International Political Science Association

Research Committee 25:

Comparative Health Policy

Call for Papers (2006)

Globalization and Regulatory Governance:
The Case of Health Care and Healthcare Products

During the period of 2004 to 2006, RC 25 will continue its two-pronged approach to comparative health policy: the study of regulatory governance of industries, healthcare markets and products, on the one hand, and, on the other, health care reform. However, since 1997, when RC 25 began to examine regulatory governance in health care and healthcare products, the project description for this three-year period will expand the theoretical and empirical approaches to a novel element, namely, a focus on diseases.

RC 25 calls for papers to be presented at the 20th IPSA World Congress in Fukuoka, Japan, 9-14 July 2006. A paper should address international, regional or domestic health issues that use a variety of approaches in studying disease-related strategies and outcomes. Empirically, papers should include an exploration of the social, economic and political factors bearing on health and human rights, AIDs-HIV, health care at the end of life, healthcare reform, the distribution and frequency of certain diseases among specific population groups, etc.), and policy proposals adopted in response to specific health problems.

Unlike previous deadlines for IPSA World Congresses, this year the deadline for submitting the two panels is December 31, 2006. If you are interested in preparing a paper, please send a 300 page synopsis to the President of RC, Christa Altenstetter at caltenstetter@gc.cuny.edu no later than December 31, 2004.

Rationale: Dramatic political and economic transformations are taking place around the globe. Not only have these blurred the boundaries between public administration and healthcare systems towards competition and privatization, thus generating a shift in the balance of power away from the stewardship of the state to free markets, but also the boundaries traditionally drawn around subfields in political science: international relations, comparative politics and public policy. The imperative of “think globally, act locally” became the conventional wisdom throughout the 1980s. Fifteen years later, the conventional wisdom is replaced by another imperative: “Think globally, act globally.” The implications of these shifts in discourse and public action for the international health policy community(ies) are not always clear nor are they problematized or examined. Yet globalizing forces are at work at every level of decision-making: global, regional, national and local, which warrant systematic analysis.

Diseases pose severe challenges to the international (health) community, healthcare budgets, and stakeholders. The United Nations, WHO, UNICEF, and the World Bank and others have responded with a policy shift away from the delivery of health care to a disease orientation. This novel approach to fighting diseases raises high expectations everywhere. Yet, realistically, all international commitments to funding cures and services for special diseases fully depend on local capacities and care infrastructures to yield any significant outcomes and impacts. And despite these newly emerging international commitments by IGOs and NGOs, meaningful public action primarily remains a national and local enterprise, and any progress toward the achievement of goals largely depends on local educational and care infrastructures. Governments in industrialized and developing countries alike continue to face severe challenges in both implementing established regulatory policies and laws and launching regulatory strategies with a focus on new diseases. If the international community wants to better understand whether a disease-orientation works better than other approaches tried before, we need systematic research that explores the factors that shape and/or inhibit the domestic implementation of regulatory policies while recognizing that international and global as well as regional (e.g. European Union) factors remain crucial in any conversion process of international, transnational or national goals into concrete strategies and programs.

In contrast to the discipline of political science as a whole, which has used a variety of approaches, in health policy research the politics of policy making approach has been a dominant paradigm for the last twenty years. RC 25 invites these and complementary analytical perspectives on the well-founded belief that no single approach or methodology can explain the effectiveness of a disease-oriented strategy, a regulatory strategy or a cost containment strategy. Health policy research could use, for example, international relations approaches to explain the how and why of globalization and international trade with pharmaceuticals and medical technologies and regional integration (e.g. EU, MERCUSOR, ASEAN etc.). In the field of comparative politics, the new institutionalism would be useful in explaining the functioning of institutions in charge of regulation or a disease-strategy and in highlighting the particular trajectory of such institutions and the way they shape decisions on new health strategies. A public policy approach could help explain how policies are made on a daily basis, who participates in policy processes, and who is in charge of domestic implementation.

A few key issues stand out: under what conditions and with what policy tools can the international, regional or local health community implement its goals and strategies? What are the new institutional forms (formal and informal) for managing the growing interdependence of health policy discourse and national, transnational and global policy actors (state and non-state) Are nationally-oriented regulatory regimes, procurement, and other administrative practices being replaced and/or complemented by new global or regional regulatory regimes? What are the effects of globalization and regionalization of healthcare and healthcare product markets and industries on healthcare systems? How does a disease-oriented strategy fit into established practices?

A better fit between political discourse and pragmatic solutions is needed.

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