Report of the Annual General Assembly - medicusmundi.org · Amanda Banda, Wemos Andrea Atzori, DWA Cuamm, MMI Board member Andréa Rajman, Medicus Mundi Switzerland Carlos Mediano,

Report of the MMI Annual General Assembly, 25 May 2019 – Author: Thomas Schwarz, 7 June 2019. Status: draft, sent to Board for initial review on 7 June 2019; revisited draft published in the Dropbox on 20 June 2019 – Approval by MMI Annual General Assembly: pending

MMI GA 2019

Report of the Annual General Assembly Saturday 25 May 2019 in Geneva

Venue: Graduate Institute, Maison de la Paix, Geneva Present: Albert van Hal, Cordaid

Amanda Banda, Wemos Andrea Atzori, DWA Cuamm, MMI Board member Andréa Rajman, Medicus Mundi Switzerland Carlos Mediano, Medicus Mundi Spain, MMI President Christina de Vries, Cordaid, MMI Vice President Boutaina Emrani, ITM Antwerp R. Fabian Schumacher, Medicus Mundi Italia, MMI Secretary Felipe Sere, Memisa Mariëlle Bemelmans, Wemos Martin Leschhorn, Medicus Mundi Switzerland, MMI Board member Michaela Told, Global Health Center, Medicus Mundi Switzerland Mirfin Mpundu, EPN and ACHAP Thomas Schwarz, MMI Secretariat Thomas Vogel, Medicus Mundi Switzerland Vittorio Giorgetti, MMI Secretariat

Guests: Guus Eskens, former MMI President Various participants at the public side event to the Assembly

Apologized: Christoph Bonsmann, MMI Treasurer Remco van de Pas, ITM Antwerp, MMI Board member various members and partners of the Network

.................................... Report of MMI Annual General Assembly, 25 May 2019 Page 2/8

Final agenda

1. Opening of the Assembly and communications 2. Credentials 3. Adoption of the agenda 4. Report of the General Assembly in Geneva, 26 May 2018 5. Annual Report 2018 6. Financial Report 2018 7. Network activities 2019-20: our plans and how to engage 8. Budget 2019 and financial perspectives 9. Elections of the MMI Chairperson and Board 10. Communications by Board and Network members 11. Closure of the Assembly Documentation

The full documentation of the Assembly is available in a dedicated Dropbox folder and can be ordered at the Secretariat.

Schedule

9.30-11.30 MMI Annual General Assembly

11.30-13.30 Public lunch event

UN High-Level Meeting on UHC and Global Action Plan on Health-Related SDGs (GAP) MMI is engaged in both current processes, and both of them need and deserve our sustained attention. The Secretariat provided introductions and reported from hearings at the UN in New York, followed by an open discussion (assessments, priorities, positions, perspectives)

13.30-15.30 Planning meeting: MMI and Effective Health Cooperation (MMI EHC)

Other MMI events during the WHA An overview of other MMI activities and events related to its Assembly and the World Health Assembly is available at https://www.medicusmundi.org/contributions/events/2019/wha72

https://www.medicusmundi.org/contributions/events/2019/wha72


Assembly report 1. Opening of the Assembly and communications

Carlos Mediano welcomes the participants to the Assembly. He expresses his appreciation for the secretary’s efforts in moderating the Network and in preparing the Assembly. He also expresses our thanks to the Graduate Institute and its Global Health Centre, represented in the Assembly by Michaela Told, Board member of Medicus Mundi Switzerland, for kindly hosting today’s meetings.

The President then invites participants to introduce themselves, also indicating their institutional background. Thomas Schwarz adds that several Network members have sent their apologies, including two last minute apologies due to a cancelled flight from Amsterdam. As in previous years there have been many Network members present in Geneva during the World Health Assembly, but unfortunately not able to stay until the MMI Assembly.

Documentation: PPT slides on MMI activities related to the World Health Assembly.

2. Credentials

1. Andrea Atzori is authorized to vote on behalf of DWA Cuamm 2. Boutaina Emrani is authorized to vote on behalf of the ITM Antwerp 3. Carlos Mediano is authorized to vote on behalf of Medicus Mundi Spain 4. Christina de Vries is authorized to vote on behalf of Cordaid 5. Fabian Schumacher is authorized to vote on behalf of Medicus Mundi Italy 6. Felipe Sere is authorized to vote on behalf of Memisa 7. Mariëlle Bemelmans is authorized to vote on behalf of Wemos 8. Mirfin Mpundu is authorized to vote on behalf of EPN 9. Mirfin Mpundu (EPN) is also authorized to vote on behalf of ACHAP 10. Martin Leschhorn is authorized to vote on behalf of Medicus Mundi Switzerland

With 10 members present/represented, the quorum (7 out of 20 members) is reached.

