Globalization and Health最新文献

{"title":"Political prioritization of alcohol and sugar-sweetened beverage taxation in Uganda: Agenda dynamics amidst a shifting funding landscape.","authors":"Eric Ssegujja, Henry Zakumumpa, Richard Ssempala, Kaung Suu Lwin, Adam D Koon, Freddie Ssengooba","doi":"10.1186/s12992-026-01229-5","DOIUrl":"10.1186/s12992-026-01229-5","url":null,"abstract":"<p><strong>Introduction: </strong>Uganda faces a rising burden of noncommunicable diseases (NCDs) at a time when pressure to mobilize domestic health financing is increasing. These challenges have become more acute since January 2025, when geopolitical shifts and donor fiscal tightening led to substantial reductions in external health funding. Consequently, policymakers have renewed interest in health taxes as a mechanism both to reduce consumption of harmful products and generate domestic revenue for health. While tobacco taxation has received sustained policy attention, largely due to the influence of the WHO Framework Convention on Tobacco Control, considerably less is known about the political dynamics shaping alcohol and sugar-sweetened beverage (SSB) taxation. This study therefore examines the factors contributing to the relatively low prioritization of alcohol and SSB taxes within Uganda's policy agenda.</p><p><strong>Methods: </strong>Guided by the framework on political priority, we conducted 25 semi-structured interviews with stakeholders from government, parliament, civil society, academia, industry, and the media. We also reviewed 22 documents from 2015 to 2025, including policy papers, fiscal records, parliamentary debates, and industry materials. We analyzed the data thematically following an inductive thematic analysis approach. Coding was informed by the framework and strengthened through triangulation across interviews and documentary sources to enhance credibility.</p><p><strong>Results: </strong>We identified three levels of barriers. First, transnational norms promoted health taxes, but regional tax harmonization commitments within the East African community constrained national policy space. Second, domestic advocacy was weakened by fragmented ministerial mandates, limited local evidence, retreating policy entrepreneurs, and industry lobbying. Third, within the national political environment, the multiparty legislative dynamics, the high cost of sponsoring private members' bills, and revenue-centric fiscal framing limited traction. The 2025 donor financing contraction acted as a focusing event that revived debate on health taxes primarily as domestic health financing stabilization instruments rather than NCD prevention tools.</p><p><strong>Conclusion: </strong>While policymakers support health taxes to curb NCDs and increase domestic revenues, taxes on alcohol and SSBs remain underprioritized in Uganda due to institutional fragmentation, political-economic incentives, and legislative resource constraints. As external financing declines, it will be essential to strengthen locally grounded evidence, cross-sector coalitions, and integration of health objectives into fiscal reforms. In this way, health taxes represent a durable policy option for quickly mobilizing financial resources for health and preventing NCDs.</p>","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13628942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148396584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental health knowledge production on Palestinians: a historical and analytical study (1948-2024).","authors":"Fareeda Abo-Rass","doi":"10.1186/s12992-026-01227-7","DOIUrl":"10.1186/s12992-026-01227-7","url":null,"abstract":"<p><p>Research on Palestinian mental health has expanded substantially over recent decades. However, limited attention has been paid to how this body of knowledge has been historically produced. Knowledge production is not neutral but rather shaped by broader global political dynamics that influence how research is framed, prioritized, funded, and legitimized. In contexts shaped by intractable conflict and structural inequality, examining knowledge production is essential to understanding how mental health is framed. This study offers a narrative-historical examination of academic knowledge on Palestinian mental health from 1948 to 2024, situating it within broader discussions in global health. Using a narrative review approach, 193 publications indexed in PsycINFO were analyzed across three periods and three population groups: Palestinians in the Gaza Strip, the West Bank, and Israel. An eight-dimensional analytical framework is applied: discourse, psychological concepts, theoretical frameworks, methodologies, producing institutions, political positioning, population subgroups, and research objectives. The findings show that despite substantial growth in research output, the field remains largely grounded in individualized, clinical, and Western psychological frameworks. Across periods, psychological distress is primarily conceptualized through constructs such as PTSD, anxiety, and depression, with limited adaptation to the Palestinian cultural context. Political and colonial conditions are frequently treated as background context rather than analytically integrated components of explanatory models. Finally, knowledge production is shaped by the involvement of international actors and broader academic structures, with limited local epistemic leadership. These findings highlight the need for greater attention to the conditions under which mental health knowledge is produced. Contextually grounded and structurally informed approaches are required. Finally, these local findings suggest the need to examine how health knowledge is shaped within unequal global structures and apply context-sensitive approaches to mental health research.