Southgate Institute for Health, Society and Equity, Flinders University, SA, Australia.
Int J Health Policy Manag. 2020 Mar 1;9(3):116-118. doi: 10.15171/ijhpm.2019.95.
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.'
伦丘卡和索指出,新自由主义如何被奉为机构机制的核心,并塑造了非传染性疾病(NCDs)的政策环境。他们批评公共卫生政策研究过于关注企业利益对 NCD 政策的影响,并指出新自由主义政策范式正在塑造国家、市场和社会之间的关系,这是一个值得批评和进一步探索的领域。他们还强调了新自由主义政策范式如何塑造不健康商品的供应,并认为健康倡导者在批评 NCD 政策辩论时,没有充分参与供应方问题。这是一个重要的考虑因素,特别是在亚太地区,贸易和农业政策明显塑造了各国内部和之间的生产和产品种类。在这篇评论中,我反思了新自由主义如何在贸易、发展和卫生等部门之间以及机构内部塑造跨部门行动。我还考虑了国际民间社会在 NCD 问题上进行倡导的范围,特别是在受到新自由主义影响的难以捉摸的“话语联盟”存在的情况下,而不是协调一致的“倡导联盟”。