147.03 A theory of ‘institutional gaps': A study of the role of civil society organizations in global health governance

Thursday, April 30, 2009
Sadrivaan A and B (The Hilton Istanbul Hotel )
Raphael Lencucha, PhD(c) University of Western Ontario, Canada
Anita Kothari University of Western Ontario, Canada
Thelma Sumsion University of Western Ontario, Canada
Background: Chronic disease has become a global challenge and has been attributed to shifts in global patterns of production and consumption of health related goods and services. One landmark response to this challenge, within the emerging architecture of global health governance, has been the Framework Convention for Tobacco Control (FCTC), a first for the World Health Organization. One of the innovative features of the FCTC was the involvement of civil society organizations (CSOs) in its negotiation.
Research Question: What was the role of Canadian CSOs in the development of the FCTC?  
Methodology/Methods: Canadian CSOs were involved in the development stages of the FCTC and were the sight of study to address the above research question. Data were collected from 18 in-depth interviews with Canadian government officials and CSOs. A systematic document search was conducted. This search yielded 30 documents pertaining the involvement of Canadian NGOs in the development of the FCTC. The interviews and documents were analyzed using open coding. Codes were then analyzed a second time and organized along salient themes.  
Findings: The analysis indicated that there were six primary roles that the Canadian CSOs played in the development of the FCTC: 1) watchdog role, which included such activities as monitoring industry activity and identifying ‘missing’ information, 2) to enforce a moral standard, 3) aim for the inclusion of other CSOs from low and middle-income countries and facilitate relationships among delegates, 4) ‘push for more’, 5) broker information, and 6) provide technical expertise to government delegations and other CSOs.
Discussion/Implications: From the findings of this study a theory of ‘institutional gaps’ was developed. The features of this theory will be articulated during the presentation. The implications of this theory for both the research and practice of global health governance will be discussed.

Learning Objectives: 1) To identify the role that Canadian civil society organizations (CSOs) played in the development of the Framework Convention for Tobacco Control. 2) To assess how CSOs may contribute to the future of global health governance. 3) To articulate a theory of CSO participation in global health governance.

Sub-Theme: The global threat of chronic diseases