGHI Report
Update: You can find the response of the FGHI co-chair to this statement here and our call for signature on the civil society red lines here.
Feedback and Reflections on the FGHI Report: A statement by GFAN
GFAN appreciates the significant efforts invested in producing the FGHI report and the importance of ongoing reflections on how to structure global health institutions to fill the gaps revealed by the COVID-19 pandemic. We would like to offer preliminary feedback and insights on various aspects of the report.
First and foremost, the report’s extensive consultations with experts from diverse backgrounds, including government, academia, civil society, technical agencies, and funders, are commendable, and make the report into a valuable snapshot of the way GHIs are perceived after 20 years of operation. We would however like to share some constructive feedback regarding the content and structure of the report:
1. Structure of the Findings
The report’s approach of merging all discussions into a continuous narrative, without distinguishing between consensus and divergent opinions, inadvertently diminishes the significance of areas of consensus while highlighting criticisms. The lack of clarity regarding which issues enjoy broad support and which represent minority viewpoints affects the report’s overall balance. Furthermore, the report’s structure does not effectively categorize or prioritize the issues raised during consultations. This results in a fragmented presentation of concerns without providing guidance on their relative importance or urgency. To enhance the report’s utility moving forward, we recommend a clearer differentiation between consensus and dissenting views, as well as a prioritization of key issues.
2. Coherence
The report’s Findings section juxtaposes conflicting viewpoints without adequate context or analysis. For example, the report contrasts perspectives on whether GHIs are too narrowly focused or have illegitimately expanded beyond their mandates. While both views have merit, subsequent steps in the FGHI process should offer an analysis that helps stakeholders understand the underlying reasons for these differing opinions and potential avenues for resolution.
3. Factual Accuracy and Sourcing
The inclusion of quotes from interviews without thorough fact-checking raises concerns about the report’s accuracy and credibility. For instance, discrepancies in the figures related to HIV spending in Mozambique have been noted. These inaccuracies cast further doubt of the relevance of some of the criticism levied against GHIs, suggesting that they could be based on out-of-date inaccurate data.
We strongly recommend implementing a rigorous fact-checking process for all information included in the report to ensure its accuracy and reliability. Properly cited sources for statistics and claims should be provided to enhance credibility, and quotes containing inaccurate figures should be identified as such or corrected in the main text before utilizing the findings of this report for future FGHI work.
4. Understanding the Political Economy of GHIs and other bureaucracies
While the report effectively highlights the influence and power dynamics surrounding GHIs, it does not use the same lens to think about development banks, United Nations agencies and implementing governments, which are positively contrasted to GHIs. We believe adopting a broader perspective would have enable a more nuanced evaluation of the relative advantages and disadvantages of GHIs within the broader global health sphere and recommend the FGHI process ensure such analysis is included going forward.
Conclusions and Recommendations
The report’s conclusions and recommendations, while thought-provoking, appear disconnected from the content of the report itself. Establishing a stronger link between the findings and proposed recommendations would enhance the report’s overall coherence and utility. Additionally, recommendations range from minor adjustments to substantial overhauls, and would have benefitted from being grouped along these lines as well as thematically; considerations that should be taken into account as the FGHI process moves forward and seeks external validation and commitment to the principles espoused in the report.
In conclusion, the FGHI report offers valuable insights into the discussions around the needed reform of our global health infrastructure. We believe that addressing the concerns will contribute to the report’s overall effectiveness and usefulness as a tool in the FGHI process. It is essential to strike a balance between highlighting valid criticisms and recognizing the substantial contributions of GHIs over the past two decades, and their own effort to reform and adapt both before, but especially after COVID-19.