Duckett, J.

English

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       Duckett, J. (2008) Health NGOs: a second generation of policy advocates? China Review, 42 (6). p. 16. ISSN 1359-5091  http://eprints.gla.ac.uk/47466  Deposited on: 4 March 2011   Enlighten – Research publications by members of the University of Glasgow http://eprints.gla.ac.uk Issue 42 Page 16 Calum MacLeod is China correspondent for USA Today Jane Duckett GRASSROOTS NGOs have developed rapidly in China since the early 1990s. Following “first generation” environmental activism, health sector NGOs are now widespread and taking policy advocate roles.  Some health sector NGOs were established in the 1990s but their numbers only grew rapidly  fol lowing encouragement from the central government in 2004. In recognition of the difficulties the state faces tackling China’s HIV/AIDS epidemic, top leaders openly supported NGO involvement in this issue. Leaders seemed to accept that NGOs may be better able to reach marginalised groups at high risk of infection, particularly sex-workers and “men who have sex with men”. (MSM)  Growing NGO activity  The largest and fastest-growing group of grassroots health NGOs is active in the area of HIV/AIDS. The 2006-7 China HIV/AIDS Directory lists 240 organisations working on HIV/AIDS. However, activists estimate that there may be as many as 500 operating across the country. Many are support groups for MSM, who have shifted into HIV/AIDS education and awareness-raising. There are a growing number of organisations specifically set up to help people living with HIV/AIDS. Others – often at risk of conflict with local authorities – supply clean needles to intravenous drug users or condoms to sex workers.  Beyond HIV/AIDS, there is a small but growing number of other active organisations. These, too, tend to be organised around particular diseases, such as hepatitis B, tuberculosis, haemophilia, leprosy, and cancer. They often focus on providing services, from practical advice and counselling to financial support, for those affected by these diseases. They are largely small, unwilling or unable to register as NGOs, and underfunded.  Policy advocacy efforts The majority of grassroots health NGOs focus on awareness-raising or providing support and services. Some have greater aspirations. They not only fill gaps in public sector provision for isolated and vulnerable social groups, but are also increasingly lobbying on their behalf. They attempt to engender change to discriminatory laws and regulations; get medicines included in state-run health insurance schemes; ban fake medicines and their advertising; or demand state support for people with HIV/AIDS and their families and justice where officials are responsible for the spread of diseases.  Multiple channels Grassroots NGOs have a few formal channels for influencing policy. They write letters to ministers and local health d e p a r t me n t s  a n d  m a k e submiss ions  in  of f ic ia l consultations. They also use a range of informal channels, including personal connections to doctors and delegates to the National People’s Congress and Chinese People’s Consultative Conference, as well as seeking publicity. However, their personal connections are often poor and use of the media risks damaging relations with government.  Another strategy is to support individuals taking cases to the courts. This might involve seeking compensation e.g. from drug companies who did not screen their blood products for HIV/AIDS. Alternatively, they might pursue employers for discrimination against hepatitis B carriers. This strategy is seen as benefiting individuals and also a means of publicising their issue and gaining popular and media support for policy goals.  Constraints on a second generation NGO successes in shaping policies include having discriminatory sections of laws and regulations removed and medicines included as reimbursable drugs in state health insurance programs, and some fake medicine advertising banned. But the numbers of health NGOs involved in policy advocacy remains small, their channels for exerting influence are few, and their successes are limited. Although committed and persistent, they face greater  policy obstacles than environmental NGOs because they are operating in an area dominated by medical professionals and a powerful Ministry of Health. It will continue to be difficult for them to develop the presence and strategies to justify labelling them a second generation. NGO: THE NEXT GENERATION J A N E  D U C K E T T  A N A LY S E S  N G O  I N F L U E N C E  O N  H E A LT H  P O L I C Y  Jane Duckett is Reader in Chinese and Comparative Politics at the University of Glasgow. The research on which this article is based was funded by a Leverhulme Trust Research Fellowship, 2006-07. An HBV anti-discrimination poster 

Health NGOs: a second generation of policy advocates?

