National Negotiations Research Articles

Layers of Politics and Power Struggles in the SDG Indicators Process

AbstractThe process of designing the 2030 Agenda for Sustainable Development was intensely political, as it can be expected of United Nations negotiations of that magnitude. Inevitably, those politics have spilled over into the technical process of formulating global indicators to monitor the Sustainable Development Goals. This commentary explores some of the tensions between competing priorities and various constituencies that affect the design of the global SDG indicator framework.

PCP15 - WHY EUROPEAN CROSS-BORDER INITIATIVES ON DRUG PROCUREMENT MAY FAIL?

Over recent years, ten European cross-country collaborations for drug procurement emerged to contain pharmaceutical costs. These initiatives encompass thirty countries. Although they share multiple objectives, the ultimate goal is a joint procurement of expensive medicines, leveraging the population size of involved countries. The prominent one is the Valletta Declaration. It gathers countries with a broad range of GDP and population size. The lack of operational framework is delaying the procurement initiation. To be attractive, they should operate like a single market with a unique price and a simultaneous access; however it is unlikely due to heterogeneous affordability. Due to subsidiarity principle of pricing policies, delegation of price negotiation to Valletta group will require national legislation. Large countries are not ready to give up their additional negotiation power and are looking for a second national negotiation, while smaller countries expect a single negotiation and a same net price for all countries. Low GDP countries expect subsidies from high GDP countries through differential pricing to ensure simultaneous launch which may not happen. Some countries, such as Spain and Portugal have organised joint tenders for generics and biosimilars until the Valletta framework is clarified. BeneluxA-I is expected to be the most promising collaboration; it gathers homogeneous countries with close culture and vision. The first attempt for joint procurement failed highlighting the limited power negotiation despite a quite well established framework. Other initiatives gather small countries, except Poland, with low affordability making them unattractive for providers to offer significant rebates. The top five markets in EU represent 75% of the whole European market providing them a strong negotiation power and leaving the smaller markets unease to achieve substantial discounts even when joining forces. Joined procurement requires a European Union engagement together with a differential pricing to help low affordability countries.

PSY31 - Europe-China Comparison of Orphan Drugs Approvals

Rare diseases, today, constitute a public health issue. Specific legislations to incentivize the development of orphan drugs were adopted in Europe in 1999, whereas no specific legislation was established in China until now. Therefore, our study aimed to assess the availability of orphan drugs in China compared to Europe and to discuss potential challenges facing orphan drugs in China. The official websites of European Medicine Agency (EMA) and China Food and Drug administration (CFDA) were searched to identify approved orphan drugs up until 01/03/2018 in Europe and China, respectively. The delays in approval were calculated and delay rationales were discussed. A total of 102 orphan drugs were approved in Europe. Among these 102 orphan drugs, 15 (14.7%) were approved in China. Only the drug Dacogen® was approved earlier in China than in Europe, with a time interval of 3.98 years. The median delay was 3.29 years. The shortest and longest time lags were 55 days and 14 years, for the drugs Nexavar® and Zavesca®, respectively. Delays in approval may be due to several reasons: 1) the lack of a clear definition of rare disease in China, 2) the requirement of completing a phase 1 study outside China before implementing clinical trial in China, 3) manufacturers’ decision because of complex procedures, concerns regarding the profitability and uptake in the market 4) other reasons include staff shortage in drug evaluation center and inadequate intellectual-property protection in China. Special approval procedure for priority review of orphan drugs has been established as of 2017 in China. In addition, orphan drugs may also achieve faster reimbursement by national drug price negotiation. Improvement is expected for orphan drugs access. However, more efforts and a specific legislation for orphan drugs are still needed in China to ensure rapid patient access to orphan drugs.

Quality standards and monitoring as water management tools: the case of nitrogen in rivers in France and Brittany

AbstractWater quality standards (QS) and river monitoring are widely accepted as preventive management strategies for the preservation of watercourses and at the same time they are criticized for imposing universal threshold values, leading to regulatory rather than voluntary action. Based on the example of nitrate, the article explains how QS applications are the result of national or regional negotiations, with no direct link to the scientific foundations underlying the development of these tools. These conflicting perceptions and how these tools are actually used are illustrated by the situation in Brittany. Here, the monitoring network and actions to prevent increasing nitrate concentrations in rivers form part of regional programs set up jointly by all the main stakeholders. However, while QS can act as an alarm signal, their effectiveness depends on local political support, which depends on the extent to which river quality is recognized as a key factor in regional development.

