Courting Diasporas: The Politics of Emigration Policies in Latin America

DipticBy Dr. Ana Margheritis, Reader in International Relations at University of Southampton (Twitter, Academia.edu). You can find more posts by Ana here.


Dr Ana Margheritis was recently invited to give a talk at the John Hopkins School of Advanced International Studies in Bologna, Italy on the politics of emigration policies in Latin America.

A short interview with Dr Margheritis on the subject of her talk is below, and the full audio and a summary is available here.

 

 

 

 

Argentina departs from the Kirchner model, but Mauricio Macri now has to govern a divided nation

By Pia Riggirozzi. Pia Riggirozzi is Associate Professor in Global Politics at the University of Southampton (@PRiggirozziAcademia.edu). You can find more posts by Pia here.


Read Dr Pia Riggirozzi’s new piece for The Conversation on the outcome of Argentina’s 2015 presidential elections.

Follow this link for the full article.

Polling Observatory #1: Estimating support for the parties (with some trepidation…)

DipticBy The Polling Observatory (Robert FordWill JenningsMark Pickup and Christopher Wlezien). The homepage of The Polling Observatory can be found here, and you can read more posts by The Polling Observatory here.


This post is part of a long-standing series (dating to before the 2010 election) that reports on the state of the parties as measured by vote intention polls. By pooling together all the available polling evidence we can reduce the impact of the random variation each individual survey inevitably produces. Most of the short term advances and setbacks in party polling fortunes are nothing more than random noise; the underlying trends – in which we are interested and which best assess the parties’ standings – are relatively stable and little influenced by day-to-day events. Further details of the method we use to build our estimates can be found here.

It is now six months since the television headlines rolled at 10am on May 7th, with the exit poll dropping the bombshell that the polls had got it badly wrong. The election forecasters fared little better, including us: even though our vote model had predicted a Conservative lead of 2-3 points, our seat prediction was nowhere close to the majority achieved by David Cameron. It is with a little trepidation then that the Polling Observatory team returns to provide its assessment on the state of public opinion in late 2015.

As regular readers will know, we pool all the information that we have from current polling to estimate the underlying trend in public opinion, controlling for random noise in the polls. Our method controls for systematic differences between pollsters – the propensity for some pollsters to produce estimates that are higher/lower on average for a particular party than other pollsters. While we can estimate how one pollster systematically differs from another, we have no way of assessing which is closer to the truth.

One possibility with this method is to use the result of the last election to ‘anchor’ our estimates of bias in the polls against the last election result. This treats the election result as if it was produced by a pollster with no systematic error. We can then estimate the systematic difference of each pollster with this hypothetical perfect pollster. With this method, for example, if pollster X produces results which are systematically 2 percentage points higher for the Conservatives than what would be produced by this perfect pollster, we would interpret a poll indicating 40% support for the Conservatives from such a pollster as 38% support for the Conservatives. This approach can be useful where there are recurring historical patterns (such as the tendency of the polls to overestimate the Labour vote and underestimate the Conservative vote), and might allow us to control for systematic bias in the polls.

We have chosen, for now, to anchor our estimates on the average pollster. This means the results presented here are those of a hypothetical pollster that, on average, falls in the middle of the pack.[1] We have chosen to use such a middle pollster rather than anchor on the election result because we believe that the inaccuracies/biases revealed in the polls in May will be different from those which may occur in this election cycle.[2] All of the pollsters have been undertaking reviews of their methods following the big polling miss in May, and it is unlikely that the biases in polling will be unaffected by the changes they are gradually introducing. Because of this, we offer our estimates of party support with an important caveat: while our method accounts for the uncertainty due to random fluctuation in the polls and for differences between polling houses, we cannot be sure that there is no systematic bias in the average polling house (i.e., the industry as a whole could be wrong once again). It may be that the polls are collectively right or wrong. It may also be that a pollster producing figures higher or lower than the average is more accurately reflecting the state of support for the parties than their competitors. Our estimates cannot adjudicate on whether figures on the high or the low side for a party better reflect the underlying preference of the electorate. The only test is on Election Day. Fortunately, none of this prevents us from identifying and reporting on the underlying trends over time.

