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Journal Article•DOI•

Sitting on the FENSA: WHO engagement with industry.

Kent Buse1, Sarah Hawkes2•
Joint United Nations Programme on HIV/AIDS1, University College London2
30 Jul 2016-The Lancet (Elsevier)-Vol. 388, Iss: 10043, pp 446-447
TL;DR: When decisions are made that will impact on people’s health, who should be represented at the policy-making table?
About: This article is published in The Lancet.The article was published on 2016-07-30 and is currently open access. It has received 28 citations till now. The article focuses on the topics: Sitting.
Citations
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Journal Article•DOI•
Big food and the World Health Organization: a qualitative study of industry attempts to influence global-level non-communicable disease policy

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Kathrin Lauber1, Harry Rutter1, Anna Gilmore1•
University of Bath1
01 Jun 2021-BMJ Global Health
TL;DR: In this article, a combination of inductive and deductive thematic coding of internal industry documents, academic literature and interviews with key informants from international organisations and global civil society was used to identify action-based strategies ultra-processed food industry actors employ to influence global-level policy.
Abstract: Introduction There is an urgent need for effective action to address the over 10 million annual deaths attributable to unhealthy diets. Food industry interference with policies aimed at reducing non-communicable diseases (NCDs) is widely documented at the national level but remains under-researched at the global level. Thus, this study explores how ultra-processed food industry actors have attempted to influence NCD policy at WHO. Methods A combination of inductive and deductive thematic coding of internal industry documents, academic literature and interviews with key informants from international organisations and global civil society was used to identify action-based strategies ultra-processed food industry actors employ to influence global-level policy. Results Ultra-processed food industry actors have attempted to influence WHO and its policies through three main action-based strategies: coalition management, involvement in policy formulation, and information management. Coalition management includes the creation and use of overt alliances between corporations—business associations—and more covert science-focused and policy-focused intermediaries, the hiring of former WHO staff and attempted co-option of civil society organisations. Industry involvement in policy formulation is operationalised largely through the lobbying of Member States to support industry positions, and business associations gaining access to WHO through formal consultations and hearings. Information management involves funding and disseminating research favourable to commercial interests, and challenging unfavourable evidence. Conclusion We provide novel insights into how ultra-processed food industry actors shape global-level NCD policy and identify a clear need to guard against commercial interference to advance NCD policy. In their approach, the political behaviour of multinational food corporations bears similarities to that of the tobacco industry. Increased awareness of, and safeguarding against, commercial interference at the national as well as the global level have the potential to strengthen the crucial work of WHO.

20 citations

Journal Article•DOI•
Occupational health: a world of false promises.

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Joseph LaDou1, Leslie London2, Andrew Watterson3•
University of California, San Francisco1, University of Cape Town2, University of Stirling3
21 Nov 2018-Environmental Health
TL;DR: It is found that United Nations agencies, WHO and the International Labor Organization (ILO), are faced with the global problem of inadequate worker protections and a growing crisis in occupational health.
Abstract: The response of the World Health Organization (WHO) to the Ebola outbreak in West Africa in 2015 demonstrated that the global health system is unprepared to address what should be its primary mission, control of disease epidemics while protecting health workers. Critics blamed WHO politics and its rigid culture for the poor response to the epidemic. We find that United Nations agencies, WHO and the International Labor Organization (ILO), are faced with the global problem of inadequate worker protections and a growing crisis in occupational health. The WHO and ILO are given monumental tasks but only trivial budgets, and funding trends show UN agency dependence on private donations which are far larger than funds contributed by member states. The WHO and ILO have limited capacity to make the necessary changes occupational health and safety demand. The UN could strengthen the national and global civil society voice in WHO and ILO structures, and by keeping conflict of interest out of policy decisions, ensure greater freedom to operate without interference.

