University of Leeds, Leeds, UK.
School of Politics and International Studies (POLIS), University of Leeds, Leeds, UK.
Int J Health Policy Manag. 2023;12:7806. doi: 10.34172/ijhpm.2023.7806. Epub 2023 May 10.
This article agrees with Lassa et al that biomedical paradigms and medical professionals are a dominating force within the policy dynamics of the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) and that there needs to be greater community involvement in how global health initiatives (GHIs) are adopted, designed, implemented and evaluated. However, we argue that many of the conditions identified are entrenched and perpetuated by how GHIs are financed and the financing modalities employed in Development Aid for Health (DAH), particularly in low resource settings. As a result, the dynamics of power not only flow from traditionally entrenched epistemic authorities but are disproportionally sustained by global health financing modalities that favour particular GHIs over others. As we argue, these DAH modalities can exert forms of power with problematic effects on policy-making.
本文同意 Lassa 等人的观点，即生物医学范式和医学专业人员是全球抗击艾滋病、结核病和疟疾基金（全球基金）政策动态中的主导力量，需要在全球卫生倡议（GHIs）的采用、设计、实施和评估方面加强社区参与。然而，我们认为，许多既定条件是由 GHIs 的融资方式以及卫生发展援助（DAH）中采用的融资模式所造成的，特别是在资源匮乏的环境中。因此，权力的动态不仅源于传统的固有知识权威，而且还受到有利于特定 GHIs 而不是其他 GHIs 的全球卫生融资模式的不成比例的维持。正如我们所主张的，这些 DAH 模式可以发挥出对决策产生不良影响的权力形式。