The friction of the mundane: on the problematic marketization of the carbon stored by trees in the tropics

ABSTRACTCarbon dioxide released from the burning of fossil fuels is a major concern of our times. There is now a political agreement that these emissions must decrease. So far one way forward has been to design and maintain carbon markets. As part of this process, trees in the tropics have been enrolled in peculiar transactions: actions such as reforesting a land of degraded savannah or preserving a piece of forest can produce tradable emission credits to offset against CO2 emissions in distant locations. Based on a multi-sited investigation of carbon offsetting, including fieldwork in the Congo, the paper presents a journey across different marketization sites where the enrolment of forest carbon into market exchanges can be seen to be at stake. Several operations are foregrounded, from United Nations negotiations and the measurement of carbon stocks, to business venture and legal work. The paper proposes a focus on the mundane that attends to details and frictions. This provides a deflationary story of the marketization of forest carbon, a story of contingencies and unexpected ramifications.

Carbon sink geopolitics

This paper explores an example of global politics in action by attending to the modalities and outcomes of United Nations negotiations on global warming. More precisely, the paper ethnographically traces how the capacity of tropical forests to act as carbon sinks is turned into a matter of global concern. The focus is on a negotiated policy called Reducing Emissions from Deforestation and forest Degradation (REDD+) and its anchoring in the Democratic Republic of the Congo, whose territory contains the second largest area of rainforest after Brazil. The paper discusses the importance of the promissory in climate actions, the multivalence of what is at stake and the porosity and resilience of national demarcation. To do so, it identifies three moments and sites of geopolitical re-composition: the formulation of international consensus, the work of preparatory agents and the quest for metrological inclusiveness. These moments and sites point to the theatricality and semi-secrecy of United Nations negotiations, the mobilizing activities of expatriate consultants hired with overseas aid funding and the unstable evidential grounds on which emission reduction efforts are based. The paper suggests that, through this series of processes, the carbon stored by tropical forests becomes a matter of global exigency.

Implementing integrated Care in Belgium: a nationwide mobilization

Introduction- background and problem statement. Belgium as well as other European countries are faced with an increasing prevalence of chronic diseases and an aging population, intensified by the complexity of multimorbidity. This demands changing the current health system which is primarily focused on specific disease management and acute care. The World Health Organization calls for a global movement towards integrated, people centered health services.5 Description of policy context and objective: Belgium has an accessible health care with a national, compulsory health insurance (covering 99% of the Belgian population). Health care system is highly fragmented, providers work on a ‘fee for service’ base, and there is little stimulation for multidisciplinary consultation and integration. In 2013 a national survey on health in a representative sample of the Belgian population stated that 28,5% reported one or more chronic disease.6 In October 2015 a national Plan: “Integrated Care for a better health” 7 was approved by all competent national and regional Ministers of public health. This Plan is based on the principles of Triple Aim8, and complementary principles of improving equity and job satisfaction for the care providers. The implementation of the national plan is one of the major health care reforms under the current government. A strategic choice has been made for a bottom up implementation strategy in pilot regions rather than the more classic top down regulation approach based on national negotiations with interest groups. At the same time a strong national guidance framework has been put in place. Target population: The Plan targets the whole Belgian population with a focus on people with a chronic disease. The call for pilot projects was successful with 70 applicants in regions of 100 000 to 150 000 inhabitants. Twenty candidates were selected, covering 1/3th of the Belgian population (3.672.558 inhabitants). Highlights: (innovation,impact,outcomes) These 20 pilot projects are being coached by an external consultant and receive state funding for coordination costs to develop a regional 4-year action plan. This regional action plan must be based on the needs and resources in their region (stratification of the population). Actions should cover 14 components: patient empowerment, case management, informal care, social and professional reintegration, prevention, care coordination and care continuity, incorporating the experience of the patients organizations, electronic shared/integrated patient record, multidisciplinary guidelines, testing innovative ways of financing integrated care, installing a culture of quality. All these actions should be dealt with according to the principles of change management. Those regional action plans that are approved will receive coordination funding to roll out their actions over 4 years., A scientific team will assist the pilot projects in building a culture of quality and procedures for auto-evaluation. The aim is to increase efficiency, these gains are reassigned to the project through a system of budget guarantees in health care. Comments on transferability and conclusion: The Belgian approach combines stimulation of bottom up ideas and entrepreneurship with guidance from the policymakers by setting out the framework for innovation and encouraging the collaboration between partners in the region. The co-creative process between policy makers and partners on the field seeks to establish the partnerships necessary to reach a sustainable integrated care system.

