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Abstract

This dissertation documents the dynamics of global priority setting for health, focusing on the conditions under which issues manage to capture global policy attention. Dwelling on the issue attention cycle and on the advocacy coalition framework, it contributes to the literature by acknowledging the agency of issue entrepreneurs in building alliances and interpreting context to influence agenda formation. The analysis builds on four propositions to evaluate how coalitions, led by issue entrepreneurs, improve the likelihood of raising global attention. First, when advocacy coalitions are able to connect or benefit from ties with agenda gatekeepers and enabling platforms. Second, when they forge or identify focusing events. Third, when advocacy coalitions trace slow variables that inspire new ideas and paradigms. Fourth and finally, when they leverage one or various modes of power (material, discursive, knowledge and relational). Three case studies are investigated. (1) The attention to malaria control beginning in the late 1990s, past the failure of a previous global eradication campaign, reveals the ability of coalitions to transform—their promise of a successful story suited a moment when WHO and donors sought a cause to support. (2) The prioritization of neglected tropical diseases underlines the importance of advocacy coalition expansion, as well as the role of research and capacity building in constructing justification for policy pursuits. (3) Finally, the efforts to make non-communicable diseases global priorities depict how issue entrepreneurs learn from successful stories and academic literature to formulate agenda-setting strategies.

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