28 Apr 2020 : Nudging will not redress the inequalities of COVID-19 in Latin America

By Professor Pia Riggirozzi

Since the first case of coronavirus was confirmed in January 2020 the disease has killed about 200,000 people worldwide (as of 28 April 2020). In this same period, Oxfam reports that over 900 thousand people died from other causes due to lack of access to health care, amongst other socio-political and economic determinants. Poverty is as lethal than the virus; or more…

We know that the coronavirus will have devastating effects on the world economy, certainly more intense and different from those experienced during the financial crisis of 2008-2009, and this will negatively affect Latin America and the Caribbean, already the most unequal region in the planet. According to the Economic Commission for Latin America and the Caribbean (ECLAC) Latin America will see 5.3% decrease in the region’s GDP,  the worst in its history since the Great Depression in the 1920s. It is also expected that this retraction will push up the number of poor people in the region, from the current 185 million to about 220 million, out of a total of 620 million inhabitants. Likewise, the number of people living in extreme poverty would rise from 67.4 million to 90 million. unemployment rate would be around 11.5%, which implies an increase of 3.4% compared to 2019. Adding to this bleak situation, unemployment is expected to affect 37.7 million people, 11.6 million more than last year.

Not surprisingly, across Latin America, the poorest see the pandemic with more fear of poverty and hunger than the virus. Certainly, we have learned from previous pandemics like Ebola Zika and swine flu or Influenza A that pandemics exacerbate almost all forms of social injustice and that inadequate political responses leave legacies that can be as severe as the disease itself. How will the region face the epidemic with a predicted increase of 34% of its population living in poverty and 11% in extreme poverty?

COVID-19 reveals and deepens three challenges in Latin America. There is an immediate health challenges (in weak or weakened states) with fragile health systems. There is also medium and long-term challenges related to fighting poverty, socioeconomic and gender inequalities and inequities, as well as job insecurity. The challenge for Latin America and the Caribbean is not only to contain the spread of the virus, but to address the living conditions of its citizens, many of them with informal jobs, that in confinement means not even accessing to any social protection, income and labour rights – also many of them women, as they are more likely to work in the informal economy with little or no employment rights. Finally, there is a challenge of financing social policies in the context of falling activity and taxes while additional spending needs associated with short and long-term medical and social needs will increase.

These are extraordinary threats. Whatever it takes to address them should lead to inclusive policies and resources from governments, multilateral organisations and philanthropies to redress structurally inequalities and long term vulnerabilities within and across societies. For this will be imperative to increase coverage through cash transfer programmes but also the introduction of emergency employment programmes, to create job opportunities for those displaced from formal sector and to absorb those in informality, as well as health, sanitation, and housing policies. This will also require to move away from the already very problematic, popularised and normalised politics of nudging. Incorporating nudges into COVID approaches and communication is not only unrealistic in many situations in developing countries but also insulting. Wash your hands, don’t touch your face, don’t shake hands with others, stay at home, do home schooling (again, a burden that disproportionately fall on women) do not work where many have no access to water, sanitary conditions, leave in crowded slams or semi-urbanisation where it is difficult to ensure physical space, and have no access to internet or to education. This is not just a health crisis, controlling the pandemic is about taking full account of long-term gendered development needs and human rights to redress inequalities and cycles of deprivation and exclusion.

 

Displaced women and girls in Latin America threatened by COVID-19

This article by Professor Pia Riggirozzi, Natalia Cintra and Jean Grugel originally appeared in Open Democracy on the 15th of April 2020. The original version can be found at: https://www.opendemocracy.net/en/democraciaabierta/displaced-women-and-girls-latin-america-threatened-covid-19/

Health emergencies exacerbate almost every form of social injustice in the global South. State biases, governance failures and inadequate and inappropriate policy responses leave legacies that can be as bad as the disease itself. In situations of crisis, public service provision and access to health and welfare services can rapidly deteriorate.

The impacts are greatest on the already vulnerable, including poor women and children, ethnic minorities, displaced people and the long-term poor. Communities and people displaced by war, conflict and violence are exceptionally vulnerable to COVID-19, as The Lancet recently noted. With physical distancing almost impossible, and access to crowded housing and shared water supplies, policies based on quarantine and ‘sheltering at home’ are of very limited value.

For displaced women and girls, who account for around 50% of displaced people, and whose needs are invisiblised even in ‘normal’ times, the health risks posed by COVID-19 are huge.

Pandemics are not gender neutral. We know from previous outbreaks such as Ebola, Zika and SARS that they reinforce gendered roles of care and reduce access to sexual and reproductive health services, either because of shortages of supplies, medicines and specialist health care workers or because resources are redirected in times of crisis in ways that reflect away the priorities of (generally male) policy makers, rather than the needs of women.

Levels of domestic and gender-based violence rise. For displaced women and girls who often rely on relief and humanitarian organisations for accessing gender-based violence services and counselling, sexual and reproductive health information services, HIV and sexually transmitted infections tests, contraception, abortion, and gynaecological care.

COVID-19 may well deprive displaced women and girls of the essential protection services they depend on and exacerbate the risks they already face to their wellbeing and lives.

A policy paradigm is needed based on both recognising the dignity of women and girls and state obligations to respect, protect and deliver human rights.

How will COVID-19 impact on the health and well-being of this exceptionally vulnerable group? How should policy makers respond so as to minimise the immediate impacts and promote longer-term health needs of women and girls in displacement? We consider these questions in relation to the growing numbers of displaced women and girls in Latin America and as part of a call for redressing gendered health inequalities in displacement.

We suggest that international organisations and states of transit and abode need urgently to target resources to address the immediate and long term health needs of women and girls in displacement. A policy paradigm is needed based on both recognising the dignity of women and girls and state obligations to respect, protect and deliver human rights in ways that protect the health of vulnerable populations, and contribute to breaking cycles of deprivation and exclusion.

Displaced women and girls in Latin America: rising numbers, unaddressed health needs

In the last decade alone, El Salvador, Guatemala and Honduras have seen the number of asylum-seekers and refugees northwards grow rapidly, to a total of 396,000 – an increase of 58% from 2016. In Venezuela, 5 million have left their country for Colombia, Brazil, Ecuador and the Caribbean since 2014. Women represent around 30% of the total of Central American migrants to Mexico, and 50% of Venezuelan migration to Brazil and Colombia.

These women and girls have often faced greater protection risks associated with violence, intimidation, trafficking, abuse, rape, sexual assault, as well as situations of discrimination and stigma, language barriers and differences in sociocultural norms, social exclusion and poverty. These risks may be increased due to internal and external travel restrictions, difficulties in accessing health services and medicines at border sites, in transit and in settlements, as well as a lack of documentation. Many work in the informal sector without social protection and take responsibility for children and other members of their households. Even without a pandemic, displaced people living as refugees, migrants or internally displaced due to conflict, natural disaster or extreme poverty, are often unwell and face immense barriers to accessing healthcare and sanitation facilities, in often over-crowded camps or shelters.

Take for instance Boa Vista, a Brazilian city in the northern state of Roraima and main gateway into Brazil for Venezuelans fleeing the ongoing economic, political and social crisis, including the collapse of health systems. The UNHCR reported that only 3 out of 13 shelters are currently considered low risk in terms of spreading the coronavirus. In addition, increasing numbers of Venezuelans are being made homeless following evictions and closures of shelters, impacting negatively on public perceptions of these refugees and migrants.

Health policy neglect is particularly worrying amongst indigenous women, such as those from the Warao communities, who are part of the thousands of Venezuelans that have fled to Boa Vista.

