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How to set the agenda for hepatitis C: a theory-driven policy analysis
BACKGROUND: Hepatitis C virus (HCV) represents a significant public health burden. When new HCV drugs arrived in 2014, the disease became curable, but the administration remained reluctant to address this public health issue. However, the Swiss parliament recently decided to integrate HCV into the n...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8842797/ https://www.ncbi.nlm.nih.gov/pubmed/35164777 http://dx.doi.org/10.1186/s12961-022-00824-3 |
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author | Kind, Julia Maeschli, Bettina Bruggmann, Philip |
author_facet | Kind, Julia Maeschli, Bettina Bruggmann, Philip |
author_sort | Kind, Julia |
collection | PubMed |
description | BACKGROUND: Hepatitis C virus (HCV) represents a significant public health burden. When new HCV drugs arrived in 2014, the disease became curable, but the administration remained reluctant to address this public health issue. However, the Swiss parliament recently decided to integrate HCV into the next national HIV programme. This study investigates how HCV came onto the political agenda in Switzerland and which actors and factors were influential in this process. METHODS: The data collection is based on document analysis and semi-structured interviews. The transcripts were coded by deriving the codes from the data in terms of content followed by the application of the multiple streams framework. RESULTS: Health authorities, unlike experts, did not see the HCV epidemic as a relevant public health threat. Due to cost-related restriction of access to treatment, the potential of the new HCV drugs could not be fully exploited. The administration’s position proved difficult to change, despite evidence to the contrary. For 30 years, authorities set the agenda in health policy regarding HCV, unheeded by politicians. But recently, a policy entrepreneur has for the first time successfully managed to put HCV on the political agenda. After years of education and lobbying, it used the window of opportunity in the form of the new edition of the national HIV programme. The parliamentary decision to include HCV in this programme broke the long-standing primacy of the administration in the field of HCV, which had long prevented a more active handling of the HCV field. CONCLUSIONS: The case of HCV in Switzerland shows that evidence alone is not enough to bring about health policy changes. A policy entrepreneur is needed who overcomes resistance, brings together the three streams—problem, policy and political—and exploits the window of opportunity at the right time. To be successful, the policy entrepreneur must identify the indicators that map the problem, network and convince decision-makers, recognize policy windows and use them—as has been the case with HCV in Switzerland. |
format | Online Article Text |
id | pubmed-8842797 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-88427972022-02-16 How to set the agenda for hepatitis C: a theory-driven policy analysis Kind, Julia Maeschli, Bettina Bruggmann, Philip Health Res Policy Syst Research BACKGROUND: Hepatitis C virus (HCV) represents a significant public health burden. When new HCV drugs arrived in 2014, the disease became curable, but the administration remained reluctant to address this public health issue. However, the Swiss parliament recently decided to integrate HCV into the next national HIV programme. This study investigates how HCV came onto the political agenda in Switzerland and which actors and factors were influential in this process. METHODS: The data collection is based on document analysis and semi-structured interviews. The transcripts were coded by deriving the codes from the data in terms of content followed by the application of the multiple streams framework. RESULTS: Health authorities, unlike experts, did not see the HCV epidemic as a relevant public health threat. Due to cost-related restriction of access to treatment, the potential of the new HCV drugs could not be fully exploited. The administration’s position proved difficult to change, despite evidence to the contrary. For 30 years, authorities set the agenda in health policy regarding HCV, unheeded by politicians. But recently, a policy entrepreneur has for the first time successfully managed to put HCV on the political agenda. After years of education and lobbying, it used the window of opportunity in the form of the new edition of the national HIV programme. The parliamentary decision to include HCV in this programme broke the long-standing primacy of the administration in the field of HCV, which had long prevented a more active handling of the HCV field. CONCLUSIONS: The case of HCV in Switzerland shows that evidence alone is not enough to bring about health policy changes. A policy entrepreneur is needed who overcomes resistance, brings together the three streams—problem, policy and political—and exploits the window of opportunity at the right time. To be successful, the policy entrepreneur must identify the indicators that map the problem, network and convince decision-makers, recognize policy windows and use them—as has been the case with HCV in Switzerland. BioMed Central 2022-02-14 /pmc/articles/PMC8842797/ /pubmed/35164777 http://dx.doi.org/10.1186/s12961-022-00824-3 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Kind, Julia Maeschli, Bettina Bruggmann, Philip How to set the agenda for hepatitis C: a theory-driven policy analysis |
title | How to set the agenda for hepatitis C: a theory-driven policy analysis |
title_full | How to set the agenda for hepatitis C: a theory-driven policy analysis |
title_fullStr | How to set the agenda for hepatitis C: a theory-driven policy analysis |
title_full_unstemmed | How to set the agenda for hepatitis C: a theory-driven policy analysis |
title_short | How to set the agenda for hepatitis C: a theory-driven policy analysis |
title_sort | how to set the agenda for hepatitis c: a theory-driven policy analysis |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8842797/ https://www.ncbi.nlm.nih.gov/pubmed/35164777 http://dx.doi.org/10.1186/s12961-022-00824-3 |
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