Back from oblivion? The rise and fall of the early initiatives against corporate tax avoidance from the 1960s to the 1980s

Tax havens and tax avoidance have gathered much interest, e.g., in the United Nations (UN) negotiations on the post-2015 development goals. The analyses of initiatives against corporate tax avoidance typically focus on developments from the mid-1990s onward. This article shows that contrary to the common perception, the country-by-country reporting initiative and many of the other contemporary policy responses had already been developed and discussed in the 1970s by the United Nations Commission and Centre for Transnational Corporations. I demonstrate how the weakening of the policy community of the UN and the failure of the Organisation of Economic Co-operation and Development (OECD) to refer to the earlier discussions, not only in the UN but also in the OECD, contributed to the passing into oblivion of these ideas. Other factors were the reframing of the UN work on multinational enterprises to human rights issues and the transformation of academic theories of the firm. The examples demonstrate how ideas shape world politics and how the oblivion of certain ideas can have concrete impacts on the power relations between its actors. The oblivion of the earlier debates paved the way for the triumph of more business-friendly discourses centred on the anti-corruption and corporate social responsibility arguments.

Early Insights from Commercialization of Gene Therapies in Europe.

After years of research and development, gene therapies are now becoming a commercial reality with several products approved by European regulatory authorities [...].

Participation, public policy-making, and legitimacy in the EU Voluntary Partnership Agreement process: The Cameroon case

This paper discusses how participatory policy-making processes such as the Voluntary Partnership Agreement (VPA) negotiations are and should be organised to foster political legitimacy and support. The VPAs are bilateral agreements between the European Union (EU) and timber producing countries. VPAs constitute a cornerstone in EU's Forest Law Enforcement, Governance and Trade (FLEGT) programme, the most important tool for the EU to address illegal logging problems. The EU requires that national VPA negotiations include participation by the relevant stakeholders. Based on primary data, we compare the VPA negotiations in Cameroon (2006–2009) with three different ‘ideal’ models of participatory policy-making: the rationalist, the communicative incremental and the mixed model, which we expect have different implications for legitimacy. We conclude that the Cameroonian process is closest to a rationalist model with elements of the mixed model, and that this has increased legitimacy and support only to a limited extent. For future processes in other countries, we recommend stronger elements of the mixed model, and more careful considerations about stakeholder identification processes; how to adapt policy-process to specific contexts; and how to strengthen communication and information flows. Considerations about these elements could also strengthen the applicability of the ideal models.

"Everywhere but not specifically somewhere": a qualitative study on why the right to health is not explicit in the post-2015 negotiations.

BackgroundThe Millennium Development Goals expire at the end of 2015 and global negotiations are underway to finalise the post-2015 Sustainable Development Goals. Much activism has occurred encouraging a post-2015 health and development goal embedded in the highest attainable standard of health (‘right to health’). Despite this, the right to health was absent in three key post-2015 intergovernmental Sustainable Development Goal proposals in 2014, one of which was reinforced by the United Nations General Assembly in September 2014 as the guiding document for ongoing interstate negotiations. This article examines why it appears the right to health, so far, is not gaining direct expression in post-2015 discussion.MethodsThis qualitative research is part of a broader study using thematic and discourse analysis examining the high-level policy debate on health goals in the discourse of the formulation of the post-2015 Sustainable Development Goals. Key-informant interviews were conducted in two interview rounds in 2013 and 2014, with participants from multilateral and other organisations (government, academia, civil society and philanthropy) responsible for health in the post-2015 development agenda (or the post-2015 development agenda more broadly). This study synthesises data from both interview rounds on Health and Human Rights in post-2015 Sustainable Development Goal negotiations.ResultsSix reasons why the right to health may not have gained effective traction in the unfolding post-2015 Member State negotiations were found. The first three reasons relate to broader issues surrounding human rights’ (including sexual and reproductive health and rights) positioning within international relations discourse, and the second three relate to the challenges of transforming the human right to health into a practically applied post-2015 health goal.ConclusionsThis paper reports the views of participants, many of who sit at the interface of United Nations and Member State negotiations, on the right to health’s location (and projected trajectory) at two temporal junctions in evolving post-2015 negotiations. The interviews provide insight into high-level hesitancy that the right to health be expressly incorporated in the final post-2015 health and development goal, as well as documents participants’ doubt that rights language will explicitly frame the broader Sustainable Development Goals, their targets and indicators.

