The Association called the NGO Forum for Health was dissolved on 23 January 2018 at an Extraordinary General Assembly that was held in Geneva, at the World Council of Churches, by unanimous vote of a quorum of its Members in good standing. There was no single reason for this, and the vote was taken with pride for the Forum’s achievements and optimism for the future achievements of civil society actions in the field of global health.
We live in a world where change is occurring more rapidly each year, and in our microcosm of it – the community of nongovernmental organizations and more broadly of civil society – the impact is no different. We are all carried by that flow of change; we cannot ignore it and we all need to choose among the range of appropriate responses.
The NGO Forum for Health: A Global Network Committed to partnering to make health a reality, promoting equity and justice in health carewas formalized at its Annual General Assembly in May 1998, at the Palais des Nationsin Geneva. But the Forum already had a proud history. It originated in the mid-1970s in the NGO Joint Planning Exercise in Primary Health Carethat preceded the International Conference on Primary Health Care held at Alma-Ata, USSR, on 6 to 12 September 1978, which promulgated the Alma Ata Declaration calling for “urgent and effective national and international action to develop and implement primary health care throughout the world and particularly in developing countries in a spirit of technical cooperation”.
Those times were heady, and we gathered momentum and members. And we grew for several decades, our activities expanded, our connections extended and our membership swelled. We found a common voice and advocated loudly for our shared objectives.
The landscape of the nongovernmental community began to change, however, imperceptibly at first and then unmistakably. Challenges and obstacles to the growth of networks and international collaboration between nongovernmental organizations at national and regional level transformed into an unrelenting contraction, first in our scope of action and then in our resources.
In the last ten years, the downward trend sharpened, especially since the onset of the financial crisis that began now ten years ago and that was compounded by an economic crisis, a crisis of the “real” economy. Importantly, the balance of power between governments and financial actors became altered. In a few years, also, what was thought to be an acute, momentary disruption of the systems we knew transformed into a new state of affairs, and a new daily reality.
From the perspective of our analysis of the changes that influenced the microcosm of the nongovernmental community that we know, we have concluded that seven factors have resulted in the current situation that the NGO Forum for Health, in particular, faced in deciding on its future:
- The transfer of resources from donors to nongovernmental organizations has shrunk on balance globally, as potential donors have both reduced the volume of transfers and shifted their priorities, often narrowing and focusing their areas of concern.
- Nongovernmental organizations have increasingly needed to conserve resources for their highest priority actions, and have had decreasing financial capacity to pay to join regional or international networks. This has meant a greater concentration of resources to ensure the horizontal survival of nongovernmental organizations to the detriment of joining vertical structures that require the transfer of resources from the bottom to the top of regional and international groupings, and regardless of the benefits that joining provided.
- The need for international coordination has been increasingly met by the functionality of internet connectivity and the phenomenal growth in its global reach through the World Wide Web. Most importantly, high levels of successful international collaboration can now be achieved at very low cost.
- The sharpening divide between the rich and the poor globally and within societies has altered the stakes for the nongovernmental community. The range of problems that result from continuous growth in returns to capital and persistent decline in returns to labour calls for an intensification of nongovernmental action. This has encouraged specialization in issues and favoured collaboration that is issue-based over comprehensive coalitions.
- The exponential growth in information on the widening number of issues that concern us and its increasing complexity have also led naturally to an increased focus on single issues that are shared and mastered, that more specifically mobilize members and galvanize collective energy for action.
- Organized networks that are successful tend to follow the affinity of a concern for a single issue across countries and regions. It is less meaningful to create networks that cut across issues, simply because each member finds that its particular interest is diluted in a larger pool of issues.
This is even more so in respect to the vast agenda of the Sustainable Development Goals. Whereas the Millennium Development Goals offered a very limited number of issues to latch onto, and many civil society actors were unable to find in them their issue of primary concern, the SDGs offer a virtually innumerable range of very specific issues for civil society to focus on and to which it may dedicate its efforts.
- Alliances between various institutions of civil society that include nongovernmental organizations appear to work better and be more successful when they also focus on clearly delineated and circumscribed issues.
- A network such as the NGO Forum for Healththat keeps the focus on global issues that rest on many streams and sub-sets of contributing issues cannot continue – and should not try – to be all things to all its Members.
Taking all these points into consideration, the Extraordinary General Assembly was called on to vote on a motion to dissolve the NGO Forum for Healthin accordance with the lawful means to do so under the provisions of Articles 7 and 10 of the Association’s Statutes:
“Article 7.The AGM shall be held once each year, preferably during the period of time when the World Health Assembly sits. It may also meet in extraordinary sessions whenever deemed necessary by decision of the Committee, or at the request of one-fifth of the membership.
The AGM shall be deemed lawful if the quorum of at least one third of the membership is met, by presence or proxy votes. Each member (individual or organization) has one vote. In the event of a tie vote on any issue, the President shall have the right to cast one vote”.
“Article 10.Decisions concerning the amendment of the Statutes and the dissolution of the Forum shall be approved by a two-thirds majority of the members present; proxy votes shall not be valid in the case of dissolution of the Forum”.
On passing the motion, the Assembly also acknowledged and celebrated the achievements of the NGO Forum for Health over 40 years. The organization had fulfilled its purpose in all senses and would, if continued, outlive its usefulness. In releasing its members from the responsibilities of membership, the EGA strongly urged all the NGO F4H Members to carry on in the same vein and continue their actions by means of collaboration with other associations that share the same focus and are like-minded.
The Extraordinary General Assembly was then called on to proceed to the second vote, on the statutory transfer of the resources held by the NGO Forum for Healthin accordance with Article 15:
“Article 15.In the case of the Forum being dissolved by lawful vote of the AGM, the assets shall be allocated to a non-profit organization pursuing goals of public interest similar to those of the Forum. The assets cannot be returned to the founders or members, nor be used to theirs nor any other individual’s or entity’s own profit”.
By unanimous vote, a proposal was approved to transfer the resources of the NGO Forum for Healthto the International Association for Hospice and Palliative Care(IAHPC – see https://hospicecare.com/home/). The EGA further decided that the donation would not be earmarked, but would be accompanied with a special mention of the effort to decriminalize the medical use of morphine in hospice and palliative care in numerous countries.
The Bureau of the Steering Committee thanked all the Members of the NGO Forum for Health past and present for their commitment to the NGO Forum for Healthas an Association and to the Forum’s collective commitment to make health a reality, promoting equity and justice in health care.
The Assembly also wished all Members past and present every success in future endeavours.