Capitalizing on success against childhood HIV/AIDS in Botswana: Towards a comprehensive healthcare policy for pediatric oncology in Botswana

Pediatric HIV/AIDS in sub-Saharan Africa has been a major public health crisis with an estimated 3.5 million children infected. Baylor International Pediatric AIDS Initiative (BIPAI) has created a network of centers providing care and treatment for these children in several countries. In Botswana, where the first BIPAI center in Africa was opened, childhood mortality from HIV/AIDS is now less than 1%. Botswana is a middle-income country that previously held the highest HIV prevalence rate in the world. Efforts against HIV/AIDS have resulted in the building of a strong medical infrastructure with clear success against pediatric HIV/AIDS. The WHO predicts the next global health crisis will be cancer. Given the increased incidence of cancer in the setting of HIV/AIDS, Botswana has already implemented strategies to combat HIV-related malignancies in adults, but efforts in pediatrics have been lagging. This policy paper describes the importance of building on success against pediatric HIV/AIDS and extending this success to pediatric cancer in general. Specifically, it outlines a comprehensive pediatric cancer policy for the education and training of health professionals, the development of a pediatric cancer program, a pediatric cancer registry, public awareness efforts, and an appropriate, country specific pediatric cancer research agenda.^

A comparative state policy analysis of the adoption of birth defects surveillance legislation

Birth defects are the leading cause of infant mortality in the United States and are a major cause of lifetime disability. However, efforts to understand their causes have been hampered by a lack of population-specific data. During 1990–2004, 22 state legislatures responded to this need by proposing birth defects surveillance legislation (BDSL). The contrast between these states and those that did not pass BDSL provides an opportunity to better understand conditions associated with US public health policy diffusion. ^ This study identifies key state-specific determinants that predict: (1) the introduction of birth defects surveillance legislation (BDSL) onto states' formal legislative agenda, and (2) the successful adoption of these laws. Secondary aims were to interpret these findings in a theoretically sound framework and to incorporate evidence from three analytical approaches. ^ The study begins with a comparative case study of Texas and Oregon (states with divergent BDSL outcomes), including a review of historical documentation and content analysis of key informant interviews. After selecting and operationalizing explanatory variables suggested by the case study, Qualitative Comparative Analysis (QCA) was applied to publically available data to describe important patterns of variation among 37 states. Results from logistic regression were compared to determine whether the two methods produced consistent findings. ^ Themes emerging from the comparative case study included differing budgetary conditions and the significance of relationships within policy issue networks. However, the QCA and statistical analysis pointed to the importance of political parties and contrasting societal contexts. Notably, state policies that allow greater access to citizen-driven ballot initiatives were consistently associated with lower likelihood of introducing BDSL. ^ Methodologically, these results indicate that a case study approach, while important for eliciting valuable context-specific detail, may fail to detect the influence of overarching, systemic variables, such as party competition. However, QCA and statistical analyses were limited by a lack of existing data to operationalize policy issue networks, and thus may have downplayed the impact of personal interactions. ^ This study contributes to the field of health policy studies in three ways. First, it emphasizes the importance of collegial and consistent relationships among policy issue network members. Second, it calls attention to political party systems in predicting policy outcomes. Finally, a novel approach to interpreting state data in a theoretically significant manner (QCA) has been demonstrated.^

Observations from the Balcony: Directions for Pediatric Health Disparities Research and Policy

In 2002, the Institute of Medicine released Unequal Treatment: Confronting Racial and Ethnic Disparities in Healthcare, a landmark monograph documenting health disparities in the U.S. health care system. Since the publication of Unequal Treatment, the field of pediatric health disparities research has advanced significantly with a proliferation of studies examining a wide array of topics concerning inequities in child health. Advances in health care policy and legislation have also added to a heightened discourse on pediatric health disparities. While there has been substantial activity in efforts to address pediatric health disparities, questions remain regarding whether these efforts have changed the trajectory of health equity among children. The aim of this paper is to examine the practical challenges of addressing pediatric health disparities in the dynamic context of global changes in health care research, policy, and legislation relevant to children. Using the Adaptive Leadership framework, this paper outlines a conceptual model for assessing the scope of progress made in addressing pediatric health disparities, diagnoses the continued adaptive challenges of pediatric health disparities, and provides an agenda for further work and future investment.