The Sendai Framework for Disaster Risk Reduction: Renewing the Global Commitment to People’s Resilience, Health, and Well-being

The Sendai Framework for Disaster Risk Reduction 2015–2030 (SFDRR) is the first global policy framework of the United Nations’ post-2015 agenda. It represents a step in the direction of global policy coherence with explicit reference to health, development, and climate change. To develop SFDRR, the United Nations Office for Disaster Risk Reduction (UNISDR) organized and facilitated several global, regional, national, and intergovernmental negotiations and technical meetings in the period preceding the World Conference on Disaster Risk Reduction (WCDRR) 2015 where SFDRR was adopted. UNISDR also worked with representatives of governments, UN agencies, and scientists to develop targets and indicators for SFDRR and proposed them to member states for negotiation and adoption as measures of progress and achievement in protecting lives and livelihoods. The multiple efforts of the health community in the policy development process, including campaigning for safe schools and hospitals, helped to put people’s mental and physical health, resilience, and well-being higher up the disaster risk reduction (DRR) agenda compared with the Hyogo Framework for Action 2005–2015. This article reviews the historical and contemporary policy development process that led to the SFDRR with particular reference to the development of the health theme.

‘Neutral’ experts? How input of scientific expertise matters in international environmental negotiations

This contribution analyses under what conditions expert input is most likely to be regarded by government representatives as useful and how government representatives use input provided by experts. It widens the analytical lens examining multilateral negotiations within the United Nations Framework Convention on Climate Change (UNFCCC) between 2009 and 2011. The findings confirm the importance of deep knowledge, long-term involvement in the policy subsystem and networks. This research illustrates the importance of policy-entrepreneurial strategies such as proactively approaching government representatives and volunteering knowledge. Joining government delegations can increase expert input as they may gain access to the negotiation text. It is crucial to provide input early on in the negotiation cycle before the national negotiation position is decided. Scientific consensus on climate change facilitated by the Intergovernmental Panel on Climate Change (IPCC) resulted in a convergence of the actor’s beliefs towards understanding climate mitigation and adaptation as normative imperative. Actors, however, interpret expert input based on the consensual IPCC findings differently depending on their conflicting political objectives. Thus, instrumental and political use of expert input by the interest groups overlaps in the UNFCCC.

National identity and otherness in Greek speakers’ talk about immigration: Methodological and transdisciplinary reflections

The aim of the paper is to present the potential contribution of using Critical Discursive Psychology to study national identity and immigration. It draws upon a study on Greek national identity negotiations in relation to immigration. The study was guided by the perspective of banal nationalism which treats national identity as a form of life in a world divided into nation-states (Billig, 1995). In terms of Greek national identity and immigration, the study drew similarities between the perspective of banal nationalism and the critique of methodological nationalism (Wimmer and Schiller, 2002).

The Holy See on sexual and reproductive health rights: conservative in position, dynamic in response

The Holy See has engaged extensively in United Nations negotiations on issues concerning sexual and reproductive health rights as they have emerged and evolved in a dynamic global agenda over the past two decades. A meta-narrative review of the mission’s official statements was conducted to examine the positions, discourses and tensions across the broad range of agendas. The Holy See represents a fundamentally conservative and stable position on a range of sexual and reproductive health rights concerns. However, the mission has been dynamic in the ways in which it has forwarded its arguments, increasingly relying upon secularised technical claims and empirical evidence; strategically interpreting human rights norms in ways consistent with its own position; and framing sexuality and reproduction in the context of “the family”. Seen in the broader context of a “religious resurgence” in international relations, and in light of the fact that the Holy See has frequently sought to form alliances with conservative State and non-State actors, these findings make an important contribution to understanding the slow progress as well as the potential obstacles that lie ahead in the battle to realise sexual and reproductive health rights in a changing global political environment.

