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Poverty Reduction and Regional Integration

A comparative analysis of SADC and UNASUR health policies

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We are committed to disseminating findings and promoting discussion on the topic of regional integration, poverty reduction, health and wider social development through a wide range of media. Links and information about the project's ongoing dissemination and public/stakeholder engagement activity can be found on this page.

These and a range of other activities over the duration of the project will contribute to ongoing discussion and debate with policy, practitioner, end-beneficiary and policy-facing academic communities working in the intersections of regionalism, poverty and health.

Policy Briefs

Spanish Version

Working Papers

Media, Short Articles and Interviews

  • Watch this short video about poverty eradication and the global south by Nicola Yeates (The Open University)
  • Listen to an interview with Mariana Faria (Institute of South American Health Governance) talk about issues of health and medicines seen from a regional perspective in the context of South America (in Spanish, October 2015) English overview

    Mariana Farias introduces the importance of PRARI by contextualizing it. There is a pressing issue regarding access to medicines and chronic diseases in an aging population. The journalist asked Mrs. Faria three questions relating to the relevance of her work: the added value of UNASUR in these objectives; the importance of monitoring; and the contributions of PRARI. She explains that the added value of UNASUR is threefold. First, it enables to share best practices and knowledge among UNASUR member states. Second, UNASUR can be a platform for “health diplomacy”, in the sense that voices from the region can be heard at a regional, multilateral and global level. Third, as UNASUR is becoming a global actor, it can influence the national and global level with its member states’ values regarding health.

    Mariana argues that the UNASUR region has a poor record on monitoring activity. UNASUR is now at the close of its first 5 year plan and it is important to keep a record of progress and its methods. There are also key opportunities to prepare for the future. PRARI is important in this context, in two ways. UNASUR does not have the capacity to build a database yet and can therefore use data generated by PRARI. UNASUR can also take ownership for the PRARI Toolkit of indicators of regional health policy progress and can use this as a basis to undertake other projects in the future.

  • Erica Penfold (2015) ‘Why a renewed focus on regional governance is needed post-2015’, Global Social Policy Forum, 15(3): 348-351
  • Erica Penfold (2015) ‘Featured Article: Global poverty eradication and the post-2015 agenda: what can regional organisations do?’, Global Cooperation Newsletter, International Council on Social Welfare, August 2015
  • Following Erica Penfold’s article in The Conversation Africa on how a stronger regional health governance could improve maternal and child health, she is interviewed on local talk radio 702 on Friday 10th July and her article is reprinted in TimesLive and IFLS
  • Watch Pia Riggirozzi (2015) being interviewed at a conference on ‘Consolidation of Democracy in Regional Organisations: Lessons from Latin America and EU’, Montevideo, Uruguay, 6-7th May 2015
  • PRARI reported in ISAGS Report January 2015
  • Escuchar a Mariana Faria hablar de la salud y medicinas visto desde una perspectiva regional en el contexto de América del Sur
  • ISAGS Informe: ISAGS realiza semana presencial du su primer curso
  • Stephen Kingah: Sit up or shut up: regional organisations and health, November 2014
  • PRARI/UNU-CRIS toolkit development highlights in the November issues of the EQUINET Africa newsletter
  • Watch this short video with Erica Penfold discussing 'What can we learn from Ebola?'
  • Stephen Kingah and Ana Amaya (2014) "Fixing the weakest link in global health governance" published on Our World, United Nations University, October 2014
  • BBC three counties radio drive-time interview with Roberto Perrone 16 October 2014 – Nicola Yeates on global and regional responses to Ebola
  • Stephen Kingah "SADC – EU EPA and pro-poor health policies in Southern Africa" Botswana Guardian. 3rd October 2014 (only available in print)
  • The expert: Economies at risk with ebola [Italian], August 2014
  • María Belén Herrero (2014) ‘Informe:Reducción de la pobreza e integración regional Las políticas de salud de UNASUR y SADC PRARI/RePIR’ [ES; ‘Poverty Reduction and Regional Integration. Health policies of SADC and UNASUR (PRARI / RePIR)’, Revista del ITAES (Instituto Tecnico para la Acreditacion de Establecimientios de Salud) (Buenos Aires, Argentina) 16(3): 31-34. ISSN: 1851-5703
  • Mail and Guardian article (South Africa): Share in the politics of poor health 24 July 2014


Journal Articles

  • Marcela Belardo, Jorgelina Loza and Maria Herrero(2018) '?Trayectorias de pensamiento, integración regional y soberanía sanitaria en Suramérica', in Revista de Ciencias Sociales y Humanas, Vol 12, October 2018 – March 2019.
  • Ka Ho Mok, Stefan Kühner and Nicola Yeates 'Managing Welfare Expectations and Social Change', Social Policy & Administration, 51(6): 845-856.
  • Pia Riggirozzi (2017) 'Regional Integration: Framing and Advocating Pro-Poor Norms through Southern Regionalisms', New Political Economy, 22(6).
  • Pia Riggirozzi and Nicola Yeates Global Social Policy: a journal of international development and public policy, guest editors, Open Access special issue on Regional Health Governance and Diplomacy (vol 15, issue 3). The Special Issue includes a broad range of full-length research articles and shorter ones on this topic. View articles

