Developmental states,civil society,and public health: Patent regulation for HIV/AIDS pharmaceuticals in India and Brazil

While both India and Brazil are seriously affected by the HIV/AIDS epidemic, each country has chosen a different approach to providing affordable pharmaceutical treatment. Whereas the Indian government has paved the way for market-driven solutions, Brazilian public authorities are strongly involved in the research and production of HIV/AIDS medication. Brazilian regulations permit comprehensive and free provision of HIV/AIDS drugs, whereas the majority of the affected population in India does not receive adequate pharmaceutical treatment. To explain the different policy outputs, we draw on the developmental state literature. Efficient decisionmaking structures, a devoted bureaucracy, and effective policy instruments enable public authorities to provide public goods even in the context of relative scarcity. We show that the assumptions of developmental state theory have to be complemented by the assessment of civil society actors' potential to trigger governmental interventions in the market.     

Why Do Institutions Matter? An Audience–Cost Theory of Institutional Commitment

Institutions constrain political choices and thus commit the future path of policy. Well–designed institutions square the circle of generating commitment that is both credible and flexible. This article develops an audience–cost theory of flexible commitment that addresses some vexing questions. Where does institutional commitment come from? Why is institutional commitment feasible when policy commitment is not? How can an institution achieve credible and flexible commitment without flexibility undermining credibility by opening the back door to defections? How does partial commitment work, or how is it possible for defections to occur in an equilibrium with credible commitment? Why do policy–makers sometimes respect institutional constraints and other times defect on institutional commitments? Why are some defections punished severely, while others are instantly forgiven and forgotten?     

The influence of institutions and culture on health policies: different approaches to integrated care in England and The Netherlands

The concept of integrated care has assumed growing importance on the policy agendas both in England and The Netherlands and elsewhere. It is characterized as health and health care-related social care needed by patients with multi-faceted needs. This article compares policy approaches to integrated care in England and The Netherlands. Differing political strategies and conditions for integrated care correspond to the dissimilarities in the institutional structure and culture of their health care systems. Health care systems are understood as specific national and historical configurations. We review the last decade's relevant policy processes, using the concepts of hierarchy, market and network. The state health care system in England relies mainly on hierarchical steering, thus creating tight network structures for integrated care on the local level. The Netherlands, with its health care system in a public-private mix, has set incentives for voluntary, loosely coupled and partly market-driven cooperation on the local level. Implications for success or failure are mixed in both configurations. Policy recommendations have to be tailored to each systems' characteristics.     

Governance in der politischen Ökonomie — zum Stand der Debatte

Ohne Zusammenfassung     

Immigration and the emergence of right-wing violence in unified Germany

The articles that make up this special issue were all derived from presentations at a conference that took place at the Pennsylvania State University in the Fall of 1993. This paper presents an overview of the themes and issues discussed at that conference. While the conference was broadly international, co-sponsored by Penn State University and the Max-Planck-Institut and supported financially by the DAAD, the articles included in this special issue focus principally on the nature and amount of hate crimes and xenophobia in Germany. This article describes the international and comparative nature of the conference and explains the decision to focus on the German situation.