Furthermore, restrictions to migrants’ access to healthcare services is deepening their neglect. Some responses from the federal government and international organisations have sought to address this, for example by setting up emergency ‘COVID-19’ centres, but the focus is on treating patients from the pandemic, rather than the provision of wider health services.

Health policy neglect is particularly worrying amongst indigenous women, such as those from the Warao communities, who are part of the thousands of Venezuelans that have fled to neighbouring Boa Vista, in Roraima. Poor health conditions and high prevalence of infectious diseases, particularly HIV, along with barriers to health service access due to cultural and linguistic differences, mean that COVID-19 could exacerbate an existing health crisis as well as bringing its own; the Warao shelter in Boa Vista is regarded as particularly vulnerable to an outbreak of COVID 19.

This is also true in Bogotá, Colombia, which hosts almost 20% of the close to 2 million Venezuelans in the country, has similar issues. Unable to afford local housing because of high rents, many Venezuelan migrants are now homeless.

Accessing healthcare in normal times is already a major issue in Colombia, since the national health system excludes irregular migrants’ (around 20% of the displaced population) from non-emergency services, Additionally, rising xenophobia in Colombia means that Venezuelans are frequently accused of spreading COVID-19 throughout the country.

Both Brazil and Colombia have now closed their borders with Venezuela, with Colombia even returning a number of migrants to Venezuela in response to the outbreak. Brazil has passed a decree allowing returns, which are cases of violation to the principle of non-refoulement. This places displaced women and girls at an even greater risk.

The denial of a place to stay also means the denial of their right to health. Restricted provision of refuge and asylum severely disrupts access to sexual and reproductive health services and to adequate medical care for the prevention and management of gender-based violence, at a time when it is most needed.

If these harms are not redressed, the consequences for migrant and refugee women and girls will be catastrophic in terms of access to contraceptives, medicines and personal hygiene products, increases in unwanted pregnancies, lack of access to safe abortions, increased risk of maternal and infant morbidity and mortality, undermining every principle of autonomy, equality and dignity of women and girls.

Leaving No One Behind: the importance of human rights

In 2015, the Sustainable Development Goals (SDGs) promised the introduction of global development policies based on a meaningful engagement with the human rights of the poorest and most vulnerable. Even before the COVID 19 outbreak, there were serious doubts about the pace and direction of global change and commitment to the target of ‘leaving no one behind’.

Governments cannot afford to ignore the rights of the most vulnerable, now during the pandemic if they remain committed to the 2030 agenda. As Sara Pantuliano, Head of the Overseas Development Institute, one the UK’s largest development organisations, argues, upholding human rights as a tool for addressing inequalities is essential, and the backlash against women’s human rights is a particularly critical faultline.

The solution? Placing the human rights of the most vulnerable, including displaced women and girls, at the very centre of policy responses

What does this mean for women and girls displaced by conflict, poverty and political harms? First, we need to recognise that COVID-19 is only the latest of the many challenges to their wellbeing. It is important not to forget how far their rights have already been stripped away, even before the pandemic. For this reason, it is crucial that we challenge the naturalization of gendered violence and invisibility displaced populations face. COVID-19 is not disrupting their otherwise ‘normal’ lives, so much increasing their dehumanization still further.

The solution? Placing the human rights of the most vulnerable, including displaced women and girls, at the very centre of policy responses. This requires commitment from governments to put in place resources needed to address the needs of the most vulnerable in the COVID-19 and deploy them in ways that mitigate their risks and uphold their dignity.

For current and future policies, displaced women and girls need to be listened to and their perspectives incorporated into the responses government make to this and other development crises. Now, and after the COVID-19 crisis, we need a human rights-based approach to public health that directly addresses gendered global health inequalities, asserts the indivisibility of human rights, promotes the agency of vulnerable individuals and holds state authorities to account for their actions.

Governments in Latin America and elsewhere have legal and ethical obligations under international law to ensure the best possible provision of services for all. They cannot be allowed to choose which rights, or whose rights, to realise and which to ignore. We agree with the Lancet Migration that transparency and accountability in their policies towards displaced communities, as well as appropriate resources for gendered-sensitive responses are paramount in addressing COVID-19 and every heath crisis.

As a response to the current crisis, we call for a suspension of all attempts, legal or otherwise, to limit migrant and refugee access to healthcare and an end of forced returns; and for governments to counter the xenophobia that undermines migrants’ rights to health and to work across borders to ensure that a full range of gendered health services reaches displaced women and girls now and in the future.

 

CORONAVIRUS Y EL DESAFÍO PARA LA GOBERNANZA REGIONAL EN AMÉRICA LATINA

This article by Professor Pia Riggirozzi appeared originally on the blog 0f Fundación Carolina on the 30th March 2020 https://www.fundacioncarolina.es/wp-content/uploads/2020/03/AC-12.2020.pdf

Introducción  Una de las verdades entre las incertidumbres que provocan las pandemias es que enfermedades de pronta transmisión y largo alcance, como el coronavirus, propulsan la inequidad, menoscaban los logros económicos de los países y de su ciudadanía, y obstaculizan los objetivos y programas de desarrollo sostenible. Sumado a ello, la pertenencia racial, los sesgos culturales y los roles de género son factores que profundizan desproporcionadamente los riesgos de las poblaciones más vulnerables (y vulneradas).

Estos son desafíos de política pública. Como la mayoría de los ámbitos de la política social, la salud pública ha sido tradicionalmente un área sensible, donde la instancia dominante de organización y provisión política ha sido el Estado. Sin embargo, muchos determinantes de la salud se extienden más allá del territorio nacional. Efectivamente, hay determinantes de salud pública, asociados con enfermedades, que migran a través de la porosidad de las fronteras y de las economías interdependientes.

El Estado aún ejerce un poder regulador indudable e indiscutible sobre las decisiones en materia de salud pública en sus propios límites territoriales. Pero por su alcance e implicancias como problema transfronterizo y global, la salud se convierte también en un elemento central de la política exterior.

Desde la década de 1990, ha habido crisis mundiales originadas por pandemias, como el virus de inmunodeficiencia humana (VIH) que causa el sida, los brotes del síndrome respiratorio agudo severo (SARS) en China y Canadá, o la propagación de la influenza pandémica A (H1N1) entre México y Estados Unidos; fenómenos que no respetan las fronteras estatales o la noción de soberanía. En consecuencia, los desafíos en materia de enfermedades transmisibles, desarrollo de sistemas sanitarios y avance de la ciencia y la tecnología de la salud, se plantean cada vez más como cuestiones de seguridad mundial, por lo que están sujetas a la coordinación internacional en lugar de a las autoridades locales o regionales.

En este marco nos preguntamos, ¿cuáles son las posibilidades, si las hay, para que las instituciones regionales, de manera general, y las de América Latina, de manera particular, lideren y dirijan la gobernanza de la salud?

Algunas de las premisas críticas para detener las pandemias son la distancia social y el liderazgo político. Ambas afectan a las posibles respuestas regionales. Elaborando este punto, el presente análisis plantea que, a diferencia de la década pasada, la pandemia del coronavirus se extiende en una región donde el distanciamiento político entre sus países y la falta de liderazgo limitan la posibilidad de alcanzar políticas concertadas en términos de gobernanza regional sanitaria. Esta situación es problemática, entre otras cosas, porque la crisis de salud global, desatada a raíz de la expansión y rápida propagación del coronavirus, genera una amenaza hacia una región que tendrá consecuencias, no solo en términos de morbilidad, mortalidad e impacto en los sistemas de salud, sino también en la actividad económica y en la movilidad de la población, todo lo cual requeriría respuestas en múltiples niveles de gobernanza.

