Chapter 9: Coordinating...Chapter 9: Coordinating International Donor Agencies And Non-Government Organizations To Fight Hiv/Aids

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The Editors

This resource book aims to illustrate the possibility of drafting instrumental, evidence-based legislation to resolve social problems like those that block a majority of East Africans from gaining access to adequate health care.  In the East African Community – as in developing countries everywhere – the instrumental use of law (properly employed) constitutes society's most powerful tool for altering or eliminating the dysfunctional institutions that perpetuate most inhabitants' poverty and vulnerability.  

This final chapter first, briefly, summarizes this resource book's potential contribution to understanding the use of institutional legislative theory and methodology (ILTAM) as a guide for designing and drafting instrumental laws to solve the many social problems characteristic of today's rapidly changing technologies.   For this purpose, the book focuses on East Africa's persistent health care delivery problems as a case study.  Its several chapters underscore the necessity of strengthening country-nationals' capacity to draft effectively implemented instrumental laws, grounded on evidence, to transform relevant social actors' repetitive patterns of behaviors – by definition, the dysfunctional institutions – that tend to perpetuate the problems targeted.  Secondly, this chapter suggests that, as a matter of urgency, the proposed workshop participants formulate plans to institutionalize ongoing 'learning-by-doing' processes for drafting the full range of instrumental laws required to resolve the social problems specified by the 2007 EAC Leaders' Summit Meeting.  Finally, this chapter suggests that the workshop participants begin to formulate criteria and procedures for identifying and strengthening the EAC's and its partner states' law-making institutions' role in the development project.

A. Rapidly changing global technology trends underscore both the importance and the possibility of drafting effective law

On one hand, rapidly changing global technology trends accelerate the need to draft instrumental laws to alter or eliminate inherited dysfunctional institutions.  On the other hand, new technologies make possible the improved use of global human and technological resources for drafting new, effectively implemented, laws.

East Africa's health crisis illustrate both the importance of improving developing countries' use of law to take advantage of today's rapidly changing global technologies; and those technologies' potential contribution to using reason and experience – not  authoritarian state power – to draft and implement evidence-based legislation.   The global transportation revolution has accelerated the spread of diseases like HIV/AIDS, tuberculosis, and malaria that still drastically reduce Africans' life expectancy.   To combat that increased risk, the use of law to mobilize available human, physical and financial resources with the assistance of modern technologies, offers the possibility of expanding sustainable health care to extend all East Africans' lives.  In particular, Internet and wireless mobile phones empower organizations like APKN and ICLAD⁷²² to facilitate rapid, relatively inexpensive, global exchanges as to the availability of emerging theoretical tools and new sources of evidence for conceptualizing and drafting transformative legislation.

This resource book also illustrates the way new technologies have opened exciting new possibilities for engaging students in universities, thousands of miles from Africa, in gathering and organizing evidence into research reports to begin justifying proposed laws likely to improve East Africans' health care. New technologies also facilitates bringing East African law-makers together with concerned university and non-government personnel into the proposed workshop where they can review and assess, revise and improve those reports and bills in light of their own in-depth knowledge of East African realities.   In that process, they may also assess, and as necessary, suggest improvements in ILTAM as a guide for conducting research and drafting evidence-based legislation to establish additional Commissions to draft legislative programs, as called for by the EAC leadership's Summit Meeting in Uganda in 2007.⁷²³  

B. Institutionalization of ongoing programs to strengthen the legislative drafting capacity of the EAC and its member states

Building on their workshop experience, the workshop participants may want to begin planning to institutionalize ongoing 'learning-by-doing' processes.  These would equip East African government, university and civil society leaders to assess and, as necessary, help to draft the innumerable bills, justified by research reports, required to attain the broader objectives of good governance and development throughout East Africa. 

As a critical aspect, the workshop participants should consider incorporating in those plans university interdisciplinary legislative drafting programs.  In those programs, students, working under faculty supervision, could produce draft research reports and bills like those incorporated in this resource book. Experience elsewhere has demonstrated ⁷²⁴ that students constitute a cost-effective resource for gathering the facts essential for drafting effective evidence-based legislation.  In the process, as future societal leaders, they may learn to use – and sometimes even to improve – the available theoretical and practical tools as guides to drafting effectively implemented legislation.⁷²⁵  

C. Unfinished questions

The proposed workshop teams' discussions about the bills and research reports contained in this source book will, inevitably, raise general questions.  Many of these will concern the relationships between other regional commissions, established to conduct research and draft bills in a particular area like health,⁷²⁶ and existing partner-state and regional law-making institutions.⁷²⁷  What factors should partner-state and larger federation law-makers take into account in deciding on their respective governmental responsibilities?  What advantages and disadvantages likely accompany alternative possible decisions? Does political-economic cooperation between a federation's partner-states offer sufficiently significant savings or the improved use of human, physical, and financial resources to warrant reducing the individual states' elected law-makers' potential for controlling those resources' use in the interest of their own constituents?   

At the workshop, a team's members should determine the likely optimal answers to those questions.  Self-evidently, for example, the advantages of region-wide legislation will likely prove greater for registration and licensing of medicines than for the distribution of medicines or providing health care in the different partner states' widely differing rural areas.  In specific cases, like bills that propose training of nurses or community health workers, savings may seem possible by pooling training and related research capacities in a few regional centers.  Regional cooperation might provide more effective training materials, or facilitate the purchase of new communication technologies to community health workers and more highly trained personnel working in urban centers.  Drafters should consider these kinds of possibilities in weighing the social and economic costs of alternative legislative solutions.  In each case, do the estimated advantages seem likely to outweigh the disadvantages for those whom the bill's detailed provisions will likely affect?   Workshop participants should provide whatever additional evidence they can include in the relevant research report to help law-makers decide whether and how to judge these, and possible other, advantages and disadvantages of legislative proposals for EAC-wide cooperation as compared to retaining partner state sovereignty.  Over time, ILTAM's fourth step, requiring the monitoring and evaluation of a law's the implementation and social impact, once enacted,  should help to make future estimates of potential advantages and disadvantages more reliable.
       
In sum, as editors, we hope this resource book engages the proposed workshop team participants in assessing – and perhaps improving – the available theoretical and practical tools as guides for conducting research and drafting evidence-based health legislation.   In the process, we hope that they will learn to use law, not only to improve East Africans' health care, but also to help overcome the full range of obstacles likely to block good governance and people-oriented development throughout the Community.

Chapter 9: Coordinating...Chapter 9: Coordinating International Donor Agencies And Non-Government Organizations To Fight Hiv/Aids