17 citations

Dissertation•
Intersectoral Action for Health: Challenges, Opportunities, and Future Directions in the WHO European Region

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Juha Mikkonen
07 May 2018
TL;DR: This dissertation increases understanding of the political, technical, institutional, and managerial barriers to intersectoral action for health and presents a systematic analysis of the factors that can facilitate inter sectoral actionFor health and considers the future of inter Sectoral approaches in health promotion.
Abstract: Human health is shaped by public policy decisions made not only by the health sector, but numerous other sectors and actors that influence people’s social, economic, and cultural conditions. Therefore, national health ministries cannot solve the root causes of many health problems without also engaging non-health sectors to implement healthpromoting public policies. For over three decades, the World Health Organization (WHO) has actively endorsed the concept of “intersectoral action for health” as a key approach to address the most pressing health challenges at the national and international levels. At the international level, the need to engage non-health sectors in health promotion activities has been repeated in nine outcome documents of the global health promotion conferences organized by WHO between 1986 and 2016. However, calls to promote health through greater intersectoral action have not led to wide-scale and systematic implementation by national governments and jurisdictions. The challenges and opportunities to intersectoral action for health are rarely identified in a systematic way in the existing research literature. To address the current gap in knowledge, this dissertation was based on three key research questions: (1) How do the expert informants within the WHO Regional Office for Europe understand the concepts of “intersectoral action for health” and “governance for health?”, (2) What do the academic literature and key informants identify as the challenges and barriers to intersectoral action for health?, and (3) Which factors facilitate the implementation of the intersectoral action for health and what are the opportunities to promote health through such action in the future? The methods of this study included an in-depth review of literature and primary data collection that involved 28 semi-structured interviews with WHO Programme Managers, Unit Leaders, Directors, and Technical Officers working at the WHO Regional Office for Europe in Copenhagen. A thematic analysis of the key informant interviews focused on the challenges and opportunities to intersectoral action for health. The aim of this analysis is to shed light on the factors that are relevant to the policy process and dynamics of intersectoral policymaking. The findings of this study draw on the perspectives that the informants had gained by working with many of the 53 countries that comprise the WHO European region. The analysis involved a computer-assisted coding process with NVivo software and led to ten thematic challenges/barriers and to ten thematic opportunities/facilitators. Overall, this dissertation increases understanding of the political, technical, institutional, and managerial barriers to intersectoral action for health. In addition, it presents a systematic analysis of the factors that can facilitate intersectoral action for health and considers the future of intersectoral approaches in health promotion. Based on the empirical findings, the concluding section includes eighteen recommendations for strategies to overcome the challenges and barriers to the implementation of intersectoral

15 citations

Journal Article•DOI•
Loyal at once? The EU’s global health awakening in the Covid-19 pandemic

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Louise van Schaik, Knud Erik Jørgensen, Remco van de Pas1, Remco van de Pas2•
Institute of Tropical Medicine Antwerp1, Maastricht University2
29 Dec 2020-Journal of European Integration
TL;DR: The Covid-19 pandemic marked a shift in the EU's approach to the multilateral system as mentioned in this paper, at a time when the EU aspires to avoid being crushed between the US and China, the World Health Organizatio...
Abstract: The Covid-19 pandemic marks a shift in the EU’s approach to the multilateral system. Just at a time when the EU aspires to avoid being crushed between the US and China, the World Health Organizatio...

13 citations

Journal Article•DOI•
Global Health in the Anthropocene: Moving Beyond Resilience and Capitalism Comment on "Health Promotion in an Age of Normative Equity and Rampant Inequality"

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Remco van de Pas1•
Institute of Tropical Medicine Antwerp1
24 Dec 2016-International journal of health policy and management
TL;DR: In this paper, a dual track approach is suggested to transform capitalism into something better for global health while in parallel there is an urgent need to imagine a future and pathways to a different world order rooted in the principles of social justice, protecting the commons and a central role for the preservation of ecology.
Abstract: There has been much reflection on the need for a new understanding of global health and the urgency of a paradigm shift to address global health issues. A crucial question is whether this is still possible in current modes of global governance based on capitalist values. Four reflections are provided. (1) Ecological -centered values must become central in any future global health framework. (2) The objectives of 'sustainability' and 'economic growth' present a profound contradiction. (3) The resilience discourse maintains a gridlock in the functioning of the global health system. (4) The legitimacy of multi-stakeholder governance arrangements in global health requires urgent attention. A dual track approach is suggested. It must be aimed to transform capitalism into something better for global health while in parallel there is an urgent need to imagine a future and pathways to a different world order rooted in the principles of social justice, protecting the commons and a central role for the preservation of ecology.

