Thinking Politically About UN Political Declarations: A Recipe for Healthier Commitments—Free of Commercial Interests Comment on "Competing Frames in Global Health Governance: An Analysis of Stakeholder Influence on the Political Declaration on Non-communicable Diseases"

Abstract

As evidence mounts that corporate actor engagement in United Nations (UN) policy-making processes leads to weaker and shallower public health commitments, greater attention is being paid to how to minimise undue interference and manage conflicts of interest (CoI). While we welcome efforts to develop normative guidance on managing such conflicts, we argue that there is the need to go further. In particular, we propose that an index be developed that would assess the health impacts of individual corporate actors, and those actors who fail to achieve a set benchmark would not have engagement privileges. We further propose the establishment of an independent panel of experts to advise on corporate actor engagement as well as on ambiguous and potentially health-harming commitments in text under negotiation in the UN. Recognising that the implementation of such measures will be contested, we recommend a number of practical steps to make their implementation more politically palatable.

Using Regulatory Stances to See All the Commercial Determinants of Health

“…Lencucha and Thow briefly recognize the role of “healthy commodity industries” in their response to a wide‐ranging critique of their investigation into the relationship of neoliberalism to CDoH 76,77,58 . Buse and coauthors suggest developing a formula to determine the harm caused by individual corporate actors to determine which entities should be excluded from political participation, 78 in the fashion of Article 5.3 of the Framework Convention on Tobacco Control which requires governments to protect policymaking activities from tobacco industry influence. Some CDoH scholars come close to recognizing a difference between different kinds of corporate entities or market activity, 79 but few have formalized this boundary and explained why an expansion of the CDoH to cover these other types of markets is necessary.…”

Competing Values in Global Health: Is Inclusive Governance Valued Higher Than the Right to Health? A Response to the Recent Commentaries

“…Ralston 4 points out that ‘inclusiveness’ is proving to be a misnomer because power imbalances in the consultation processes are skewing outcomes to the benefit of the powerful, and that this is de facto excluding voices of civil society and low- and middle-income countries (LMICs) while perpetuating colonialism in global health. Stronger and more coordinated patient and civil society voices and demands, as advocated by Ralston, 4 Rinaldi 2 and Buse et al, 5 are key to challenging power asymmetries in policy debates. Yet, coalition strengthening is not enough where mere opposition of positions, irrespective of the evidence base or number of advocates, results in weaker commitments, as our paper showed.…”

“…The commentaries offer promising and practical proposals to that end. To inform decisions around inclusion and exclusion of stakeholders, Buse and colleagues 5 recommend the development of an index to capture impacts on health and other negative externalities of individual corporate actors based on their products and operations. This process would be facilitated by an independent expert advisory body on public health, corporations and COI, which would also make public, evidence-based recommendations regarding language and proposals made by stakeholders during consultation and negotiation processes.…”

“…We strongly endorse such moves to more firmly anchor policy-making to independent, trustworthy and expert consideration of public health impact. We would welcome WHO’s leadership in supporting such directions, as suggested by Buse et al, 5 and encourage additional coherent support across the multilateral system, for example leveraging the ustainable Development Goal 3 Global Action Plan for Health and Well-being for All. 8 This would enable enhanced understanding and cross-application of effective strategies in governance for health and development, for example in gender, environment, and pandemic preparedness and response.…”

Examining Intersectoral Action as an Approach to Implementing Multistakeholder Collaborations to Achieve the Sustainable Development Goals

“…The UN has developed the SDG Partnership Guidebook [ 10 ] to help organizations understand the building blocks of successful partnerships, from stakeholder engagement to implementation to review and renewal. Other research has focused on public-private partnerships, surfacing best practices and critical considerations for engaging the private sector in sustainable development (see [ 11 – 14 ]). In this paper, we examine the research on intersectoral action (IA) as an approach to achieve coherence and multistakeholder partnerships.…”