Investigación sobre aborto en América Latina y El Caribe : una agenda renovada para informar políticas públicas e incidencia. Resumen ejecutivo

Es un resumen ejecutivo de la publicación con el mismo título que refiere a un estado del arte que reúne el conocimiento disponible, producido en América Latina en el período 2009 a 2014. Aborda diversos aspectos de los temas más relevantes de la investigación sobre aborto inducido, desde una revisión crítica de resultados y metodologías, que apunta a identificar tendencias y resultados notables en cada temática, así como a reseñar sugerencias que podrían fortalecer el enfoque o el abordaje del tema, a identificar los vacíos o las lagunas de conocimiento en cada temática y, sobre todo, a ofrecer insumos para la elaboración de una agenda de investigación en la región, la cual oriente el trabajo de la comunidad de investigadores/as y activistas y responda a la demanda de producción de información confiable basada en evidencias, lo cual fortalecerá acciones de incidencia informada. Se encuentra disponible en español y en inglés.

Policy forums: Why do they exist and what are they used for?

Policy forums are issue-based intermediary organizations where diverse types of political and societal actors repeatedly interact. Policy forums are important elements of modern governance systems as they allow actors to learn, negotiate, or build trust. They can vary in composition, size, membership logic, and other distinct features. This article lays the foundation of a theory of policy forums based on three interrelated elements: First, it discusses conditions for the formation of a forum and describes the logic of these organizations as one of an asymmetric multipartite exchange. Second, it enumerates the potential set of goals and motivations of participating actors that are fed into this exchange. Third, it proposes eight different dimensions on which policy forums differ and which affect the exchange mechanisms among actors. We claim that empirical work on policy forums should systematically take these elements into account and propose elements of a research agenda.

Greece and the European Agenda: EU Enlargement and European Monetary Union. Program for the Study of Germany & Europe Working Paper 8.2

In the decade to come, the European Union will embark on two new projects, each destined to transform it in fundamental ways: (i) Eastern enlargement, and (ii) economic and monetary union. Neither of these projects will affect all members equally or in the same way. But Greece will, for two reasons, be affected in a manner qualitatively different to all other member states. First, Greece is the only country physically affected by the Luxembourg Summit's decision to begin accession negotiations with some, but not all, Central and Eastern European applicant countries: as a result of this decision, she will continue, for at least another eight to ten years, to be the only member country not to share a common border with another member state, with all the consequent implications in economic and geostrategic tenns. Second, when the European Council meets in early May to select those member states that are deemed to have met the convergence criteria, it will find that Greece is the only member state falling short of those criteria. This development may create additional difficulties for her economy during the transitional period of derogation. It will also pose new risks to Greece, insofar as she will be absent during the initial-and crucial-years of establishing a common monetary policy.

Europe's growth problem (and what to do about it). Bruegel Policy Brief 2013/03, April 2013

The issue: The European Union's pre-crisis growth performance was disappointing enough, but the performance has been even more dismal since the onset of the crisis. Weak growth is undermining private and public deleveraging,and is fuelling continued banking fragility. Persistently high unemployment is eroding skills, discouraging labour market participation and undermining the EU’s long-term growth potential. Low overall growth is making it much tougher for the hard-hit economies in southern Europe to recover competitiveness and regain control of their public finances. Stagnation would reduce the attractiveness of Europe for investment. Under these conditions, Europe's social models are bound to prove unsustainable. Policy Challenge: The European Union's weak long-term growth potential and unsatisfactory recovery from the crisis represent a major policy challenge. Over and above the structural reform agenda, which vitally important, bold policy action is needed. The priority is to get bank credit going. Banking problems need to be assessed properly and bank resolution and recapitalisation should be pursued. Second, fostering the reallocation of factors to the most productive firms and the sectors that contribute to aggregate rebalancing is vital. Addressing intra-euro area competitiveness divergence is essential to support growth in southern Europe. Third, the speed of fiscal adjustment needs to be appropriate and EU funds should be front loaded to countries in deep recession, while the European Investment Bank should increase investment.