3. Adoption of the agenda

Decision: The agenda of the Assembly is adopted.

4. Report of the General Assembly in Geneva, 26 May 2018

Decision: The report of the General Assembly is accepted. Documentation: Report of the General Assembly in Geneva, 26 May 2016

5. Annual Report 2018

As in every year, the Assembly is the moment when the Board and Secretariat present to the members the achievements of the MMI Network in the past year and to look out into the future. The President and Executive secretary do this with confidence, referring to the Annual Report published on the website and disseminated among Network members on 15 May, and also included in the documentation of Assembly.

The President highlights the challenge of linking the two main levels of work of the MMI members: development cooperation and advocacy. MMI needs to strengthen its capability to get these two levels closer to each other, in a dialogue with its members.

The secretary’s review of highlights of the past year follows the structure of the published report:

“Honesty, persistence and engagement”: We continued in 2018 to engage our members and partners in a conversation on how to move health cooperation “beyond aid”. And we continued to successfully play our role as both a critical civil society voice at the World Health Organization, its governing bodies and processes, and as a convenor and facilitator of civil society networking and advocacy in the field of global health and health governance.


A year of renewed attention to Primary Health Care: The engagement of the MMI Network in the celebration of the Alma-Ata Jubilee in 2018 went considerably beyond our Network’s focal topics of health cooperation and health governance. The Declaration of Alma-Ata being part of the DNA of MMI and many Network members, we asked ourselves – and others – how to translate the core of the Declaration into the present and future. The MMI Secretariat took the lead in setting up a task group of the Geneva Global Health Hub (G2H2) on the Alma-Ata Jubilee that organized a well-attended workshop in May. And representatives of MMI contributed substantially – and visibly – to the Global Conference on Primary Health Care in Astana, in October.

“Health cooperation beyond aid” …and beyond the MMI discussion paper: The year 2018 brought some good progress in this field of work, at all levels: We deepened our understanding of rights and solidarity based health cooperation, we are happy with the outcome of our activities such as health cooperation workshops in Astana and at the 4th People’s Health Assembly In Dhaka, and we succeeded to obtain the support – and a much appreciated grant – of the Open Societies Foundation for our work in this field, also as a contribution to our institutional sustainability.

Global Health Policy and Governance: Difficult questions, difficult processes: Over the last ten years, Medicus Mundi International has become a respected and well known voice of civil society at the World Health Organization, also benefitting of its status as “NGO in official relations” and its long history of collaboration with WHO. Related to this, MMI has also developed a reputation as a dedicated and unbiased networker and convener for WHO related right-based civil society advocacy. In all these areas, 2018 was a year of intensive work – with some good progress. Some of our activities are now formally “outsourced” but still very much owned and shaped by MMI and its members in the Geneva Global Health Hub hosted by MMI and the new Health Workers for All Coalition hosted by Wemos.

Network development. The Belgian NGO Medics without Vacation joined the MMI Network in July 2018. We are now again at 20 members, as shown by the secretariat in an overview of the development of the Network membership over the last 11 years:

Outlook: Steps to lead the MMI Network into the future. The fields of service provision and the achievement of financial sustainability have been identified last year by the Board as those elements in the implementation of the MMI Network Strategy 2016-20 where we not yet achieved the expected results, mostly because of lack of capacities and core skills in these fields at the secretariat.

However, even dealing with a capacity issue depends on some core capacities available. This has been realized by the MMI Board and was addressed in its conversation with OSF about the terms for their grant. As a result, both parties agreed to add, to the two


“technical” fields covered by the MMI EHC work plan and supported by OSF, a third one on “institutional strengthening and laying the ground for further activities”.

We have a window of opportunity now. Let us use it. The new MMI staff Vittorio Giorgetti started his work in January. Since then, initial steps have been undertaken– and need to be continued and intensified.

• Initial assessment available (from an external perspective)

• Structured dialogue with MMI Network members and partners undertaken: experiences, insights and assessments, practices/capacities and further demand for learning and sharing in view of “health cooperation beyond aid”.

• Plan of activities in the fields of communication, fundraising and membership development: adopted by the Board in April

A more complete SWOT analysis under the lead of an external facilitator in order to redefine our strategic positioning is scheduled for the second semester of the current year and the development of a new strategy plan in the first semester of 2020 with the “new” Board in the lead.

Elements of the discussion

• The work and efforts of the Secretariat are estimated.

• All in all, last year was successful and much fuller of activities. The picture illustrates the importance\centrality of members: MMI members were THERE, they were actively involved in several activities.