10 citations

References
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Journal Article•DOI•
Priority actions for the non-communicable disease crisis

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Robert Beaglehole1, Ruth Bonita1, Richard Horton, Cary Adams2, George Alleyne3, Perviz Asaria4, Vanessa Baugh5, Henk Bekedam, Nils Billo6, Sally Casswell7, Michele Cecchini8, Ruth Colagiuri9, Stephen Colagiuri9, Téa E Collins, Shah Ebrahim, Michael M. Engelgau10, Gauden Galea, Thomas A. Gaziano11, Robert Geneau12, Andy Haines13, James Hospedales3, Prabhat Jha, Ann Keeling9, Stephen R. Leeder14, Paul Lincoln15, Martin McKee13, Judith Mackay, Roger Magnusson14, Rob Moodie16, Modi Mwatsama15, Sania Nishtar, Bo Norrving, David Patterson, Peter Piot13, Johanna Ralston17, Manju Rani, K. Srinath Reddy18, Franco Sassi8, Nick Sheron19, David Stuckler20, Il Suh21, Julie Torode2, Cherian Varghese, Judith Watt •
University of Auckland1, Union for International Cancer Control2, Pan American Health Organization3, Imperial College London4, Commonwealth Secretariat5, International Union Against Tuberculosis and Lung Disease6, Massey University7, Organisation for Economic Co-operation and Development8, International Diabetes Federation9, World Bank10, Brigham and Women's Hospital11, University of Ottawa12, University of London13, University of Sydney14, National Heart Forum15, University of Melbourne16, World Heart Federation17, Public Health Foundation of India18, University of Southampton19, Harvard University20, Yonsei University21
13 Aug 2011-The Lancet
TL;DR: The Lancet NCD Action Group and the NCD Alliance propose five overarching priority actions for the response to the crisis and the delivery of five priority interventions--tobacco control, salt reduction, improved diets and physical activity, reduction in hazardous alcohol intake, and essential drugs and technologies.

1,418 citations

Journal Article•DOI•
Big Food, Food Systems, and Global Health

[...]

David Stuckler1, Marion Nestle2, Marion Nestle3•
University of Cambridge1, New York University2, Cornell University3
19 Jun 2012-PLOS Medicine
TL;DR: Guest editors David Stuckler and Marion Nestle lay out why more examination of the food industry is necessary, and offer three competing views on how public health professionals might engage with Big Food.
Abstract: In an article that forms part of the PLoS Medicine series on Big Food, guest editors David Stuckler and Marion Nestle lay out why more examination of the food industry is necessary, and offer three competing views on how public health professionals might engage with Big Food.

423 citations

Posted Content•
Democracy in Global Governance: The Promises and Pitfalls of Transnational Actors

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Magdalena Bexell1, Jonas Tallberg2, Anders Uhlin1•
Lund University1, Stockholm University2
01 Jan 2010-Social Science Research Network
TL;DR: In this paper, the authors assess the promises and pitfalls of transnational actors' role in global governance and explore how the structuring and operation of international institutions, public-private partnerships, and transnational agents themselves may facilitate expanded participation and enhanced accountability.
Abstract: The participation of transnational actors in global policy-making is increasingly seen as a means to democratize global governance. Drawing on alternative theories of democracy and existing empirical evidence, we assess the promises and pitfalls of this vision. We explore how the structuring and operation of international institutions, public-private partnerships, and transnational actors themselves may facilitate expanded participation and enhanced accountability in global governance. We find considerable support for an optimistic verdict on the democratizing potential of transnational actor involvement, but also identify hurdles in democratic theory and the practice of global governance that motivate a more cautious outlook. In conclusion, we call for research that explores the conditions for democracy in global governance through a combination of normative political theory and positive empirical research.

153 citations

Journal Article•DOI•
Democracy in Global Governance: The Promises and Pitfalls of Transnational Actors

[...]

Magdalena Bexell, Jonas Tallberg, Anders Uhlin
19 Dec 2010-Global Governance
TL;DR: In this article, the authors assess the promises and pitfalls of transnational actors' participation in global policymaking and assess the conditions for democracy in global governance through a combination of normative political theory and positive empirical research, finding considerable support for an optimistic verdict on the democratizing potential of trans-national actor involvement, but also identifying hurdles in democratic theory and the practice of global governance that motivate a more cautious outlook.
Abstract: The participation of transnational actors in global policymaking is increasingly seen as a means to democratize global governance. Drawing on alternative theories of democracy and existing empirical evidence, we assess the promises and pitfalls of this vision. We explore how the structuring and operation of international institutions, public-private partnerships, and transnational actors themselves may facilitate expanded participation and enhanced accountability in global governance. We find considerable support for an optimistic verdict on the democratizing potential of transnational actor involvement, but also identify hurdles in democratic theory and the practice of global governance that motivate a more cautious outlook. In conclusion, we call for research that explores the conditions for democracy in global governance through a combination of normative political theory and positive empirical research.