La gobernanza regional está en crisis, y la tensión dominante se expresa en clave político-ideológica, como una pérdida de lo que otrora se identificara como “geopolítica de la salud”. Es decir, hay una clara erosión del pensamiento y práctica de la gobernanza regional sanitaria, que a principios de siglo se había institucionalizado en las nuevas formaciones regionales.

Este texto revisa los desafíos que la actual pandemia supone para la gobernanza regional de la salud en América Latina. El trabajo presenta un análisis de las perspectivas del regionalismo sudamericano en términos de salud pública, sus rasgos definitorios como diplomacia regional —que afectan a la política nacional y global de la salud—, y los desafíos de cara a la gestión del coronavirus. A continuación, se ofrece un análisis crítico sobre las respuestas de los gobiernos ante la crisis desatada por la pandemia. Finalmente, se reflexiona sobre las oportunidades que la crisis podría generar para reconstruir una gobernanza regional en salud.

La salud como geopolítica regional: perspectivas del regionalismo sudamericano

El regionalismo es una herramienta de gobernanza crucial para el amparo y el refuerzo de la soberanía de los Estados. En América Latina, ha sido así desde las independencias, cuando la región emergió como un espacio de identificación y defensa de los intereses comunes, y el regionalismo se convirtió en una plataforma para negociar y reforzar la autonomía frente a actores externos. Unidos pero soberanos, fue la razón de ser que definió los objetivos estratégicos de este regionalismo, que procuró responder a las pretensiones, más o menos constantes, de las intervenciones externas (Hurrell, 1995; Riggirozzi y Tussie, 2012). De hecho, la evolución del regionalismo latinoamericano se ha caracterizado por una idea constante de integración regional, que defiende los intereses nacionales mediante una intensa actividad diplomática regional (Deciancio, 2016). En el terreno de la salud, las primeras experiencias de cooperación funcional surgieron en el Rio de la Plata, a mediados del siglo XIX, cuando la ola inmigratoria indujo a concertar protocolos compatibles de cuarentena (Herrero y Tussie, 2015).

Como construcción institucional, el regionalismo va más allá de la cooperación transfronteriza, aunque no ha sido lineal ni en el ámbito de las políticas públicas ni en su consolidación institucional; y tampoco ha estado exento de experimentos truncados. Por ello el regionalismo, si bien legítimo, se ha visto en ocasiones cuestionado por los cambios políticos que han afectado, a la vez, a la continuidad de su agenda.

En América Latina, y más recientemente en Europa, las instituciones regionales se han convertido en un foco destacado de contestación sociopolítica. Esto resulta cada vez más claro a medida que la política interna entronca con los resultados de la política regional y se ve influida por esta. Las disputas normativas sobre las instituciones regionales están comenzando a reflejar divisiones ideológicas. En el caso de la Unión Europa (UE), esto se refleja en los referéndums nacionales de continuidad, y, en el caso de América del Sur, en la simple renuncia a la membresía en las instituciones por decisión gubernamental. Lo que se aprecia en ambos casos es frustración social y una falta de credibilidad hacia la gobernanza regional y, en particular, hacia los organismos regionales como instrumentos reguladores. En la UE, las políticas financieras y migratorias generan descontento (Rose 2018; Bulmer y Quaglia, 2018). En América Latina, el decepcionante desempeño económico y el estancamiento político y administrativo —fruto de las divisiones políticas e ideológicas— han conducido al descrédito de las organizaciones regionales (Malamud, 2013; Quiliconi y Rivera, 2019). Ahora bien, en lugar de considerar el regionalismo en América del Sur como una sucesión de fracasos y decepciones, cabe ponderar su alcance en las políticas regionales, incluso en contextos de institucionalización débil, que han definido agendas sociales y de bienestar.

El redescubrimiento de la región como un espacio común que diseña estrategias de política exterior y de cooperación vivió un momento álgido a principios del milenio, cuando se impulsaron nuevos compromisos institucionales en apoyo a formas alternativas de gestionar el desarrollo económico y humano (Riggirozzi y Tussie, 2012; Sanahuja, 2012). Este compromiso no fue menor en países con altos niveles de pobreza, exclusión y desigualdad, que lucharon por movilizar fondos en el ámbito regional para programas de cohesión social, aunque muchas veces sin éxito. El auge regionalista fue particularmente intenso a comienzos de la década de 2000, cuando nuevas formaciones y modalidades regionalistas —aun no estrictamente de integración—, emergieron en ámbitos que iban más allá del plano comercial y de defensa, haciendo hincapié en la agenda social, sobre todo en materia sanitaria y educativa.

Como resultado, nacieron la Unión de Naciones Suramericanas (Unasur), la Comunidad de Estados Latinoamericanos y Caribeños (CELAC) y la Alianza Bolivariana para los Pueblos de Nuestra América (Alba). Estas instituciones despertaron el interés político y académico por un perfil que se definió como de “regionalismo posthegemónico” (Riggirozzi y Tussie, 2012). La construcción de este regionalismo supuso una reorganización del escenario regional y un esfuerzo por implementar nuevas agendas de cooperación. Esto no solo resignificó y revalorizó los espacios de acción estatal, sino que dio lugar a nueva concepción sobre lo qué es y para lo que sirve el regionalismo. En este sentido, diversos estudios mostraron los cambios que se produjeron en el abordaje regional sobre los derechos sociales en el campo de la salud (Fourie y Penfold, 2015; Herrero y Tussie, 2015; Riggirozzi, 2017), de las migraciones (Acosta, 2015), y de la educación (Perrotta, 2014).

Las modalidades de acción transfronteriza se manifestaron de la siguiente forma: (i) en la creación de nuevos marcos normativos que permitieron estructurar modelos de gobernanza nacional y regional, y articular redes intergubernamentales de expertos, que encontraron sustento para su acción; (ii) en la facilitación y/o redistribución de recursos materiales y de saberes en apoyo a las políticas públicas; y (iii) en la habilitación de nuevas dinámicas de representación y diplomacia en la región, frente a actores externos (Riggirozzi, 2014: 451).

El caso de las políticas regionales sanitarias fue paradigmático. Por ejemplo, los países del Mercosur, junto con Bolivia y Chile, suscribieron en 2000 la Carta de Compromiso Social de Buenos Aires, que establece un marco de obligaciones para lograr el acceso a servicios integrales en salud. Este marco estipulaba la obligación de los Estados miembros a mejorar la calidad de vida de sus poblaciones, poniendo especial atención en los sectores más vulnerables, con el fin de alcanzar el derecho a la salud para todos. Además, en 2010, el Plan Estratégico de Acción Social (PEAS) del Mercosur estableció la obligación de garantizar el acceso y la calidad integral de los servicios de salud humanizados; desarrollar estrategias coordinadas para la universalización del acceso a los servicios de salud pública; y suministrar información científica y educativa sobre salud sexual y reproductiva, con un enfoque orientado a la reducción de la morbilidad y la mortalidad femenina.

Lo más relevante radicaba en la obligación de armonizar políticas específicas, promoviendo acuerdos regionales que garantizasen el acceso a la salud pública al interior de los Estados y en zonas fronterizas. Por otra parte, también se establecieron otros marcos normativos para regular la donación y el trasplante de órganos (como la implementación del sistema Donasur, de registro de donaciones y trasplantes del Mercosur); y para el regular el control epidemiológico y responder a la propagación del dengue, el zika y el chikungunya (IPPDH, 2016).

