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"

Author(s):  
Angela Carriedo ◽  
Kathrin Lauber ◽  
Margaret M. Miller ◽  
Rob Ralston

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.

Author(s):  
Johanna Ralston

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.


Author(s):  
Marco Zenone ◽  
Benjamin Hawkins

Suzuki et al. have identified commonalities in the policy positions adopted at a global forum by commercial sector actors and high-income countries, on the one hand, and non-governmental organizations and low- and middle-income countries, on the other, in ways that may allow commercial sector actors to block or delay evidence-based policies through the creation of political controversy. The ability of industry actors to draw on the support of the most politically and economically powerful countries for their favoured policy agenda is an important contribution to understanding the dynamics of global health governance in the area of non-communicable diseases and beyond. Here we assess the relevance of this paper for the field of corporate actors’ research and the potential avenues this opens up for further study. More specifically we emphasize the need for comparative, cross disciplinary research to examine the power of heath-harming industries and the relevance of these findings for decolonizing global health.


Author(s):  
Martin Weber

Abstract The Alma Ata Declaration of 1978 proclaimed “health for all by the year 2000.” In 2019 health is mainstreamed through the United Nations’ 2030 Sustainable Development Goals (SDG s) initiative. Contributing to critical analysis of global health governance (GHG), this article reconstructs the normative premises of the Alma Ata Declaration, the political project it represented, and the successful cases it was inspired by. It contrasts this with an account of the emergence and gradual consolidation of the GHG agenda that is today reflected in the SDG s. The calls for a return to the Alma Ata Declaration resonate strongly among human rights advocates, community activists, and the medical profession. This is because of the socially exclusionary effects of the dominant health governance agenda shaped by distinctively neoliberal premises. The article argues that in the final analysis the two different approaches reflect very different ideas and ideals about “who global health governance is for.”


2018 ◽  
Vol 10 (1) ◽  
Author(s):  
Yasobant Sandul ◽  
Walter Bruchhausen ◽  
Deepak B. Saxena

ObjectiveThe present study aims to operationalize one health approach through local urban governance system in a rapidly urbanized Indian city, Ahmedabad, India.In Ahmedabad (proposed Smart city), Gujarat, India:1. To understand the pattern of zoonotic diseases in reference to urban governance system2. To develop a conceptual One Health Governance framework with reference to zoonotic diseases3. To assess the key indicators for convergence for inter-sectorial professional collaborations in One HealthIntroductionSmart governance refers to the emergence of joint action by the health and non-health sectors, public and private actors and citizens. Although, there are growing literature on governance and its potential impact on health, major challenges on collective action across sectors have been witnessed in developing countries like India. In the same line, the current forms of Global Health Governance façades operational issues and does not sufficiently meet the needs at local levels. In light of these perceived shortcomings, the local governance becomes subject of interest and should be debated especially with reference to global urbanization.Rapid and unplanned urbanization followed by the combination of high population density, poverty and lack of infrastructure have more side effects and fostering conditions for communicable diseases to flourish. Evidence suggests that new megacities could be incubators for new epidemic and zoonotic diseases, which can spread more rapidly and become worldwide threats. In India, Ministry of Urban Development initiated the concept of converting few major cities into “Smart City” in 2015-16. However, one of the major critiques of available smart city guideline is that it has no such focus on prevention of emerging and/or re-emerging zoonotic diseases. The emergence and/or re-emergence of zoonotic diseases should be considered as potential threats for these upcoming Smart Cities and hence, should be addressed by one health approach (health and non-health sectors, public and private actors) through an appropriate local governance strategy.With rapid urbanization and healthcare transformation in India, the operationalization of one health approach might become a major challenge, because of, the absence of the systematic effect at the national level and urban cities are riven between central, state and municipal authorities in terms of health policy, planning, health needs etc. There is also lack of information sharing or collaborations between the health and non-health sectors, public and private actors at the city level. Understanding these challenges can offer important lessons for strengthening both local urban governance and One Health.MethodsFor Objective-1: To understand the pattern of zoonotic diseases in reference to urban governance system1. Is there existing literature indicates the importance of governance system in prevention of zoonotic diseases in urban settingsUrban Governance System & Zoonotic diseases (Systematic Review)2. Is prevalence of zoonotic disease vary in accordance with change of local urban governance(Outcome: Prevalence of Zoonotic diseases & Exposure: Governance Index for last 10 years)For Objective-2: To develop a conceptual One Health Governance framework with reference to zoonotic diseases1. Is there evidence of existing One Health Governance framework exists One Health Governance Framework(Systematic Review & SWOT Analysis)2. To map the urban agencies working for zoonotic diseases Institutions for zoonotic diseases (Mapping)3. Is convergence possible for One Health in prevention of Zoonotic diseases (Policy Maker, System-level professionals Qualitative Key Informant Interviews)For Objective-3: To assess the key indicators for convergence for inter-sectorial professional collaborations in One Health1. Is developed governance framework operational at field level- KAP among Healthcare providers, Veterinarians, Environmental specialists2. Is there possibilities of convergence at field level for One health in prevention of zoonotic diseases (Qualitative Key Informant Interviews)ResultsThis is first of kind unique study to come up with a local urban governance convergence approach for “One Health” for the upcoming Smart city Ahmedabad, which may further be scaled up to other smart cities of India.ConclusionsUrban Health governance framework for a smart city to develop an one health approach.References[1] World Health Organization. Governance for Health in 21st Century. Available from: http://www.euro.who.int/__data/assets/pdf_file/0019/171334/RC62BD01-Governance-for-Health-Web.pdf [Last Accessed on December 2016][2] Dodgson R, Lee K, Drager N. Global Health Governance: a Conceptual Review. London: London School of Hygiene and Tropical Medicine; 2002.[3] Burris S. Governance, Microgovernance, and health. Temple Law Rev. 2004;77:334–362.[4] Hein W. Global health governance and national health policies in developing countries: conflicts and cooperation at the interfaces. In: Hein W, Kohlmorgan L, eds. Globalization, Global Health Governance and National Health Policies in Developing Countries: an Exploration Into the Dynamics of Interfaces. Hamburg: Deutschen Uebersee-Instituts; 2003:33–71.[5] Navarro V, Muntaner C, Borrell C, et al. Politics and health outcomes. Lancet. 2006; 368(9540):1033-7. 