</p>","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13377788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148382000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing the commercial determinants of unhealthy beverage exposure: a systems thinking approach.","authors":"Megan R Winkler, Yeeli Mui, Alexis Smith, James Krieger","doi":"10.1186/s12992-026-01228-6","DOIUrl":"10.1186/s12992-026-01228-6","url":null,"abstract":"<p><strong>Background: </strong>The beverage industry plays an influential role in the US. Certain beverages, such as sugar-sweetened, have long been recognized as key contributors to poor population health with inequitable impacts. In response, multiple US initiatives have attempted to address these problems through public awareness campaigns and policies, such as taxes. Yet, the persistent and increasing reliance on unhealthy commercial products produced by the beverage industry suggests additional progress is needed. Leveraging a systems thinking approach, this study aimed to map out the complex forces limiting progress and driving inequitable impacts of unhealthy commercial beverages in the US to inform innovative thinking about future actions.</p><p><strong>Methods: </strong>We facilitated a participatory group model building project to develop a systems model that depicts the main mechanisms underlying the increasing sales, marketing, and consumption of unhealthy commercial beverages. We convened 28 national experts from government, academia, advocacy, funding agencies, and community organizations for a series of workshops and interviews and supplemented their insights with other evidence (e.g., research, public records).</p><p><strong>Results: </strong>The final systems model makes visible the multiple interacting pathways through which industry protects their profits and maintains the status quo. Some are well known, such as normalizing product purchasing, influencing policymakers in their favor, and shaping public opinion to support their work. Others are less appreciated, such as how health and environmental consequences produced by beverage industry activities feedback into the system, ultimately leading to a greater reliance on beverage industry products and weakening political will for adopting equitable health promotion policies. While actions by advocates, public health departments, and others to address unhealthy beverages were identified, much of their impact is undermined by the large and influential control the beverage industry has on the system.</p><p><strong>Conclusions: </strong>Gaining traction on addressing unhealthy commercial beverages is a complex problem with reinforcing cycles that strengthen the beverage industry's power and influence. The insights gained from the model suggest an ambitious action agenda based on systems principles that also centers the commercial determinants of health.</p>","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13411964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148375292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trade, power, and public health: a political economy analysis of Thailand's CPTPP negotiation process.","authors":"Cha-Aim Pachanee, Suriwan Thaiprayoon, Thammarat Marohabutr, Peamanee Chansorklin, Siriya Sirithienthong, Nantawan Yomchan","doi":"10.1186/s12992-026-01225-9","DOIUrl":"10.1186/s12992-026-01225-9","url":null,"abstract":"<p><strong>Background: </strong>The Comprehensive and Progressive Agreement for Trans-Pacific Partnership (CPTPP) has generated intense debate in Thailand, concerning its implications for public health, particularly intellectual property, and access to medicines. During 2018-2022, Thailand undertook an extended in-country process to provide evidence on its economic opportunity and public health challenges for the Cabinet decision. However, there is no evidence indicating whether Thailand has decided to join the CPTPP. This study examines Thailand's CPTPP negotiation process using a political economy framework, focusing on the institutional and actor landscape that shaped the negotiations.</p><p><strong>Methods: </strong>This study employed a qualitative research design grounded in political economy theory, integrating state-centred and power-centred analytical frameworks. Data collection comprised a document review and in-depth interviews with 31 stakeholders from the health and trade sectors, covering state officials, academics, the private sector, and civil society representatives.