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Next Steps for Elevating Health on Trade and Investment Policy Agendas Comment on "How Neoliberalism Is Shaping the Supply of Unhealthy Commodities and What This Means for NCD Prevention".

ABSTRACT: Despite intergovernmental calls for greater policy coherence to tackle rising non-communicable diseases (NCDs), there has been a striking lack of coherence internationally and nationally between trade and health sectors. In this commentary, I explore the arguments by Lenucha and Thow in relation to barriers for greater coherence for NCDs, apply them to regional trade agreements, and point to next steps in research and advocacy for greater attention to health and NCD prevention in government trade agendas.

SUBMITTER: Townsend B

PROVIDER: S-EPMC7444437 | biostudies-literature | 2020 Jul

REPOSITORIES: biostudies-literature

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Next Steps for Elevating Health on Trade and Investment Policy Agendas Comment on "How Neoliberalism Is Shaping the Supply of Unhealthy Commodities and What This Means for NCD Prevention".

Townsend Belinda B

International journal of health policy and management 20200701 7

Despite intergovernmental calls for greater policy coherence to tackle rising non-communicable diseases (NCDs), there has been a striking lack of coherence internationally and nationally between trade and health sectors. In this commentary, I explore the arguments by Lenucha and Thow in relation to barriers for greater coherence for NCDs, apply them to regional trade agreements, and point to next steps in research and advocacy for greater attention to health and NCD prevention in government trad ...[more]

PMID: 32613803

Similar Datasets

Neoliberalism 4.0: The Rise of Illiberal Capitalism Comment on "How Neoliberalism Is Shaping the Supply of Unhealthy Commodities and What This Means for NCD Prevention".

Project description:Neoliberal logic and institutional lethargy may well explain part of the reason why governments pay little attention to how their economic and development policies negatively affect health outcomes associated with the global diffusion of unhealthy commodities. In calling attention to this the authors encourage health advocates to consider strategies other than just regulation to curb both the supply and demand for these commodities, by better understanding how neoliberal logic suffuses institutional regimes, and how it might be coopted to alternative ends. The argument is compelling as possible mid-level reform, but it omits the history of the development of neoliberalism, from its founding in liberal philosophy and ethics in the transition from feudalism to capitalism, to its hegemonic rise in global economics over the past four decades. This rise was as much due to elites (the 1% and now 0.001%) wanting to reverse the progressive compression in income and wealth distribution during the first three decades that followed World War Two. Through three phases of neoliberal policy (structural adjustment, financialization, austerity) wealth ceased trickling downwards, and spiralled upwards. Citizen discontent with stagnating or declining livelihoods became the fuel for illiberal leaders to take power in many countries, heralding a new, autocratic and nationalistic form of neoliberalism. With climate crises mounting and ecological limits rendering mid-level reform of coopting the neoliberal logic to incentivize production of healthier commodities, health advocates need to consider more profound idea of how to tame or erode (increasingly predatory) capitalism itself.

| S-EPMC7182151 | biostudies-literature

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".

Project description: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.

| S-EPMC7093042 | biostudies-literature

A Systems Thinking Approach to Inform Coherent Policy Action for NCD Prevention Comment on "How Neoliberalism Is Shaping the Supply of Unhealthy Commodities and What This Means for NCD Prevention".

Project description:Lencucha and Thow tackle the enormous public health challenge of developing non-communicable disease (NCD) policy coherence within a world structured and ruled by neoliberalism. Their work compliments scholarship on other causal mechanisms, including the commercial determinants of health, that have contributed to creating the risk commodity environment and barriers to NCD prevention policy coherence. However, there remain significant gaps in the understanding of how these causal mechanisms interact within a whole system. As such, public health researchers' suggestions for how to effectively prevent NCDs through addressing the risk commodity environment tend to remain fragmented, incomplete and piecemeal. We suggest this is, in part, because conventional policy analysis methods tend to be reductionist, considering causal mechanisms in relative isolation and conceptualizing them as linear chains of cause and effect. This commentary discusses how a systems thinking approach offers methods that could help with better understanding the risk commodity environment problem, identifying a more comprehensive set of effective solutions across sectors and its utility more broadly for gaining insight into how to ensure recommended solutions are translated into policy, including though transformation at the paradigmatic level.

