Leslie Dan Faculty of Pharmacy, University of Toronto, 144 College Street, Toronto, Ontario, Canada.
BMC Int Health Hum Rights. 2010 Jan 4;10:1. doi: 10.1186/1472-698X-10-1.
In September 2003, the Canadian government committed to developing legislation that would facilitate greater access to affordable medicines for developing countries. Over the course of eight months, the legislation, now known as Canada's Access to Medicines Regime (CAMR), went through a controversial policy development process and the newspaper media was one of the major venues in which the policy debates took place. The purpose of this study was to examine how the media framed CAMR to determine how policy goals were conceptualized, which stakeholder interests controlled the public debate and how these variables related to the public policy process.
We conducted a qualitative content analysis of newspaper coverage of the CAMR policy and implementation process from 2003-2008. The primary theoretical framework for this study was framing theory. A total of 90 articles from 11 Canadian newspapers were selected for inclusion in our analysis. A team of four researchers coded the articles for themes relating to access to medicines and which stakeholders' voice figured more prominently on each issue. Stakeholders examined included: the research-based industry, the generic industry, civil society, the Canadian government, and developing country representatives.
The most frequently mentioned themes across all documents were the issues of drug affordability, intellectual property, trade agreements and obligations, and development. Issues such as human rights, pharmaceutical innovation, and economic competitiveness got little media representation. Civil society dominated the media contents, followed far behind by the Canadian government, the research-based and generic pharmaceutical industries. Developing country representatives were hardly represented in the media.
Media framing obscured the discussion of some of the underlying policy goals in this case and failed to highlight issues which are now significant barriers to the use of the legislation. Using the media to engage the public in more in-depth exploration of the policy issues at stake may contribute to a more informed policy development process. The media can be an effective channel for those stakeholders with a weaker voice in policy deliberations to raise public attention to particular issues; however, the political and institutional context must be taken into account as it may outweigh media framing effects.
2003 年 9 月，加拿大政府承诺制定立法，为发展中国家提供更多负担得起的药品。在八个月的时间里，这项现已被称为加拿大药品准入制度（CAMR）的立法经历了一个有争议的政策制定过程，而报纸媒体是政策辩论的主要场所之一。本研究的目的是考察媒体如何构建 CAMR，以确定政策目标是如何被概念化的，哪些利益相关者的利益控制了公共辩论，以及这些变量与公共政策过程的关系。
我们对 2003 年至 2008 年期间有关 CAMR 政策和实施过程的报纸报道进行了定性内容分析。本研究的主要理论框架是框架理论。从 11 家加拿大报纸中选择了 90 篇文章进行分析。一个由四名研究人员组成的团队对这些文章进行了编码，以确定与药品获取有关的主题，以及哪些利益相关者的声音在每个问题上更为突出。审查的利益相关者包括：研究型产业、仿制药产业、民间社会、加拿大政府和发展中国家代表。
在所有文件中最常提到的主题是药品可负担性、知识产权、贸易协定和义务以及发展问题。人权、药品创新和经济竞争力等问题在媒体上的报道很少。民间社会在媒体内容中占据主导地位，其次是加拿大政府、研究型和仿制药产业。发展中国家代表在媒体上几乎没有代表。
媒体框架掩盖了对该立法的一些潜在政策目标的讨论，未能突出目前对该立法使用的重要障碍问题。利用媒体让公众更深入地探讨所涉政策问题，可能有助于更明智地制定政策。媒体可以成为政策审议中发言权较弱的利益相关者引起公众关注特定问题的有效渠道；然而，必须考虑到政治和制度背景，因为它可能会超过媒体框架的影响。
