TY - JOUR
T1 - Framing and the formation of global health priorities
AU - Shiffman, Jeremy
AU - Shawar, Yusra Ribhi
N1 - Funding Information:
We thank Sarah Dalglish, Joseph Harris, Carmen Ho, Hina Khalid, Robert Marten, Simon Rushton, Kimberly Skead, and Joseph Wong for valuable feedback on drafts of this Series paper. We also thank Eduardo Gómez for leading the Series. We take full responsibility for all errors.
Publisher Copyright:
© 2022 Elsevier Ltd
PY - 2022/5/21
Y1 - 2022/5/21
N2 - Health issues vary in the amount of attention and resources they receive from global health organisations and national governments. How issues are framed could shape differences in levels of priority. We reviewed scholarship on global health policy making to examine the role of framing in shaping global health priorities. The review provides evidence of the influence of three framing processes—securitisation, moralisation, and technification. Securitisation refers to an issue's framing as an existential threat, moralisation as an ethical imperative, and technification as a wise investment that science can solve. These framing processes concern more than how issues are portrayed publicly. They are socio-political processes, characterised by contestation among actors in civil society, government, international organisations, foundations, and research institutions. These actors deploy various forms of power to advance particular frames as a means of securing attention and resources for the issues that concern them. The ascription of an issue as a security concern, an ethical imperative, or a wise investment is historically contingent: it is not inevitable that any given issue will be framed in one or more of these ways. A health issue's inherent characteristics—such as the lethality of a pathogen that causes it—also shape these ascriptions, but do not fully determine them. Although commonly facing resistance, global health elites often determine which frames prevail, raising questions about the legitimacy of priority-setting processes. We draw on the review to offer ideas on how to make these processes fairer than they are at present, including a call for democratic representation even as necessary space is preserved for elite expertise.
AB - Health issues vary in the amount of attention and resources they receive from global health organisations and national governments. How issues are framed could shape differences in levels of priority. We reviewed scholarship on global health policy making to examine the role of framing in shaping global health priorities. The review provides evidence of the influence of three framing processes—securitisation, moralisation, and technification. Securitisation refers to an issue's framing as an existential threat, moralisation as an ethical imperative, and technification as a wise investment that science can solve. These framing processes concern more than how issues are portrayed publicly. They are socio-political processes, characterised by contestation among actors in civil society, government, international organisations, foundations, and research institutions. These actors deploy various forms of power to advance particular frames as a means of securing attention and resources for the issues that concern them. The ascription of an issue as a security concern, an ethical imperative, or a wise investment is historically contingent: it is not inevitable that any given issue will be framed in one or more of these ways. A health issue's inherent characteristics—such as the lethality of a pathogen that causes it—also shape these ascriptions, but do not fully determine them. Although commonly facing resistance, global health elites often determine which frames prevail, raising questions about the legitimacy of priority-setting processes. We draw on the review to offer ideas on how to make these processes fairer than they are at present, including a call for democratic representation even as necessary space is preserved for elite expertise.
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U2 - 10.1016/S0140-6736(22)00584-0
DO - 10.1016/S0140-6736(22)00584-0
M3 - Review article
C2 - 35594874
AN - SCOPUS:85130862166
SN - 0140-6736
VL - 399
SP - 1977
EP - 1990
JO - The Lancet
JF - The Lancet
IS - 10339
ER -