Argentina: Recovering with Integrity - Fostering Preventive Transparency in the Health System

Lessons Learned by Ana Pichon Riviere

Public Sector Coordinator and Institutional Strengthening, Poder Ciudadano.

Results included:

- - Providing vital Covid-19 healthcare information to citizens;
  - Exposing abuses by high government officials;
  - Litigating to enhance government accountability; and
  - Building partnerships with other CSOs in Argentina and in the region.

As Ana describes, the core model used in the programs was based on four strategic pillars:

1. ethical exercise of the public function;
2. transparency and maximum disclosure of the acts of the government;
3. participation and social control of public management; and
4. accountability

The intervention model aims to strengthen the entire value chain—prevention, detection, investigation, sanction, recovery of property and reparation of victims. Poder Ciudadano as a civil society organization used a five-tier strategy against opacity and demand greater accountability:

1. Monitoring Institutions
2. Generating Information and Evidence
3. Building Networks
4. Engage Constructively and
5. Strategic Litigation

With the onset of COVID-19, and with PTF support, “information gathering” was the first critical goal of the program. Poder Ciudadano quickly recognized that government agencies were failing totally and efforts were launched, eventually leading to the creation of a special website -“The Observatory” – to ensure citizens received vital information. The success of the program also demanded “monitoring” – with investigationjs uncovering that privileged people were receiving special healthcare and, in fact, a celebration was held during the full lock-down period at the President’s official residence. These initiatives led to the resignation of a Minister of Health, and to judicial investigations.

As Ana explains in the accompanying video, Poder Ciudadano, inhitiated litigation when governmenta agencies failed to provide information to citizens, it worked with other CSOs to ensure maximum information dissemination to the public, and where possible, it sought to work constructively with the government.

Overview

Argentina: Recovering with Integrity – Fostering Preventive Transparency in the Health System is our fourth project with Poder Ciudadano, Transparency International’s affiliate in Argentina, seeking to increase the openness and accountability of the national health system in the purchase of vaccines.

The current project aims to use the immunization system to broaden the effort to make public health procurement an open and transparent process. It will do so in four explicit ways. First, it will continue to press for decisions from the judiciary on formal complaints on citizen rights to information (RTI). Second, Poder Ciudadano will extend its procurement monitoring to vaccines produced and bought locally. (In the past, most vaccines were provided by PAHO, the WHO program in Latin America). Third, it will establish accountability labs in three provinces—Cordoba, Mendoza, and Buenos Aries—and help build the capacity of local civil society organizations to monitor the distribution and delivery of vaccines. Fourth, Poder will create a “preventive transparency toolkit” that will identify the kinds of information the public has a right to know and tools for analysis, reporting and monitoring responses. It hopes to engage the Ministry of Health in the preparation and demonstrate the value of citizen engagement in regaining the trust of the population seriously eroded by the COVID response.

The unique nature of this program is Poder’s long-term commitment to promoting transparency and integrity in vaccine procurement. Poder and PTF have collaborated on four projects over four years, recognizing that reforming public agencies is a long and incremental process. The goal is to make health information accessible to all and engage citizens more actively in a health system badly in need of renewed public trust.

A concept note for the project can be found here.

Project Objectives

The overall aim of this project is to enhance the openness and accountability of Argentina’s national health system in vaccine procurement which will be implemented through three objectives.

Objective 1: Strengthen the national health integrity environment through persistence and adaptation.

Objective 2: Promote CSO-government cooperation in integrity systems.

Objective 3: Deepen the accountability environment at the sub-national level.

Project Activities

To achieve the objectives, a comprehensive set of activities will be undertaken:

1. Enhance Transparency: Update the Procurement Observatory to provide real-time insights into vaccine procurement processes, ensuring transparency and informed decision-making.

2. Strengthen Accountability: Pursue judicial litigation to hold stakeholders accountable, fostering integrity in the vaccine procurement system and addressing any discrepancies or malpractices.

3. Expand National Reporting: Extend the report on procurement to include national purchases of vaccines, offering a comprehensive overview that supports a more inclusive and effective national vaccine procurement strategy.

4. Collaborative Toolkit Development: Work with the Ministry of Health (MOH) to create a preventive transparency toolkit aimed at optimizing accountability in healthcare processes.

5. Information Dissemination: Disseminate the developed toolkit to Civil Society Organizations (CSOs), healthcare providers, and the public to empower them with the tools needed for transparent and accountable practices in the healthcare sector.

6. Regional Accountability Labs: Establish accountability labs in three provinces (Cordoba, Mendoza, Buenos Aires) to serve as regional hubs for fostering transparency and accountability in vaccine-related processes.

7. Provincial CSO Network: Create a network of Civil Society Organizations (CSOs) at the provincial level to facilitate collaboration, information sharing, and coordinated efforts in promoting accountability within the healthcare sector.

8. Capacity Building: Conduct training sessions for local CSOs in the targeted provinces, focusing on equipping them with the skills to effectively monitor vaccine storage, distribution, and delivery, thereby enhancing their role in ensuring accountable practices.

9. Collaborative Mechanisms: Promote collaborative mechanisms between CSOs and health authorities at the sub-national level, fostering partnerships that contribute to transparent and accountable vaccine-related initiatives.

Project Team

Pablo Secchi

Executive Director, Poder Ciudadano

Karina Kalpschtrej

Deputy Executive Director, Poder Ciudadano

Ana Pichon Riviere

Public Sector Coordinator and Institutional Strengthening, Poder Ciudadano

Ramana Gandham

Project Adviser, PTF

About Our Partner

Poder Ciudadano is a non-partisan and non-profit foundation born in 1989 as an initiative of a group of people concerned about the defense of civic rights in Argentina.