En Unasur también se dio un compromiso de apoyo a las políticas sociales. Su gestación, en 2004, se fraguó a partir de tres objetivos principales. Dos de ellos son propios de estas instituciones: revitalizar las relaciones intrarregionales y mejorar las infraestructuras físicas (de carreteras, energías y comunicaciones) para fortalecer desarrollo regional. Pero, junto a esto, había un tercer objetivo dirigido a lograr una mayor cooperación para erradicar la pobreza. Dentro de esta agenda, la salud se convirtió en un área temática inherentemente vinculada a la idea de un giro social del regionalismo (Unasur 2009; Unasur, 2011).

Para avanzar en esta agenda, en 2009 se diseñó un Plan Quinquenal que definió acciones en cinco áreas prioritarias: (i) vigilancia, prevención y control de enfermedades; (2) desarrollo de sistemas de salud universal; (3) información para la implementación y monitoreo de políticas sanitarias; (iv) estrategias para aumentar el acceso a medicinas y fomentar la producción y comercialización de medicamentos genéricos; y (v) creación de capacidades dirigidas a los profesionales de la salud y a los decisores políticos para la formulación, gestión y negociación de políticas de salud a nivel nacional e internacional (Unasur, 2009). También se institucionalizó un grupo de expertos en salud regional, en torno al Instituto Sudamericano de Gobernanza de la Salud (ISAGS), bajo los auspicios del Consejo Sudamericano de Salud. El trabajo del ISAGS proporcionó importantes aportes de investigación para los procesos de toma de decisiones de los ministerios de Salud de los países miembros, así como para la formulación de políticas comunes en respaldo a las negociaciones internacionales (Riggirozzi, 2017).

Tanto el Mercosur como Unasur contribuyeron, por tanto, a la construcción de una nueva diplomacia que generó espacios para aprovechar sus ventajas competitivas y negociar el acceso internacional de sus países a medicamentos. Por ejemplo, el Mercosur se coordinó con Unasur para articular mecanismos de compra conjunta de medicamentos en la Organización Panamericana de la Salud (OPS). Se estableció así un cartel regional de compradores que operaba mediante negociaciones conjuntas, adquisiciones agrupadas, o de ambas maneras, que lograba reducir los precios de los medicamentos de alto costo, como los antivirales, los oncológicos y los tratamientos para la hepatitis C (OPS, 2015; O’Keefe, 2019). En las negociaciones sobre los productos farmacéuticos internacionales, Unasur desarrolló un banco de precios compartidos, al tiempo que entre 2010 y 2015 aseguró la defensa de posiciones coordinadas en las asambleas anuales de la Organización Mundial de la Salud (OMS) (Riggirozzi, 2017). Antes, en 2009, los presidentes del Mercosur también trabajaron en conjunto ante la OMS para lograr la flexibilización de las patentes de los medicamentos, y conseguir que los países latinoamericanos tuviesen más opciones para desarrollar una vacuna contra la gripe A H1N1 (El Comercio, 2009).

Fue así como los países de América del Sur construyeron y coordinaron su soberanía en salud, es decir: mantenían el margen de discrecionalidad política en el ámbito nacional, pero actuaban conjuntamente para aumentar su poder de negociación en situaciones asimétricas. Estas características son centrales para entender el regionalismo posthegemónico. Sin embargo, a partir de 2010 los desafíos estratégicos de los países sudamericanos empezaron a dejar de definirse en términos regionales, para hacerlo cada vez más en términos nacionales, luego de que la región reorientase su compás ideológicopolítico en un contexto económico menos favorable para incentivar la cooperación regional (Sanahuja, 2019). Más aún, la mayor parte de los integrantes de Unasur, que llegó a estar compuesto por 12 países, lo abandonó en 2018, principalmente por diferencias ideológicas. Entre ellos, Argentina, Brasil, Chile, Colombia, Paraguay, Perú, Ecuador y, ya en 2020, Uruguay.

A diferencia de entonces, actualmente prevalece una total ausencia de coordinación, lo que —ante el impacto del coronavirus— afecta a los sistemas de salud pública y a la economía. La sintonía que exhibía la región ha sido reemplazada por el Foro para el Progreso de América del Sur (Prosur), una formación hibrida, de carácter declaratorio, creada en 2019 por casi los mismos países que salieron de Unasur. Aunque el cambio de paradigma en los procesos regionalistas y de integración parece ineludible conforme cambian las preferencias sociales y electorales, la crisis sanitaria mundial encuentra a America Latina sin parámetros comunes para hacerla frente. En su lugar, se responde con decisiones unilaterales, e incluso defensivas, muchas veces en detrimento de los países vecinos.

 

La respuesta de los gobiernos ante la nueva pandemia

Una de las características diplomáticas a principios de siglo fue blandir la salud como un parámetro regional. Como se ha indicado, tanto el Mercosur como Unasur, diseñaron estrategias regionales y crearon oportunidades para la producción y comercialización de medicamentos, el intercambio de conocimientos y buenas prácticas y la coordinación de posiciones comunes en los foros multilaterales para la promoción de la equidad en materia de salud.

La pandemia de la enfermedad por coronavirus (Covid-19) alcanzó a América Latina a finales de febrero, cuando Brasil confirmó su primer caso en São Paulo. Cuatro semanas más tarde, el 20 de marzo de 2020, ya se registraban más de 2.000 casos: 981 en Ecuador, 911 en Chile, más de 400 en Argentina y Colombia, y alrededor de 400 en Perú y México, y la tendencia era de claro ascenso (BBC Mundo, 2020a).

Las implicancias del crecimiento exponencial del Covid-19 sobre la salud pública deben ser medidas en términos más amplios, poniéndolas en relación con la vulnerabilidad, las desigualdades y la exclusión de diferentes grupos de población. Sus efectos habrán de ser examinados según el sistema de salud de cada país; a partir de variables de género o edad; en función de la condición de refugiado o migrante de las personas a las que afecte, o según se trate de personas con discapacidad, con enfermedades crónicas no transmisibles, o con enfermedades infecciosas propias de los países menos desarrollados, es decir, con “enfermedades de pobres” que se reproducen en condiciones de precariedad socioeconómica.

Además hay que tener en cuenta las consecuencias económicas que provocará la retracción productiva. Con una recesión que ya empezaba a asomar antes de la pandemia, América Latina enfrentará desafíos políticos severos que conllevarán a su vez riesgos para la seguridad ciudadana. La amenaza del virus es una “tormenta perfecta” de gobernanza.

Los gobiernos de la región han tomado una serie de medidas para proteger a su ciudadanía y contener la propagación de Covid-19, haciéndose eco de las recomendaciones de la OMS. Sin embargo, han puesto el énfasis en dos ejes que entran en tensión con toda respuesta coordinada por una gobernabilidad regional. El primer eje gestiona la crisis sanitaria con políticas de puertas adentro, que impulsan un renacimiento nacionalista que considera que la “seguridad nacional” está amenazada, de modo que lo que cada Estado busca es proteger a sus ciudadanos. Esta interpretación choca con lo que el director general de la OMS, el doctor Tedros Adhanom, ha manifestado, en tanto el Covid-19 representa “una amenaza sin precedentes, pero también es una oportunidad sin precedentes, para unirse como uno contra un enemigo común: un enemigo contra la humanidad”, añadiendo que “ningún país puede abordarla solo” (OMS, 2020).

Específicamente, a 25 de marzo de 2020, Argentina y Colombia habían decretado la cuarentena obligatoria; Bolivia y Chile, el cierre de fronteras; Ecuador y Perú, el toque de queda, además de una suspensión de vuelos generalizada y restricciones en políticas migratorias (BBC Mundo, 2020b). En Chile, Sebastián Piñera ha declarado el estado de excepción, dejando en manos de las Fuerzas Armadas el resguardo de la seguridad interior y la custodia de los servicios sanitarios (Página 12, 2020a).

