Expanding Public Health Policy Analysis for Transformative Change: The Importance of Power and Ideas; Comment on “What Generates Attention to Health in Trade Policy-Making? Lessons From Success in Tobacco Control and Access to Medicines: A Qualitative Study of Australia and the (Comprehensive and Progressive) Trans-Pacific Partnership”

Document Type : Commentary

Authors

1 Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine. London, UK

2 College of Medicine and Health, University of Exeter, Exeter, UK

Abstract

It is increasingly recognised within public health scholarship that policy change depends on the nature of the power relations surrounding and embedded within decision-making spaces. It is only through sustained shifts in power in all its forms (visible, hidden and invisible) that previously excluded perspectives have influence in policy decisions. Further, consideration of the underlying neoliberal paradigm is essential for understanding how existing power dynamics and relations have emerged and are sustained. In their analysis of political and governance factors, Townsend et al have provided critical insight into future potential strategies for increasing attention to health concerns in trade policy. In this commentary we explore how incorporating theories of power more rigorously into similar political analyses, as well as more explicit critical consideration of the neoliberal political paradigm, can assist in analysing if and how strategies can effectively challenge existing power relations in ways that are necessary for transformative policy change.

Keywords

References

  1. Townsend B, Friel S, Schram A, Baum F, Labonté R. What Generates Attention to Health in Trade Policy-Making? Lessons From Success in Tobacco Control and Access to Medicines: A Qualitative Study of Australia and the (Comprehensive and Progressive) Trans-Pacific Partnership. International Journal of Health Policy and Management. 2020;x(x):1-12. doi:10.34172/ijhpm.2020.80
  2. Gaventa J. Finding the spaces for change: A power analysis. IDS Bulletin. 2006;37(6).
  3. Shiffman J, Smith S. Generation of political priority for global health initiatives: a framework and case study of maternal mortality. The Lancet. Heath Policy. 2007;370(9595):1370-1379. doi:https://doi.org/10.1016/S0140-6736(07)61579-7
  4. Fuchs D, Lederer M. The power of business. Business in Politics. 2007;9(3). doi:https://doi.org/10.2202/1469-3569.1214
  5. Lukes S. Power: A Radical Approach. London: McMillan; 1974.
  6. Madureira Lima J, Galea S. Corporate practices and health: a framework and mechanisms. Global Health. 2018;14(1):21. doi:10.1186/s12992-018-0336-y
  7. Battams S, Townsend B. Power asymmetries, policy incoherence and noncommunicable disease control - a qualitative study of policy actor views Crit Public Health. 2018. doi:10.1080/09581596.2018.1492093
  8. Baker P, Friel S, Gleeson D, Thow AM, Labonte R. Trade and nutrition policy coherence: a framing analysis and Australian case study. Public Health Nutrition. 2019;22(12):2329-2337. doi:http://dx.doi.org/10.1017/S1368980019000752
  9. Thow A-M, Greenberg S, Hara M, Friel S, duToit A, Sanders D. Improving policy coherence for food security and nutrition in South Africa: a qualitative policy analysis Food Security. 2018;10:1105-1130.
  10. Harvey D. A Brief History of Neoliberalism. Oxford: Oxford University Press; 2007.
  11. Kingfisher C, Maskovsky J. Introduction: The limits of neoliberalism. Critique of Anthropology. 2008;28:115-126. doi:10.1177/0308275X08090544
  12. Rushton SB, Williams DO. Frames, Paradigms and Power: Global Health Policy-Making under Neoliberalism. . Global Society. 2012;26(2):147-167. doi:10.1080/13600826.2012.656266
  13. Bell K, Green J. On the perils of invoking neoliberalism in public health critique. Critical Public Health. 2016;26(2). doi:10.1080/09581596.2016.1144872
  14. Friel S, Hattersley L, Townsend R. Trade Policy and Public Health. Annual Review of Public Health, Vol 36. Vol 362015:325-344.
  15. Hawkes C. Uneven dietary development: linking the policies and processes of globalization with the nutrition transition, obesity and diet-related chronic diseases. . Global Health. 2006;2(4).
  16. Milsom P, Smith R, Baker P, Walls H. Corporate power and the international trade regime as drivers of NCD policy non-decisions: A realist review. Health Policy Plan. 2020; Forthcoming.
  17. Hawkins B, Parkhurst J. The ‘good governance’ of evidence in health policy. Evidence and Policy. 2015;12(4).
  18. Crosbie E, Gonzalez M, Glantz SA. Health preemption behind closed doors: trade agreements and fast-track authority. American Journal of Public Health. 2014;104(9):e7-e13. doi:http://dx.doi.org/10.2105/AJPH.2014.302014
  19. Thaiprayoon S, Smith R. Capacity building for global health diplomacy: Thailand's experience of trade and health. Health Policy and Planning. 2015;30(9):1118-1128. doi:10.1093/heapol/czu117
  20. Schram A, Goldman S. Paradigm Shift: New Ideas for a Structural Approach to NCD Prevention. Comment on “How Neoliberalism Is Shaping the Supply of Unhealthy Commodities and What This Means for NCD Prevention”. International Journal of Health Policy and Management. 2020;9(3). doi:10.15171/ijhpm.2019.105
  21. Raworth K. Donut Economics. Seven Ways to Think Like a 21st Century Economist. London: Penguin Random House; 2017.
  22. Palier B. Tracking the Evolution of a Single Instrument Can Reveal Profound Changes: The Case of Funded Pensions in France. Govenance. 2007;20(1):85-107.
International Journal of Health Policy and Management
Volume 11, Issue 4
April 2022
Pages 521-524

Files

History

  • Receive Date: 14 August 2020
  • Revise Date: 03 October 2020
  • Accept Date: 04 October 2020
  • First Publish Date: 19 October 2020

Share

How to cite

Statistics