2016 ◽  
Vol 2 (3_suppl) ◽  
pp. 44s-44s
Author(s):  
Shannon L. Silkensen ◽  
John S. Flanigan

Abstract 78 In many low and middle-income countries (LMICs) there is a marked need to build or enhance research infrastructure to support basic, translational, clinical, and population science on non-communicable diseases, mental health and injuries (NCDs). To support this growing need, the NCI's Center for Global Health recently invited investigators throughout the world to apply for Planning Grants for Regional Infrastructure Centers (RCREs) for the coordination of research on NCDs in LMICs. The purpose of the funding opportunity (FOA) is to facilitate the planning and designing of RCRE that will build on collaborative partnerships among investigators from institutions in high-income countries (HICs)/ Upper Middle Income Countries (UMIC) and LMICs. The presentation will provide details of the opportunity for funding from the NCI, how partnerships can be created, the requirements for the application to the program and its multiple funding timelines, and early information about the program's global reach. The NCI Center for Global Health encourages the CUGH community to examine and become involved in this this opportunity as primary or partner applicants. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST: No COIs from either author.


2014 ◽  
Vol 40 (5) ◽  
pp. 897-918 ◽  
Author(s):  
ANNE ROEMER-MAHLER

AbstractThe article analyses the involvement of pharmaceutical companies from emerging markets in global health governance. It finds that they play a central role as low-cost suppliers of medicines and vaccines and, increasingly, new technologies. In so doing, pharmaceutical companies from emerging markets have facilitated the implementation of a key goal of global health policy: widening access to pharmaceutical treatment and prevention. Yet, looking closer at the political economy underlying their involvement, the article exposes a tension between this policy goal and the political economy of pharmaceutical development and production. By declaring access to pharmaceuticals a goal of global health policy, governments and global health partnerships have made themselves dependent on pharmaceutical companies to supply them. Moreover, to provide pharmaceutical treatment and prevention at the global level, they depend on companies to supply medicines and vaccines at extremely low prices. Yet, the development and production of pharmaceuticals is organised around commercial incentives that are at odds with the prices required. The increasing involvement of low-cost suppliers from emerging markets mitigates this tension in the short run. In the long run, this tension endangers the sustainability of global access policies and may even undermine some of the successes already achieved.


Author(s):  
David McCoy ◽  
Joseph Gafton

Civil society may be defined as both a space in society and a collection of certain types of actor. As a space, it exists alongside the state and markets; as a set of actors, it interacts with a range of governmental bodies and businesses. Over the past three or four decades, neoliberal globalisation has dramatically changed the distribution of power across society, while also institutionalising a set of policies that have diminished the role of the state, undermined democracy, and established the dominance of market logic. These developments have influenced both international health policy and the structures of global governance. Furthermore, they have also shaped the nature of civil society’s participation in global health policy and governance. Crucially, civil society does not merely intervene in global health politics from outside, but is itself sculpted by the ideologies and political conditions that surround it. This chapter explores the political nature of civil society and its relationship to global health politics, including the political nature of new non-state actors such as the Bill and Melinda Gates Foundation and the emergence of global health partnerships, which have ostensibly increased civil society involvement in global health governance. It argues that civil society participation in global health governance tends to represent powerful and hegemonic interests rather than those most in need. It also discusses how current political, economic and technological developments will influence civil society’s participation in global health politics, and shape the challenges faced by society more generally.


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