全球卫生治理的高度分散性质对概念化和系统地衡量疾病议程状况提出了重大挑战,受伤,导致集体疾病负担的风险和其他条件。最近提出了全球卫生议程设定的竞技场模型,以帮助应对这些挑战。进一步发展模型,这项研究旨在更有力地调查在全球卫生议程制定的一系列利益相关方领域中,优先级水平如何以及为什么会有所不同。我们分析了四个领域中八种传染病的优先级变化的顺序和幅度(国际援助,科学研究,制药业和新闻媒体)在超过二十年的时间里,与奖学金的五项主张有关。这些疾病的负担和在联合国可持续发展目标3中的突出地位各不相同,包括四个具有具体监测和评估指标的指标(艾滋病毒/艾滋病,结核病,疟疾,肝炎)和四个没有(登革热,腹泻病,麻疹,脑膜炎)。在任何领域,优先顺序都不符合疾病负担或国际发展目标。此外,使用新的方法来衡量指示优先级的资源分配年度变化规模,揭示了在更广泛的稳定模式下,所有领域疾病水平的波动性。对领域内和领域之间的长期优先模式的见解对于加强旨在确定关键因果机制的分析是不可或缺的。为了澄清竞技场是如何互动的,并测量它们产生的影响。
The highly decentralized nature of global health governance presents significant challenges to conceptualizing and systematically measuring the agenda status of diseases, injuries, risks and other conditions contributing to the collective disease burden. An arenas model for global health agenda setting was recently proposed to help address these challenges. Further developing the model, this study aims to advance more robust inquiry into how and why
priority levels may vary among the array of stakeholder arenas in which global health agenda setting occurs. We analyse order and the magnitude of changes in
priority for eight infectious diseases in four arenas (international aid, scientific research, pharmaceutical industry and news media) over a period of more than two decades in relation to five propositions from scholarship. The diseases vary on burden and prominence in United Nations Sustainable Development Goal 3 for health and well-being, including four with specific indicators for monitoring and evaluation (HIV/AIDS, tuberculosis, malaria, hepatitis) and four without (dengue, diarrhoeal diseases, measles, meningitis). The order of
priority did not consistently align with the disease burden or international development goals in any arena. Additionally, using new methods to measure the scale of annual change in resource allocations that are indicative of
priority reveals volatility at the disease level in all arenas amidst broader patterns of stability. Insights around long-term patterns of
priority within and among arenas are integral to strengthening analyses that aim to identify pivotal causal mechanisms, to clarify how arenas interact, and to measure the effects they produce.