In terms of the overall story, there has been little apparent change in vote preferences since the election in May. This despite the triumphant budget announced by George Osborne, the surprise ascension of Jeremy Corbyn to leader of the Labour Party (and the onslaught on him and his team from outside and inside the party), and the tax credits row that has quickly taken the shine off the government’s honeymoon period. Unlike the last election, there has been no sudden flight of voters from one party to another, as occurred with the collapse of Liberal Democrat support in the first six months after the Coalition government was formed.

Our estimates suggest that Conservative support has slipped slightly since the heady days of May and June, from around 40% to closer to 37% at the start of November. Despite Labour being divided and in some disarray over its direction, it has made slight gains from around 30% to 32%. This upward drift in the polls largely occurred before election of Jeremy Corbyn as Labour leader, so cannot be attributed to a Corbyn effect. Whether these gains will persist as the election nears and PM Corbyn becomes a possibility, is of course open to debate. At present, though, there is no sign of Mr Corbyn’s election having any impact on his party’s overall support. UKIP support has remained steady at around 13%, and the party shows no signs of going away – even with its own internal conflicts following Nigel Farage’s “unresignation” in the summer. Lagging somewhat behind, the Liberal Democrats continue to flat-line at just under 7%. One of the patterns of the last parliament was the stubborn immovability of Liberal Democrat support. New party leader Tim Farron has much work on his hands to win back voters, and so far there are no green shoots for the party in our estimates. Finally, speaking of the Greens, their support appears to have been squeezed since Labour election Jeremy Corbyn – perhaps because voters attracted by their distinct left wing platform now feel more at home in the Labour party. It has fallen around 1.5 points since the summer. Our estimates for all the parties suggest that the electorate is still to make up its mind on both the new government and the fragmented and much changed opposition. But there are some big events on the horizon, in particular the EU referendum, which may yet provide a shock to move political support in one direction or the other.

UK 01-11-15 anchor on average (1)

One of the reasons why the polling miss back in May came as such a shock was that by election eve there was broad consensus among the pollsters about the level of support for the parties (though of course we noted house effects earlier in the campaign). However, in the period since May the polling has been characterised by much more variation in the standing of the parties. This is revealed in the figure above. The size of the confidence intervals for our estimates in the period since the election (an average of 2.3 points) are more than twice those for the 2010-15 election cycle or for the month just before the start of the short campaign (each an average of 1.1 points). This indicates a much higher level of uncertainty about the state of public opinion today. Part of this could be due to a lower volume of polling since May, or more variation in polling methodologies as pollsters take different approaches in response to May’s polling miss. The greater uncertainty may also reflect the much lower frequency of polling since the election – election watchers used to multiple daily polls have now to accept a more meagre diet of one or two polls a week. The greater uncertainty may, however, also reflect something more fundamental: genuine uncertainty, and hence greater volatility, in the minds of the electorate. Voters are faced with an unexpected Conservative majority government and an unfamiliar and polarising opposition leader attracting widely varying reactions in the media and within his own party. In such circumstances many may be genuinely unsure as to their preferences. Only time will tell whether this uncertainty lasts until the next general election. For now, it provides an important reminder of the need to take single poll results with a degree of caution.

 

Robert FordWill JenningsMark Pickup and Christopher Wlezien

 

[1] The average difference between this middle pollster and those pollsters that produce estimates that are systematically higher for a given party is the same as the average difference between this middle pollster and those pollsters that produce estimates that are systematically lower for that same party.

[2] We came to a similar conclusion during the last election cycle when it became apparent that our method of anchoring on the election result was excessively reducing the estimated level of support for the Liberal Democrats.

 

Dr Ana Margheritis on the National Elections in Argentina

DipticBy Dr. Ana Margheritis, Reader in International Relations at University of Southampton (Twitter, Academia.edu). You can find more posts by Ana here.