• We need to think more on milestones and results. Annual reports are read by donors: we could be a bit more precise. MMI is in so many different fields, but it’s difficult to quantify, to measure our achievements.

• We need to find better ways to sustain each other to bring forward our shared interests.

• Wemos representatives report about the setup of the “Health Workers for All Coalition”.

• Discussion on membership growth: Is having more members directly linked to improved sustainability? How to sustain our core identity with new members joining? – We need to have wide ownership and clout to target more objectives and run activities. New members also means more ideas and inputs. – Membership needs to grow in terms of quality and geographic representation/outreach. Where are the members from the global South? We try to reach out to them (e.g. 2019 workshop in Eastern Africa), but formalization of the relation as membership is sometimes difficult (also a matter of organization’s shrinking free budget and high MMI membership fees).

• All Network members have donors behind them, MMI not: We shall try to tap 2 to 3 donors providing funding for 5 years

Decision: The Annual Report 2018 is approved. Documentation: Annual Report 2018; Assembly moderation slides

6. Financial Report 2018

Replacing the Treasurer Christoph Bonsmann, Thomas Schwarz refers to the summary of the MMI financial report 2018 and to the audited financial statement. The loss of 8.541 EUR is less than we feared (Budget: loss of 14'630 EUR), but still too high, and leading to a further reduction of the net equity from 80’536 to 71’994 EUR. This negative result for the 5th year in a row is hard to accept, though still not a situation of immediate crisis, but everybody agrees that we need a turning point now – as discussed in the outlook part of the Annual Report.

The postings and bookkeeping for 2018 have been executed for the first time after many years not through action medeor but externally. The expenses exceeding the regular amount action medeor was charging were taken over by action medeor. Although MMI does not longer benefit from tax privileges based on its charity status no income taxes had to be payed because no profits were gained.

The secretariat reports to the Assembly the auditors’ conclusions as follows: “Through the Executive Board of the registered association under German law (Verein) Medicus Mundi


International - Netzwerk Gesundheit für alle e.V., Tönisvorst, we were assigned to audit the financial accounting including the bookkeeping system for the financial year 2018 and to report to the association. The association is not subject to audit within the meaning of sections 316 et seq. HGB. It is a voluntary audit. (…) In our opinion, based on the findings of our audit, the financial accounting comply in all material respects with the German legal requirements applicable to merchants and, as resulting from the interaction of the statement of assets and liabilities and the statement of revenue and expenses, give a true and fair view of the net assets, financial position and results of operations of the association in accordance with German principles of proper accounting.”

Decision:

• The annual result for 2018 is adopted.

• Formal approval of the actions of the Executive Board is given. The Board and Treasurer are discharged from all liability with respect to their duties.

Documentation: Accounts 2018; Audited financial statement

7. Network activities 2019-20: our plans and how to engage

Because of time constraints and most elements being covered under item 5, Annual Report and in a planning meeting after the AGM, only an outline is provided and noted by the Assembly:

• Effective Health Cooperation See planning meeting after the Assembly

• Global Health Governance WHA related activities already undertaken WHO governance and related: Ongoing intensive process

• Institutional development and sustainability See above, item 5: Annual Report 2018, section “outlook” Vittorio will reach out to members for particular input Core task of Board and Secretariat in the current and next year

8. Budget 2019 and financial perspectives

According to the statutes, the General Assembly fixes the annual contributions of the Network members. Budget approval is not a mandatory item of the General Assembly, but in order to determine the annual contribution, it makes sense to draw a picture of the expected income and expenses.

At its meeting in January 2019, the Board approved a MMI budget for 2019 with a “black zero”, but including a total amount of 17’000 EUR as “revenue from new sources” under the condition that it will be reviewed at a next Board meeting in April, based on the information available at that moment. In April, the Secretariat reported back to the board that they are not confident any more to achieve the task of generating a net additional revenue of 17’000 EUR in the current year already. The secretariat then submitted to the Board a budget with a loss of approx. 8000 EUR.

Board members agreed in April that this was the best way we could act by that time, adopted the budget and stated that, for 2020, the investments in our sustainability need to show concrete results, and in any way, the budget of the next year needs to be equal at least. The development of our net equity needs to be carefully watched.

The Executive Secretary leads the Assembly though the budget adopted by the Board in April. Figures of both revenue and expenses are higher this year due to the OSF grant and related increase of secretariat capacities and external costs.

Elements of the discussion:

• A member opens a first discussion by questioning the Board decision in April and asks how long we shall continue to adopt negative budgets? Many members are ready to invest more than their dues in MMI, and have done so in the past, but this is difficult to maintain when the organization ends every year with a deficit. There are legal requirements not allowing some members to continue support partners that are not


financially self-sustained. This assessment being supported by other members, this leads to a long and controversial debate if a negative budget can/shall be approved for the current year.

