(p. xiii) Foreword
(p. xiii) Foreword
Politics is at the heart of global and public health; scientific evidence alone is very desirable but is insufficient for setting policy and changing practise, and politics can be dangerous if it rejects scientific evidence. From tobacco control to vaccine delivery, we have repeatedly seen that political movements, action, and leadership are an integral part of achieving global health goals.
As executive director of UNAIDS, I witnessed first-hand what is possible for public health when politics, science, and people-centred action converge on the ground. The response to HIV/AIDS is one of the most striking examples of politics as a driver of both action and impact and inaction and denial. Take the case of antiretroviral medicines. One of my top priorities at UNAIDS was to negotiate a reduction in the price of treatment, which involved navigating the choppy waters of so-called good and bad politics.1 This tension is even more dramatic when it comes to prevention, where on the one hand, ‘good’ politics is based on evidence-based programmes to reduce HIV infection through sexual transmission or through injecting drug use, whilst on the other hand, ‘bad’ politics was responsible for sidelining scientific evidence and blocking critical policy developments to expand treatment access in South Africa and to prevent HIV amongst people who inject drugs in Russia or gay men and other men who have sex with men in numerous countries. Similar tensions are rife when it comes to prevention of obesity, diabetes, cancers, and other chronic conditions. Navigating these contradictions is of course central to the process of achieving global health goals; however, the role of politics is still underappreciated in many public health circles.
Key turning points in the global AIDS response came in 2000 when the United Nations (UN) Security Council debated a health issue for the first time in history and unanimously adopted Resolution 1308, which recognised the severity of AIDS, and in 2001 when the Caribbean Community (CARICOM), the Organisation of African Unity, and a UN General Assembly Special Session all expanded the AIDS response beyond the health community, which laid the foundation for current achievements. This opened many doors for the global response and thrust AIDS into ‘high politics’, where I believe global health issues rightly belong.
(p. xiv) I therefore welcome this timely and important handbook, which collates and analyses key themes and issues in global health politics but also contributes new insights that advance the field. Addressing topics from the politics of agenda setting in global health to celebrity and global health advocacy, this collection of thirty-four essays offers a vital resource for a diversity of readers. Its relevance extends beyond academia; Colin McInnes, Kelley Lee, and Jeremy Youde have clearly articulated the case for action as a cross-cutting theme throughout the edited collection, offering practical insight into how decisions are made in global health and how these decisions can make an impact on the ground. I highly recommend this handbook to researchers, students, policymakers, practitioners, and all of those with an interest in global health. I trust that it will be as thought provoking for you as it has been for me, and that it encourages us all to be more active in policy and politics with the aim of delivering results for people on the ground.
(1.) Peter Piot, Sarah Russell, and Heidi Larson, “Good Politics, Bad Politics: The Experience of AIDS.” American Journal of Public Health 97, no. 11 (2007): 1934–1936.