Regional health governance: a comparative perspective on EU and ASEAN. EU Centre in Singapore Policy Brief No. 4, June 2012

Globalisation has led to new health challenges for the 21st Century. These challenges have transnational implications and involve a large range of actors and stakeholders. National governments no longer hold the sole responsibility for the health of their people. These changes in health trends have led to the rise of Global Health Governance as a theoretical notion for health policy-making. The Southeast Asian region is particularly prone to public health threats and it is for this reason that this brief looks at the potential of the Association of Southeast Asian Nations (ASEAN) as a regional organisation to take a lead in health cooperation. Through a comparative study between the regional mechanisms for health cooperation of the European Union (EU) and ASEAN, we look at how ASEAN could maximise its potential as a global health actor. Regional institutions and a network of civil society organisations are crucial in relaying global initiatives for health, and ensuring their effective implementation at the national level. While the EU benefits from higher degrees of integration and involvement in the sector of health policy making, ASEAN’s role as a regional body for health governance will depend both on greater horizontal and vertical regional integration through enhanced regional mechanisms and a wider matrix of cooperation.

Restoring Order in Global Health Governance: Do Metagovernance Norms Affect Interorganizational Convergence? CES Open Forum Series #23, 2014-2015

This paper theorizes about the convergence of international organizations in global health governance, a field of international cooperation that is commonly portrayed as particularly hit by institutional fragmentation. Unlike existing theories on interorganizationalism that have mainly looked to intra- and extraorganizational factors in order to explain why international organizations cooperate with each other in the first place, the paper is interested in the link between causes and systemic effects of interorganizational convergence. The paper begins by defining interorganizational convergence. It then proceeds to discuss why conventional theories on interorganizational- ism fail to explain the aggregate effects of convergence between IOs in global (health) governance which tend to worsen rather than cushion fragmentation — so-called "hypercollective action" (Severino & Ray 2010). In order to remedy this explanatory blind-spot the paper formulates an alternative sociological institutionalist theory on interorganizational convergence that makes two core theoretical propositions: first that emerging norms of metagovernance are a powerful driver behind interorganizational convergence in global health governance, and secondly that IOs are engaged in a fierce meaning-struggle over these norms which results in hypercollective action. In its empirical part, the paper’s core theoretical propositions are corroborated by analyzing discourses and practices of interorganizational convergence in global health. The empirical analysis allows drawing two far-reaching conclusions. On the one hand, interorganizational harmonization has emerged as a largely undisputed norm in global health which has been translated into ever more institutionalized forms of interorganizational cooperation. On the other, discourses and practices of interorganizational harmonization exhibit conflicts over the ordering principles according to which the policies and actions of international organizations with overlapping mandates and missions should be harmonized. In combination, these two empirical findings explain why interorganizational convergence has so far failed to strengthen the global health architecture.

Keeping health high on the EU agenda: role for economic governance? EPC Policy Brief, 7 May 2015

In an attempt to get Europe out of the economic crisis and establish right conditions for growth, the EU coordinates and monitors member states’ economic and budgetary policies via a system called the European Semester. As member states’ spending on the health sector accounts for 10% of GDP and is expected to grow, it is no wonder that an increasing emphasis has been paid to sustainability of health systems – an area that is traditionally considered as a national competence. In this Policy Brief, Annika Hedberg and Martina Morosi reflect on the strengths and weaknesses of the European Semester and country-specific recommendations in promoting more sustainable and efficient health systems in Europe, and why the EU must continue to play a role in encouraging member states to value health and improve their spending on health.