129 citations

Journal Article•DOI•
Global Health Philanthropy and Institutional Relationships: How Should Conflicts of Interest Be Addressed?

[...]

David Stuckler1, Sanjay Basu2, Sanjay Basu3, Martin McKee4•
Harvard University1, University of California, San Francisco2, San Francisco General Hospital3, University of London4
12 Apr 2011-PLOS Medicine
TL;DR: Five large private global health foundations are examined and the scope of relationships between these tax-exempt foundations and for-profit corporations including major food and pharmaceutical companies are reported on.
Abstract: David Stuckler and colleagues examine five large private global health foundations and report on the scope of relationships between these tax-exempt foundations and for-profit corporations including major food and pharmaceutical companies.

108 citations

Related Papers (2)
The political origins of health inequity: prospects for change

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15 Feb 2014-The Lancet
Ole Petter Ottersen, Jashodhara Dasgupta, Chantal Blouin, Paulo Marchiori Buss, Virasakdi Chongsuvivatwong, Julio Frenk, Sakiko Fukuda-Parr, Bience P Gawanas, Rita Giacaman, John O. Gyapong, Jennifer Leaning, Michael Marmot, Desmond McNeill, Gertrude I Mongella, Nkosana Moyo, Sigrun Møgedal, Ayanda Ntsaluba, Gorik Ooms, Espen Bjertness, Ann Louise Lie, Suerie Moon, Sidsel Roalkvam, Kristin Ingstad Sandberg, Inger B. Scheel 
Profits and pandemics: prevention of harmful effects of tobacco, alcohol, and ultra-processed food and drink industries

[...]

23 Feb 2013-The Lancet
Rob Moodie, David Stuckler, Carlos Augusto Monteiro, Nick Sheron, Bruce Neal, Thaksaphon Thamarangsi, Paul Lincoln, Sally Casswell 
Frequently Asked Questions (8)
Q1. What contributions have the authors mentioned in the paper "Sitting on the fensa: who engagement with industry" ?

In this paper, the World Health Assembly ( WHA ) reached consensus: `` WHO engages with non-State actors to encourage them to protect and promote public health '' and considered non-state actors as `` nongovernmental organizations [ NGOs ], private sector entities, philanthropic foundations and academic institutions ''. 

WHO and its governing body have taken an important step in democratizing the invite list to the policy table and establishing the dining etiquette. 

Do the authors rely upon self-regulation by industry (e.g., marketing codes or voluntary initiatives to reduce harmful exposure), co-regulation of the activities of industry (e.g. public sector partnerships with the private sector are an overarching approach within of WHO’s 2013-2020 Global Action Plan on NCDs8), or public regulation of private sector activities. 

A small but not insignificant part of the project entails embracing the public interest NGOs, which it has too long treated as adversaries, as the partners it needs to generate both public support and political incentives to induce national leaders to act. 

Concerns have long been raised about potential and actual conflicts of interest arising from WHO’s engagement with non-State actors (NSA), particularly those whose mandate hingesforemost upon the pursuit of profit rather than public health. 

Members States were generally supportive of the Framework, but NGOs voiced concern that “FENSA will increase….problematic entanglements between WHO and powerful private sector actors”, and were disappointed that the Framework fails to “acknowledge the different nature – and thus different roles – public and private sector actors should play in global health governance”3. 

Now WHO needs to jump decisively off the right side of the fence and take more impactful measures, globally and nationally, to protect the health of the public by aggressively supporting governments and their partners to govern the health impact of Big Industry. 

A Reuters investigation, for example, found not only that regional office PAHO had accepted money from companies such as Coca-Cola, Nestle and Unilever, but also that at least two of the 15 members of WHO’s Nutrition Guidance Expert Advisory Group had direct financial ties to the food industry5.