scholarly journals Competing Frames in Global Health Governance: An Analysis of Stakeholder Influence on the Political Declaration on Non-communicable Diseases

2021 ◽  
Author(s):  
Mao Suzuki ◽  
Douglas Webb ◽  
Roy Small
Keyword(s):  
Private Sector ◽  
Conflicts Of Interest ◽  
Cost Effective ◽  
Communicable Diseases ◽  
Negotiation Process ◽  
High Income ◽  
The Political ◽  
Member States ◽  
Non Communicable Diseases ◽  
High Level

Background: Non-communicable diseases (NCDs) are increasingly recognized as a significant threat to health and development globally, and United Nations (UN) Member States adopted the Political Declaration of the Third High-level Meeting (HLM) on the prevention and control of NCDs in 2018. The negotiation process for the Declaration included consultations with Member States, intergovernmental organizations (IGOs), and non-state actors such as non-governmental organizations (NGOs) and the private sector. With NCD responses facing charges of inadequacy, it is important to scrutinize the governance process behind relevant high-level global decisions and commitments. Methods: Through a review of 159 documents submitted by stakeholders during the negotiation process, we outline a typology of policy positions advocated by various stakeholders in the development of the Declaration. We document changes in text from the draft to the final version of the Declaration to analyse the extent to which various positions and their proponents were influential. Results: NGOs and low- and middle-income countries (LMICs) generally pursued ‘stricter’ governance of NCD risk factors including stronger regulation of unhealthy products and improved management of conflicts of interest that arise when health-harming industries are involved in health policy-making. The private sector and high-income countries generally opposed greater restrictions on commercial factors. The pattern of changes between the draft and final Declaration indicate that advocated positions tended to be included in the Declaration if there was no clear opponent, whereas opposed positions were either not included or included with ambiguous language. Conclusion: Many cost-effective policy options to address NCDs, such as taxation of health-harming products, were opposed by high-income countries and the private sector and not well-represented in the Declaration. To ensure robust political commitments and action on NCDs, multi-stakeholder governance for NCDs must consider imbalances in power and influence amongst constituents as well as biases and conflicts in positioning.

"A Promise Unfulfilled": Stakeholder Influence and the 2018 UN High-Level Meeting on NCDs; Comment on "Competing Frames in Global Health Governance: an Analysis of Stakeholder Influence on the Political Declaration on Non-Communicable Diseases

2021 ◽  
Author(s):  
Johanna Ralston
Keyword(s):  
Global Health ◽  
Private Sector ◽  
Communicable Diseases ◽  
Noncommunicable Diseases ◽  
The Political ◽  
Global Health Governance ◽  
Health Governance ◽  
Non Communicable Diseases ◽  
Stakeholder Influence ◽  
High Level

In recognition of the global burden of noncommunicable diseases (NCDs), the past decade has seen three U.N. High Level Meetings on NCDs. Yet progress in terms of political or financial commitments has been very slow. At the 2018 meeting, a political declaration was approved but featured language that had been watered down in terms of commitments. In "Competing Frames of Global Health Governance: An Analysis of Stakeholder Influence on the Political Declaration on Non-communicable Diseases," Suzuki et al analyze the documents that were submitted by Member States, NGOs and the private sector during the consultation period and conclude that the private sector and several high-income countries appeared to oppose regulatory frameworks for products associated with NCDs , that wealthier countries resisted financing commitments, and that general power asymmetries affected the final document. This comment supports their findings and provides additional considerations for why the NCD response has yet to produce significant commitments.

Conflicts of interest and the UN high-level meeting on non-communicable diseases

The Lancet ◽  
2011 ◽  
Vol 378 (9804) ◽  
pp. e6 ◽  
Author(s):  
Paul Lincoln ◽  
Patti Rundall ◽  
Bill Jeffery ◽  
Gigi Kellett ◽  
Tim Lobstein ◽  
...  
Keyword(s):  
Conflicts Of Interest ◽  
Communicable Diseases ◽  
Non Communicable Diseases ◽  
High Level

scholarly journals Lacking Clarity or Strategic Ambiguity? Comment on "Competing Frames in Global Health Governance: An Analysis of Stakeholder Influence on the Political Declaration on Non-Communicable Diseases"

