consucrats and pathocrats: the prequel, quel, and sequel; a response to the recent commentaries

In recognition of the global burden of non-communicable diseases (ncds), the past decade has seen three united nations high-level meetings (un hlms) on ncds. yet progress in terms of political or financial commitments has been very slow. at the 2018 meeting, a political declaration was approved but featured language that had been watered down in terms of commitments. in “competing frames of global health governance: an analysis of stakeholder influence on the political declaration on non-communicable diseases,” suzuki et al analyze the documents that were submitted by member states, non-governmental organizations and the private sector during the consultation period and conclude that the private sector and several high-income countries (hics) appeared to oppose regulatory frameworks for products associated with ncds, that wealthier countries resisted financing commitments, and that general power asymmetries affected the final document. this comment supports their findings and provides additional considerations for why the ncd response has yet to produce significant commitments.