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Towards Critical Analysis of the Political Determinants of Health Comment on "How Neoliberalism Is Shaping the Supply of Unhealthy Commodities and What This Means for NCD Prevention".

Project description:The recent perspective article "How Neoliberalism Is Shaping the Supply of Unhealthy Commodities and What This Means for NCD Prevention," by Lencucha and Throw, interrogates how the dominant neoliberal paradigm restricts meaningful policy action to prevent non-communicable diseases (NCDs). It contributes an NCD perspective to the existing literature on neoliberalism and health, which to date has been dominated by a focus on HIV, gender and trade agreements. It further advances the emerging commercial determinants of health (CDoH) scholarship by calling for more nuanced analysis of how the governance of both health and the economy facilitates corporate influence in policy-making. In political science terms, Lencucha and Throw are calling for greater structural analysis. However, their focus on the pragmatic, as opposed to political, aspects of neoliberalism reflects a hesitancy within health scholarship to engage in political analysis. This depoliticization of health serves neoliberal interests by delegitimizing critical questions about who sustains and benefits from current institutional norms. Lencucha and Throw's call for greater interrogation of the structures of neoliberalism forms a basis from which to advance analysis of the political determinants of health.

| S-EPMC7093045 | biostudies-literature

Understanding Structure and Agency as Commercial Determinants of Health Comment on "How Neoliberalism Is Shaping the Supply of Unhealthy Commodities and What This Means for NCD Prevention".

Project description:The limited success to date, by the public health community, to address the dramatic rise in non-communicable diseases (NCDs) has prompted growing attention to the commercial determinants of health. This has led to a much needed shift in attention, from metabolic and behavioural risk factors, to the production and consumption of health-harming products by the commercial sector. Building on Lencucha and Thow's analysis of neoliberalism, in shaping the underlying policy environment favouring commercial interests, we argue for fuller engagement with structure and agency interaction when conceptualising, assessing, and identifying public health measures to address the commercial determinants of health.

| S-EPMC7444439 | biostudies-literature

On the Perils of Universal and Product-Led Thinking Comment on "How Neoliberalism Is Shaping the Supply of Unhealthy Commodities and What This Means for NCD Prevention".

Project description:Lencucha and Thow's paper offers an important addition and corrective to the burgeoning body of work in public health on the 'commercial determinants of health' in the context of non-communicable diseases (NCDs). Rather than tracing the origins of incoherence across policy sectors to the nefarious actions of industry, they argue that we need to be better attuned to the neoliberal ideologies that underpin these policies. In this commentary I explore two aspects of their argument that I find to be problematic: First, the suggestion that neoliberalism itself has some kind of deterministic or explanatory capacity across vastly different social, spatial, economic and political contexts. Second, I explore their concept of 'product-based NCD risk,' a perspective that disembodies and detaches risk from the social and structural conditions of their making.

| S-EPMC7306111 | biostudies-literature

Neo-Liberalism, Policy Incoherence and Discourse Coalitions Influencing Non-Communicable Disease Strategy Comment on "How Neoliberalism Is Shaping the Supply of Unhealthy Commodities and What This Means for NCD Prevention".