Climate Change Triage

Climate change is the first global triage crisis. It is caused by the overuse of a severely limited natural resource — the atmosphere’s capacity to absorb greenhouse gases — and millions of lives depend on how international law allocates this resource among nations. This Article is the first to explore solutions for climate change mitigation through the lens of triage ethics, drawing on law, philosophy, moral theory, and economics. The literature on triage ethics — developed in contexts such as battlefield trauma, organ donation, emergency medicine, and distribution of food and shelter — has direct implications for climate policy, yet it has been overlooked by climate change scholars. The triage lens rules out climate policies (including the current emissions path) that will lead to catastrophic warming, and it puts options on the table that are marginalized in the current United Nations negotiations on a climate change agreement. This Article examines three potential allocation principles that could potentially apply in climate change triage — utilitarianism, egalitarianism, and a market-based distribution — it concludes that egalitarianism is the preferable allocation principle from the standpoint of ethics and international law. This Article ends by exploring four major policy implications that emerge from viewing climate change through the lens of triage.

Input–output analysis of CO2 emissions embodied in trade: A multi-region model for China

Energy-related CO2 emissions embodied in international trade have been widely studied at the national level in recent years. The embodiment estimates help to explain the “weak carbon leakage” between industrial and developing countries and to reveal the so-called “consumption-based” emissions (or carbon footprint). These findings have implications on national climate policy and international negotiations. For a large country like China, spatial aggregation issues are important in embodied emission studies. Dividing the country into several regions, previous studies propose the hybrid emissions embodied in trade (HEET) approach for regional emission studies and use step-wise distribution of emissions embodied in trade (SWD-EET) analysis to explain indirect absorption patterns. In this paper, we combine the HEET approach and SWD-EET analysis to conduct a comprehensive study of China’s regional emission embodiments. We explain how inter-regional trade and international trade affect China’s regional domestic emissions, and present the resulting regional carbon footprint. Policy implications from the empirical results obtained are discussed.

The demise of social partnership or a balanced recovery? The crisis and collective bargaining in Slovakia

This article analyses the effects the crisis is having on collective bargaining processes, outcomes and institutions in national and sectoral negotiations in the Slovak Republic. It argues that the crisis has had no effect on the continuing demise of social partnership and on trade union marginalization at national level. At sectoral level, the crisis helped two highly organized sectors from the private and public domains of the Slovak economy – the metalworking and health care sectors – consolidate their bargaining institutions, though without bargaining outcomes improving trade union positions. Consolidation has been achieved through procedural changes to bargaining specific to each sector: intensified bargaining as a result of social partners’ common interest in anti-crisis employment measures in the metalworking sector; and the associational strength of trade unions and employer organizations despite escalating post-crisis wage disputes in the health care sector. Sector-level bargaining has thus contributed to a balanced recovery from the crisis more than national-level social dialogue.

Workers’ Agency and Re-Working Power Relations in Cambodia's Garment Industry

This paper explores Cambodian garment factory workers’ collective voice and ability to negotiate a living wage. Workers’ agency is examined through a case study of a large-scale strike in September 2010 over national minimum wage negotiations, led by two Cambodian trade union federations. Analysis is centred on four structural impediments to workers’ wage demands. First, the Cambodian People’s Party (CPP) consolidated power in 2008. As a result, space for independent trade unions and civil society is decreasing. Second, Cambodia is not deemed ‘competitive’ as a global sourcing option in terms of price, quality and speed to market. As a result, low wages and a proliferation of unmonitored subcontract factories are increasingly becoming the industry’s competitive advantage vis-a-vis Bangladesh and Vietnam. Third, the proliferation of fixed-duration contracts in Cambodia means work is less secure, with attendant impacts on workers and unions’ negotiating strength. And fourth, the unusually high number of plant-level and national trade union federations makes it difficult for ‘genuine’ unions to promote the rights of their members, and workers’ agency potential is marginalized. The intersection of these four structural forces circumscribes workers and independent trade unions’ ability to rework power relations with the employers association, the Garment Manufacturers Association in Cambodia (GMAC). Despite the challenges, workers and independent unions recognize themselves as the agents who must shape key demands, including on wages.

Patterns of National Factions' Strategic Moves in Peace Negotiations: A Perception-oriented Typology

By proposing a perception-oriented typology and applying it to the Cambodian peace negotiations, this study attempts to provide an analytic framework for examining the changes in national factions' negotiation strategies during civil war peace negotiation processes. Specifically, this article stresses that domestic negotiating actors readjust their strategies ‘phase by phase’ according to their subjective consideration of three factors: the contents of the peace proposal, the resources under their control, and the strength of the incentives and pressures from external interveners. Based on this finding, this study further (1) demonstrates that a peace negotiation is a continuous process in which multiple chances for successful conflict resolution also continuously change and (2) highlights the importance of perceptual factors in explaining the behaviour of national factions in peace negotiations.