PAIR’s Dr Ana Margheritis has been busy in the national and international media over the past week, offering reflection and analysis on the current national elections in Argentina. Ana has contributed to discussion programmes for Radio FM4 in Austria and for the BBC World Service, and featured in an article in the Daily Express.

You can listen to/view each of Ana’s contributions by following the links above.

PAIR’s Dr Kamil Zwolski commenting on the upcoming Polish election for France 24

By Dr. Kamil Zwolski, Lecturer in Global Politics and Policy at University of Southampton (Academia.edu). You can find more posts by Kamil here.


France 24 snap copy

Kamil Zwolski, Lecturer in Global Politics and Policy at the University of Southampton, has commented on the forthcoming Polish elections for the Paris-based international news and current affairs television channel France 24.

You can view the programme segment by following this link.

Should Parents Choose More Intelligent Children?

By Ben Saunders, Associate Professor in Political Philosophy at University of Southampton (@DrBenSaunders, Academia.edu).


The Oxford philosopher Julian Savulescu proposed that, where screening technology is available, parents have a moral obligation to select the children expected to enjoy the best lives. He terms this the principle of procreative beneficence. Unsurprisingly, this principle is controversial and it has been subjected to a number of criticisms, including accusations that it is eugenic. (I have criticised it myself here.)

My latest publication, ‘Procreative Beneficence, Intelligence, and the Optimization Problem’ (forthcoming in the Journal of Medicine and Philosophy; doi 10.1093/jmp/jhv026), is a response to another line of criticism.

In a recent piece in the Journal of Applied Philosophy, Adam Carter and Emma Gordon argued that even if we accept the principle of procreative beneficence, the results are less radical than Savulescu suggests. They accept, at least for sake of argument, that parents might have an obligation to choose healthy children rather than those that will suffer (or are likely to suffer) from disease or disability. However, they argue that Savulescu fails to provide a clear example of a non-disease trait that parents have an obligation to select for (or against). In particular, they focus on Savulescu’s favoured example of intelligence, arguing that greater intelligence need not conduce to greater wellbeing.

My paper responds to this criticism, on behalf of Savulescu. First of all, I argue that while greater intelligence does not necessarily improve wellbeing, it is nonetheless plausible that if often does (at least within a certain range). Second, I argue that, even if this is false, Carter and Gordon’s objection to Savulescu succeeds only if the net effect of intelligence on wellbeing is neutral. If, contrary to my earlier argument, intelligence is inversely correlated with wellbeing, then parents should select in favour of lower intelligence.

Finally, I note that the effects of intelligence on wellbeing are likely to vary at different levels, partly for social or positional reasons (for instance, as Carter and Gordon point out, someone much more intelligent than his or her peers may have difficulty finding companions). Consequently, the optimum intelligence, with respect to wellbeing, is unlikely to be either the maximum or minimum possible. Further, this optimum level will likely vary depending upon the reproductive choices of other parents. Thus, the principle of procreative beneficence does make demands on parents, but compliance with these demands is likely to be more difficult than hitherto realised.

Upcoming Conference on Global Migration

This year the Institute for Latin American Studies at the School of Advanced Study, University of London, have situated global issues (including migration) at the top of their agenda for debate. They invited Dr. Ana Margheritis to co-organize an interdisciplinary conference with broad aims. Please find more details in the call for papers and link to webpage below.

Managing Global Migration: New Perspectives from Latin America and Europe

November 12, 2015

Institute of Latin American Studies, School of Advanced Study, University of London

This one-day ILAS conference at the University of London will present and debate new research on the multiple ways and means of addressing and managing global migration flows between Latin America and Europe. The conference will move beyond area studies by focusing on two world regions historically linked by human mobility and cultural exchange but now grappling with significant demographic changes and new migration trends. These changes and trends include the reversal of flows, the greater heterogeneity of migrant groups, the pull of women leaders in family migration projects, the concentration of newcomers in non-traditional destinations, the intensification of dual or multiple engagements in the country of origin and residence, and the development of new forms of citizenship beyond borders. The aim of the conference is to assess how and to what extent state and non-state actors in both Latin America and Europe are coping with and capitalizing upon the complex and creative implications of these new trends.

