# Session Overview [[Politics vs policy]] [[Policy]] was defined as a set of goals designed to guide action and was differentiated with politics, which refers to the formal and informal processes through which policy decisions are adopted, resources are allocated and differing political priorities and objective are evaluated, reconciled and accommodated in policy decisions. > Policies can be analyzed through various angles, whether they are effective (policy evaluation) and how efficiently they use a given set of resources (economic analysis). Political analysis takes a different angle. It focuses on the conflicts of interests and ideas that shape how policies are made and implemented. For example, political analysis looks at how [[Power in Global Health - who holds it and why?|power]] shapes the relations between groups with different interests and structures their capabilities to influence policy. ## Learning outcomes - Identify overarching themes across the module - Apply key concepts used in political science and international relations to analyse core topics in [[global health policy]] - Compare and contrast key global health policy issues, using concepts introduced in the module to examine the similarities, differences and the interrelationship between these topics. # 1. Concepts ## 1.1 [[global governance]] [[Global health governance now is more about informal mechanisms between state and non-state negotiations. The governance space is now accessible by states and non-state actors, a condition Fidler called "open-source anarchy"]] Anarcy speaks about the absence of supreme formal authority above the state - to describe the systemic conditions within which policymaking takes place at the global level. Consequently, the concept of governance (as opposed to government) is more appropriate for describing and analysing policy-making at the global level. More precisely, it is illustrated in the switch from the traditional discussion of international health governance to the more contemporary discourse of global health governance. The former refers to governance carried out by states, through inter-state relations, while the latter refers to more diffuse and complex process of governance carried out through trans-state relations. ## 1.2 [[GHM102 Session 08 Partnerships for global health|partnership]] > the advent of global health partnerships reflected the emergence of a new “framework of thought”, underpinning the relationship between the public and private sectors. This new framework of thought emphasises shared responsibility between state and non-state actors for the process of global policymaking. Partnerships have fulfilled important functions in global health governance. For instance, they have enchanced [[GHM102 Session 08 Partnerships for global health#Accountability|accountability]] and promoted the representation of social interests, that they may have found it difficult to influence global policy solely through the channels provided by state bureaucracies. Partnerships also contributed to mobilising attention and funds for global health issues, thereby increasing the importance of health issues on the wider global policies agenda. However, partnerships also have negative effects, for example, it may obscure dynamics of [[Power]] and privilege within the institutional structures to which it gives rise. > Partnerships have been used not only as fora to exchange ideas and pool resources but also as vehicles to promote particular interests, notably those of business but also those of NGOs on these two groups pointed out (Sessions 6 & 7). ## 1.3 [[GHM102 Session 03 Power in Global Health Policy|Power]] The first two types of power - [[compulsory power]] and [[institutional power]]. They differ in that compulsory power works through direct social relations while institutional power works through indirect social relations, namely through an institution. [[structural power]] and [[productive power]] work in the absence of explicit conflict. Also they are not about changing the actions of specific groups but about continuous domination by creating social positions of privilege and disadvantage. The difference between structural and productive power is that the structural power refers to social positions that are directly related to one another, such as capital and labour, expert and layman, and innovator and imitator, for example. Productive power, on the other hand, refers to social positions that are generated through the ideational and normative framework that dominates a specific sphere in society. > For instance, the framing of intellectual property as an issue of international trade confers power to national ministries of commerce, while the framing of intellectual property as an issue of public health confers power to national ministries of health. NGOs have used expertise, [[International Baby Food Action Network|generated through their own research and the monitoring of existing policies]], to shape global health policies. The type of power that is most commonly associated with business is [[structural power]] because of the role of business as capital owner. They use [[institutional power]] through engaging in public private partnership and [[self-regulation]]. The governments of high-income countries have frequently used their control over large markets to exercise compulsory power in [[global health policy]] making. Examples you heard about in various sessions are the threat of trade sanctions used by the US, in the negotiations of global intellectual property standards and the threat of removing access to development assistance. However, control over access to markets as a resource of power has increasingly been used also by middle-income countries. One example is the increased influence of middle-income countries in the Doha Round of World Trade Organization (WTO) negotiations. Importantly for the context for global health governance, the increased influence of middle-income countries contributed to the [[Doha Declaration]] on Trade Related Aspects of [[Intellectual Property Rights (IPR)]] and Public Health. This Declaration underscores the right of governments to break patents in order to protect public health, for example. The Doha Declaration thereby confers significant institutional power to social groups that oppose more extensive protection of intellectual property for pharmaceutical products. # 2. Actors ## 2.1 [[GHM102 Session 04 Global Health Institutions|Institutions]] ## 2.2 The role of the state ## 2.3 The role of civil society ## 2.4 The role of business ## 2.5 [[transnational expert networks (TENs)]] # 3. Cross cutting [[Issue construction|issues]] ## 3.1 Human rights and health ## 3.2 Development and health ## 3.3 [[GHM102 Session 12 Global health financing|global health financing]] ## 3.4 [[GHM102 Session 13 Global health politics and identity|identity]] # 4. Integrating activity # 5. Summary