El segundo eje percibe la salud como un estorbo político. En Brasil y México, pese a que se han registrado muertes a causa del coronavirus, los gobiernos han sido ambiguos en sus medidas y en las restricciones impuestas para frenar la pandemia. Sus líderes, Jair Bolsonaro y Andrés Manuel López Obrador (AMLO), han aparecido en actos populares masivos, y han promovido manifestaciones y movilizaciones políticas (Lissidini, 2020). En Brasil, a pesar de ser una olla de cultivo del virus dada su dimensión geográfica, Bolsonaro ha manifestado su escepticismo sobre la amenaza del coronavirus —al que considera una “pequeña gripe”, o “una fantasía”—, y ha reprendido a los gobernadores por instituir cuarentenas obligatorias en algunos de los principales Estados del país (Página 12, 2020b). Aquí, como en México o en Estados Unidos, la dimensión política y, en gran medida, la motivación económica de evitar el cierre de la actividad productiva y el coste sobre las empresas, parece primar sobre las medidas sanitarias.

Ambas respuestas se alejan de la concepción de la salud englobada en una geopolítica regional y de “soberanía sanitaria”, donde los intereses nacionales se fortalecen de forma coordinada. Más bien, lo nacional reemplaza lo regional por medio de un retorno a las fronteras nacionales, cerradas en muchos casos.

 

Regionalismo y diplomacia en salud: ¿hay un legado? 

Los ya debilitados sistemas de salud pública habrán de afrontar en el corto plazo tanto desafíos nuevos como preexistentes, de higiene y saneamiento, de carácter socioeconómico, y de inequidad. A mediano plazo deberán buscarse formas de canalizar las inversiones, así como de reducir la fragilidad económica y de la población. Todo esto sugiere que será necesaria una mayor cooperación, no solo para enfrentar la pandemia con más coordinación en la vigilancia epidemiológica y en el intercambio de información, sino también para fortalecer las políticas públicas de los Estados.

La cooperación en materia de salud acumula una larga trayectoria en la región y se ha demostrado que se pueden alcanzar consensos regionales, a pesar de las divergencias entre los países. América del Sur es una de las regiones del mundo que ha dado mayores pasos en la promoción de la cooperación regional. Así, uno de los aprendizajes de las experiencias de Unasur y del Mercosur es que los organismos regionales pueden proporcionar recursos normativos e institucionales para armonizar políticas y definir estrategias regionales, en lo que Acharya denomina “congruencia normativa” (2011). Asimismo, el valor agregado de la gobernanza regional se aprecia en la capacidad de las organizaciones para “traducir” las reglas internacionales a los entornos locales, fusionándose a menudo con normas vigentes en la región y en los ámbitos domésticos.

En segundo lugar, los organismos regionales pueden facilitar la movilización de recursos humanos, financieros y de conocimiento, en apoyo de las políticas sociales. Y pueden respaldar la continuidad en la cadena de producción y suministro de productos críticos —vacunas, dispositivos anticonceptivos, de inmunización, alimentos—, que de otro modo podrían verse interrumpidos por el impacto de Covid-19. Esto es clave si se tiene en cuenta que la escasez o interrupción del suministro de productos y servicios médicos acrecienta el riesgo de muerte por abortos inseguros o embarazos adolescentes que, entre otras cuestiones, representan un desafío para la salud pública en América Latina. Finalmente, los organismos regionales abren oportunidades para la promoción y la acción política colectiva en foros internacionales en los que se acuerdan los flujos de inversión para los sistemas sanitarios y el apoyo humanitario en escenarios de crisis.

En el actual contexto de pujas y realineamientos los incentivos varían. Es difícil pensar que una gestión de la salud vinculada al renacimiento nacionalista y a su interpretación como estorbo político, pueda generar lógicas integracionistas. Aun así, las dinámicas de regionalización transfronterizas podrían encontrar maneras de avanzar en la agenda política y en prácticas específicas. Los miembros del Mercosur ya han acordado compartir información y estadísticas sobre la evolución del coronavirus, como parte de una estrategia común destinada a combatir la pandemia, y a eliminar obstáculos que podrían dificultar o impedir el tránsito de suministros y elementos esenciales, como alimentos, productos de higiene y de cuidado de la salud. Los países del Prosur y de la CELAC también se han pronunciado a favor de compartir información y datos de vigilancia epidemiológica, así como de elaborar propuestas comunes.

Probablemente, una de las principales lecciones que evidencie esta crisis de salud pública mundial, consista en subrayar la importancia social y política del regionalismo. Si es así, es posible que la cooperación regional pueda recuperarse como una herramienta fundamental para la gobernanza en lugar de ser la primera víctima política del coronavirus.

Pia Riggirozzi es doctora en Política y Estudios Internacionales por la Universidad de Warwick. Magíster en Relaciones Internacionales por la Universidad de Miami y Magíster en

Relaciones Internacionales por la FLACSO. Actualmente es profesora de Política Global en la Universidad de Southampton.

 

Referencias bibliográficas

ACHARYA, A. (2011): “Norm subsidiarity and regional orders: sovereignty, regionalism, and rule-making in the Third World”, International Studies Quarterly, 55(1), pp. 95-123.

ACOSTA, D. (2015): “Toward a South American citizenship? The development of a new post-national form of membership in the region”, Journal of International Affairs, 6(2), pp. 213-221.

BBC MUNDO (2020a): “El coronavirus llega a todos los países de América                       Latina” (20/03/2020). Disponible en: https://www.bbc.com/mundo/ noticias-america-latina51713166.

— (2020b): “Cómo hace frente al Covid-19 cada país de América Latina” (25/03/2010).          Disponible en https://www.bbc.com/mundo/ noticias-america-latina51881075.

BULMER, S. y QUAGLIA, L. (2018): “The politics and economics of Brexit”, Journal of European Public Policy, 25(8), pp. 1.0891.098.

DECIANCIO, M. (2016): “International Relations from the south: A regional research agenda for global IR”, International Studies Review, 18(1), pp. 106–119.

EL COMERCIO (2009): “En breve” (25/072009). Disponible en https://www.elcomercio.com/ actualidad/breve-2.html.

FOURIE, P. y PENFOLD, E. (2015): “Southern regionalisms and the Southern African Development Community: Promoting           greater             access to healthcare and medicines”, PRARI Working Paper. Disponible en http://www.open.ac.uk/social sciences/prari/.

HERRERO, B. y TUSSIE, D. (2015): “Unasur health: A quiet revolution in health diplomacy in South America”, Global Social Policy, 15 (3), pp. 261277.

HURRELL, A. (1995): “Regionalism in the Americas”, en HURRELL A. y FAWCETT, L. (eds.): Regionalism in world politics, Nueva York, Oxford University Press, pp. 250282.

IPPDH (2016): Institucionalidad pública en derechos humanos del Mercosur. Disponible en http://www.ippdh.mercosur.i nt/wpcontent/uploads/2018/08/Resume n-IPPDH.2016-color.pdf.

LISSIDINI, A. (2020): “Uruguay: La política debe salir de la cuarentena”, Agenda Pública. Disponible en http://agendapublica.elpais.co m/uruguay-la-politica-debesalir-de-la-cuarentena/.

MALAMUD, A. (2013): “Overlapping regionalism, no integration: Conceptual issues and the Latin American experiences”, EUI Working Paper, RSCAS 2013/20, Florencia, European University Institute.