We aim to critically address the need to reconcile the political regulation of new trends in human mobility with democratic and multicultural demands for respect of rights and difference. We welcome papers that address this broad scope and aim from a variety of disciplinary, methodological, experiential, and comparative perspectives. ILAS aims to publish a selection of previously unpublished papers. Limited funding is available for travel expenses of participants. Please submit an abstract of 250 words with short bio and contact information by SEPTEMBER 15 to the conference co-organizers:

Dr. Ana Margheritis, University of Southampton
A.Margheritis@southampton.ac.uk

Dr. Mark Thurner, ILAS, University of London
mark.thurner@sas.ac.uk

Demystifying the Climate Crisis: A Review of Naomi Klein’s “This Changes Everything”

By Meg Sherman, a student of Modern History and Politics at University of Southampton.


The global movement to divest from fossil fuels is a clear-thinking, progressive choice for action on climate change. This Changes Everything: Capitalism VS The Climate, a newly published volume by Naomi Klein, provides an invaluable history of environmental and economic injustices and should be required reading for anyone interested in the divestment movement.

The truth on climate change is hard to identify in a world where business is powerfully invested in misinformation. But under the smog of denialism the effects of human-made global warming (via carbon emissions) are already being wrought in real, violent ways upon the planet: ways of life are being extinguished; low-lying pacific islands look set to be swallowed by the sea; global temperatures melt previous records with alarming alacrity, and extreme weather events displacing large populations are fast becoming the norm. Our generation lives throughout the endgame of industrial civilization, a time when humanity urgently needs new, compelling narratives about potential transformations in society, economics and politics. Incisive, compelling and relevant as its predecessors, Capitalism VS The Climate appears as a stray flicker of hope, imploring a thoughtful resistance to predatory capitalism and envisioning a real place for a climate movement with redistributive justice at its’ core.

Following in the path of No Logo and Shock Doctrine, Klein’s latest volume deepens her earlier work exposing the disastrous underbelly of neoliberal globalization. The crux of her argument is that the environmental crisis is itself a consequence of the systematic desolation of the global commons, increasingly privatized and deregulated by centralized trading regimes, dominated by the richer industrialized nations, questing for more control of planetary resources. Shock Doctrine railed against the callousness of structural adjustment regimes which deprived nascent economies in the global south of their health, wealth and stability in order to serve the narrow interests and myopic greed of corporations and profiteers, that is to say, the agenda of the 1%. And in Capitalism VS The Climate Klein, using the aftermath of hurricane Katrina by way of example as to how reconstruction efforts can be hijacked and stymied, argues that global warming itself will be hoisted to the engine of the shock doctrine insofar as business competes to advantage from mounting crises without advancing help, solutions, assistance or attempts to mitigate and alleviate the accruing damage. Instead they use crises cynically as a platform for further deregulation and privatization, undermining public unity and collective solidarity. This is disaster capitalism laid bare: a lethal obstacle to public health and environmental sustainability. Major economies founded on the extraction of fossil fuels and emission of greenhouse gases are the major crisis culprits, stoking inequalities. Key stakeholder groups with historically the least restricted access to resources deriving from this foundation are called upon to amend their high-consumption lifestyles, to rediscover the real need for economic justice, or condemn global citizens to further disaster.

Klein looks to initiatives already underway which speak to hopes of achieving lasting social and environmental security by approximating more conscientious and democratic ways of life. Capitalism VS The Climate integrates the lessons and voices of Cheyenne social movements who live on lands intersected by the Keystone XL pipeline, and who have given life to the concept of stewardship by taking bold leaps forward in the resistance against big oil with public education initiatives empowering citizens to establish clean forms of power production in their own communities, harnessing abundant sources like solar and wind energy. Corporate rhetoric has a canny habit of reframing disastrous policies which attack the lives of vulnerable people as a triumph for democracy as much as it has a way of casting radical change as beyond the spectrum of possibility. But in Klein’s view the alternative is not only clear, but well within the means and creativity of people everywhere:

“with the right kind of public pressure, money can be marshaled not just to rebuild cities and communities, but to transform them into models of nonextractive living… activists can demand everything from free, democratically controlled public transit, to more public housing along those transit lines, powered by community-controlled renewable energy – with the jobs created by this investment going to local workers and paying a living wage.”

