MDG 5, HUMAN RIGHTS, AND MATERNAL HEALTH IN AFRICA
appreciate the skepticism and indifference to announced government
programs as an inoculation against risk of disappointment or financial loss.
This is particularly true when individual financial contributions are required
as a condition for participation in the program.
This lack of trust grounds the need for active participation of CSOs in
“selling” relevant health programs to the population. CSOs have
experience in this kind of partnership. For instance, in 2003, the Hausa-Fulani people in Northern Nigeria, who are predominantly Muslims,
refused to participate in a government-sponsored polio eradication
campaign.159 It was the combined efforts of local religious-based CSOs,
Muslim clerics, and government operatives that convinced them the
program was in fact useful and not, as they had assumed, a disguised
attempt by the global community, particularly Christians, to decimate the
Islamic population in the country. The role each CSO can play and the
means it will adopt in operationalizing the role would, of course, vary,
depending on the nature of the organization and its target group. There are
many avenues through which these organizations could be effective
contributors to improving maternal health in Africa. Noteworthy amongst
them are litigation, advocacy, community mobilization, ensuring
transparency and accountability, lobbying, and, where appropriate,
involvement in direct provision of services.
Unlike public officials, CSOs are unconstrained by unnecessary
bureaucracy and red tape in discharging their duties to the citizenry.
Litigation is an effective weapon available to them in moving the
governments in the direction of impactful responsibility for the needs of the
people. Especially in the realm of health, CSOs in Africa have been
particularly successful in using the judiciary to compel desired action.160 A
great illustration is the TAC case, mentioned previously,161 in which TAC, a
CSO, successfully sued the government of South Africa.162 TAC’s
principal argument was that the government policy, which restricted the
administration of Nevirapine to designated pilot sites, was unreasonable and
a breach of the constitution as it excluded a significant segment of the
159. Judith R. Kaufmann & Harley Feldbaum, Diplomacy and the Polio Immunization
Boycott in Northern Nigeria, 28 HEALTH AFF. 1091, 1091–1101 (2009).
160. See Kleptocracy, supra note 145.
161. Treatment Action Campaign, supra note 90, paras. 98-99.
162. Id. para. 124.
163. Id. para. 4.