O’KEEFE, T. (2019): “Latin America takes on Big Pharma”, Aula Blog.     Disponible en: https://aulablog.net/2019/02/1 9/latin-america-takes-on-bigpharma/.

OMS     (2020):     “WHO Director-General’s opening remarks at the media briefing on COVID-19” (16 de marzo). Disponible en: https://www.who.int/dg/speec hes/detail/who-directorgeneral-s-opening-remarksat-the-media-briefing-oncovid-19—16-march-2020.

OPS (2015): “Países del Mercosur y estados asociados concretaron mecanismo de compra de medicamentos de alto costo con el apoyo de la OPS” Disponible en: https://www.paho.org/uru/ind ex.php?option=com_content &view=article&id=1000:pais es-del-mercosur-y-estadosasociados-concretaronmecanismo-de-compra-demedicamentos-de-alto-costocon-el-apoyo-de-laops&Itemid=451.

PÁGINA 12 (2020a): “Coronavirus: Piñera decretó el ‘estado de excepción’  en Chile” (18/03/2020). Disponible en https://www.pagina12.com.ar /253704-coronavirus-pineradecreto-el-estado-deexcepcion-en-chile.

— (2020b): “Jair Bolsonaro llamó a boicotear la cuarentena en Brasil” (27/03/2020). Disponible en: https://www.pagina12.com.ar /255728-jair-bolsonarollamo-a-boicotear-lacuarentena-en-brasil.

PERROTTA, D. (2014): “La educación superior en el MERCOSUR: la acomodación entre las políticas       domésticas      y          la política        regional”, Revista Perspectivas de        Políticas Públicas 3 (6), pp. 177-206.

QUILICONI, C. y RIVERA, R. (2019): “Ideology and leadership in regional cooperation: The cases of defense and the world against drugs councils in Unasur”, Revista Uruguaya de Ciencia Política, 28 (1), pp. 219-248.

RIGGIROZZI, P. (2014): “Regionalism through social policy: Collective action and health diplomacy in South America”, Economy and Society, 43(2), pp. 432-454.

— (2017): “Regional integration and welfare: Framing and advocating       pro-poor norms through southern regionalisms”, New Political Economy, 22 (6), pp. 661-675.

RIGGIROZZI, P. y TUSSIE D. (eds.) (2012): The Rise of Post- Hegemonic Regionalism: The Case of Latin America, Dordrecht, Springer UNU/CRIS.

ROSE, R. (2018): “Referendum challenges to the EU’s policy legitimacy – and how the EU responds”, Journal of European Public Policy, 26: 2, pp.207-225.

SANAHUJA, J. A. (2012) “Post-liberal Regionalism in South America: The case of Unasur”, Robert Schuman Centre for Advance Studies, EUI Working Paper RSCAS 2012/05, Florencia, European University Institute.

— (2019): “La crisis de la integración y el regionalismo en América Latina: giro liberalconservador y contestación normativa”, Madrid, Anuario CEIPAZ 2018-2019, pp. 107126.

Unasur (2009): Plan Quinquenal 2010-2015. Disponible en http://www.isagsunasul.org/media/file/PLAN%20QUINQUE-NAL%20abril%202010%20ESP.pdf.

— (2011): Salud: Report of the Pro Tempore Secretariat. Disponible         en             http://isags-unasul.org/site/wpcontent/uploads/2011/12/Informe -2011.pdf.

The Sobering Reality of Unpredicted Scenarios: COVID-19, Health and Regional Politics in Latin America

This article by Professor Pia Riggirozzi originally appeared on April 6th 2020 in the United Nations University blog: http://cris.unu.edu/covid19-health-and-politics-latin-america

An Epidemic That Challenges Political Scenarios

Scenarios are plausible stories that help imagine and forecast future developments. Political scientists have developed scenario-based forecasting, modelling, simulations and other techniques to, if impossible to predict, at least estimate political-institutional, socio-economic and demographic futures. In theoretical debates, prediction represents a central premise regarding the extent to which we can consider the study of politics a scientific matter. In times of global (health) crisis, however, this premise succumbs. What COVID-19 reveals is a fog of uncertainty for the study and practice of politics. For Latin America this is particularly sobering, as the crisis collides immediate sanitary challenges in weak – or weakened – states, and fragile health systems, with long term impacts on poverty, socio-economic and gender inequalities, and labour precarity and informality. Certainly, the magnitude of COVID-19 puts not only governments and health systems under immense stress, but also the economy, employment, and social habits of everyday life. Furthermore, many determinants of health extend beyond the national territory.

While the state still exercises undoubted and indisputable regulatory power over public health decisions and over societies within their own territorial limits, the scope and implications of health crises, as manifested in the COVID-19 pandemic, are and will be a cross-border and global problem. Health, after all, is not only political but also a central element of foreign policy. It has been so in Latin America since the first experiences of cooperation in the Rio de la Plata in the mid-19th Century, when an immigration wave induced the establishment of compatible quarantine protocols. In the 20th Century, global crises stemming from pandemics such as HIV and AIDS, severe acute respiratory syndrome (SARS), or the spread of pandemic influenza A (H1N1) showed little respect for state borders or notions of sovereignty.

In this framework we ask, what, if any, are the possibilities for regional organisations, in general, and in the case of Latin America, to provide leadership and direction in support of health governance?

In the current scenario, some of the critical premises for stopping the spread of COVID-19 are social distance and political leadership. It is precisely distance and leadership that are at the core of any stark response to the crisis. In elaborating this point, I propose that, unlike in the past decade, political distance between the countries of the region and lack of leadership affect the possibility of reaching concerted policies in terms of regional health governance, and to address coronavirus more specifically. This situation is problematic, among other things, because the global health crisis unleashed by the expansion and rapid spread of the coronavirus poses threats and challenges for a region that will see consequences, not only in terms of morbidity and mortality, and impact on health systems. Health, but also in economic activity and population movement, all will require responses at multiple levels of governance.

 

A “Perfect Governance Storm”

One of the main characteristics in global health diplomacy in the last decades has been how to reinforce multilateral and regional cooperation for health governance.  In South America, both Mercosur and UNASUR created regional opportunities and strategies for health diplomacy in the direction of production and commercialisation of medicines, joint purchases and cartels of buyers lobbying prices vis-à-vis international pharmaceuticals, the exchange of knowledge and good practices in health policy between countries, and the coordination of common positions in multilateral forums, particularly at the World Health Organization, for the promotion of equity in health and participation of developing countries in global governance of health.

The coronavirus pandemic, however, reached a dis-united Latin America. It hit in late February, when Brazil confirmed a case in São Paulo. To date (6th April) nearly 12,000 cases were already registered in that country, over 3600 in Ecuador, 4471 in Chile, more than 1500 in Argentina and Colombia, around 1500 in Peru and Mexico, and the trend is clearly on the rise.

But the implications of the exponential growth of COVID-19 on public health must also be measured in broader terms; particularly in relation to vulnerabilities, inequalities and exclusion of different population groups, of gender, age, for being refugees, migrants, people with disabilities, living with HIV, with chronic non-communicable diseases, and with infectious diseases typical of lesser countries developed – that is, with “diseases of the poor” that reproduce in conditions of socio-economic precariousness – and with weak health systems. There are, in addition, other economic consequences that will cause a retraction in production, and the economy in general. With a recession that was already beginning to bite before the pandemic, Latin America faces severe political challenges and citizen security risks. The virus threat is a “perfect storm” of governance.