When it comes to climate change prominent politicians and business leaders argue that we can overcome it by investing more faith in technological and market-based solutions, perpetuating the idea that we don’t need wholesale social and economic reform to underwrite the transition to a low-carbon future. Klein on the other paw argues that a deregulated system which creates the widespread market failure of climate change has obviously outlived its utility, and she argues for more support for research directed at renewable energies, as a pre-requisite for solving issues of public health and the environment. She is astute when she argues that if you take the warnings of modern climate science to their logical conclusion then we ought to have democratically control over public utilities so that they are governed less recklessly. A well-known truism states that madness is doing the same thing repeatedly and expecting different results. Einstein put it this way: We cannot solve our problems with the same thinking we used when we created them.” How, then, can we rely on plutocratic capitalism to solve a problem it created and support the long term needs of life on Earth?

Global forecasts predict another unassailable reality aside climate change, that fledgling economies like Brazil, Russia, India and China, tailed by developing LEDCS, will together surpass the activity of the traditional MEDCs and G7 by the middle of this century. The total energy demanded to support those transitions is huge. And two imperatives are to meet that demand and to do it whilst reducing overall greenhouse gas emissions. Concurrently. An immense challenge. It is clear that climate change is an urgent global issue and getting good policy and functional alternatives on the go is crucial as only this will form the basis for societies and industries to reverse the very damaging practices inherent in current methods of production, to respect the balance of nature, and ensure we put a stop to pollution everywhere to protect the shared lands which sustain life on the planet. And the narrative in Capitalism VS The Climate is driven by a heartfelt wish to open people’s eyes to the collective power we have to create new visions and strategies, real options and choices for progressive, radical change in a future which runs fugitive from the totalizing, destructive ambitions of corporate capitalism.

All Change in Argentina as Sun Sets on the Kirchner Era

By Pia Riggirozzi. Pia Riggirozzi is Associate Professor in Global Politics at the University of Southampton (@PRiggirozziAcademia.edu). You can find more posts by Pia here.


Argentina’s open presidential primary is over, and the stage is now set for the election in October. With the current president, Cristina Fernández de Kirchner, constitutionally barred from running again, the autumn poll looks set to be a fight between Argentina’s two main political coalitions.

On the left is Daniel Scioli, the current governor of Buenos Aires province, who leads the official Peronist party Front for Victory. He is Cristina de Kirchner’s candidate of choice, though has stayed shy of taking on an explicitly Kirchnerist political identity. On the right is the current mayor of Buenos Aires, Mauricio Macri; he heads a coalition of strange bedfellows called Cambiemos (Let’s Change), which comprises Macri’s conservative Republican Proposal party, social democrats, and the Radical Civic Union.

The primary system pits all the parties’ candidates against each other in one poll to determine who runs in the general election. Scioli and the Front for Victory got the biggest share with more than 38%. That sets him up well for the elections in October, bodes well for the nation’s verdict on the highly contentious and deeply personalised Kirchnerist legacy.

Twilight

When Fernández de Kirchner’s term ends in December 2015, she and her late husband and predecessor Néstor Kirchner, who ruled from 2003-7, will have enjoyed the longest unbroken presidential tenure since Argentina became a democracy, in the course of which they left a profound mark on their country. As Juan and Eva Peron did before them, the Kirchners have managed to establish a political style that will bear their name long after Cristina finally leaves office.

Governor Scioli: Cristina’s best hope?
Reuters/Martin Acosta

The political project now known as Kirchnerismo (Kirchnerism) is undoubtedly very divisive. For some, it stands for a return (at least in aspiration) to economic growth, prosperity, and the expansion of citizenship rights, all led by the state. For others, it represents a corrupt quasi-authoritarianism, combined with cynical populism and meddlesome state intervention.