2021 ◽  
Author(s):  
Angela Carriedo ◽  
Kathrin Lauber ◽  
Margaret M. Miller ◽  
Rob Ralston
Keyword(s):  
Global Health ◽  
Conflicts Of Interest ◽  
Communicable Diseases ◽  
The Political ◽  
Global Health Governance ◽  
Health Governance ◽  
Public And Private ◽  
Non Communicable Diseases ◽  
Multi Stakeholder ◽  
Public And Private Sector

This commentary engages with Suzuki and colleagues’ analysis about the ambiguity of multi-stakeholder discourses in the United Nations (UN) Political Declaration of the 3rd High-Level Meeting of the General Assembly on the Prevention and Control of Non-Communicable Diseases (HLM-NCDs), suggesting that blurring between public and private sector in this declaration reflects broader debates about multi-stakeholder partnerships (MSPs) and public-private partnerships (PPPs) in health governance. We argue that the ambiguity between the roles and responsibilities of public and private actors involved may downplay the role (and regulation) of conflicts of interest (COI) between unhealthy commodity industries and public health. We argue that this ambiguity is not simply an artefact of the Political Declaration process, but a feature of multi-stakeholderism, which assumes that commercial actors´ interests can be aligned with the public interest. To safeguard global health governance, we recommend further empirical and conceptual research on COI and how it can be managed.

scholarly journals Commercial Influence on Political Declarations: The Crucial Distinction Between Consultation and Negotiation and the Need for Transparency in Lobbying Comment on "Competing Frames in Global Health Governance: An Analysis of Stakeholder Influence on the Political Declaration on Non-Communicable Diseases"

2021 ◽  
Author(s):  
Astrid Berner-Rodoreda ◽  
Albrecht Jahn
Keyword(s):  
Communicable Diseases ◽  
The Political ◽  
Global Public Health ◽  
Non Communicable Diseases ◽  
Public Health Policies ◽  
Political Processes ◽  
Stakeholder Influence ◽  
Multi Stakeholder ◽  
High Level ◽  
Public Consultations

Suzuki and colleagues’ rare and elaborate analysis of the political processes behind the 2018 United Nations (UN) non-communicable diseases (NCD) Declaration discloses various pathways towards influencing global public health policies. Their study should be a wake-up call for further scientific political scrutiny and analysis, including clearly distinguishing between consultations such as UN multi-stakeholder hearings preceding high-level meetings and the actual negotiating and decision making process. While stakeholder positions at interactive hearings are documented and published and thus made transparent, the negotiating process among member states is not publicly known. The extent to which intergovernmental negotiations are influenced at country or regional levels by commercial interests through direct and indirect lobbying outside of public consultations should be given more attention. Lobby registers should be implemented more stringently and legislative footprints required and applied not only to legally binding but also to internationally important documents such as political declarations.

Non-Communicable Diseases and Global Health Politics

2019 ◽  
pp. 626-659
Author(s):  
Roger Magnusson
Keyword(s):  
Respiratory Diseases ◽  
Communicable Diseases ◽  
World Health ◽  
Global Response ◽  
Non Communicable Diseases ◽  
Health Politics ◽  
Chronic Respiratory Diseases ◽  
Health Organization ◽  
High Level ◽  
And Control

Non-communicable diseases (NCDs), including cardiovascular disease, cancer, chronic respiratory diseases, and diabetes, are responsible for around 70 percent of global deaths each year. This chapter describes how NCDs have become prevalent and critically evaluates global efforts to address NCDs and their risk factors, with a particular focus on the World Health Organization (WHO) and United Nations (UN) system. It explores the factors that have prevented those addressing NCDs from achieving access to resources and a priority commensurate with their impact on people’s lives. The chapter evaluates the global response to NCDs both prior to and since the UN High-Level Meeting on Prevention and Control of Non-communicable Diseases, held in 2011, and considers opportunities for strengthening that response in future.

scholarly journals How to tackle the growing problem of type 2 diabetes in the European Union?

