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机不可失:将政治置于全球非传染性疾病政策议程的核心 评《从政治经济学角度看世卫组织“最佳采购”非传染性疾病政策采纳与实施的障碍与机遇:一项复杂性系统评价》

No Time Like the Present: Centring Politics in the Global NCD Policy Agenda Comment on "Barriers and Opportunities for WHO 'Best Buys' Non-Communicable Disease Policy Adoption and Implementation From a Political Economy Perspective: A Complexity Systematic Review".

作者信息

Elliott Lana M, Topp Stephanie M

机构信息

Centre for Justice, School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia.

College of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia.

出版信息

Int J Health Policy Manag. 2025;14:9145. doi: 10.34172/ijhpm.9145. Epub 2025 Jun 17.

Abstract

The World Health Organization's (WHO's) non-communicable disease (NCD) Best Buys provides a comprehensive package of technically sound policy advice in response to the growing global burden of NCDs. However, despite these policy mechanisms being touted as beneficial to countries' health and economic bottom lines, uptake has remained slow and globally disparate. Loffreda and colleagues' analysis draws attention to the importance of political economy forces in shaping governments' responses to NCDs and, in particular, their uptake of the NCD Best Buys. In building on this work, we examine the history and instances of contemporary application of the NCD Best Buys to consider the limitations of these technocratically framed policy recommendations. In doing so, we highlight the risks present in focusing on the technical - while negating the contextually nuanced political - dimension of policy adoption. We thus advocate for greater political engagement in policy design and implementation as well as a revitalised "double-loop" approach to NCD policy learning, where policy and system feedback is not solely used to reify policy advice but rather interrogate the assumptions underpinning such.

摘要

世界卫生组织(WHO)的非传染性疾病(NCD)最佳实践方案提供了一套全面的、技术上合理的政策建议,以应对全球日益沉重的非传染性疾病负担。然而,尽管这些政策机制被吹捧为对各国的健康和经济底线有益,但采用速度仍然缓慢,且在全球范围内存在差异。洛弗雷达及其同事的分析提请人们注意政治经济力量在塑造政府对非传染性疾病的应对措施,特别是在采用非传染性疾病最佳实践方案方面的重要性。在此基础上,我们研究了非传染性疾病最佳实践方案的历史和当代应用实例,以考虑这些技术官僚框架下的政策建议的局限性。通过这样做,我们强调了在关注政策采用的技术层面的同时,忽略其在具体情境下细微的政治层面所带来的风险。因此,我们主张在政策设计和实施中加强政治参与,并对非传染性疾病政策学习采用一种复兴的“双循环”方法,即政策和系统反馈不仅用于强化政策建议,还用于审视其背后的假设。

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