Is it disrespect or disinterest? Too high-up to exchange with folks from the ‘bottom’? Too well-paid and too professional to collaborate with unpaid activists and their community based organisations?
Why is there such an enormous barrier between those who make global health policies and those who must live, or die, by their decisions? Why is there such a gap between their stated goals on “inclusive engagement” and the de-facto exclusion of affected communities from the decision-making processes?
Over the years, we have tried to connect with many public health professionals that make decisions that impact on our health and that of our communities. The aim is always to begin a dialogue on how to turn their noble words, like ‘leaving no one behind’, into realities on the ground through collaboration and cooperation.
Sometimes, we have had responses to our e-mails and start an exchange which is of mutual interest. We’ve established some ongoing relationships and a few direct collaborations, which has shown that working together as real partners is possible even within the top-down world of public health governance.
However, too often we have not had any replies to our correspondence. Too often attempts to establish contact are like a long one-way street that goes nowhere — a dead end. Gentle reminders have proved to be a waste of gentleness. We are not alone in being disempowered and disheartened — many other community activists and NGOs are becoming jaded by public health experts that say “we need to hear the ‘voices’ of the community” yet make it impossible to actually do so in real terms. The hypocrisy of those at the ‘top’ is eating away at the good will of engaged folks at the ‘bottom’, which discourages the local public participation that should be central to efforts to improve health and well-being on the ground.