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
N M Mahrouseh ◽  
D W Njuguna ◽  
O A Varga
Keyword(s):  
Type 2 Diabetes ◽  
European Union ◽  
Communicable Diseases ◽  
Health Determinants ◽  
Diabetic Patients ◽  
The European Union ◽  
Member States ◽  
Non Communicable Diseases ◽  
The Eu

Abstract Background There is an alerting increase in the population affected by type 2 diabetes mellitus (T2DM) in the European Union (EU) with significant socioeconomic burden. According to an estimation by the International Diabetes Federation, by 2030, the total number of diabetic patients will be 38 million in EU. The “screen and treat” strategies that predominantly applied in policies to prevent T2DM have not achieved significant success, as reported by a large systematic review and meta-analysis published in 2017. Although the member states of the EU have almost full responsibilities for actions in the field of health, the EU has to tackle non-communicable diseases by targeting health determinants and lifestyle mostly through non-binding policies. The goal of this work is to review the T2DM prevention policies in the EU and compare with tobacco policies, from a legal perspective. Methods Following the systematic search and screening of policies from EUR-lex, a content analysis was carried out by using MonQcle as publicly available legal text document analysis platform, by two coders. The search was limited for regulations, directives and white papers. Results Our data collection consisted of 19 documents including 10 regulations, 6 directives and 3 white papers with relevance to T2DM, covering the following topics: health infrastructure and services, informational policies, economic policies, environmental policies, command and control and social policies. The identified policies covered the time frame of 1972 to 2020. Diabetes was targeted as part of non-communicable diseases. None of the policies was legally binding addressing T2DM directly which is in sharp contrast to the tobacco control policies in the EU. Conclusions T2DM, in fact, is largely preventable. EU institutions should consider to reframe T2DM prevention strategies and consider applying a wide range of population-level legislative and innovative actions to prevent T2DM e.g. taxes on unhealthy food products. Key messages T2DM is a largely preventable disease, effective legal tools should be created and applied matching the scale of such public health problem. T2DM policies of the EU may be subject to change due to additional value of actions taken by the EU compared to that could have been achieved by member states alone.

scholarly journals Proposals for the Negotiation Process on the United Nations Global Compact for Migration

2017 ◽  
Vol 5 (3) ◽  
pp. 682-693 ◽  
Author(s):  
Víctor Genina
Keyword(s):  
New York ◽  
United Nations ◽  
International Migration ◽  
Negotiation Process ◽  
General Assembly ◽  
Global Compact ◽  
Member States ◽  
Un General Assembly ◽  
The United Nations ◽  
High Level

On September 19th, 2016, the United Nations (UN) General Assembly adopted Resolution 71/1, the text of the New York Declaration for Refugees and Migrants (the “New York Declaration”). Resolution 71/1 is the outcome document of the high-level plenary meeting on addressing large movements of refugees and migrants, held at the UN headquarters. The New York Declaration reflects how UN member states have decided to address the challenge of large movements of people in two main legal categories: asylum seekers/refugees and migrants. Resolution 71/1 includes an annex titled “Towards a Global Compact for Safe, Orderly and Regular Migration” (the “global compact for migration” or “global compact”). This document is comprised of several thematic issues related to international migration that will be the basis of a globally negotiated agreement on how member states should respond to international migration at the national, regional, and international levels, as well as to issues related to international migration and development. The global compact for migration is intended to be adopted at a conference on international migration and development before the inauguration of the 73rd annual session of the UN General Assembly in September 2018. This paper addresses how UN member states should plan to address international migration in the future. It does not refer to refugees and asylum seekers: a global compact on refugees will be drafted by the United Nations High Commissioner for Refugees (UNHCR) in 2018, and to be presented to the UN General Assembly for states' consideration during its 73rd annual session, which starts in September 2018.1 For those who have been involved in migration issues within the United Nations, the fact that member states have finally agreed to convene an international conference on international migration represents a major achievement. It is the result of an extended process that started decades ago and was made possible by a long chain of efforts by many state delegations and other stakeholders. The global compact for migration will not be the first outcome document dealing exclusively with international migration. A declaration2 adopted at a high-level meeting at the United Nations in October 2013, for example, paved the way for the 2018 conference. Nonetheless, the global compact represents a unique opportunity to address international migration comprehensively and humanely. This paper contributes to the discussion on the elements that should be included in the global compact for migration. The paper is divided into two sections. The first section analyzes the main elements of Annex II, “Towards a Global Compact for Safe, Orderly and Regular Migration,” and the criteria that needs to be adopted in order to achieve a substantive outcome. In particular, participants in the negotiation process should aim to balance the concerns of states and the members of host societies, on one hand, with the needs and rights of migrants, on the other. The second section includes proposals to enrich the final global compact for migration and takes into account two documents written by two different actors within the UN system, the Special Representative of the Secretary-General on Migration, and the Special Rapporteur on the Human Rights of Migrants. In particular, the paper proposes that the global compact for migration: • sets forth principles that can inform the actions of governments in relation to international migration at all levels; • enunciates a clearer definition of state protection responsibilities in relation to migrants in crisis situations and so-called “mixed flows”3; affords a substantive role to civil society organizations, the private sector, and academic institutions in the global compact's follow-up and review process; • defines the institutional framework for the implementation and follow-up of the global compact within the United Nations, including through the work of the UN High-level Political Forum on Sustainable Development (HLPF); • establishes a mechanism to fund migration policies for states that lack enough resources to invest sufficiently in this task; and • builds a cooperation-oriented, peer-review mechanism to review migration policies. The paper has been conceived as an input for those who will take part in the negotiation of the global compact for migration, as well as those who will closely follow those negotiations. Thus, the paper assumes a level of knowledge on how international migration has been addressed within the United Nations during the last several years and of the complexities of these negotiation processes. The author took part in different UN negotiation processes on international migration from 2004 to 2013. The paper is primarily based on this experience.4

