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Maximising synergies and minimising conflicts (i.e. building policy coherence) between trade and nutrition policy is an important objective. One understudied driver of policy coherence is the alignment in the frames, discourses and values of actors involved in the respective sectors. In the present analysis, we aim to understand how such actors interpret (i.e. ‘frame’) nutrition and the implications for building trade–nutrition policy coherence.
We adopted a qualitative single case study design, drawing on key informant interviews with those involved in trade policy.
We focused on the Australian trade policy sub-system, which has historically emphasised achieving market growth and export opportunities for Australian food producers.
Nineteen key informants involved in trade policy spanning the government, civil society, business and academic sectors.
Nutrition had low ‘salience’ in Australian trade policy for several reasons. First, it was not a domestic political priority in Australia nor among its trading partners; few advocacy groups were advocating for nutrition in trade policy. Second, a ‘productivist’ policy paradigm in the food and trade policy sectors strongly emphasised market growth, export opportunities and deregulation over nutrition and other social objectives. Third, few opportunities existed for health advocates to influence trade policy, largely because of limited consultation processes. Fourth, the complexity of nutrition and its inter-linkages with trade presented difficulties for developing a ‘broader discourse’ for engaging the public and political leaders on the topic.
Overcoming these ‘ideational challenges’ is likely to be important to building greater coherence between trade and nutrition policy going forward.
Sir Michael Marmot, who chaired the World Health Organization (WHO) Commission on Social Determinants of Health, has identified the need to seek “public policy based on a vision of the world where people matter and social justice is paramount” (Marmot, 2005, p. 1099). In this chapter, we ground this imperative in evidence of dramatic disparities in health status that are traceable, in large measure, to the globally unequal distribution of resources necessary for health. We further outline the contours of an international economic and political order that often magnifies those inequalities, and conclude that the imperative of mobilizing resources to protect health on a much larger scale than at present is central to any global health ethics worthy of the name.
“If living were a thing that money could buy”
Imagine for a moment a series of disasters that killed almost 1400 women every day for a year: the equivalent of four or five daily crashes of crowded long-distance airliners. There is little question that such a situation would quickly be regarded as a humanitarian emergency, as the stuff of headlines, especially if ways of preventing the events were well known and widely practised in some parts of the world. However, remarkably little attention is paid outside the global health and human rights domains to complications of pregnancy and childbirth that kill more than 500,000 women every year – a cause of death now almost unheard-of in high-income countries (HICs).
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