An exploration of power asymmetries and their impact on global COVID-19 access to medicines response

1.权力不对称如何在ACT A中表现出来，这如何影响ACT A的治理过程，以及这对该倡议促进公平获得医疗技术的目标有什么影响？a.哪些行动者参与了ACT A，他们使用了什么样的权力？B.这些行为者如何影响“行动A”的方案设定、拟订、决策和产出？C.什么样的结构性因素影响着权力行为者可以使用的类型，它们又是如何影响ACT A的？D.存在哪些权力不对称，这些不对称对ACT A进程有什么影响，如何减轻这些影响？e.行为者的权力与拟议的获取问题解决办法之间存在何种联系？F.关于温室气体的结构和问责制，行动A能告诉我们什么？2.哪些功率理论模型最适合用于理解温室气体中的功率？为了回答研究问题，该项目将采用混合方法，结合定性案头政策审查和跨部门利益相关者访谈。这将通过使用政策和灰色文献的范围审查、二级学术分析的文献审查、利益攸关方分析、利益攸关方访谈、内容分析和权力图来实现。本研究将从全球健康与政治研究中，找出具有理论价值的权力模型，并加以适应性修正，作为一个新的理论框架加以应用。因此，本项目的原创性贡献将是四方面的。首先，本项目将构建并试点一个植根于政治学和全球健康的跨学科混合理论分析框架，以提供一个理论上严格的研究与温室气体中的ACT A相关的权力。第二，从分析框架中产生的见解将对其他关键温室气体机制产生补充作用，这将为更广泛的温室气体研究提供一个有价值的模型。第三，该项目提供了一个及时和重要的分析温室气体和它的一个关键的获得药物的结构在最近历史上最大的健康危机。第四，鉴于ACT A是全球COVID-19免疫接种的一个新的基本组成部分，该项目将处于该领域新生和发展中研究的前沿。这些实证研究结果将对全球卫生行为体产生重要影响，包括它们各自如何占据政治空间和权力，以及这对多边倡议，特别是《行动建议A》的宗旨和成果的影响。此外，在与民间社会伙伴的合作下，这项研究的结果将能够就如何缓解权力不对称以及处于权力分配较弱一端的行为者如何更好地利用现有机会和发挥影响力提出建议。更重要的是，该项目旨在设计规范性和实用性建议，以帮助在ACT A倡议下增加公平分配，这是目前面临失败威胁的事情。

1. How have power asymmetries manifested within ACT A, how does this influence the governance processes of ACT A, and what implications does this have on the initiative's aim to promote equitable access to medical technology?a. Which actors are engaged in ACT A and what kind of power do they employ?b. How did/do these actors influence the agenda-setting, formulation, decision-making and outputs of ACT A?c. What structural factors influence the kinds of power actors can employ and how do they influence ACT A?d. Which power asymmetries exist, what impact did these have on ACT A process and how could these have been mitigated?e. What linkages, if any, exist between an actor's power and the proposed solutions to access issues?f. What can ACT A tell us about the architecture of and accountability in GHG?2. Which theoretical models of power can best be applied to understand power in GHG?To answer the research questions, the project will adopt a mixed-methods approach combining qualitative desk-based policy review and cross-sectional stakeholder interviews. This will be achieved through the use of a scoping review of policy and grey literature, a literature review of secondary academic analysis, a stakeholder analysis, stakeholder interviews, content analysis and power mapping. Theoretically valuable models of power from global health and political studies will be mapped out, amalgamated with adaptive revision, and applied as a novel theoretical framework.Consequently, the original contribution of this project will be four-fold. First, this project will construct, and pilot a cross-disciplinary mixed theory analytical framework rooted in political science and global health to offer a theoretically rigorous study of power associated with ACT A in GHG. Second, insights generated from the analytical framework will have complimentary translations to other key GHG mechanisms, which will provide a heuristically valuable model in the study of GHG more broadly. Third, this project offers a timely and significant analysis of GHG and one of its key access to medicines structures during the biggest health crisis in recent history. Fourth, given that ACT A is a new, yet fundamental component to global COVID-19 immunization, this project will be at the cutting edge of nascent and developing research in this area. These empirical findings will contain important implications for global health actors in terms of how they each occupy political space and power, and the implications this has on the purpose and outcomes of multilateral initiatives, particularly ACT A. Additionally, in collaboration with civil society partners, the findings of this research will be able to form recommendations as to how power asymmetries might be mitigated, and how actors at the weaker end of the distribution can better harness existing opportunities and have influence. More importantly, the project aims to design normative and practical recommendations to help increase equitable distribution under the ACT A initiative, something that is currently under threat of failure.