scispace - formally typeset
Search or ask a question
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
More filters
Journal Article•DOI•
Between Participation and Capture in International Rule-Making: The WHO Framework of Engagement with Non-State Actors

[...]

Ayelet Berman1•
National University of Singapore1
15 Jan 2020-Social Science Research Network
TL;DR: In 2016, the WHO became one of the first IOs to adopt a comprehensive policy for encouraging non-state actor engagement while simultaneously mitigating the accompanying risks as discussed by the authors, and the Framework of Engagement with Non-State Actors (FENSA) was explored how and whether FENSA prevents capture risks.
Abstract: Following demands for more democratic legitimacy and given the growing dependency of international organizations (IOs) on external information and resources, in the past decade and a half, IOs have opened up their rule-making to non-state actor (NSA) participation. In a broad sense, this participation trend tracks the 20th-century administrative law revolution in many democracies, whereby an expanding and more powerful administrative state engendered greater demands for transparency and citizen participation in rule-making. Such opening-up would indeed appear to improve the democratic responsiveness of IOs, yet what the literature has largely ignored so far is that it also increases the risk that rule-making becomes captured by the interests of narrow groups. Three main types of capture risks have become particularly prevalent in international rule-making: capture caused by the dependency of IOs on the information held by business entities, capture caused by the over-representation of business entities, and capture caused by the financial contributions of NSAs to IOs. The recent Boeing 737 Max scandal highlights the potentially tragic consequences of capture. In 2016, the WHO became one of the first IOs to adopt a comprehensive policy for encouraging NSA engagement while simultaneously mitigating the accompanying risks—the Framework of Engagement with Non-State Actors (FENSA). In this article, I explore how and whether FENSA prevents capture risks — on paper and in practice. Further, NSA engagement is a central feature of the 2030 Agenda for Sustainable Development and of the 2016 Sustainable Development Goals (SDGs), and many IOs are adapting their strategic approaches and work plans towards more NSA engagement. In the process, the IOs are considering ways to develop or revise outdated policies to address the risks of engagement, and they will likely look to FENSA for inspiration. FENSA thus also serves as a case from which I seek to draw more general lessons as to the capability of such engagement reforms to prevent capture in international rule-making.

4 citations

Journal Article•DOI•
Don't Discount Societal Value in Cost-Effectiveness Comment on "Priority Setting for Universal Health Coverage: We Need Evidence-Informed Deliberative Processes, Not Just More Evidence on Cost-Effectiveness".

[...]

William Hall1•
Vancouver Coastal Health1
01 Sep 2017-International journal of health policy and management
TL;DR: If decision-makers intend to not only incorporates the values of the public they serve into decisions but have the decisions enacted as well, consideration should be given to more direct involvement of stakeholders.
Abstract: As healthcare resources become increasingly scarce due to growing demand and stagnating budgets, the need for effective priority setting and resource allocation will become ever more critical to providing sustainable care to patients. While societal values should certainly play a part in guiding these processes, the methodology used to capture these values need not necessarily be limited to multi-criterion decision analysis (MCDA)-based processes including ‘evidence-informed deliberative processes.’ However, if decision-makers intend to not only incorporates the values of the public they serve into decisions but have the decisions enacted as well, consideration should be given to more direct involvement of stakeholders. Based on the examples provided by Baltussen et al, MCDA-based processes like ‘evidence-informed deliberative processes’ could be one way of achieving this laudable goal.

4 citations

Journal Article•DOI•
Public-private partnering as a modus operandi: Explaining the Gates Foundation's approach to global health governance.

[...]

Michael Stevenson1, Jeremy Youde2•
University of Waterloo1, University of Minnesota2
04 Mar 2021-Global Public Health
TL;DR: It is argued that BMGF’s embrace of PPPs was adopted out of the belief that neither public agencies nor industry were capable of providing LICs with essential health technologies autonomously, and that their conflicting mandates required an honest broker to initiate and sustain collaboration between the two sectors.
Abstract: In its first decade, The Bill and Melinda Gates Foundation (BMGF) focused much of its efforts on enabling the establishment of transnational public-private partnerships (PPPs) oriented towards incr...

4 citations

Journal Article•DOI•
An Urgent Call for the Renaissance of the World Health Organization: Needed Now More than Ever Before.

[...]

