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Take-Home Exam Thoughts Part 1 - Coggle Diagram
Take-Home Exam Thoughts Part 1
HPA Triangle
Content
Context
Thai Rak Thai party come into power in 2001 with a "land slide vistory". They are presumed to have a large number of parliamentary voters if they had so much success. This can change how the process unfolds with less contestation from opposition parties around proposals
Mandate to provide UHC. Part of UHC is providing healthcare treatment that the people need. Once the need for HIV/AIDS treatment was established by civil society, the part would need to uphold the principles of UHC.
The Thai constitution was changed in 1977 to facilitate the inclusion of citizens in policy-making. Civil society has an easier time getting citizens to partake in policy discussion and can make an argument to uphold constitutional rights. This right can help frame topics if needed and empowers citizens to take responsibility
International Context
Access to HIV/AIDS treatment becoming globally recognized. WHO, UNAIDS and the pharmaceutical comapnies promoting wider access to ARVs. Philanthropic organisations and industrialized countries supporting the scale up of HIV/AIDs tretament
High costs of ARVs and lab tests, treatment complexity and lack of health system capacity (resources, finances, health staff, expertise, infrastructure)
Problem idetified
The HIV epidemic in Thailand started in
the late 1980s, and had affected almost 1 million of its 60
million population by the mid-1990s
Context changes when ART prices drop rapidly with local production of the GPO-Vir, a fixed dose combination drug.
Thailand is mix of state centred and Scoiety centred approach to policy making
Actors
International Actors
WHO
UNAIDS
Pharmaceutical industry
National Actors
Thai Health Minister
Committed to expand treatment to cover all Persons Living with HIV/AIDs. in the late 2001.
Civil Society Organizations (CSO)
WHO
The first formal signs of the agenda setting phase starts in 1994 when the WHO organise the Greater Involvement of People with HIV/AIDs meeting in paris where thailand and 42 other countries sign this declaration. This helps form the HIV/AIDs network. This declaration shows that the Thai government are serious about addressing HIV/AIDs. It encouraged PHA and CSOs to engage with the government on this topic.
Thai Rak Thai party
PHA network
Introduce actors in HPA
The actors are at the centre of the HPA triangle - refer to Buse.
Process
Intro
What is the HPA triangle
A framework that seeks to incorporate and understand political factors that influence policy-making.
"the role of policy actors in policy change, how they influence and are themselves influenced by contextual factors, policy design details, the processes of developing and implementing policy, and – centrally – how power plays out in these processes" - walt and Gilson 1994
"They are also influenced by process (were their interests and opinions considered and at which point/stage? Did they have access to the decision-making space was there a task force including civil society or only experts, or if they are implementers how was the policy communicated to them, do they understand the policy and agree with the intentions behind it?"
Notes from eleanor on actors at the centre and being influenced and influencing processes
"it puts actors at the centre and it says these other factors help to explain why actors behave as they do to push policy processes forward. But also, the red arrows are reminding you to think about the interactions between these sets of factors"
Why is it needed?
The policy making process (including agenda setting) is more than just good content in the policy. There are factors that influence what happens in the policy process and they factors influence each other. The politics of the policy is important through power dynamics.
I will be doing analysis of the Thai HIV/AIDS ART policy implementation and how the HPA framework can be used to understand how agenda setting took place.
The goal is not to show what happened but how it happened!
Interactions
Push to make ARVs cheaper by pharmaceutical companies changed the context of ARTs treatment. It is now much more affordable to implement. Actors influencing the context.
General thoughts
This exam is a culmination of the term but only the last big (agenda vs implementation) is a difference. Must go back to slides from the term.
Need to link what happened to why it happened using theory.
Question: Do references have to be recent (email Eleanor)