3,362 research outputs found
Analysing Leadership in Global Health Governance
Rhetoric around the need for more and better leadership is everywhere in contemporary global health governance, yet there has been little articulation of what type of leadership is required, who might play leadership roles, and in what fora leadership might be exercised. Global health governance has widely been seen as a policy space characterised by a multiplicity of (often competing) actors with no overall authority. Yet despite this things do âget doneâ, and in some cases there are impressive levels of collective action to address particular health problems. We argue that leadership provides an important lens for understanding how things do (or do not) get done in global health governance. Drawing on the existing literatures on global health governance and leadership and agency in international relations, we set out in this paper a framework for analysing leadership in global health governance. Crucially, we argue, such a framework must be specific enough to be operationalisable in terms of a program of research and at the same time broad enough to capture a wide variety of different sources, sites and forms of leadership â including the roles played by âhidden leadersâ who are seldom acknowledged in mainstream analyses of global health politics
Recommended from our members
The (Mis)appropriation of HIV/AIDS advocacy strategies in Global Mental Health: towards a more nuanced approach
Background: Mental health is increasingly finding a place on global health and international development agendas. Advocates for Global Mental Health (GMH), and international organizations such as the World Health Organization (WHO) and the World Bank, argue that treatments available in high-income countries should also be made available in low- and middle-income countries. Such arguments are often made by comparing mental health to infectious diseases, including the relative disease and economic burdens they impose, and pointing to the applicability of the right to access treatment for mental health, not only infectious diseases. HIV/AIDS advocacy in particular has been held up by GMH advocates as offering an appropriate strategy for generating global commitment.
Discussion: There is a need to assess how health issues are framed not only in relation to social goods outside of health (such as human rights, security or development), but also in relation to other health or disease models, and how health policy and practice is shaped as a result. The article debates the merits and consequences of likening mental health to HIV/AIDS, and identifies four major problems with the model for GMH advocacy being developed through these analogies: 1. An inappropriately universalizing global approach to context-specific problems; 2. A conception of human rights that focuses on the right to access treatment at the expense of the right to refuse it; 3. A tendency to treat poverty as a psychiatric issue, rather than recognizing that mental distress can be the result of poverty and other forms of inequality; 4. The prioritization of destigmatization of disease over social justice models.
Conclusion: There are significant problems with the wholesale adoption of an (often simplified) version of HIV/AIDS advocacy as a model for GMH. Yet critical engagement with the important and nuanced differences between HIV/AIDS and mental health may nevertheless point to some possibilities for productive engagement and cross-fertilisation between advocates, activists and scholars in both fields
Anti-microbial Use in Animals: How to Assess the Trade-offs
Antimicrobials are widely used in preventive and curative medicine in animals. Benefits from curative use are clear â it allows sick animals to be healthy with a gain in human welfare. The case for preventive use of antimicrobials is less clear cut with debates on the value of antimicrobials as growth promoters in the intensive livestock industries. The possible benefits from the use of antimicrobials need to be balanced against their cost and the increased risk of emergence of resistance due to their use in animals. The study examines the importance of animals in society and how the role and management of animals is changing including the use of antimicrobials. It proposes an economic framework to assess the trade-offs of anti-microbial use and examines the current level of data collection and analysis of these trade-offs. An exploratory review identifies a number of weaknesses. Rarely are we consistent in the frameworks applied to the economic assessment anti-microbial use in animals, which may well be due to gaps in data or the prejudices of the analysts. There is a need for more careful data collection that would allow information on (i) which species and production systems antimicrobials are used in, (ii) what active substance of antimicrobials and the application method and (iii) what dosage rates. The species need to include companion animals as well as the farmed animals as it is still not known how important direct versus indirect spread of resistance to humans is. In addition, research is needed on pricing antimicrobials used in animals to ensure that prices reflect production and marketing costs, the fixed costs of anti-microbial development and the externalities of resistance emergence. Overall, much work is needed to provide greater guidance to policy, and such work should be informed by rigorous data collection and analysis systems
The politics of researching global health politics. A comment on Jeremy Shiffmanâs âKnowledge, moral claims and the exercise of power in global health'
In this comment, I build on Shiffmanâs call for the global health community to more deeply investigate structural and productive power. I highlight two challenges we must grapple with as social scientists carrying out the types of investigation that Shiffman proposes: the politics of challenging the powerful; and the need to investigate types of expertise that have traditionally been thought of as âoutsideâ global health. In doing so, I argue that moving forward with the agenda Shiffman sets out requires social scientists interested in the global politics of health to be reflexive about our own exercise of structural and productive power and the fact that researching global health politics is itself a political undertaking
Estimating the burden of occupational cancer: assessing bias and uncertainty.
BACKGROUND AND OBJECTIVES: We aimed to estimate credibility intervals for the British occupational cancer burden to account for bias uncertainty, using a method adapted from Greenland's Monte Carlo sensitivity analysis. METHODS: The attributable fraction (AF) methodology used for our cancer burden estimates requires risk estimates and population proportions exposed for each agent/cancer pair. Sources of bias operating on AF estimator components include non-portability of risk estimates, inadequate models, inaccurate data including unknown cancer latency and employment turnover and compromises in using the available estimators. Each source of bias operates on a component of the AF estimator. Independent prior distributions were estimated for each bias, or graphical sensitivity analysis was used to identify plausible distribution ranges for the component variables, with AF recalculated following Monte Carlo repeated sampling from these distributions. The methods are illustrated using the example of lung cancer due to occupational exposure to respirable crystalline silica in men. RESULTS: Results are presented graphically for a hierarchy of biases contributing to an overall credibility interval for lung cancer and respirable crystalline silica exposure. An overall credibility interval of 2.0% to 16.2% was estimated for an AF of 3.9% in men. Choice of relative risk and employment turnover were shown to contribute most to overall estimate uncertainty. Bias from using an incorrect estimator makes a much lower contribution. CONCLUSIONS: The method illustrates the use of credibility intervals to indicate relative contributions of important sources of uncertainty and identifies important data gaps; results depend greatly on the priors chosen
Hanging In, Stepping up and Stepping Out: Livelihood Aspirations and Strategies of the Poor Development in Practice
In recent years understanding of poverty and of ways in which people escape from or fall into poverty has become more holistic. This should improve the capabilities of policy analysts and others working to reduce poverty, but it also makes analysis more complex. This paper describes a simple schema which integrates multidimensional, multilevel and dynamic understandings of poverty, of poor peopleâs livelihoods, and of changing roles of agricultural systems. The paper suggests three broad types of strategy pursued by poor people: âhanging inâ; âstepping upâ; and âstepping outâ. This simple schema explicitly recognises the dynamic aspirations of poor people; diversity among them; and livelihood diversification. It also brings together aspirations of poor people with wider sectoral, inter-sectoral and macro-economic questions about policies necessary for realisation of those aspirations
- âŠ