• A related discussion is opened on the roles of the Assembly and Board in budgeting. There is an overall agreement that adopting a budget in May only, does not allow proper planning and implementation of activities, thus asking that a final budget should be available at the beginning of the year. – The secretariat confirms that this corresponds with the MMI practice of the last years and with the fact that the final responsibility for budgeting is with the Board. This year the budget was initially discussed and approved by the Board in January, but then reconsidered in April as the bottom line turned from zero to negative.

• Members agree that all efforts should be undertaken to achieve an equal result in 2019 already, a third debate is opened about what shall be done if it becomes obvious that this is not possible through achieving additional income. Decreasing the expenses, in particular by cutting the Secretariat’s capacity, is the most controversial proposal in this debate. Though at the moment it seems to be the only possibility, it is strongly opposed by some members. The secretariat also refers to the agreement with MM Switzerland (secretariat not direct employed by MMI) that would make such a step legally difficult.

Members finally agree that efforts will focus first in achieving additional income in 2019 at the same time strictly controlling expenses. The Board is requested to provide new assessments and guidance at a moment when decisions to reduce costs can still be taken.

Decisions

• The Assembly approves the budget under the condition that it will be equalized (as assessed by the Board) by 31 August 2019, in order to not further decrease the net equity. In particular, members will be asked again for voluntary contributions, and the Board will meet within August to decide the necessary measures to have this equalized budget.

• The Assembly endorses the statement of the Board meeting in April that, for 2020, the investments in our sustainability need to show concrete results, and that, in any way, the budget of the next year needs to be available at the end of 2019 (as Board decision) and needs to be equal.

• The Assembly confirms the members’ regular contributions for the year 2018 as listed in the budget overview.

Documentation: Budget 2019

9 Elections of the MMI Chairperson and Board

According to the statutes, the General Assembly, as the highest authority of the organization, elects the Chairperson and the Board of Medicus Mundi International. The Board is chosen from candidates proposed by the members and/or by the Board for a term of 3 years. Retiring members are eligible for re-election. The Chairperson may be re-elected once in succession.

The Board is composed of the Chairperson, 2 Vice Chairpersons, the Secretary, the Treasurer and 2 ordinary Members. The Board remains in office until new elections. The Board determines its own method of work.

Christoph Bonsmann, action medeor, MMI Board Member and current Treasurer, announced earlier in the year that he will step back as am MMI Board member. We will miss him, and his engagement and contributions to the MMI Network.

Ahead of the Assembly, Christoph sent us the following message by E-mail: “From the year 2013 until 2019 I had the privilege to serve Medicus Mundi International as the treasurer. During these years I have gained a lot from MMI and the numerous board meetings, the conferences and each individual board member and the MMI members I’ve met. For this I’d like to thank all of you. That my term comes to an end does not mean that I am going to escape. For sure you’ll meet me again at conferences or “open” board meetings. For the general assembly I wish you all the best.”


The President expresses the gratitude of the network for the excellent work done by Chrisotoph Bonsman and action medeor.

In view of the elections, the MMI Executive Board, referring to the statutes, invited all Network members to propose candidates for the Board and/or the Presidency.

Since then, Memisa proposed Felipe Sere, as a new Board member. No other proposals have been received. Felipe Sere who already attended last year’s Assembly and the planning meeting in Basel in autumn last year introduces himself to the Assembly

All other current Board members and confirmed their availability for a next term.

Candidates for election

• Carlos Mediano as Chairperson • Andrea Atzori as Board member • Christina de Vries as Board member • Felipe Sere (new) as Board member • Martin Leschhorn as Board member • Fabian Schumacher as Board member • Remco van de Pas as Board member

Decision

• The Assembly unanimously elects/reelects the Chairperson and all proposed Board members.

Documentation: Board election with application by Felipe Sere and supportive documents

10 Communications

Members who report on planned meetings in autumn 2019 and in 2020 are invited by the Secretariat to reach out to all Network members by posting announcements of these events on the “MMI-collaborate” mailing list

10. Closure of the meeting

The President closes the Assembly, that was suspended from 11.30 to 13.45 hrs for a public side event, at 15.00 hrs.

Report written and signed

by Thomas Schwarz Basel, 7 June 2019

Report of the Annual General Assembly - medicusmundi.org · Amanda Banda, Wemos Andrea Atzori, DWA Cuamm, MMI Board member Andréa Rajman, Medicus Mundi Switzerland Carlos Mediano,

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