Enlargement Agenda - Special focus on Macedonia, Serbia and Kosovo. CEPS Commentary, 27 March 2013

This CEPS Commentary notes that this is a critical time for the EU’s enlargement agenda with competing interests at play – between those who suggest that further enlargement is a heavy burden that the EU can ill afford in the current economic climate, and others who continue to believe that extending the frontiers of peace and security to include the Balkan countries will make the EU a safer place. To counter the naysayers, Erwan Fouéré underlines the importance for the EU to show that its current strategy continues to deliver dividends, as it certainly does in the case of Kosovo and Serbia. He further advises the EU to be ready to adapt its strategy where necessary, as in the case of Macedonia, by using whatever leverage it has in a more direct and consistent way and ensuring that its policy objectives and strategy in this area are based on the progress assessment narrative and not the other way around. In his view, opening accession negotiations with Macedonia will be the only way to prevent the country from sinking into further political instability.

Juncker raises high expectations with ambitious agenda. CEPS Commentary, 16 July 2014

Based on his speech to the European Parliament on July 15th, following his election as President of the European Commission, Jean-Claude Juncker has clearly opted for ‘more Union’ during his five-year term, offering up an ambitious agenda that raises a host of expectations. In this CEPS Commentary, Karel Lannoo outlines the most salient items on Juncker’s agenda, focusing on the most laudable and those that will pose the greatest challenges.

The New Juncker Commission: The Digital Agenda. CEPS Commentary, 26 September 2014

In assessing the challenges facing Andrus Ansip, as Vice-President-designate for the Digital Single Market, and Günther Oettinger, as Commissioner-designate for Digital Economy and Society, Colin Blackman and Andrea Renda find that leadership and building real consensus among the member states will be the main keys to achieving what is, in their view, the most ambitious and important of the new Commission’s objectives. And, as they note further, their challenge is even greater, if one considers that, if successful, the Digital Agenda will have to be the last one. Five years from now, the ‘digital agenda’ will have become, simply, the agenda.

The parliamentary elections in Ukraine: new hope? EPC Policy Brief, 21 October 2014

Ukraine’s parliamentary elections on 26 October 2014 seem set to be the most important and most challenging the country has ever held. For the first time in Ukraine’s history, the presidential election of Petro Poroshenko in May gave many Ukrainians new hope. His victory seemed to unite the country, being the first president to have won in most of the regions despite the ongoing conflict in the East. However, with many corrupt elites still in power, reforms have become hostage to vested interests and in-fighting which has raised fears of ‘business as usual’. This has made this election campaign set against a backdrop of serious challenges dominating the agenda for the foreseeable future. In this policy brief, Amanda Paul and Svitlana Kobzar explore the status of the reform agenda needed for a stable and democratic Ukraine as well as the challenges in the run up to the election including corruption, energy and EU relations.

It has only just begun: EU and anticorruption institutions in Moldova. EPC Policy Brief, 1 August 2014

The Republic of Moldova recently signed the Association Agreement with the EU, closely followed by a detailed Association Agenda, which comes with concrete steps and conditionalities in the future dialogue between Chisinau and Brussels. The current paper discusses the most recent evolutions of the anticorruption institutions in Moldova, which owe a lot to EU`s influence. We pay specific attention to the justice reforms chapters in the Agenda and we conclude with recommendations for the EU to continue to pay attention to corruption in Moldova, but address it in a more coherent manner.

