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Table 2 Analytical framework for examining negotiations

From: Global Health diplomacy for noncommunicable diseases prevention and control: a systematic review

(1) The specific problem requiring global collective action- Globalization of marketing and advertising strategies
- Sanctions, including financial, travel and trade restrictions
- Multinational companies undermining the regulatory authority of national governments through public relations and lobbying strategies, and the need to develop coordinated strategies and diplomatic initiatives to address the multinational nature of the problem
- GHD on obesity and tobacco control requires stronger engagement with developing countries
- The need for collective action against NCDs given the current migration and travel patterns
- Smuggling
- Trade liberalization, including a reduction in trade barriers and prices to increase competition in the international market
- New global challenges such as climate change
(2) Key actors- United Nations and associated agencies and groups, including the WHO and the Independent High-level Commission on NCDs, and groups and important political clubs such as G7, G8/ BRICS
- the Food and Agricultural Organisation (FAO)
- the World Bank
- the World Trade Organisation (WTO)
- the Codex Alimentarius Commission
- Heads of government
- National governments and ministries (e.g. health, foreign policy, education, finance, labor, etc.)
- Regional coalitions of countries
- International Diabetes Federation
- World Heart Federation
- Asia-Pacific Economic Cooperation (APEC)
- Health advocacy groups, NGOs, and humanitarian organizations
- International professional associations
- Commercial actors (e.g. pharmaceutical companies, a variety of businesses involved in the production, processing, distribution, marketing, and sales of food and beverage)
- Civil society organizations and coalitions (e.g. Nutrition Foundation, National Center for Chronic Disease Prevention, National Cancer Institute)
- Healthcare regulatory agencies
- Parliamentary Committee for Prevention and Control of NCDs
- National Inter-ministerial Tobacco Control Committee
- NCD Alliance, Framework Convention on Tobacco Control, and Union for International Cancer Control
- Research centers and the academia
- The medical community
- The private sector
- Patients and their families
- International donors
(3) Actors’ interests in the problem- UN and WHO: technical support, non-binding recommendations and policy advice, international legal obligations and laws, advocacy
- Groups and political clubs such as G7, G8/ BRICS: Supporting reforms, develop framwork for regulation, support growth and development across globe, Strengthen international cooperation
- Governmental actors: governments represent power in diplomacy, while NGOs represent ideas and knowledge
- NGOs: monitoring, lobbying, brokering knowledge, offering technical expertise, and fostering inclusion; NGOs act as a catalyst to the process of developing policies and drive it by including stakeholders, offering technical expertise, and providing financial assistance; multisectoral partnerships aimed at capacity-building and strengthening health systems
- Industrial actors: reduced market share and profits due to measures to limit tobacco use
- Unions: advocacy of NCD Alliance to trigger a global policy response, the role of Framework Convention Alliance (FCA) in agenda-setting for tobacco control
- Policy champions: strong supportive role
(4) Potential negotiation process- Scientific and technical capacity building
- Preparation for negotiations, mobilization of civil society organizations, dialogue with industry, consultation with experts, and sharing of information among national health agencies
- Entering the negotiating forum
- Monitoring, lobbying, brokering knowledge, offering technical expertise, and fostering inclusion
(5) Potential scenarios for collective action- Drawing attention to issues that are not yet on the GHD agenda or are largely overlooked
- Political leadership, strong mobilization, and advocacy from well-organized groups globally are crucial in triggering and sustaining a global policy response such as an international treaty
- A monitoring role that involves publicizing the diplomatic process