Nonetheless, the expansion of rights and welfare provision under the Kirchners has been so widely welcomed in Argentina that none of this election’s contenders dares to challenge it. And with such a strong consensus on a big tranche of Kirchner-era social policy, the campaign might fast descend into a game of character mudslinging.

That’s partly a factor of the weakness of the candidates themselves. De Kirchner has failed to cultivate a strong heir, and the opposition isn’t faring much better. Cambiemos, for its part, has not developed a convincing and comprehensive political platform to take Argentina in a new direction.

All it seems able to do is mount fierce attacks on the personal and political style of Fernández de Kirchner and her entourage – something the last few years have hardly made difficult.

Counting the days

Throughout their 12 years in office, the Kirchners have been dogged by accusations of corruption, which have badly eroded Fernández de Kirchner’s popularity and legitimacy. Things have only gotten worse in recent years. Discontent and distrust have grown under Kirchnerist statism, with its apparent reluctance to protect private property, and alleged propensity to favour government cronies with subsidies and contracts.

Conflicts with the media and opposition media groups have also led Argentine investigative reporter Jorge Lanata to investigate a possible network of international bank accounts and unaccounted wealth connected with the state.

Things reached a fever pitch when prosecutor Alberto Nisman was found dead in his apartment on January 18 2015. His body was discovered just hours before a judicial inquiry was expecting to examine claims that Fernández de Kirchner and her foreign minister, Héctor Timerman, tried to cover up Iran’s role in the country’s deadliest ever terrorist attack. Nisman’s case against Fernández de Kirchner and Timerman was dismissed on February 2, but it dealt a heavy blow to the government’s credibility and authority.

Adding to the twilight atmosphere is a seriously beleagured economy. Some pessimists are even predicting collapse, a forecast born of creeping inflation, slow to non-existent growth, a serious dependence on commodities markets, and a deeply destructive default.

Detractors of Fernández de Kirchner, and Kirchnerism, want Argentina to save itself from true disaster with a return to capital markets, even becoming a major regional economic power again if the right economic policies are implemented and sustained. Such accommodation with global neoliberalism would mark the true end of the Kirchnerist project.

A lasting legacy

Latin American politics expert Steven Levitsky argued that we might in fact be facing “the end of the left in Latin America”. The commodity boom has all but ended, and many of the leftist movements that rode it to power in Argentina, Brazil, Chile and Uruguay are running out of steam after too many years in power.

But what this analysis misses is the depth of the left’s legacy – a plethora of policies for social inclusion, citizenship and rights that has left a deep imprint on the continent. Kirchner-era Argentina, for its part, has taken bold steps to widen its social safety net and citizenship rights. Targeted cash transfer programmes, which were initially short-term, were extended by the plan Argentina Trabaja, supporting co-operative enterprises in poor neighbourhoods.

On to the next one.
Reuters/Marcos Brindicci

Cristina’s government also introduced a targeted programme for children, the Universal Child Benefit (Asignación Universal por Hijo or AUH). It’s not the country’s first child benefit scheme, but it covers the population on an unprecedented scale. The AUH provides around 200 Argentine pesos (US$50) a month to nearly 4m children and families, and 80% of Argentina’s children now receive some form of child benefit.

For the first time, the government is extending welfare programmes directly to children and to workers who are not unionised. In fact, most beneficiaries will be self-employed or in the informal economy – groups that were particularly active in the protests of 2001.

The Fernández de Kirchner government also introduced a “reasonable” minimum wage for non-unionised workers (including domestic workers) in 2008, and has put pressure on private health companies to extend their coverage and reduce their charges. An anti-poverty strategy has brought poverty down to around 25% from more than 50% in the wake the 2001-02 economic crisis.

In this scenario, it is not surprising that the poor voters who have benefited from state largesse over the past eight years remain loyal to the Kirchnerist project. This explains why Scioli is riding high, for now at least. His ascendance is a sign that despite all the problems they and their country have faced, the Kirchners have managed to construct a legacy of inclusion and social rights that may yet endure.

This article was originally published on The Conversation. Read the original article.

