Firstly, does the involvement of civil society in global health governance help deepen democracy at the global level? ‘Democratic deficit’ is a term used to describe a situation in which there is a perceived lack of accountability, transparency, and democratic control over the decision-making process. From this perspective, a number of arguments can be listed to support the involvement of CSOs in global health governance: - CSOs increase transparency of global health policy-making processes - CSOs monitor and criticise global policies and raise public awareness when decisions are being taken - CSOs provide platforms and mechanisms with which citizens can claim their rights or seek redress for rights infringements - CSOs provide democratic foundation for policies and programmes where they do not exist However, more sceptical views have emerged, stressing that: - CSOs often have ‘self-elected’ spokespersons - No formal democratic procedures are involved in the establishment of CSOs - Channels of accountability are not clear – whom are CSOs accountable to and whom are they responsible for? In a similar vein, some people have argued that CSOs don’t make global health governance more pluralist and representative but can in fact make it more elitist. For example: - There is a struggle among CSOs for legitimate representation of constituencies and interests - There are large gaps between CSOs operating on the global level and in the local communities - New power asymmetries among CSOs themselves can be observed - Issues and discourses from the global South are still under-represented # How well are these functions fulfilled? # Are CSOs sufficiently accountable and transparent, and to whom? # To what extent is there sufficient evaluation of CSO activities? # Related [[global civil society]] [[Power asymmetry]] [[How does power came to be?]]