Policies are the guiding principles adapted by an individual, group of people, or governments. Policies can be divided into several groups according to their action period. Some policies are formulated for the short duration while others are designed for strategizing purposes for long-term use. Administering new order in developing nations is prone to massive challenges from economic constrains, low literacy levels among citizens, and disagreements between formulators, stakeholders, and the public in general. Non-state actors are those who do not directly participate in government business (Marsh, and Rhodes, 1992).
In 2001, Thai government adopted the antiretroviral therapy (ART). It purposed to increase accessibility and availability of HIV/AIDS treatment to meet the needs of all citizens. The government employed different services of the non-state actors in collecting data, including vast interviewing, direct observations, and document reviews. The subject of the study scrutinized Universal Antiretroviral Therapy (ART) policy, developed between 2001 and 2007. The governmental bodies involved people both in an out of the governmental institutions. Others, who were not a part of the government, included either civil groups or academicians (so called non-state actors) (Piot, 2006). The research findings revealed that non-state actors made a significant contribution to the formulation of policy. At each policymaking stage, the efforts from the civic networks were evidenced vividly (Piot, 2006). As a rule, the state actors dominates the national policy making process; in this case, however, also non-state actors were also incorporated in the policymaking process and they made an immense influence. Today, their contributions are evident in all policymaking processes. Moreover, the policymaking process was not restricted to local actors only; it incorporated global individuals and organizations.
Roles of Policy Networks
Roles of policy networks (non-state actors) are critical in policymaking process. Such associations usually appear if a person is not a part of the government and is not involved directly in the general policymaking process. Nevertheless, such employment of outside agents in the policymaking process by certain governments plays a crucial role since government cannot serve its personal interest only, in the expense of the citizens. In Thailand, civil actors have played a vital role in policy formulation for many years. This practice was restored by the Thai Rak Thai party that came to power in 2001. The new government promised a better life for the country’s citizens, for instance, universal medical care to everyone as cited above (antiretroviral therapy or ART). In addition, policy networks were allowed to take part in all stages of the policymaking process.
Nowadays, integration of policy phase’s framework and policy network is of great significance. Handling the disagreements in policy formulating procedures and incorporating all people concerned is crucial, as it helps in disaggregating the complexes involved. Usually, when there is an urgent necessity to change existing policies, a totally new group of people steps on the board. The new actors on stage come with different views, beliefs, norms, and preferences, which affect the policy subsystems significantly. In certain political situations, such complexities may lead to alternation of the policies due to disturbances. These conditions may cause drastic changes in the policies agenda. Other political factors that may result in shifting the policy agenda can change due to public opinion influenced by the media, social and political campaigns, and changes in the set committees (Marsh, and Rhodes, 1992). In Thailand, NGOs and other civil society groups played a crucial role in the formulation of the antiretroviral therapy. They pushed for scaling of the treatment problem to the national level. Initially, only those who could afford medical care could receive it; this situation urged the civil groups to fight for voice of the unheard in Thailand.
At the formulation stage, the civil society organizations examined various options in line with the policy formulation of the antiretroviral therapy. They included examining sources from governmental institutions, particularly Ministry of Public Health. The collected data were analyzed in-depth, in order to figure out current Thai economic conditions. The government brought on board other actors, who shared the common interest to establish a universal health care policy for all country’s citizens.
In the implementation stage, the non-state actors played a significant role in informing and communicating the information to both the government and people. They acted as a bridge between the two parties. It was the action phase; collaboration between the government and civic groups in the adaption of the antiretroviral therapy (ART) scaling up policy got a boost in 2003. It resulted in the increased involvement of the non-state actors under National Access in Antiretroviral Programs (NAPHA) (Sripen and Gill, 2005). The antiretroviral therapy campaign was massive in all HIV-prevalent provinces of Thailand.
Significance of the Non-State Actors Activity
Civil society organization, non-governmental organizations, intellectual groups, and other civil groups may play a significant role in the policymaking process in different ways. At the policy formulation stage, the non-actors can cause a shift in interests since they put pressure on the government to adopt new health policy. In addition, the non-state actors can implement the control aspect on the governmental actions, during the whole policy making process. For instance, during the implementation of the universal health care and antiretroviral therapy, specific civil groups made sure that the health cover was provided equally to all citizens despite their social class and status. The scientist and other intellect classes provide technical assistance during the implementation of the universal health care bill (Piot, 2006). It is obvious that inclusion of the civil organizations in the policymaking process increases the trust of people to the governmental initiatives. Such organizations work closely with the people; thus, if they take part in the policymaking process, they get a sense of belonging and significance.
In Thailand, public participation in policymaking was given a go ahead in 1997 by the constitutional amendments; the document allowed the public to take part in public decision-making. This event marked the beginning of the civil groups’ participation in the policy formulation process. The non-state actors pushed for the inclusion of ART under the universal health care program, accepted by the government of Thailand. From this very moment, the non-state actors began to participate in formulating health policy actively. Before 2003, they were seen as outsiders; however, since the time when the antiretroviral therapy was included in the universal health program, they had become active stakeholders. This step was a key milestone for the voice of unheard to be heard; it caused substantial change in how government functions were carried out hereafter (Piot, 2006).
The country also experienced intervention of the world communities, which supported the provision of medical care in Thailand. Various non-governmental organizations supported the realization of universal health care policy in the country; Bill and Melinda Gates Foundation that boosted the program was among them (Sripen, and Gill, 2005).
Moreover, the non-state actors actively participated in the implementation process. The provincial interviews aired by the media and documentaries revealed that non-state actors took part in the manifestation of the health care policy into action.
It should be mentioned that, on the other hand, various challenges arose from the employment of the non-state actors in policy formulation since there was confusion on who would set the policy schema. In addition, since non- state actors included international bodies, such as the World Health Organization (WHO) among others, the question was where the country sovereignty reclined. (Piot, 2006)
Moreover, government interest was being served despite the employment of the civil groups in making national decisions. This situation was caused by the fact that government agencies, experts, and consultants were advantaged over others in the policymaking process. This treatment was felt from people in and out of the government. For instance, the government economic technocrats were opposed to the inclusion of the antiretroviral therapy (ART) in the universal health care. They prevented the development of the project by a long-term funding; it caused the future of the initiative to be uncertain.
During the antiretroviral therapy (ART) implementation, various challenges also aroused. They incorporated unclear objectives, poor communication among stakeholders, inadequate resources, and even rejection of the front line government officials. For example, some people in government under the Ministry of Health disagreed to the rapid development of the therapy. Their concern was the nation unpreparedness and the long-term financing side of the program (Sripen, and Gill, 2005).
In conclusion, the participation of the non-state actors in national policymaking in Thailand can be described as the voice of the unheard, to make the government hear all citizens and take appropriate actions. In most countries, the civil groups are not considered to play any decisive role in national decision-making. Most governments view the civil groups’ efforts as meddling with their business and compromising the sovereignty of a nation.