A social explanation for the rise and fall of global health issues

Abstract

This paper proposes an explanation concerning why some global health issues such as HIV/AIDS attract significant attention from international and national leaders, while other issues that also represent a high mortality and morbidity burden, such as pneumonia and malnutrition, remain neglected. The rise, persistence and decline of a global health issue may best be explained by the way in which its policy community -the network of individuals and organizations concerned with the problem -comes to understand and portray the issue and establishes institutions that can sustain this portrayal. This explanation emphasizes the power of ideas and challenges interpretations of issue ascendance and decline that place primary emphasis on material, objective factors such as mortality and morbidity levels and the existence of cost-effective interventions. This explanation has implications for our understanding of strategic public health communication. If ideas in the form of issue portrayals are central, strategic communication is far from a secondary public health activity: it is at the heart of what global health policy communities do.Une traduction en français de ce résumé figure à la fin de l'article. Al final del artículo se facilita una traducción al español. ‫املقالة.‬ ‫لهذه‬ ‫الكامل‬ ‫النص‬ ‫نهاية‬ ‫يف‬ ‫الخالصة‬ ‫لهذه‬ ‫العربية‬ ‫الرتجمة‬

Stillbirths: how can health systems deliver for mothers and babies?

“…These questions focused on service delivery in low-income and middle-income countries, drawing on experience, published reports of delivery of interventions to prevent stillbirths, and reviews of the pregnancy and childbirth database of Cochrane systematic reviews (webappendix pp [23][24][25][26][27][28][29][30]. 17,51 The research questions were divided into categories of development and implementation of interventions; those pertaining to development are reported in the third paper of this Series.…”

Diseases of the Rich? The Social Patterning of Hypertension in Six Low- and Middle-Income Countries

“…Social constructionist policy theory posits that the specific framing of policy issues and the nature of global policy communities can exert an equal or greater influence than objective, scientific evidence on priority-setting (Shiffman, 2009). Until recently, global institutional communities with particular interests in NCDs were weakly-articulated and uninfluential (Alleyne et al, 2013).…”

The politics of researching global health politics Comment on "Knowledge, moral claims and the exercise of power in global health"

“…And we see productive power at work as they create concepts for thinking about health priority-setting, such as the burden of disease, treatment cost-effectiveness and the right to receive care". These structural and productive forms of power, often rooted in actors' claims to expertise and moral authority, are, for Shiffman, important for understanding how decisions are made and how agendas are set within global health [themes on which Shiffman has made some important previous contributions (2,3)]. I concur wholeheartedly with his analysis, and with his conclusion that we ought to interrogate the origins and uses of both of these forms of power.…”