Luchuo Engelbert Bain1, Ikenna Desmond Ebuenyi1•
VU University Amsterdam1
10 Mar 2017-Frontiers in Public Health
TL;DR: This year's elections of the next WHO Director-General could be a unique opportunity for the WHO to undertake reforms to regain the trust it rightly deserves and to relieve the organization from unnecessary and potentially sub-optimal …
Abstract: The World Health Organization (WHO) remains the most authoritative actor in global health in the world's history. However, its roles and prestige have reduced over time, and the trend, though dangerous to global health, might not change if practical and radical changes are not put in place. The deficiencies to properly contain and manage the recent Ebola and Zika virus epidemics are fresh and glaring examples (1). Transparency, substandard institutional reform to meet current challenges, funding gaps, and undefined scope of action characterize the WHO of today. This year's elections of the next WHO Director-General could be a unique opportunity for the WHO to undertake reforms to regain the trust it rightly deserves. Epidemics, humanitarian crises, resistance to medication (HIV, tuberculosis, and malaria), explosion of non-communicable diseases (NCDs), and cancers are clear indications that the WHO cannot claim to be able to singlehandedly cope with these challenges. Constraints could arise from inadequate funding, human resource and technical management gaps, and lack of coordination and needed expertise in certain areas. The growing involvement of many organizations, research institutions, industry (2), and academia in the health welfare of the world compels institutional reform within the organization to explore and contain collaborations with organizations with proven expertise in specific domains. One of the key unmet ideals in the history of the world, for the high-, low-, and middle-income countries has been under appraisal of social determinants of health, inequities in health care, and disregard of health-care provision as a fundamental human right (3). In the interview report with candidates for this years' WHO Director-General position, this theme was unanimously recognized as a priority action area from all aspirants (4). This must remain a key mandate of the WHO. The health of mothers and children is a top priority, despite the remarkable gains that have been recorded in the past decades. There is growing evidence of increased risk of obesity, diabetes, and cardio-metabolic adverse outcomes in early adulthood resulting from materno-fetal health status (5, 6). The socioeconomic potential of the world is largely dependent on acceptable maternal and child health status and in no way should be undermined. Disaster response and preparedness coupled with epidemiologic surveillance of disease are issues necessitating coordination from an authoritative structure such as the WHO. Creating healthy collaborating frameworks with organizations with proven track records in humanitarian response and disasters could relieve the organization from unnecessary and potentially sub-optimal …

3 citations

Journal Article•DOI•
Using Regulatory Stances to See All the Commercial Determinants of Health.

[...]

Alex C. Liber
17 May 2022-Milbank Quarterly
TL;DR: By using the regulatory stances framework to encompass markets that have positive or conditional effects on health as well as those that have adverse health effects, the CDoH conversation can shift away from the exclusive focus on strategies to shrink markets with adverse health impacts to consider a wider array of policy options.
Abstract: Policy Points The commercial determinants of health (CDoH) concept, which currently focuses on markets that harm health, should be expanded to refer to the interface between commerce and health, which can sometimes have positive public health consequences. The regulatory stances framework helps us classify public health preferences for regulating specific markets related to CDoH, based on the intended effects of regulations on market size. The regulatory stances a jurisdiction can adopt can be classified as ranging from prohibitionist through contractionist, permissive, and expansionist, to universalist. The regulatory stances framework increases the usefulness of the CDoH concept by expanding the conversation beyond negative determinants of health and providing a fuller view of the tools at the disposal of society to alter markets and improve health. CONTEXT The effects of commerce on the public health are omnipresent. The commercial determinants of health (CDoH) represent a burgeoning area of scholarly debate and activist policymaking to redress markets that adversely affect public health. The CDoH debate is a logical extension of the tobacco control movement, but, to its detriment, the CDoH conversation remains primarily focused policies and proposals that are analogous to historical tobacco control strategies. METHODS This paper argues that for the CDoH to develop further and broaden its appeal, it should expand to cover markets with conditional and positive impacts on health. To explain and order this conversation, a comparative framework for regulatory policy is introduced: the regulatory stances. The regulatory stances classify a regulatory policy based on the intended effect of policy on the size of a market in the future relative to the present. FINDINGS Some markets that interface between commerce and health do not inherently harm health. Regulatory policy toward these markets should be different in intent than regulatory policy for markets with negative health effects. CONCLUSIONS By using the regulatory stances framework to encompass markets that have positive or conditional effects on health as well as those that have adverse health effects, the CDoH conversation can shift away from the exclusive focus on strategies to shrink markets with adverse health impacts to consider a wider array of policy options.

3 citations

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

[...]

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

[...]

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

[...]

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.