Bargaining for Developing Countries in Access to Medicines

By Pia Riggirozzi. Pia Riggirozzi is Associate Professor in Global Politics at the University of Southampton (@PRiggirozziAcademia.edu). You can find more posts by Pia here.


An earlier version of this piece first appeared at Latin America Goes Global.

By bringing together the 12 South American countries, the Union of South American Nations (UNASUR) is advancing an effective rights agenda in access to medicines and attention to developing country demands. 

In an open letter to the heads of government of all Trans-Pacific Partnership Agreement (TPP) negotiating countries, Médecins Sans Frontières / Doctors Without Borders, expressed serious concerns over provisions under TTP and bilateral trade negotiation that threaten to restrict access to affordable medicines for millions of people in low- and middle-income countries, and hence their right to health as expressed by the UN Committee on Economic, Social and Cultural Rights in numerous international declarations. This is the case for instance of the EU-Andean Trade Agreement on Access to Medicines in countries such as Peru and Colombia. It is estimated that the introduction of the measures on patent protection would lead to an increase of 459 million USD in Peru’s total pharmaceutical expenditure by 2025;    and of 756 million USD in Colombia’s total pharmaceutical expenditure, leading to a significant decrease in consumption of life saving medicines.

Facing this scenario it is not surprising that attention to access to medicines as an issue of rights is increasing. In 2014, a joint commission from the medical journal The Lancet and the University of Oslo published policy report in which it cited the imbalance of political power between nations as a major cause of health care inequality across the world. According to the report, disparities in health are not just linked to poverty but also to the unequal distribution of material and knowledge resources across nations and the capacity to influence global governance.

While there have been tremendous global advances in expanding civil liberties—through international laws and practice—much of the normative infrastructure and policy to support rights was crafted and is still shaped by the interests of the developed north.  Even in the morality of rights—civil, political, social, and economic—power rules.

International frameworks pushing for universal human rights in relation to social and economic development are still filtered through institutions such as the UN, the Bretton Woods institutions (the International Monetary Fund and the World Bank) and northern donor organizations.  These are conservative institutions that have been slow to embrace broader economic and social rights, including health.

Today, though, in the new rash of regional organizations, can the Global South reset the norms and rework global (health) governance in support of rights and social justice goals?

While the Global South has struggled to advance broader economic and social rights in the development agenda, the Union of South American Nations (UNASUR) has focused on a significant concern for its regional members: the right to health.

 

Access to medicines and the right to health

In the area of health, developing countries have historically been disadvantaged in the access to medicines and influence in setting the global health agenda—a result of they weaker status relative to business and the developed north.  Developing countries’ access to medicines has been hampered by trade negotiations that reinforce existing intellectual property standing and international institutions and laws governing intellectual property rights that favor business over patients in the developing world.

In South America, the high cost of medicine and the lack of alternatives to existing drugs is particularly acute.  Medicines not only define who lives and who dies but also why (and how) countries in the south.  According to the Secretary General of UNASUR, Ernesto Samper, almost 30 percent of the total public and private health care in South America is spent on medicine. UNASUR picked up this challenge, creating the UNASUR Health Council—one of the first councils created by the new regional group—and forming an alliance with the regional health think tank, the South American Institute of Health Governance (Instituto Sudamericano de Gobierno en Salud, ISAGS), in Rio de Janeiro, Brazil.

The new alliance is in a far strong position to pursue South America’s agenda in medicine than the traditional Washington, DC-based Pan-American Health Organization (PAHO) UNASUR/ISAGS is in a better position to deliver effective health governance than PAHO, which is focused on “health coverage” instead of UNASUR/ISAGS’ more ambitious agenda of “universal access to health.”  These two approaches represent different ways of addressing how health care reaches societies, and ultimately speak of different conceptions of entitlement and equality. ISAGS focus has been on the broader idea of strengthening health governance capacity, advocating the right to health and supporting policymaking and policy reforms towards the universalization of health care. In this capacity it has trained policy-makers and practitioners by setting up UNASUR-sponsored public health schools in Bolivia, Guyana, Peru and Uruguay, and assisted in the creation of a UNASUR network of public health schools.

