School of Health & Social Care, University of Essex, Colchester, UK.
Int J Health Policy Manag. 2023;12:8019. doi: 10.34172/ijhpm.2023.8019. Epub 2023 Jul 3.
Lassa and colleagues' study is a strong commentary on the biomedical hegemony and professional monopoly of medical doctors in the policy landscape of the Global Fund in Nigeria. Situating this critical dimension of professional power within wider scholarship of power and governance of global health initiatives (such as the Global Fund), in this comment, I put forth two core arguments. I call for a relational perspective of power in a dynamic policy space that the Fund characterises. I argue that a systems-view analysis of power requires a thorough examination of subsystems, how they interact, and the diverse forms of power-individual agentic, ideational, and structural-and the mechanisms through which power is wielded. The lens of governmentality allows linking individual (expertise and practices) with institutional regimes and social practices these enable; and in examining the interface of local/ sub-national, national, and global within which policy formulation and implementation occurs.
拉萨和同事的研究强烈批判了全球基金在尼日利亚的政策格局中，医学专业人员在生物医学霸权和专业垄断方面的主导地位。在本评论中，我将专业权力的这一关键维度置于更广泛的权力和全球卫生倡议（如全球基金）治理学术研究中，提出了两个核心论点。我呼吁在该基金所描绘的动态政策空间中采用权力的关系视角。我认为，权力的系统观分析需要彻底检查子系统、它们的相互作用方式以及权力的各种形式——个人的能动性、观念性和结构性——以及权力行使的机制。治理学的视角允许将个人（专业知识和实践）与制度机制和社会实践联系起来，这些机制和实践使权力得以施展；并在研究地方/次国家、国家和全球之间的接口，政策制定和实施都发生在这一接口中。
