Political Economy of Non-Communicable Diseases: From Unconventional to Essential

Abstract

In January 2019, the Prince Mahidol Award Conference organized an international meeting on “the political economy of non-communicable diseases”—the first major global health symposium to include political economy in its title and as its frame for discussion. This commentary is based on a plenary presentation made at the start of the conference. The overall goal of PMAC 2019was “to foster and enhance global momentum for NCD prevention and control,” using a political economy perspective. The organizers called this “an unconventional outlook.” This commentary argues that political economy should become viewed as a conventional, indeed, an essential outlook for NCDs, and more broadly for global health. Political economy factors are integral to the problems of NCDs and therefore must also be integral to the policy responses. I have often argued inmy career for more attention to political economy in public health—for more attention to the political dimensions of health policy, especially for lowand middleincome countries. This undoubtedly reflects my training as a political scientist. Political scientists constitute a tiny disciplinary club in global health. Just as health economists have a significant organization and a global meeting every two years in the International Health Economics Association, so too should political scientists engaged in health policy issues. The study of politics remains on the margins in the global health community, despite decades of scholarship on this topic, while economics and economic analysis are squarely situated at the center. PMAC 2019 contributed to placing political economy analysis more visibly at the core of debates on global health policy. While a prolonged discussion of the definition of political economy is not appropriate here, some consideration of definitions is necessary to ensure clarity. In general, most definitions of political economy focus on how the distributions of political and economic resources affect something we care about: inequality, economic growth, some specific policy, who controls a country, or health. The analysis of political economy typically involves consideration of power,