"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.

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.

Powerful Allies and Weak Consensus: Towards a Deeper Understanding of how Health-Harming Industries Seek to Influence Global Health Governance; Comment on "Competing Frames in Global Health Governance: An Analysis of Stakeholder Influence on the Political Declaration on Non-Communicable Diseases"

2021 ◽  
Author(s):  
Marco Zenone ◽  
Benjamin Hawkins
Keyword(s):  
Global Health ◽  
Communicable Diseases ◽  
Global Health Governance ◽  
Commercial Sector ◽  
Health Governance ◽  
Middle Income ◽  
Non Communicable Diseases ◽  
Governmental Organizations ◽  
Non Governmental Organizations ◽  
The One

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.

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.

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.

From Alma Ata to the SDG s

2020 ◽  
Vol 26 (1) ◽  
pp. 176-197 ◽  
Author(s):  
Martin Weber
Keyword(s):  
Global Health ◽  
Sustainable Development Goals ◽  
Medical Profession ◽  
Final Analysis ◽  
The Political ◽  
Global Health Governance ◽  
Health Governance ◽  
Community Activists ◽  
Development Goals ◽  
Year 2000

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.”

Global Health Governance as Shared Health Governance

2018 ◽  
Author(s):  
Jennifer Prah Ruger
Keyword(s):  
Global Health ◽  
Private Sector ◽  
Health Equity ◽  
Policy Framework ◽  
Global Health Governance ◽  
Health Governance ◽  
Potential Health ◽  
Health Justice ◽  
Shared Health Governance ◽  
Global Health Justice

PG as a global health justice theory joins with the theory of SHG to apply justice principles to health governance. SHG rests on a genuine commitment among global health actors to achieve health justice as opposed to pursuing narrow self, group, or state interests alone. SHG elucidates standards of global and domestic responsibility and accountability for health equity. It proposes a common conceptual and policy framework with a set of distinct but complementary responsibilities for governments, nongovernmental organizations (NGOs), the private sector, and individuals themselves. In the SHG framework, the state has duties to create conditions in which all individuals have the opportunity to be healthy and to reduce and prevent the shortfall between actual and potential health within their countries. Global actors have a duty to help shape conditions in which countries can develop and flourish and promote the health of their populations.

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