Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Sep 10;39(8):805-818.
doi: 10.1093/heapol/czae035.

Shifting patterns and competing explanations for infectious disease priority in global health agenda setting arenas

Stephanie L Smith  1 , Rakesh Parashar  2   3 , Sharmishtha Nanda  4 , Jeremy Shiffman  5   6 , Zubin Cyrus Shroff  7 , Yusra Ribhi Shawar  5 , Dereck L Hamunakwadi  1
Affiliations

Shifting patterns and competing explanations for infectious disease priority in global health agenda setting arenas

Stephanie L Smith et al. Health Policy Plan. .

Abstract

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.

Keywords: Global health; agenda setting; arenas model; communicable disease; health policy; infectious disease; neglected disease; priority.

PubMed Disclaimer

Conflict of interest statement

None declared.

Figures

Figure 1.
Figure 1.
Global mortality burden, 2000–2021
Figure 2.
Figure 2.
International aid arena: DAH, 2000–2021
Figure 3.
Figure 3.
Scientific research arena: publishing, 2000–2022
Figure 4.
Figure 4.
Scientific research arena: non-industry-sponsored clinical trials, 2004–2022
Figure 5.
Figure 5.
Pharmaceutical industry arena: industry-sponsored clinical trials, 2004–2022
Figure 6.
Figure 6.
News media arena: articles, 2000–2021
Figure 7.
Figure 7.
Scale of annual change in DAH by disease, 2000–2021
Figure 8.
Figure 8.
Scale of annual change in research publishing by disease, 2000–2022
Figure 9.
Figure 9.
Scale of annual change in non-industry-funded clinical trials by disease, 2004–2022
Figure 10.
Figure 10.
Scale of annual change in industry-funded clinical trials by disease, 2004–2022
Figure 11.
Figure 11.
Scale of annual change in news media articles by disease, 2000–2022
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Baumgartner FR, Jones BD. 1993. Agendas and Instability in American Politics. Chicago: The University of Chicago Press.
    1. Baumgartner FR, Jones BD, Mortensen PB. 2018. Punctuated equilibrium theory: explaining stability and change in public policymaking. In: Sabatier PA, Weible CM, Jenkins-Smith HC Theories of the Policy Process, Fourth. New York: Routledge, 55–101.
    1. Breunig C, Koski C. 2006. Punctuated equilibria and budgets in the American states. Policy Studies Journal 34: 363–79.
    1. Bump JB, Reich MR, Johnson AM. 2013. Diarrhoeal diseases and the global health agenda: measuring and changing priority. Health Policy & Planning 28: 799–808. - PubMed
    1. Dowding K, Hindmoor A, Martin A. 2016. The comparative policy agendas project: theory, measurement and findings. Journal of Public Policy 36: 3–25.