ISAGS has also provided support directly to ministries of health in Guyana and Paraguay on primary care and the preparation of clinical protocols, and has supported reforms aimed to move towards universalization of health sector provision in Bolivia, Colombia and Peru.  ISAGS is involved in the diffusion of information on combating HIV/AIDS, influenza and dengue fever across the region, and has developed mapping techniques to coordinate shared policies for the production of some key medicines.

Policy advances of this sort—concrete, modest, focused and cheap to deliver taken in a relatively short timeframe and below the radar of political commentary—are unusual in previous efforts in at regionalism in South America.  And they stand as evidence of UNASUR’s focused, grounded approach.

ISAGS has begun to scale up its level of activity on behalf of UNASUR, once again with relatively little attendant publicity. ISAGS has been quietly targeting global health governance forums and is trying to establish a joint bargaining position for South American negotiators vis-à-vis pharmaceutical companies and in the World Health Organization (WHO). ISAGS now holds meetings prior to each annual gathering of the WHO, so that UNASUR member states coordinate their actions at the WHO.  It’s an approach that both UNASUR and ISAGS are now using to speak out more widely on behalf of other developing countries.

 

Reclaiming sovereignty, rebuilding diplomacy

As part of this campaign, UNASUR has also begun to take action on access to medicines.  The strategy centers on coordinating active resistance to the dominance of pharmaceutical companies under a motto that links regional health diplomacy with sovereignty.

For instance, UNASUR is setting up a “Medicine Price Bank”, a computerized database revealing the prices paid by UNASUR countries for drug purchases.  By making the information public and comparative, UNASUR is seeking to provide policymakers and health authorities information to strengthen the position of member states in purchases of medicines vis-à-vis pharmaceutical companies. Likewise, UNASUR’s Health Council has approved a project for the mapping regional pharmaceutical capacities in 2012, to coordinate common policies among member states for production of medicines.

Within the WHO, UNASUR has pressed to change international norms regarding the combat of counterfeit medical products. Until recently that effort was spearheaded by the International Medical Products Anti-Counterfeiting Taskforce (IMPACT), an agency led by big pharma and the International Criminal Police Organization (Interpol) and funded by developed countries engaged in intellectual property rights enforcement.

At the 63rd World Health Assembly in 2010, UNASUR successfully proposed that an intergovernmental group replaced IMPACT to act on, and prevent, counterfeiting of medical products. This resolution was approved at the 65th World Health Assembly in May 2012. In the course of the meeting, UNASUR also lobbied for opening negotiations for a binding agreement on financial support and research to meet the pharmaceutical needs of developing countries, and issue that was resumed at the 67th WHO meeting last May.

More recently, a key policy has been agreed in support of the establishment of a fund to negotiate centralized purchases of the Hepatitis C virus treatments. This proposal, agreed by UNASUR Health Council in July 2015, will represent a milestone in the region in savings through price negotiation on an innovative and expensive medicine. It could also create incentives for the industry as centralized purchases could be a more conciliatory route towards medicine price reduction rather than the practice of compulsory licenses and direct government price cuts in the region.

The presence of UNASUR in this type of health diplomacy, and its coordinated efforts to redefine rules of participation and representation in the governing of global health, demonstrate that there is a new logic and momentum in regional integration and regional policy-making in Latin America. These actions create new spaces for policy coordination and collective action.  In the all-important case of health rights, UNASUR—and other regional institutions too—can become an opportunity for practitioners, academics and policy makers to collaborate and network in support of better access to healthcare, medicines and policy-making.

 

Author’s note: This article draws on a combination of documentary analysis and interview data. Some of the research was carried out in the context of the research project Poverty Reduction and Regional Integration: SADC and UNASUR Health Policies (PRARI)’, supported by the Economic and Social Research Council (ESRC), grant ref. ES/L005336/1. The article does not necessarily reflect the opinions of the ESRC. For information on the project: http://www.open.ac.uk/socialsciences/prari/