Upload
thomasine-moody
View
218
Download
1
Tags:
Embed Size (px)
Citation preview
Polycentric Governance of Whole of Society (WoS) Prevention of Obesity and NCDs:
On Conflict of Interests, Multi-Stakeholder Partnerships, Competition and Cooperation
Laurette Dube & Nii A. Addy
Third American Conference on Obesity-PACO3Aruba, June 8 2013
Agenda
• The Challenge• The Present Public Health Prevention Context• Whole-of-Government Approach to Health and
Economic Convergence• Polycentric Governance of WoS Prevention of
Obesity and NCDs– A Path from Dogmatic to Pragmatic Approach to Conflict of
Interest and Multistakeholder Engagement and Partnership
The Challenge
Cross-sectoral and multi-level/scale approaches needed in WoG and WoS prevention are “wicked problems”– actors from state, market and civil society– actors from health, food, nutrition, other domains– Policy and action at local, state/province, national,
and global levels• Defining and managing conflict of interest vs
collaborative interdependency and trust needed for impact, scale and resilience
The Public Health Context
• Sectoral approaches– Health agencies deal with health problems within
health systems-TYPICALLY FOCUS ON CLINICAL• Damage limitation: trade and health
– E.g. United States–Central America Free Trade Agreement (CAFTA) reduced access to drugs in some countries
– more dialogue and joint fact-finding by actors from health and other sectors -> better understanding of the implications of CAFTA
Recent approaches
• Health in All Policies (HiAP)– Focus on health within non-health sectoral policies,
including agriculture, industry, trade policies– multiple levels - individual, intermediary, and social– One-way direction in spite of much Win-Win talks
• Whole of Government (WoG) Prevention– Earlier and deeper integration of health in non-heath
budgets, activities and program– Formal and/or informal networks across the different
agencies within that government
Present WoG and WoS in Public Health
• Health strategy – involves stakeholders in all sectors promoting health priorities
• Mutual Gains or Win-Win strategy– actors outside the health sector are also convinced that their concerns
remain as priorities together with health concerns• Cooperation strategy
– health sector experts seeking how to cooperate with colleagues in other sectors to achieve their respective goals
• Economic cost strategy– Estimating long term economic costs of obesity and NCDs
WoG Approach to Health and Economic Convergence
•Information & Communication Technology Sectors & Systems
•Trade, Finance and, Other Economic Sectors & Systems
•Housing, Transportation & Infrastructure Sectors & Systems
•Agriculture/Agri-food Sectors & Systems
•School, Education & Health Systems
•Social Support & Systems
•Economic Development Outcomes
•Human Development Outcomes
WoS: Actors in Multiple SectorsPrivate Sectors – Agriculture, Agri-Food and Other Economic Sectors
Private Sector – Bio-tech, Pharma, Medicine, Health, Healthcare, Education & other Human Sectors
Human & Economic
Development & Growth Government Sectors
Civil Society Sectors
WoS Approach for 21st Century Convergence of Human and Economic Development/Growth
10
Private Sectors –Agriculture, Agri-Food and Other Economic Sectors
Private Sector – Bio-tech, Pharma, Medicine, Health, Healthcare, Education & other Human Sectors
Human & Economic
Development & Growth Government Sectors
Civil Society Sectors
Polycentric Governance of
GOVERNMENT
COMMUNITY
PRIVATE SECTOR
Polycentric Governance in WoS
Consumers
Grassroots
Community
Small & Medium
Businesses
Cooperatives
Large NGO’s
(Global & Nat’l)
Many Stakeholders in Gov’t and Public Policy
Large businesses (Global &
Nat’l)
Regulator
Provide of Public Goods
and Services
Steward of Pulbic
Resoures & Investmens
Partner in multi-sector
collaboration
Enabler of social and business
innovation
Enabler of Whole
of Society Action
Government & Public Policy in its many roles
11
Polycentric Governance : 3 Society Arenas with Different Exchange Mechanism
(Lifetime work of Elinor Ostrom, Economic Nobel Laureate)
GOVERNMENT
COMMUNITY
PRIVATE SECTOR
Polycentric Governance in WoS
Introducing Polycentric Systems
• “Polycentric” systems connote many centers of decision that are formally independent of each other and jointly affect collective –and sometimes individual-- benefits and costs
• Engaged in competition, cooperation, contract and many other forms of engagement and collaboration
• Rules-based governance and pragmatic trust need to completement traditional states and market mechanisms.
Polycentric Governance Pragmatic Collaborative Rules
Boundary rules are clear and locally understood boundaries between CI partners, and between them and collaborators;
Position rules specify a set of positions in the consortia and how many partners hold each position;
Choice rules specify which actions are assigned to a partner in a particular position;Information rules specify channels of communication among partners and what information
must, may, or must not be shared;Scope rules specify the outcomes that are targeted and measures of success in terms of
effectiveness, efficiency, and fairness;Aggregation rules (such as majority or unanimity rules) specify how the decisions of partners at a
decision point are to be mapped to intermediate or final outcomes;Conflict resolution rules. Rapid, low-cost, local arenas exist for resolving conflicts among partners
or with external organizations. For instance, sanctions for rule violations start very low but become stronger;
Nested enterprises rules. CI activities being closely connected to social-political-economic systems of partners and society in general, governance activities are organized in multiple nested layers.
Path from Dogmatism from Pragmatism In Conflict of Interest and Multistakeholder Engagement and Partnership
for Obesity and NCDs Prevention: Critical, Urgent but Clallenging
Regulator
Provide of Public Goods
and Services
Steward of Pulbic
Resoures & Investmens
Partner in multi-sector
collaboration
Enabler of social and business
innovation
Enabler of Whole
of Society Action
Government & Public Policy in its many roles