scholarly journals Burden of Communicable and Non-Communicable Diseases Among Elderly in India: A Study Based on LASI Survey

2021 ◽  
Author(s):  
Shekhar Chauhan ◽  
Shubham Kumar ◽  
Ratna Patel ◽  
David Jean Simon ◽  
Aradhana Singh
Keyword(s):  
Higher Education ◽  
Rural Areas ◽  
Binary Logistic Regression ◽  
Cost Effective ◽  
The Elderly ◽  
Communicable Diseases ◽  
Rural Elderly ◽  
Urban Elderly ◽  
Non Communicable Diseases ◽  
Urban Inequality

Abstract Background: While controlling the outbreak of communicable diseases (CDs) remained a priority, non-communicable diseases (NCDs) are placing an unavoidable burden on the health and social security system. India, a developing nation in South Asia, has seen an unprecedented economic growth in the past few years; however, it struggled to fight the burden of communicable and non-communicable diseases. Therefore, this study aimed at examining the burden of CDs and NCDs among elderly in India.Methods: Data from Longitudinal Ageing Study in India (LASI Wave-I, 2017-18) were drawn to conduct this study. Response variables were the occurrence of CDs and NCDs. The bi-variate and binary logistic regression were used to predict the association between communicable and non-communicable diseases by various socio-demographic and health parameters. Furthermore, to understand the inequalities of communicable and non-communicable diseases in urban and rural areas, the Fairlie decomposition technique was used to predict the contribution toward rural-urban inequalities in CDs and NCDs.Results: Prevalence of communicable diseases was higher among uneducated elderly than those with higher education (31.9% vs. 17.3%); however, the prevalence of non-communicable diseases was higher among those with higher education (67.4% vs. 47.1%) than uneducated elderly. The odds of NCDs were higher among female elderly (OR=1.13; C.I. = 1-1.27) than their male counterparts. Similarly, the odds of CDs were lower among urban elderly (OR=0.70; C.I. = 0.62-0.81) than rural elderly, and odds of NCDs were higher among urban elderly (OR=1.85; C.I. = 1.62-2.10) than their rural counterparts. Results found that education (50%) contributes nearly half of the rural-urban inequality in the prevalence of CDs among the elderly. Education status and current working status were the two significant predictors of widening rural-urban inequality in the prevalence of NCDs among the elderly.Conclusion: The burden of both CD and NCD among the elderly population requires immediate intervention. The needs of men and women and urban and rural elderly must be addressed through appropriate effort. In a developing country like India, preventive measures, rather than curative measures of communicable diseases, will be cost-effective and helpful.

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