Accountability of International NGOs: Human Rights Violations in Healthcare Provision in Developing Countries and the Effectiveness of Current Measures

Sharmeen Ahmed 

Golden Gate University School of Law 

Article 6 

ABSTRACT 

In recent years, the number of non-governmental organizations (NGOs) working in the international arena has vastly increased, generally making a positive impact. But, as this influence has deepened, governments in the developing world and scholars have scrutinized the work and ac- countability of NGOs given they are mostly independent and not sub- jected to international law. While NGOs must adhere to the domestic laws of the places within which they work, adherence is dependent upon the strength of enforcement of those laws. Proponents argue that this independence is essential for NGOs to effectively carry out their work. However, a review of healthcare programs funded by the Bill & Melinda Gates Foundation (Gates Foundation) calls into question current account- ability measures of NGOs in the healthcare sector and can shine a light on weaknesses and potential areas of improvement in the current ac- countability regime for NGOs. 

* LL.M., J.D., Golden Gate University School of Law; M.A., San Francisco State University; B.S., Arizona State University. 

34 ANNUAL SURVEY OF INT’L & COMP. LAW [Vol. XXII 

The Gates Foundation focuses on world health and population and high- lights its strategy of accelerating scientific discovery with reducing costs. Since the early 2000s, the Global Alliance for Vaccines and Immuniza- tions (Gavi), Global Health Innovative Technology Fund and PATH, all heavily funded by the Gates Foundation, have been distributing vaccines and drugs to vulnerable populations in Africa and India. In 2010, the Gates Foundation funded experimental malaria and meningitis vaccine trials across Africa and HPV vaccine programs in India. All of these programs resulted in numerous deaths and injuries, with accounts of forced vaccinations and uninformed consent. Ultimately, these health campaigns, under the guise of saving lives, have relocated large scale clinical trials of untested or unapproved drugs to developing markets where administering drugs is less regulated and cheaper. 

With the revelation of such abuses, the shortcomings of the current ac- countability regime for NGOs must be addressed in two critical areas: monitoring projects and monitoring potential influences and exploitation between donors and NGOs. Through the review of recent Gates-funded healthcare campaigns in Africa and India, this paper seeks to highlight and analyze these shortcomings by looking at the failures of the current accountability regime to prevent and resolve human rights abuses com- mitted during these programs. This paper will offer recommendations to strengthen the accountability regime for NGOs through a more active role by the local governments and through community outreach and development. The findings in this paper will have implications for all NGOs working in the healthcare sector and potentially other sectors. 

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