The governments of the region have taken a series of measures to protect their citizens and contain the spread of COVID-19, echoing the WHO’s recommendations, but these responses have shown two divergent and contradictory paths, that in turn come into tension with any possible regional coordination. The first path situates health at the core of a nationalist revival, as a threat to “national security”, through which states seek to protect their citizens. Specifically, Argentina and Colombia decreed the mandatory quarantine. Bolivia and Chile, the closing of borders. Ecuador and Peru, the curfew, plus a general suspension of flights and restrictions on immigration policies. In Chile, Sebastián Piñera declared a state of emergency, leaving internal security and the custody of health services in the hands of the armed forces.

The second axis perceives health as a political hindrance: in Brazil and Mexico, despite having registered deaths due to the coronavirus, governments have been ambiguous in their measures and in the restrictions imposed to stop the pandemic. Its leaders, Jair Bolsonaro and Andrés Manuel López Obrador, privileged their appearance in mass popular events, and promoted demonstrations and mobilizations in political events. In the case of Brazil, despite being a hot spot for the virus given the geographical dimension of the country, President Bolsonaro has spoken about its threat with scepticism – considering the virus as a “little flu”, or “a fantasy”, while rebuking governors for instituting mandatory quarantines in some of the main states of Brazil. Here, as in Mexico and in the United States, the political dimension, and to a large extent an economic motivation, seems to prevail over sanitary measures.

Despite their nuances, both responses move away from the concept of health as a common regional goal of geopolitics. Rather, national interpretations of what is risks and urgent replaces regional coordination.

Ueslei Marcelino/Reuters

Regionalism and Diplomacy in Health: Is There a Legacy?

Health has a long history of cooperation in Latin America and has shown that it can be a great channel for regional consensus, despite the differences that exist between member states. South America is one of the regions of the world that has taken the greatest steps in promoting regional cooperation in this regard. Thus, one of the learnings from the experience of UNASUR and Mercosur is that regional organisations can provide normative and institutional resources for the harmonization of international and national policies and the definition of regional strategies, which Acharya identifies as “normative congruence”. In this same sense, the added value of regional governance must be seen through the ability of regional organisations to “translate” international norms into local environments, sometimes merging with norms in force in the region and in domestic settings. Second, regional organisations can facilitate the mobilization of human, financial and knowledge resources in support of social policies. Regional agencies can also effectively assist continuity in the production and supply chain of critical medical products, vaccines, contraceptives and safe abortion devices, immunizations, food – all of which could be seriously disrupted by the impact of COVID-19. This is key if considered that the shortage and interruption of the supply of medical products and services can also increase the risks and deaths from unsafe abortions or teenage pregnancies, which in Latin America, among other emergencies, is already a public health challenge. Finally, regional organisations open political opportunities for promotion and collective action in international settings, to ensure investment flows in health systems and humanitarian support in the context of a health crisis.

In the current context incentives vary, and so do predictions about regional cooperation. It is difficult to think that health, for some a matter of nationalist revival and for others a political obstacle, can create integrationist ambitions. Still, cross-border dynamics may find ways to advance policy debate and specific practices. Mercosur members have recently agreed to share information and statistics on the evolution of the coronavirus, as part of a common strategy to combat the pandemic, as well as to eliminate obstacles that could hinder or impede the transit and transportation of supplies and essential elements, such as food, hygiene and health care products. New, more hybrid and less institutionalised regional initiatives such as PROSUR and CELAC, also agreed to share information and epidemiological surveillance.

In the meantime, whether regional cooperation may recover its fundamental place is still uncertain. Predictions seem to indicate that either regional organisations reclaim centrality as a tool of governance, or they will be the first political victims of COVID-19.

The Right Honourable John Denham joins the department

John Denham and his Centre for English Identity and Politics have joined us from the University of Winchester. John was the Labour MP for Southampton Itchen from 1993-2015 and Secretary of State from 2007-2010.

While at Southampton he will continue working on deepening our understanding of English Identity creating opportunities for dialogue that go beyond academic circles.

Brexit was made in England; but will England be re-made by Brexit?” (J. Denham 2019 – England on the verge of Brexit)

 

Sino-U.S. geo-political competition, high-tech cold war and their implications for the global financial market

By Dr Ming-chin Monique Chu, Lecturer in Chinese Politics at the University of Southampton.

Panel photo

 

Dr. Ming-chin Monique Chu, Lecturer in Chinese Politics at the Department of Politics and International Relations, University of Southampton, was invited to take part in a panel debate at Sibos 2019 held in London last week. During the debate, she shed light on the implications of Sino-U.S. high-tech cold war and other risk factors for the global financial industry. Also in the panel were Gerard Lyons (Netwealth Investments) and Elizabeth Rosenberg (Centre for a New American Security). For the recorded session at Sibos, a global financial industry event with more than 9,000 delegates held every year, see: https://www.sibos.com/media/video/big-issue-debate-navigating-era-renewed-great-power-competition-25-sept-2019.

On 28th August 2019, Monique was quoted by the South China Morning Post for an in-depth news analysis of China’s semiconductor industry: https://www.scmp.com/tech/big-tech/article/3024687/how-china-still-paying-price-squandering-its-chance-build-home-grown.

Monique has published two books (one co-edited) including The East Asian Computer Chip War (Routledge, 2013/2016), which was cited by the Semiconductor Industry Association’s 2015 annual report. Her research interests include globalization-security nexus with reference to semiconductors, artificial intelligence and security, problematic sovereignty on China’s periphery, and Chinese foreign policy. She has appeared in many international news media such as BBC World News, BBC World Service, Fuji Television Network, Radio France International, Deutsche Welle, and South China Morning Post.

 

‘House effects’ and how to read the polling tea leaves…

Mark Pickup, Will Jennings and Robert Ford

We are living through a period of tremendous political uncertainty and volatility. At the time of the European Parliament elections in May – which now seems a lifetime ago – the Conservative and Labour parties contrived to win less than 25% of the vote between them, an all-time low. The ruling party was back then polling as low as 17% in terms of Westminster voting intentions. Now, under a new Prime Minister, the Conservatives find themselves polling in the 30s with a lead over Labour. These uncertain times have also seen considerable disagreement in the numbers reported by pollsters. In the week before the European Parliament elections in May, the Conservatives were put as low as 21% (Panelbase) and as high as 28% (Survation) in Westminster polling, while support for Labour was estimated between 25% (YouGov) and 33% (Survation). Meanwhile the Brexit Party were polling as high as 25% (Opinium) and as low as 12% (Survation). While European Parliament elections often shake up national polling (as voters use them to express their dissatisfaction with the main parties), this period was marked by even more volatility than usual – due to the failure of May’s Brexit deal and establishment of the Brexit Party. In the period since, the polls have continued to tell a mixed story about the state of party support.

Our latest Polling Observatory estimates of voting intentions continue to show the fragmentation of the British party system – but with the Conservative Party having bounced back under a new leader from their low at the time of the European Parliament elections, which were only held due to the previous Prime Minister’s repeated failure to secure Parliamentary support for her Brexit deal. As of the end of August, the Polling Observatory puts support for the Conservatives at 35.5% (16.9 points above where the party stood at the end of May), Labour at 24.5% (just one point higher than May), the Liberal Democrats at 18.0% (0.2 points down), the Brexit Party at 12.1% (10 points down) and the Green Party 5.3% (one point down) – with UKIP support statistically indistinguishable from 0%.

