Abstract
Suzuki and colleagues' rare and elaborate analysis of the political processes behind the 2018 United Nations (UN) non-communicable diseases (NCD) Declaration discloses various pathways towards influencing global public health policies. Their study should be a wake-up call for further scientific political scrutiny and analysis, including clearly distinguishing between consultations such as UN multi-stakeholder hearings preceding high-level meetings and the actual negotiating and decision making process. While stakeholder positions at interactive hearings are documented and published and thus made transparent, the negotiating process among member states is not publicly known. The extent to which intergovernmental negotiations are influenced at country or regional levels by commercial interests through direct and indirect lobbying outside of public consultations should be given more attention. Lobby registers should be implemented more stringently and legislative footprints required and applied not only to legally binding but also to internationally important documents such as political declarations.
Highlights
Comparing the initial draft of the non-communicable disease (NCD) Declaration of 2018 with the final and approved document, Suzuki and colleagues trace the influence of inputs from stakeholder and government groups to the final political declaration yet rightly acknowledge that the final document is negotiated between United Nations (UN) member states not between all stakeholders (p. 3).[1]
The private sector has a long history of resistance to binding political agreements which affect their business operations within and beyond NCDs as has been shown in pharmaceutical companies opposing the essential drug list by the World Health Organization (WHO) in the 1970s9; a list which led to a steep decline in drug prices and a doubling of access to essential medicines globally before the turn of the century[10] and which would not have seen the light of day if pharmaceutical companies had had their way
We concur with Suzuki and colleagues that the UN in its quest to forge sustainable partnerships may have gone too far in upholding the role of private industry and in subscribing to a market-oriented outlook
Summary
Comparing the initial draft of the non-communicable disease (NCD) Declaration of 2018 with the final and approved document, Suzuki and colleagues trace the influence of inputs from stakeholder and government groups to the final political declaration yet rightly acknowledge that the final document is negotiated between United Nations (UN) member states not between all stakeholders (p. 3).[1].
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