</p><p><strong>Results: </strong>The findings demonstrate critical public health concerns centred on pharmaceutical access, plant variety protection, and medical device regulatory standards. The findings also reveal a complex landscape of stakeholder dynamics and power asymmetries in Thailand's CPTPP negotiation process. Although both state and non-state actors played influential roles in shaping public discourse and decision-making, the decision-making was dominated by state trade actors, as the lead negotiating authority, marginalising health sector perspectives despite their active engagement. While civil society leveraged collaborative power to exert political pressure, structural imbalances and a lack of transparency persisted. In addition, intra-sectoral differences also existed and were influenced by institutional positioning.</p><p><strong>Conclusion: </strong>The study highlights the need for stronger institutional mechanisms to promote inclusive stakeholder participation and greater policy coherence between trade and public health objectives in future trade negotiations.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2026-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13579864/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148351870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global norms, local institutions: a controlled comparative case study of WHO essential medicines policy adoption in Eastern Europe.","authors":"Kristina Jenei, Elias Mossialos, Huseyin Naci","doi":"10.1186/s12992-026-01223-x","DOIUrl":"10.1186/s12992-026-01223-x","url":null,"abstract":"<p><strong>Background: </strong>To improve equitable access to medicines and avoid inefficient pharmaceutical spending, the World Health Organization (WHO) has long promoted five core principles regarding the selection of medicines for reimbursement: 1) the establishment of a national essential medicines list (NEML); 2) a diverse, independent selection committee; 3) an evidence-based methodology for selecting medicines; 4) integration with clinical guidelines; and 5) monitoring of use and expenditure. While many countries have formally adopted these principles, their integration into financing and procurement systems varies widely. Using Kingdon's Multiple Streams Approach (MSA) and the policy transfer framework, this study compares how WHO selection principles were adopted in two Eastern European countries: Ukraine (higher adopter) and Moldova (lower adopter).</p><p><strong>Results: </strong>Both countries established NEMLs aligned with WHO guidance, but only Ukraine more fully embedded these principles into pharmaceutical governance. Higer adoption in Ukraine is associated with sustained donor engagement, reform momentum, and domestic leadership. In Moldova, adoption remained largely absent, associated with weak institutional capacity and episodic donor support limiting integration.</p><p><strong>Conclusions: </strong>This study illustrates how international guidance interacts with political windows, domestic will, and patterns of donor engagement to shape reform trajectories. The findings suggest that global health guidance is most influential when coupled with long-term technical support, local champions, and mechanisms for institutional continuity, helping to move reforms towards meaningful system change.</p>","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13563743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148338463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Security governance and health inequity in contemporary crises: a critical discourse analysis of securitization, exception-making, and responsibility displacement.","authors":"Amir Khorram-Manesh, Harald De Cauwer, Dennis G Barten, Krzysztof Goniewicz","doi":"10.1186/s12992-026-01226-8","DOIUrl":"10.1186/s12992-026-01226-8","url":null,"abstract":"<p><p>Contemporary crises increasingly draw health systems, humanitarian access, medical supply chains, and civilian protection into security-oriented governance. While the health consequences of war and economic coercion, and geopolitical rivalry are widely documented, less attention has been paid to the discursive processes through which such consequences are rendered legitimate, unavoidable, or politically peripheral. This paper addresses this gap by applying a critical geopolitics framework and critical discourse analysis to examine how geopolitical narratives may structure health-relevant governance during crises. Drawing on a purposive, illustrative corpus - (i) a primary corpus of institutional and policy discourse (state communications, United Nations and World Health Organization documents, sanctions guidance, and international non-governmental organizations' reports) and (ii) a secondary corpus of scholarly literature, the study identifies three recurring discursive mechanisms: securitization, exception-making, and displacement of responsibility. Across five illustrative case contexts-US-China geopolitical rivalry, the Russia-Ukraine war, the Israel-Palestine/Gaza crisis, Iran-related sanctions and protest governance, and US-Venezuela sanctions governance-the analysis suggests how security narratives can condition humanitarian access, reshape the practical meaning of civilian protection, and diffuse accountability for health harms. Rather than arguing that discourse alone causes health outcomes, the paper treats discourse as one governance condition among others: it influences what becomes politically thinkable and institutionally actionable while interacting with military, economic, legal, and health-system factors. The findings advance critical health geopolitics and peace and security scholarship by showing how health inequities can function as a diagnostic lens through which norm erosion and the normalization of exceptional governance become empirically visible.Clinical trial numberNot applicable.