Voice & Accountability

When nations, states, provinces and districts are not allocating enough funds for malaria treatment and prevention, will people speak out? When allocated malaria funds are being used for other purposes, will people speak out? When bed nets are being given only to those who voted for a particular political party, will people speak out?  These are some of the questions that come to mind when reading the new World Bank Report on Governance.

According to the BBC, report measures the quality of government in 212 countries from 1996 to 2006 found Africa had shown the greatest improvement. Six measures that comprise governance include:

  • Voice and Accountability
  • Political Stability and Absence of Violence
  • Government Effectiveness
  • Regulatory Quality
  • Rule of Law
  • Control of Corruption

Voice and Accountability is a major concern in our efforts at the Voices Project. This measure is defined as follows: “The extent to which a country’s citizens are able to participate in selecting their government, as well as freedom of expression, freedom of association, and a free media.”

voice-accountability-rank-sm.jpgThe report links Voice and Accountability with Control of Corruption. “Countries with voice and accountability challenges … tend to have much more corruption. This is consistent with the idea that when citizens can demand more accountability through the ballot box, or where there is freedom of expression, of the media, and of information, governments become cleaner and less corrupt.” Corruption, as we know, leads to poor prognosis in terms of delivering health services, including malaria control programs, in an efficient and equitable manner.

The Voices Project is focusing on four malaria endemic countries, Ghana, Kenya, Mali and Mozambique, in addition to the major donor agencies and countries.  The World Bank report traces progress for each country on governance issues between 1996 and 2006.  A co-author of the World Bank Report states that, “The good news is that some countries, including some of the poorest ones in Africa, are deciding to move forward, and are showing to the world that it is possible to make substantial inroads in improving governance.” We can see in the chart that the rankings of the four Voices Project countries on Voices and Accountability mean that there will be challenges to advocacy efforts, but there are hopeful signs that the advocacy climate is improving in Ghana and Kenya.  Malaria advocacy will serve as a test case for improving Voice and Accountability in these countries, and the benefit will hopefully go beyond lives saved from malaria to lives lived freely in a more open and free society.

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