The Conservative rebound has clearly come at the expense of the Brexit Party, while support for the other parties has remained rather more stable. Our estimates reveal distinct trends for Labour and the Lib Dems – both parties saw a substantial shift in their support around the time of the European elections, with Lib Dem vote more than doubling and Labour’s falling over 10 points. Unlike the Conservatives – who have recovered at the expense of the Brexit Party – this shift has been sustained. The two parties are now in a new holding pattern, with Labour polling much lower than before and the Liberal Democrats much higher. Changing voter perceptions about the parties’ Brexit stances – with stronger Remainers losing faith in Labour and switching to the Lib Dems – likely has played a role. These dynamics have been reinforced by the Liberal Democrats’ election of a new leader, Jo Swinson, who has attracted considerable media attention and reinforced her party’s clear Remain message, boosted by a string of defections to the party, with a string of Remain-supporting MPs joining the party in recent months from both the Conservatives and Labour.

How this might translate into seats in Westminster remains highly uncertain. (Our estimates assume that the polling industry as a whole will not be biased in a particular direction – which of course was not the case in 2015, when Conservative support was underestimated, and in 2017, when Labour support was unusually underestimated.)

UK 04-09-19 anchor on average (1)

One of the useful features of our approach to ‘pooling’ the polls is that we are able to calculate the ‘house effect’ for each polling company for every party. That is, we can say whether a pollster tends to show high or low numbers for a particular party, relative to the vote intention figures we would expect from the average pollster. This does not indicate accuracy, since it is only on Election Day that we will know whether individual pollsters or the industry as a whole have got it right. It could be that pollsters at one end of the extreme or the other are giving a more accurate picture of voters’ intentions.

In the table below, we report all current polling companies’ ‘house effects’ for each of the parties. We also report details of whether the mode of polling is telephone or Internet-based, and notable adjustments the pollsters use to calculate the headline figures. This should provide a helpful guide for interpreting the latest polling tea leaves, since one can factor in whether seemingly good numbers for the Conservatives, Labour or some other party are a product of “house effects” related to the choices that a pollster makes in conducting their survey, or reflect a real shift in electoral preferences. As Anthony Wells has noted, prompting for the Brexit Party and controlling for past vote appear currently to have significant impacts on poll numbers. In the former case, pollsters that prompt for the Brexit Party in their surveys tend, unsurprisingly, to report higher numbers for the party. There was a similar methodological debate over whether to prompt for the UKIP party in 2012-15. The use of past vote (i.e. how people voted in 2017) to weight samples to make them representative is a longstanding practice in the polling industry. However, this can introduce error through people misreporting their past vote, leading supporters of a party to be overrepresented in the poll. Recent analysis by YouGov suggested that ‘false recall’ – people forgetting they voted Labour in 2017 – led to Labour’s estimated vote being 3% higher if not adjusted for.

Our analyses cannot discern the precise methodological reasons why particular pollsters tend to show better numbers for one party or another, but do provide a useful guide.[1]

Some pollsters tend to show Labour higher: most notably, Panelbase show them 2.4% higher than the average pollster, Survation 1.8% higher, and Deltapoll 1.1% higher. In contrast, YouGov – not least due to the false recall adjustment discussed earlier – show the party 2.4% lower than the average pollster. The Conservatives, on the other hand, tend to poll better with ICM (+1.2%) and Kantar (+1.0%), and worse with ComRes (-1.7%) and BMG Research (-1.0%). The LibDems tend to do better with BMG (+2.0%), Ipsos MORI (+1.0%) and YouGov (+0.9%). Pollsters are quite divided over the Brexit Party – perhaps unsurprisingly given there are so many unknowns about support for the brand new party. Panelbase (+2.8%) and YouGov (+1.7%) tend to report higher numbers, while Kantar (-0.9%), Survation (-0.8%), Opinium (-0.7%) and Deltapoll (-0.7%) tend to show the party lower.

The picture in terms of house effects is quite mixed then, not least as the pattern is not simply symmetrical between the Conservatives and Labour. If a pollster tends to show one of the parties doing better than the polling industry on average, it does not automatically mean their estimate for the other main party will be lower than the average.

The crucial point is that each pollsters’ latest estimate of voting intentions reflects the latest information about voters’ preferences, plus some noise and the particular methodological decisions they have made regarding the electorate.

Table 1. ‘House effects’ of pollsters against the industry average

House Mode Con Lab Lib Dem Brexit Party  UKIP Green
YouGov Online 0.2% -2.4% 0.9% 1.7% -0.4% 0.3%
ComRes Online -1.7% 1.0% -0.9% -0.7% 0.6% -0.5%
Ipsos MORI Telephone 0.3% -0.8% 1.0% -0.6% -0.4% 0.4%
Survation Online -0.0% 1.8% 0.3% -0.8% -0.4% -1.0%
BMG Research Online -1.0% -0.8% 1.9% -0.1% 0.5% 1.0%
Panelbase Online -0.5% 2.3% -0.9% 2.8% 0.2% -0.5%
Kantar Public Online 1.0% -0.9% 0.6% -0.9% -0.35% 0.2%
Opinium Online -0.6% 0.1% -1.5% -0.7% 1.0% 0.2%
ICM Research Online 1.2% -0.4% 0.2% n/a -0.3% 0.4%
Deltapoll Online 0.4% 1.1% -1.6% -0.7% -0.2% -0.7%

How might the polls perform in a general election in the near future? It is difficult to tell, and the salutary lesson to take away from 2015 and 2017 was that pollsters can face distinct challenges in elections even a short time apart given the highly volatile political environment, where voters are internally conflicted and the context of the choice is rapidly changing. The most recent benchmark we have of polling performance is the May 2019 European Parliament elections. Now, European elections tend to have lower turnout than general elections and people may use such ‘second order’ elections to defect from their traditional party loyalty and register a protest vote. Nevertheless, the polls may tell us something about whether pollsters are more or less likely to reach the supporters of particular parties. Keep in mind this was a context in which the Conservatives won 9.2% of the vote and Labour 14.1% (record lows for both parties in European Parliament elections).

Nearly all pollsters overestimated Labour in the May European Parliament elections (with the exception of YouGov who showed the party 1.1% below its final vote share) and the Conservatives (again with YouGov being the only pollster to put the party significantly below the final result (-2.1%). By way of contrast, all the pollsters underestimated the Liberal Democrats – with a range from 0.3% below their final vote share (Ipsos MORI) to 7.6% (Survation). Most pollsters (with the exception of Kantar and Panelbase) also overestimated the Brexit Party vote share.

Table 2. Error of final polls against result of 2019 European Parliament Elections

House Mode Con Lab Lib Dem Brexit Party UKIP Green
BMG 2.9% 3.9% -3.3% 3.4% -1.3% -4.1%
Ipsos MORI -0.1% 0.9% -0.3% 3.4% -0.3% -2.1%
YouGov -2.1% -1.1% -1.3% 5.4% -0.3% -0.1%
Kantar 3.9% 9.9% -5.3% -4.6% 0.7% -4.1%
Panelbase 2.9% 10.9% -5.3% -1.6% -0.3% -5.1%
ComRes 2.9% 7.9% -6.3% 0.4% -0.3% -5.1%
Survation 5.2% 9.4% -7.6% 0.5% -0.2% -4.8%
Opinium 3.2% 3.4% -4.6% 7.5% -1.2% -4.8%

While we cannot be sure how the campaign for the next general election will play out, these estimates highlight the importance of reflecting on where new polling information comes from. The different methodological designs and weighting procedures of pollsters can lead their headline numbers to differ in important and significant ways. There can be no way of knowing which pollster is right before election day, but it is worth urging some caution in how these sorts of numbers are interpreted by those in politics, media and the wider public.

 

[1] What our analysis doesn’t do is model whether those house effects are time-varying – i.e. whether the methodological decisions taken by a pollster inflate its support at one point in time and depress it at another.