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The negotiating framework is a dynamic and flexible guideline for adaptation to a given country's stage along the process of reorganization, using appropriate nomenclature and meeting local domestic policy needs. However, as a flexible guideline excessive time need not be lost in negotiating over trivial issues such as the names given to various teams, bodies or councils. The focus should be on substantive policy issues ensuring delivery of appropriate services to stakeholders and clients. Should substantive agreement not be met within the allotted time, negotiations need to stop for six months to allow for rethinking and a fresh start when negotiations resume.
Countries embarking on the reorganization of their veterinary services for the first time may readily begin at stage I. Countries well advanced with reorganization may wish to begin at various convenient entry points when considering sub-issues or newly emerging issues relating to reorganization. Countries at any stage may well find value in reviewing the check list of key issues in order to recall contentious issues (see p. 28), the guiding principles for delivery of public and private veterinary services, and the critical need for consultation with key stakeholders during the reorganization process.
To initiate stage I, the Minister of Agriculture, the Permanent Secretary and/or the Chief Veterinary Officer should agree on terms of reference for both the Veterinary Services Council and the Transition Team (suggested names), which clearly set out in general terms the specific steps in the consultative processes required to draft a time-bound, Transition Action Plan that defines the aims of the restructuring and divestment plan, recognizable steps along the way, and who will be responsible for what. The mandate will set out the government authority to commission the agreed terms of reference. The bodies will be empowered by the relevant government ministries with a mandate that delegates authority; provides a budget; sets boundaries within which to operate; determines to whom each body reports to; and establishes the overall expected time frame for completion of the work.
The Minister of Agriculture, the Permanent Secretary and/or the Chief Veterinary Officer may nominate the Veterinary Services Council made up of from five to seven senior representatives and prominent citizens from the public veterinary service; national treasury; pharmaceutical industry association; livestock producer groups; private veterinary practitioners; and consumer groups. The Veterinary Services Council will be the advisory committee for the transition process. The Transition Team could be seen as the board of the Veterinary Services Council and made up of one government representative from the treasury department, one livestock raiser and the Chief Veterinary Officer. An Executive Officer could be employed by the board. The Transition Team can be seen as the implementing arm of the Veterinary Services Council.
The allotted six months should be a maximum limit; preferably, considerably less time should be required to agree among stakeholders on the composition of the Transition Team, the Veterinary Services Council, and to produce the terms of reference.
Stage II is the crucial time allotted to obtain agreements among the major domestic stakeholders as to the aims of the reorganized veterinary services and thus how key stakeholder needs' will be met. The Transition Action Plan is the blueprint for arriving at a reorganized and restructured, broadly based public and private veterinary service, veterinary professional association, and statutory body, should any of these not exist or require redefinition. Substantial agreement among all key stakeholders is crucial.
Representatives of bilateral or multilateral funding agencies should actively participate at this and subsequent stages through the provision of practical advice based on their institutional experience and policies as well as technical advice on the process of negotiations and results expected. The Transition Action Plan should be agreed in principle by one or more funding agencies in order to plan realistically the reorganization, meet preconditions for a loan or grant, understand the economic and technical philosophy of the funding agencies, and to estimate the desired time frame for transition. Twelve months should be a maximum time allotted to complete this stage.
Stage III is a defined period during which resources and legal authority should be pledged from a funding agency or agencies, concerned government ministries and other statutory authorities. A government authorization or administrative decree should be obtained in order to proceed with the Transition Action Plan.
Stage IV is the time needed to implement the Transition Action Plan and any pilot projects or phases with support from concerned government ministries and agencies, and advanced authorizations from the funding agencies.
CHECK LIST OF KEY ISSUES
Many African countries have reviewed, and continue to review, their policies for public and private veterinary services delivery. While countries may be advanced in this process, it is well recognized that the process of review and reorganization must be continual. The check list of key issues below, and the process to resolve them, are presented for the convenience of decision-makers and stakeholders in order to make country-specific adaptations.