Immigration and free movement in an unusual electoral race: what implications for the next political cycle? EPC Policy Brief, 20 May 2014

Immigration and freedom of movement of EU citizens are among the main issues debated throughout the European Parliament election campaign and have some potential in determining who tomorrow’s EU leaders will be. This Policy Brief looks at how the two policies are debated at national level – in France, Germany and the UK – and at EU level between the ‘top candidates’ for European Commission Presidency – Jean-Claude Juncker (EPP), Ska Keller (Greens), Martin Schulz (PES) and Guy Verhofstadt (ALDE) – who have participated in several public debates. Two different campaigns have been unfolding in front of EU citizens’ eyes. The tense debate that can be identified at national level on these issues, is not transferred to the EU level, where immigration and free movement are less controversial topics. Furthermore, although participating in European elections, national parties present agendas responding exclusively to the economic and social challenges of their Member State, while the candidates for the Commission Presidency bring forward ‘more European’ programmes. Hence, several aspects need to be reflected upon: What will the consequences of this discontinuity be? How will this impact the future European agenda in terms of immigration and free movement? What institutional consequences will there be? Answering these questions is not a simple task, however, this paper aims to identify the parameters that need to be taken into account and the political landscape which will determine the future EU agenda in terms of immigration and free movement.

Defining Europe's Capital Markets Union. Bruegel Policy Contribution Issue 2014/12, 13 November 2014

The new European Commission has signalled that it will work to create a ‘capital markets union’. This is understood as an agenda to expand the non-bank part of Europe’s financial system, which is currently underdeveloped. The aim in the short term is to unlock credit provision as banks are deleveraging, and in the longer term, to favour a more diverse, competitive and resilient financial system. Direct regulation of individual non-bank market segments (such as securitisation, private placements or private equity) might be useful at the margin, but will not per se lead to significant capital markets development or the rebalancing of Europe’s financial system away from the current dominance by banks. To reach these goals, the capital markets union agenda must be broadened to address the framework conditions for the development of individual market segments. Six possible areas for policy initiative are, in increasing order of potential impact and political difficulty: regulation of securities and specific forms of intermediation; prudential regulation, especially of insurance companies and pension funds; regulation of accounting, auditing and financial transparency requirements that apply to companies that seek external finance; a supervisory framework for financial infrastructure firms, such as central counterparties, that supports market integration; partial harmonisation and improvement of insolvency and corporate restructuring frameworks;and partial harmonisation or convergence of tax policies that specifically affect financial investment.

European Neighbourhood Policy Package - Conclusions for the Eastern Partners. OSW Commentary No. 78, 2012-05-25

In 2011 the European Union began a process aimed at reforming its policy on the Eastern and Southern Neighbourhood. The change in circumstances in neighbouring countries following the Arab Spring, along with the lack of significant progress regarding Eastern Europe’s integration with the EU, formed the main driving force behind this process. The prime objective of the changes to the European Neighbourhood Policy (ENP) was the need to introduce new incentives for partner countries to modernise and integrate more closely with the EU Another aim was to increase the flexibility of EU instruments (by adapting them to the specific context of each partner state). One year later, on 15 May 2012, the European Commission and the EU High Representative for Foreign Affairs and Security Policy published the European Neighbourhood Policy Package which reported on the progress made in the implementation of the ENP over the preceding year and set out the aims and Action Plans for 20131. An analysis of the outcomes of changes made to the EU policy towards Eastern Europe and the South Caucasus suggests that the aim of the revision was aimed more at addressing the changing political landscape in the region rather than at the implementation of a substantial reform of the neighbourhood policy. The ENP is largely based on bureaucratic procedures (the negotiation of bilateral agreements, the implementation of support programmes). These have only a limited capacity to bring about lasting change in the region, as has been exemplified by the deterioration of democratic standards in a number of countries; this was highlighted in EU’s own reports. This problem is particularly clear in the case of Ukraine; until recently it was seen as the leader of European integration but is now raising much concern due to a deterioration in the state of democracy there. EU instruments have a limited influence on the situation in Eastern Partnership countries and the region’s significance on the EU’s agenda is falling (the priority is now given to counteracting the economic crisis, and prominence in the neighbourhood policy has been given to the Southern Mediterranean). In response to this EU policy on Eastern Europe will focus to a larger extent on technical and sectoral cooperation.