Enlighten: Publications

 
 
 
 
 
 
 
Duckett, J. (2008) Health NGOs: a second generation of policy 
advocates? China Review, 42 (6). p. 16. ISSN 1359-5091 
 
http://eprints.gla.ac.uk/47466 
 
Deposited on: 4 March 2011 
 
 
Enlighten – Research publications by members of the University of Glasgow 
http://eprints.gla.ac.uk 
Issue 42 Page 16 
Calum MacLeod is China correspondent for USA Today 
Jane Duckett 
GRASSROOTS NGOs have developed rapidly in China 
since the early 1990s. Following “first generation” 
environmental activism, health sector NGOs are now 
widespread and taking policy advocate roles. 
 Some health sector 
NGOs were established in the 
1990s but their numbers only 
grew rapidly  fol lowing 
encouragement from the central 
government in 2004. In 
recognition of the difficulties 
the state faces tackling China’s 
HIV/AIDS epidemic, top 
leaders openly supported NGO 
involvement in this issue. 
Leaders seemed to accept that 
NGOs may be better able to 
reach marginalised groups at 
high risk of infection, 
particularly sex-workers and 
“men who have sex with men”. 
(MSM) 
 
Growing NGO activity  
The largest and fastest-growing 
group of grassroots health 
NGOs is active in the area of 
HIV/AIDS. The 2006-7 China 
HIV/AIDS Directory lists 240 
organisations working on HIV/
AIDS. However, activists estimate that there may be as 
many as 500 operating across the country. Many are 
support groups for MSM, who have shifted into HIV/
AIDS education and awareness-raising. There are a 
growing number of organisations specifically set up to 
help people living with HIV/AIDS. Others – often at risk 
of conflict with local authorities – supply clean needles 
to intravenous drug users or condoms to sex workers. 
 Beyond HIV/AIDS, there is a small but growing 
number of other active organisations. These, too, tend to 
be organised around particular diseases, such as hepatitis 
B, tuberculosis, haemophilia, leprosy, and cancer. They 
often focus on providing services, from practical advice 
and counselling to financial support, for those affected 
by these diseases. They are largely small, unwilling or 
unable to register as NGOs, and underfunded. 
 
Policy advocacy efforts 
The majority of grassroots health NGOs focus on 
awareness-raising or providing support and services. 
Some have greater aspirations. They not only fill gaps in 
public sector provision for isolated and vulnerable social 
groups, but are also increasingly lobbying on their 
behalf. They attempt to engender change to 
discriminatory laws and regulations; get medicines 
included in state-run health insurance schemes; ban fake 
medicines and their advertising; or demand state support 
for people with HIV/AIDS and their families and justice 
where officials are responsible for the spread of diseases. 
 
Multiple channels 
Grassroots NGOs have a few 
formal channels for influencing 
policy. They write letters to 
ministers and local health 
d e p a r t me n t s  a n d  m a k e 
submiss ions  in  of f ic ia l 
consultations. They also use a 
range of informal channels, 
including personal connections 
to doctors and delegates to the 
National People’s Congress and 
Chinese People’s Consultative 
Conference, as well as seeking 
publicity. However, their 
personal connections are often 
poor and use of the media risks 
damaging relations with 
government. 
 Another strategy is to 
support individuals taking cases 
to the courts. This might involve 
seeking compensation e.g. from 
drug companies who did not 
screen their blood products for 
HIV/AIDS. Alternatively, they might pursue employers 
for discrimination against hepatitis B carriers. This 
strategy is seen as benefiting individuals and also a 
means of publicising their issue and gaining popular and 
media support for policy goals. 
 
Constraints on a second generation 
NGO successes in shaping policies include having 
discriminatory sections of laws and regulations removed 
and medicines included as reimbursable drugs in state 
health insurance programs, and some fake medicine 
advertising banned. But the numbers of health NGOs 
involved in policy advocacy remains small, their 
channels for exerting influence are few, and their 
successes are limited. Although committed and 
persistent, they face greater  policy obstacles than 
environmental NGOs because they are operating in an 
area dominated by medical professionals and a powerful 
Ministry of Health. It will continue to be difficult for 
them to develop the presence and strategies to justify 
labelling them a second generation. 
NGO: THE NEXT GENERATION 
J A N E  D U C K E T T  A N A LY S E S  N G O  I N F L U E N C E  O N  H E A LT H  P O L I C Y  
Jane Duckett is Reader in Chinese and Comparative Politics at 
the University of Glasgow. The research on which this article is 
based was funded by a Leverhulme Trust Research Fellowship, 
2006-07. 
An HBV anti-discrimination poster 


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Health NGOs: a second generation of policy advocates?

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