How ASF Governs Itself
ASF’s governance is designed to prevent it from becoming what it criticises. Four independent bodies. Seven statutory constraints. Full public transparency.
The Four Governance Bodies
Board of Directors
Responsible for strategic direction, financial oversight, and constitutional compliance. Cannot make individual accreditation decisions. Cannot alter constitutional protections without the required supermajority processes.
Accreditation Decision Committee (ADC)
Makes all formal accreditation decisions. External majority — the majority of members have no financial relationship with ASF. Chair is elected by ADC members, not appointed by ASF leadership. Decisions by defined thresholds: simple majority to accredit, two-thirds majority to deny. Structurally independent of ASF operations.
Full ADC composition and process → · ADC in the Model →
International Standards Council
Oversees standards development and revision. Includes clinical experts from multiple countries and facility types. Manages the six-step revision process, equity review requirement, and evidence base for each criterion. Conflict of interest register published publicly.
Standards Council → · How Standards Are Developed →
Patient and Public Council
Provides patient and public voice in ASF governance. Contributes to standards development. Provides a patient perspective in ADC pool membership. Manages the public concern reporting channel.
The Constitutional Protections
Seven provisions in ASF’s founding statutes that cannot be changed by management decision or standard Board vote. They include: fee schedule always public, standards always free, non-profit tier permanent, ADC independence permanent, non-distribution constraint (can never become for-profit), annual public accountability report mandatory, and five-year independent external review mandatory.
Read the Seven Constitutional Protections →
The Annual Accountability Report
Published every year without exception. Contains: total revenue and expenditure, number of accredited and certified facilities by tier, type, and country, number of certified professionals by country, ADC decisions and outcomes, re-verifications and findings, complaints received and resolution, any suspensions or revocations.
