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"

Abstract

It is a well-documented fact that transnational corporations engaged in the production and distribution of health-harmful commodities have been able to steer policy approaches to address the associated burden of non-communicable diseases (NCDs). While the political influence that corporations wield stems in part from significant financial resources, it has also been enabled and magnified by what has been referred to as global health’s neoliberal deep core, which has subjected health policy to the individualisation of risk and responsibility and the privileging of market-based policy responses. The accompanying perspective article from Lencucha and Thow draws attention to neoliberalism in the NCD space and the way it has historically structured patterns of thinking and doing that foreground economic interests over health considerations. In this commentary, we explore how shifting from a focus on material power to discursive power creates space to see the NCD agenda as a battle of economic ideas as well as dollars, and consequently the importance of public health engagement in the next vision for the economy.

Corporate power and the international trade regime preventing progressive policy action on non-communicable diseases: a realist review

“…We argue therefore that adopting the strategies to challenge THCC power described so far, as well as their ultimate effectiveness, will likely be limited under the constraints of an overarching neoliberal paradigm and system. As such, our analysis indicates that sustainably transforming existing power relations that drive health policy non-decisions will also likely require the development and adoption of a new paradigm with public interest and sustainability values and goals, supporting similar recent calls from public health academics ( Schram and Goldman, 2020 ). While hugely ambitious, the COVID-19 pandemic and broader climate crisis may offer a rare window of opportunity for public health actors to work with social, environmental, and new economics advocates and build support for such an alternative political and economic paradigm.…”

Developing a Research Agenda for the Analysis of Product Supply: A Response to the Recent Commentaries

“…Schram and Goldman 18 provide a refreshing consideration of alternative modes of production, making the point that “By underpinning market exchanges with food’s inherent value to our well-being, community life and environmental stewardship, alternative food economies are challenging neoliberalism’s conception of goods and services as ‘neutral,’ recognising value not captured in current supply, demand and price relations.” They provide starting points to consider alternative approaches to what is often implicitly accepted as the norms of production. This type of reimagining is an essential complement to fill the void that is inevitably left from critical deconstructions of dominant economic paradigms and their shortcomings.…”

The pitfalls of personalization rhetoric in time of health crisis: COVID-19 pandemic and cracks on neoliberal ideologies

“…The conceptualization of health disparities and health interventions using this narrow application of individual freedom and responsibility principles, ignores the links between free will and the structural and social conditions that shape individual action and choices ( Thomas and Buckmaster, 2010 ; Schram and Goldman, 2018 ). The social, economic and structural factors shaping individual choices, health behaviours and health outcomes are as evident in time of global pandemic events as they are in normal times.…”