Key stakeholders continually consulted
All key stakeholders with interests in animal health and production or the delivery of public health services should be included in the process of change. Producers (both commercial and subsistence); government technical ministries; the national treasury; the private sector (veterinary practitioners, distributors, traders, etc.); bankers; the veterinary association; and the veterinary statutory body should be represented. Consumer groups, trade associations and employees of government ministries (as represented through unions or associations) may be stakeholders and may need to be represented. Decisions should be taken in a transparent manner.
Special efforts are often needed to include producers (rural and intra-urban) or urban consumers in the consultation process. Representatives from membership organizations, selected NGOs, and grassroots producer groups have a useful role to play together with government and industry in discussions and decision-making relating to the delivery of veterinary services.
Definition of the pressure for change
The ultimate reason for change is suboptimal veterinary services, in their broadest sense, which do not contribute effectively to improved livestock productivity nor to enhanced human welfare. The main pressures for change should come from within the country, i.e., from clients who are now poorly served by existing structures. Any resulting change in the delivery of veterinary services should result in better and more effective services.
Pressures may arise from outside the country, from, for example, the World Trade Organization, International Office of Epizootics, or from importing country requirements; economic shocks (oil prices); or incentives (prequalifications for funding agency assistance). Pressures may arise from within, from economic reality that necessitates new policies for structural adjustment; the commercial livestock sector wishing to enter international markets; urban consumers demanding sufficient wholesome food; other producers; or government development plans.
Identify contentious issues
Each stakeholder group should identify priority issues needing to be discussed and assemble supporting arguments for positions taken. Issues at a minimum, among many others, could include:
(i) the functions, tasks and responsibilities not permitted by paraprofessionals under the practice acts and the degree of supervision warranted;(ii) classes of and prohibited use of veterinary remedies by producers and pare-professionals with objective, economic and scientifically based criteria for making these decisions;
(iii) defining the realistic level of quality, availability and access to veterinary services and remedies by various stakeholders;
(iv) measurement of the cost efficiency (or cost minimization) of various services against public sector and private sector responsibilities;
(v) setting the level of user fees;
(vi) delegation of control over user fees and revolving funds;
(vii) the types of services and inputs required and the level of cost subsidy for selected services, particularly in marginal livestock producing areas;
(viii) training and continuing education requirements for each cadre of animal health care provider;
(ix) guidelines or regulations for membership organizations and community-based groups to contract required animal health and production services;
(x) methods for quantitative measurement of the public veterinary services, production changes, and access to services and inputs required in order to evaluate the results of reorganization of the delivery system;
(xi) ensuring a balance between effective delivery of public sector responsibilities, both domestic and international, and functions delegated to the private sector;
(xii) justifying policies to allow or prohibit the undertaking for remuneration of private practice activities by public-employed veterinarians (and other publicly employed animal health care providers), either under specific circumstances during regular working hours or after official working hours;
(xiii) mechanisms to ensure access to necessary veterinary and production services by marginalized groups in an equitable manner; and
(xiv) clear procedures for full withdrawal of the official veterinary services from delivering private sector functions (clinical treatment, remedy distribution, etc.) as a precondition to enabling private veterinary practices to become established while not unduly restricting access to these functions in the transition period.
Decision-making on contentious issues
Decisions should be made taking into account economic realities; Principles for rational delivery of public and private veterinary services with reference to Africa and in light of competing but shared interests of key stakeholders. This is a continual process that may be aided by the steps set out in the negotiating framework.
The experiences of other countries, viewed in light of local conditions, would be a helpful adjunct to designing pilot projects or phasing reorganization of service delivery. The evaluation of pilot projects implemented to test various strategies would be a useful and necessary exercise.
Continual process of consultation, review and modification
The time required for the process of change and the achievement of desired results must not be underestimated. This is particularly true when major reforms in government ministries need to take place or legislation needs to be passed into law. However, experience dictates that the process of rationalization and privatization of service delivery need not wait for statutes to be enacted nor for government structures to be reorganized. The change process points out the need to alter policies, structures and statutes, while government regulatory and legislative bodies need to react such that a dynamic enabling environment is fostered. The government also has the role of representing the broadly-based national interests during the change process. Additionally, time is required for the private sector to assume some of the functions formerly undertaken by the government, such as establishing structures for marketing livestock products and distributing inputs.