# Personal Takeaways - The politics of global health, including NCDs, can be traced in three categories of incentives: 1) economic, in which business case to convince politicians and tax payers. 2) organisational. Institutions with their own mandates and agenda to pursue, often continuing along the policy path they have followed for decades ([[institutional inertia]]), and 3) political nature of decision-making processes in the health sector. Politicians who face frequent re-election often pursue short-term outcomes. Their decisions and incentives prevail depends on the policy context, including the priorities of a particular administration, [[Power]] relations, and vested interests. - Political forces and incentives are being analysed through different lenses: 1) plurality, 2) elite. Plurality means groups compete to achieve political priority, while elite means a small group of powerful individuals decide which diseases are relevant, and the criteria used to make those decisions. - The authors seek to converge those two lenses, and offer an adapted political process model. They recommend three strategies: 1) reframe the debate, 2) mobilise resources, 3) identification and creation of political opportunities. [[Biomedical interventions should be accompanied by a broader understanding of health-depriving forces found in the global political economy]] - I'm particularly intrigued by the first strategy: reframe the debate, because it sort of relate with [[Foucault]]'s way of seeing things. The author wants to debunk the myth that chronic disease is a disease of individual choice; diseases of ageing—inevitable consequences of progress in heath care. One quote that particularly struck me: *If chronic diseases are judged as an individual problem rather than a societal one, ==there is no need for social interventions, only the education of individuals==. In many societies, social interventions for individual problems are viewed as an impingement on people’s freedoms, which makes strong public-health measures, such as taxation or regulation, inappropriate.* The authors clearly understand the tension between [[individual liberty]] and societal measure, and thus, exercising [[biopower]]. - The authors made a great example, by the way, such as taxes on soft drinks, bans on smoking in public places, and other effective public health interventions can be regarded as intrusions into personal freedom rather than life-protecting measures. # Abstract Chronic diseases, especially cardiovascular diseases, diabetes, cancer, and chronic obstructive respiratory diseases, are neglected globally despite growing awareness of the serious burden that they cause. Global and national policies have failed to stop, and in many cases have contributed to, the chronic disease pandemic. Low-cost and highly effective solutions for the prevention of chronic diseases are readily available; ==the failure to respond is now a political, rather than a technical issue==. We seek to understand this failure and to position chronic disease centrally on the global health and development agendas. To identify strategies for generation of increased political priority for chronic diseases and to further the involvement of development agencies, we use an adapted political process model. This model has previously been used to assess the success and failure of social movements. On the basis of this analysis, we recommend three strategies: reframe the debate to emphasise the societal determinants of disease and the interrelation between chronic disease, poverty, and development; mobilise resources through a cooperative and inclusive approach to development and by equitably distributing resources on the basis of avoidable mortality; and build on emerging strategic and political opportunities, such as the World Health Assembly 2008–13 Action Plan and the highlevel meeting of the UN General Assembly in 2011 on chronic disease. Until the full set of threats—which include chronic disease—that trap poor households in cycles of debt and illness are addressed, progress towards equitable human development will remain inadequate. # Key messages - Chronic diseases substantially contribute to the global burden of disease but they remain neglected globally, especially in low-income and middle-income countries - Global economic and social policies are driving the chronic disease pandemic - Human development programmes must include action against chronic diseases to fulfil their potential - Neglect of chronic disease by international agencies and national governments is a political, not a technical, failure since cost-effective interventions are available - Political opportunities for progress are building, but coordinated and inclusive actions by all stakeholders are necessary to exploit these opportunities - Key actions are implementation of available cost-effective interventions, addressing the common causes of the high burden of preventable diseases irrespective of the cause, and distributing resources more equitably on the basis of avoidable mortality # Related [[Scientific knowledge generation does not automatically translate into (policy) solutions and practices]] [[@choiCanScientistsPolicy2005]] [[Non-communicable diseases (NCDs) are both a cause and a consequence of poverty and marginalisation]]