</p>","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13309965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148307926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A social determination framework for mental health.","authors":"Franco Mascayano, María Teresa Muñoz-Quezada, Alfonso Urzúa, María Soledad Burrone, Rodrigo Casanueva, Sebastián Rojas-Navarro, Pamela Grandón, Sandra Saldivia, Cristian Montenegro","doi":"10.1186/s12992-026-01222-y","DOIUrl":"10.1186/s12992-026-01222-y","url":null,"abstract":"<p><strong>Background: </strong>Mainstream global mental health continues to privilege individual-level risk factors and biomedical approaches and treatments while sidelining the structural forces that shape mental distress. Despite calls for more socially embedded and decolonial approaches, policy and research too often neglect how structural phenomena such as globalization, colonialism, and neoliberal reforms directly drive mental health inequities.</p><p><strong>Main body: </strong>Drawing on Latin American traditions of social medicine-particularly Jaime Breilh's paradigm of social determination of health-this debate article critiques reductionist frameworks that fragment structural causation into depoliticized lists of risk factors. We articulate a social determination approach for mental health research and practice, emphasizing the multi-level embodiment of power relations, the historical-political organization of social life, structural drivers embedded in institutions and policies, and the role of collective agency and praxis. Illustrative vignettes from Latin America (employment, discrimination, and environment) demonstrate how historically structured processes linking global political economy, institutional arrangements, and everyday social relations become embodied as mental distress, and how participatory and mixed-method research can help document these dynamics while supporting transformative, community-led responses.</p><p><strong>Conclusions: </strong>We argue that adopting a social determination lens can reorient global mental health policy and scholarship toward structural justice, in line with recent international calls to decolonize and politicize mental health research.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2026-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13548658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148294795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The energy transition and export-credit agencies: problems or solutions for planetary health equity?","authors":"Sharon Friel, Nick Frank","doi":"10.1186/s12992-026-01224-w","DOIUrl":"https://doi.org/10.1186/s12992-026-01224-w","url":null,"abstract":"<p><strong>Background: </strong>Fossil-fuel dependant energy systems are bad for human health, unequally distributed and environmentally destructive including as a major source of greenhouse gas emissions. Low- and middle-income countries are expected to account for the bulk of emissions growth in the coming decades. How the energy transition is supported in those countries will affect planetary health equity - the equitable enjoyment of good health in a stable earth system. Much of the health and climate-related finance research has focused on health-care systems adaptation and emissions reduction. Little attention has been paid by the health community to the role of public finance in the energy transition more broadly and what that means for planetary health equity. In this paper we examine the role of export credit agencies (ECAs) in creating an equitable global energy transition towards renewables and the implications for planetary health equity. ECAs rank among the leading public financial institutions in global energy investment.</p><p><strong>Results: </strong>To characterize the topology of global energy finance networks, we examined lender-recipient investment ties and calculated structural metrics that enabled comparison of the integration, fragmentation, and relational patterns of fossil fuel and clean-energy finance networks. Using these network analysis methods, we found that fossil fuel investments dominate ECAs' energy finance globally, with cumulative support 12 times larger than renewable energy by 2021. Five countries (Canada, China, Japan, South Korea and US) account for 84% of fossil fuel support. The flow of clean-energy finance from high-income to low- and middle-income countries remains limited, with most investments in renewable energy occurring between high-income countries.</p><p><strong>Conclusions: </strong>The continuation of current ECA practices risk widening global inequities in the energy transition, drive greenhouse gas emissions, and ultimately contribute to climate-related death and disease. To enable planetary health equity, ECAs must cease all new fossil fuel project financing; expand policies to increase clean energy exports to developing nations; simplify processes for clean-energy enterprises; and expand ECAs' role in blended finance for development. Health actors must engage in this area of public finance to ensure funding decisions do not exacerbate global health and planetary health inequities.