Project description:Lencucha and Thow have highlighted the way in which neo-liberalism is enshrined within institutional mechanisms and conditions the policy environment to shape public policy on non-communicable diseases (NCDs). They critique the strong (but important) focus of public health policy research on corporate interests and influence over NCD policy, and point toward neo-liberal policy paradigms shaping the relationship between the state, market and society as an area for critique and further exploration. They also importantly underline the way in which the neo-liberal policy paradigm shapes the supply of unhealthy goods and argue that health advocates have not engaged enough with supply side issues in critiques of policy debates on NCDs. This is an important consideration especially in the Asia-Pacific where trade and agricultural policies have markedly shaped production and what is being produced within countries. In this commentary, I reflect upon how neoliberalism shapes intersectoral action across trade, development and health within and across institutions. I also consider scope for international civil society to engage in advocacy on NCDs, especially where elusive 'discourse coalitions' influenced by neoliberalism may exist, rather than coordinated 'advocacy coalitions.'

| S-EPMC7093044 | biostudies-literature

The investment case as a mechanism for addressing the NCD burden: Evaluating the NCD institutional context in Jamaica, and the return on investment of select interventions.

Project description:Noncommunicable diseases (NCDs) are a broad challenge for decision-makers. NCDs account for seven out of every 10 deaths globally, with 42 percent occurring prematurely in individuals under age 70. Despite their heavy toll, NCDs are underfunded, with only around two percent of global funding dedicated to the disease set. Country governments are responsible for funding targeted actions to reduce the NCD burden, but among other priorities, many have yet to invest in the health-system interventions and policy measures that can reduce the burden. This article examines "investment cases" as a potential mechanism for catalyzing attention to-and funding for-NCDs. In Jamaica, using the UN inter-agency OneHealth Tool, we conducted an economic analysis to estimate the return-on-investment from scaling up strategic clinical interventions, and from implementing or intensifying policy measures that target NCD risk factors. In addition, we conducted an institutional and context (ICA) analysis, interviewing stakeholders across sectors to take stock of promising policy pathways (e.g., areas of general consensus, political appetite and opportunity) as well as challenges to implementation. The economic analysis found that scaling up clinical interventions that target CVD, diabetes, and mental health disorders, and policy measures that target tobacco and alcohol use, would save over 6,600 lives between 2017-2032, and avert JMD 81.3 billion (USD 640 million) in direct and indirect economic costs that result from mortality and morbidity linked to NCDs. The ICA uncovered government economic growth targets and social priorities that would be aided by increased attention to NCDs, and it linked these targets and priorities to the economic analysis.

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Controlling the Resit Effect by Means of Investment Depreciation.

Project description:In accordance with a rational model of study-time investment, we previously found that the prospect of a resit exam leads to lower investments of fictional study-time for a first exam opportunity in an investment game utilizing simulated exams. In the current study, we investigated whether the depreciation of one's first-exam investment reduces the resit effect. Specifically, we investigated study-time investments for a simulated multiple-choice exam in which 0, 50, or 100% of the initial study-time investment was lost before the resit exam. In accordance with our predictions, we found that the magnitude of the resit effect decreased as investment depreciation increased. This finding suggests that the negative effect of resit exams on study-time investment may be countered by creating conditions under which investment depreciation (i.e. forgetting) is expected to occur, for instance, by increasing the temporal interval between the first attempt and resit exam.

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Parent-offspring conflict and the genetic trade-offs shaping parental investment.

Project description:The genetic conflict between parents and their offspring is a cornerstone of kin selection theory and the gene-centred view of evolution, but whether it actually occurs in natural systems remains an open question. Conflict operates only if parenting is driven by genetic trade-offs between offspring performance and the parent's ability to raise additional offspring, and its expression critically depends on the shape of these trade-offs. Here we investigate the occurrence and nature of genetic conflict in an insect with maternal care, the earwig Forficula auricularia. Specifically, we test for a direct response to experimental selection on female future reproduction and correlated responses in current offspring survival, developmental rate and growth. The results demonstrate genetic trade-offs that differ in shape before and after hatching. Our study not only provides direct evidence for parent-offspring conflict but also highlights that conflict is not inevitable and critically depends on the genetic trade-offs shaping parental investment.

| S-EPMC4410627 | biostudies-other

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