Following on its special issue The Social Realities of Knowledge for Development, the Institute of Development Studies, the Impact Initiative, and Health Systems Global co-hosted a webinar on how “social” aspects contributed to strengthening evidence-informed decision-making. While technical capacities (such as translating a high volume of technical information in a digestible manner) are important, research to policy processes are also social, highlighting the role of relationships and networks.
As a webinar panelist, I discussed my experience using technical assistance as a form of knowledge brokerage with the Africa constituencies to the Global Fund to Fight AIDS, Tuberculosis and Malaria Board. The Global Fund is a multi-lateral funding mechanism that was founded in 2002 to fight the three pandemics that posed the greatest threat to the developing world: AIDS, tuberculosis and malaria. The Global Fund provides $4 billion annually in the form of grants to countries to fund their disease responses – so there’s a lot of money at stake. There are general amounts earmarked for countries to apply for based on their disease burden and ability to pay.
Two Africa constituencies represent the 47 countries of sub-Saharan Africa, that have, collectively, received about 65% of the more than $30 billion invested by the Global Fund since its inception. Each constituency has a seat on the 20-person Board. This means that their input into the governance and decision-making of the Board is critical to the Global Fund’s success.
Given the diversity of the countries that make up the constituencies, their Board representatives routinely confront challenges that impede meaningful participation and engagement with the Global Fund Board. These include language barriers, low technical capacity and inadequate time and resource allocations. In a bid to address these challenges, the constituencies developed a joint governance framework which established an Africa Constituencies Bureau (ACB): a technical resource center to provide support to delegates and constituencies to enhance participation at the Board and committee level and shape the development of policies and decisions by the Board itself.
As a permanent Bureau was being established, the African Population and Health Research Center provided technical assistance including development of briefing notes prior to Board and committee meetings; coordinated consensus positions for debate and discussion on voting and non-voting issues; and assesses the potential impact of Board. Through this work I have identified four critical lessons in how technical assistance can be an effective way to broker knowledge and drive change.
- First, what helped this effort the most was the personal investment from a core group of influencers.
There was incredible support from global partners, but this process was Africa-led. No progress would have been possible without the constituencies’ leadership identifying the problems and spearheading the calls for change, with support from the governance team at the Global Fund Secretariat and many others.
- My second point stems directly from first: and that is a group commitment to evolving the process over time.
Following the creation of the governance document, no one had a blueprint for how technical assistance might best be provided – it was up to us to figure it out together. With board members completing their two-year terms and new ones coming in, what worked in the previous year would likely change shape in the following year, to fit the next group of leaders based on their information needs and personal style.
The meaning of “technical assistance” was clarified over time. We had a learning curve in understanding the political landscape, culture and vocabulary of the Global Fund. The African representatives to the Global Fund also had a learning curving in recognizing how we could best support their leadership. Over time, this led us to discover that it was essential to tailor the technical support to the needs of the individual. This means scaling the amount and complexity of the information.
- Knowledge brokering is a two-way process, it is neither ‘push’ nor ‘pull’ alone.
As APHRC’s relationships with Board and committee members evolved over time, so did its expertise and depth of understanding about anticipating and addressing their evidence needs. Evidence had to be identified (or in some cases, created) to meet the needs of leadership. Neither evidence-producers nor users can work alone.
- As a provider of unbiased, comprehensive technical assistance, APHRC had to build a reputation as a trusted broker of information.
The two Africa constituencies increasingly speak with one voice. In the past, national representatives would at times put the needs of their own country ahead of the best interests of the wider constituency. The nature of the technical assistance provided by a neutral broker reduces the likelihood of evidence being used selectively. A broad commitment to consensus building allows for all parties to review the evidence and agree on positions that balance the needs of all countries, in advance of decision-making. As providers of technical assistance, we facilitate the consensus building and above all, maintain fidelity in evidence use to constituency priorities arrived at through these processes, and recommend adjustments as new evidence emerges.
Ultimately, none of this is about a Bureau, it is merely a means to an end, which means supporting decision-makers to make use of information for better and more effective investments to end HIV/AIDS, tuberculosis and malaria. In time, it is hoped that the permanent African Constituencies Bureau will help deliver on this promise.
A recording of the webinar is available here https://vimeo.com/224057458 and slides can be viewed from https://twitter.com/Research2Action/status/880730158168190976.