Department of International Health, Johns Hopkins School of Public Health, Baltimore, MD, USA.
Institute for Global Health, University College London, London, UK.
Int J Health Policy Manag. 2023;12:7734. doi: 10.34172/ijhpm.2022.7734. Epub 2023 Jan 4.
Medical professionals exercised structural and productive power in the Global Fund's Country Coordinating Mechanism (CCM) in Nigeria, directly impacting the selection of approaches to HIV/AIDS care, as described in a case study by Lassa and colleagues. This research contributes to a robust scholarship on how biomedical power inhibits a holistic understanding of health and prevents the adoption of solutions that are socially grounded, multi-disciplinary, and co-created with communities. We highlight Lassa and colleagues' findings demonstrating the 'long arm' of global health institutions in country-level health policy choices, and reflect on how medical dominance within global institutions serves as a tool of control in ways that pervert incentives and undermine equity and effectiveness. We call for increased research and advocacy to surface these conduits of power and begin to loosen their hold in the global health policy agenda.
医学专业人员在全球基金国家协调机制（CCM）中行使结构和生产权力，直接影响到艾滋病毒/艾滋病护理方法的选择，正如 Lassa 及其同事的案例研究所述。这项研究有助于丰富关于生物医学权力如何阻碍对健康的全面理解并阻止采用基于社会、多学科和与社区共同创造的解决方案的学术研究。我们强调了 Lassa 及其同事的发现，这些发现表明全球卫生机构的“长臂”在国家一级的卫生政策选择中发挥了作用，并反思了全球机构内部的医学主导地位如何成为一种控制工具，扭曲激励机制，破坏公平性和有效性。我们呼吁增加研究和宣传，揭示这些权力渠道，并开始在全球卫生政策议程中削弱它们的影响力。