</p>","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148277230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The policy implementation playbook: a cross-policy taxonomy of post-adoption tobacco industry tactics.","authors":"Britta K Matthes, Karen Evans-Reeves, Tom Gatehouse, Rosemary Hiscock, Iona Fitzpatrick, Anna B Gilmore","doi":"10.1186/s12992-026-01220-0","DOIUrl":"10.1186/s12992-026-01220-0","url":null,"abstract":"<p><strong>Background: </strong>Tobacco industry interference during policy development is well documented, yet evidence on how the industry responds after policies are adopted and enter into force remains fragmented across policy domains and jurisdictions. This study systematically examines post-adoption tobacco industry conduct across key tobacco control measures and develops a cross-policy taxonomy of post-adoption tactics. We conducted as scoping review and qualitative evidence synthesis of peer-reviewed and grey literature, searching six data bases and Tobacco Control's News Analysis archive. Using inductive coding, we identified recurring forms of post-adoption industry activity and synthesised these into a conceptual taxonomy - the Policy Implementation Playbook (PIP).</p><p><strong>Results: </strong>We included 308 sources (210 peer-reviewed articles and 98 News Analysis items) spanning approximately 50 countries across all WHO regions, although documentation was concentrated in a limited number of settings. The PIP identifies five recurrent tactics. One - pre-emptive adaptation - occurs before a policy enters into force and includes stockpiling, transitional packaging, and early product or marketing adjustments. After a policy enters into force, the industry may disregard requirements, adopt token implementation that signals formal compliance while reducing practical impact, circumvent regulation through product-, design-, or channel-based tactics, or seek to influence implementation indirectly through retailers, hospitality actors, public authorities, and enforcers. Circumvention was the most frequently documented response across most policies, though its specific form varied across regulatory domains. Disregard and pre-emptive adaptation were also common, while token implementation was largely confined to health warning requirements. Smoke-free regulations more often elicited intermediary-focused strategies aimed at shaping interpretation, enforcement, and compliance.</p><p><strong>Conclusions: </strong>By conceptualising policy implementation as a contested political arena and synthesising recurrent tobacco industry tactics across policies, the PIP extends existing models of corporate political activity. The taxonomy provides a structured basis for anticipating post-adoption corporate conduct and strengthening regulatory design, implementation, and governance in tobacco control and the regulation of other unhealthy commodities.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13281631/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148239227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patent challenges without entry? Reassessing first generic exclusivity under the patent-linkage system in South Korea.","authors":"Youran Noh, Kyung-Bok Son","doi":"10.1186/s12992-026-01221-z","DOIUrl":"10.1186/s12992-026-01221-z","url":null,"abstract":"<p><strong>Background: </strong>South Korea introduced the First Generic Exclusivity (FGE) system as part of the patent linkage system to promote patent challenges and market entry of generic drugs. Evaluating the impact of FGE on the number of generic entrants is central to assessing the system. This study elucidates factors-including patent characteristics-that influence the number of FGE applicants and holders at the ingredient level.</p><p><strong>Methods: </strong>Using data from the Ministry of Food and Drug Safety, 85 ingredients with FGE applications filed between 2015 and 2025 were analyzed. For each ingredient, originator-based characteristics-including manufacturer type, patent characteristics, and drug characteristics-were collected, and the year of the first FGE application for each generic was identified. Negative binomial regression analysis was performed to determine factors affecting the number of FGE applicants, holders, and non-holders.</p><p><strong>Results: </strong>Among 85 ingredients, the mean number of FGE applicants was 6.59 (SD = 9.52, IQR 1-9), and the mean number of FGE holders was 4.61 (SD = 8.08, IQR 0-4). Regression results showed that the number of FGE applicants was positively associated with the number of patents and approval year, but negatively associated with the reimbursement price. The number of FGE holders showed positive associations with approval year and negative associations with reimbursement price. The application year was negatively correlated only with the number of FGE holders.</p><p><strong>Conclusion: </strong>Although the introduction of the FGE system and the expansion of patent portfolios increased patent challenges by generic manufacturers, this did not consistently translate into actual generic market entry, underscoring the need to reexamine whether the FGE system is effectively designed to foster substantive competition.</p>","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13308185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}