    Full research articles:

    • 'Locating regional health policy: institutions, politics, and practices' Pia Riggirozzi and Nicola Yeates
    • 'Stretching Health Diplomacy beyond 'Global' Problem Solving: Bringing the Regional Normative Dimension In' Andrew F. Cooper and Asif B. Farooq
    • 'International and Regional Economic Rule-making and the Enforcement of the Right to Health: the Case of Colombia' Liliana Lizarazo Rodríguez and Philippe De Lombaerde
    • 'Regional Health Governance: A Suggested Agenda for Southern African Health Diplomacy' Erica Penfold and Pieter Fourie
    • 'Region building in South America after neoliberalism: the case of health' Diana Tussie and Belen Herrero
    • 'What’s in a word? The framing of health at the regional level: ASEAN, EU, SADC and UNASUR', Ana B. Amaya, Vincent Rollet and Stephen Kingah

    Global Social Policy Forum articles:

    • 'Advancing regionalism and a social policy agenda for positive change: from rhetoric to action' Viviene Taylor (University of Cape Town, South Africa)
    • 'Principles to guide a regional agenda on the right to health' Dainius Puras (UN Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health)
    • 'Unasur Health Council: an emerging global actor in health policy and governance' Mariana Faria (ISAGS-UNASUR)
    • 'Health governance in sub-saharan Africa' Keneilwe Sadie Mooketsane and Molefe Phirinyane (Botswana Institute for Development Policy Analysis, Gabarone, Botswana)
    • 'The Post-2015 development agenda and South-South and triangular cooperation – how the partnership model should be?' Mami Yamada Sakurai (Assistant Director for Partnerships and Triangular Cooperation, United Nations Office for South-South Cooperation (UNOSSC)
    • 'Why a renewed focus on regional governance is needed post-2015' Erica Penfold (SAIIA)
    • 'Economic Policy - Public Health Linkage, and the Importance of a Regional Platform: the case of tobacco control' Jenina Joy Chavez (Action for Economic Reforms - Industrial Policy Team, Philippines)
  • Pia Riggirozzi and Nicola Yeates (2015) 'Locating regional health policy: Institutions, politics, and practices', Global Social Policy 15(3): 212-228. Read abstract

    Abstract: Poverty reduction and health became central in the agendas of Southern regional organisations in the last two decades. Yet, little is known about how these organisations address poverty, inclusion and social inequality, and how Southern regional formations are engaging in power constellations, institutions, processes, interests and ideological positions within different spheres of governance. This article reviews academic literatures spanning global social policy, regional studies and diplomacy studies, and the state of knowledge and understanding of the ‘place’ of regional actors in health governance as a global political practice therein. It identifies theoretical and thematic points of connection between disparate literatures and how these can be bridged through research focusing on the social policies of regional organisations and regional integration processes. This framework hence locates the contributions of each of the research articles of this Special Issue of Global Social Policy on the regional dimension of health policy and diplomacy in relation to Southern Africa and South America. It also highlights the ways in which the articles bring new evidence about how social relations of welfare are being (re)made over larger scales and how regional actors may initiate new norms to improve health rights in international arenas engaging in new forms of ‘regional’ diplomacy.

    Keywords: Health diplomacy, global health governance, regional integration, SADC, UNASUR

  • Ana B. Amaya, Vincent Rollet and Stephen Kingah (2015)'What’s in a word? The framing of health at the regional level: ASEAN, EU, SADC and UNASUR', Global Social Policy 15(3):229-26. Read abstract

    Abstract: The Association of Southeast Asian Nations, the European Union, the Southern African Development Community and the Union of South American Nations have increasingly been involved in health diplomacy in the past decade, yet little is known about how they frame health as a foreign policy issue and how this has an impact on their prioritisation of policies. For this, we conducted a review of existing grey and peer-reviewed literature that address regional integration and health, as well as a documentary review according to security, development, trade, human rights, moral/ethical reasonings and global public goods frames identified in the literature. The policy frames identified responded to the challenges these regions currently face. The Association of Southeast Asian Nation’s struggle with re-emerging diseases has led to favouring a securitisation approach to health, the European Union approaches health as a cross-cutting policy issue, the Southern African Development Community presents health as a driver for development, and while the Union of South American Nations emphasises health as a human right and addresses the social determinants of health as an ethical imperative. Overall, these policy frames were useful in analysing the framing of health in foreign policy at the regional level. However, within our analysis, we identified a new frame that approaches health as an intersectoral issue. The impact of regional organisations’ forward will depend on their ability to harness their convening power and speak in a coherent voice on health matters.

    Keywords: Foreign policy, health policy, policy frames, regional organisations

  • María Belén Herrero and Diana Tussie (2015) 'UNASUR Health: A quiet revolution in health diplomacy', Global Social Policy 15(3): 261-277. Read abstract

    Abstract: Since the creation of Union of South American Nations (UNASUR), health policies became a strategic factor in South America to collectively balance the legacy of neoliberal policies in the region. The aim of this article is first to describe the social, political, and economic processes that explain the emergence of UNASUR and its focus on social policy through healthcare. We then analyze how by virtue of UNASUR’s Health Council, healthcare became the spearhead of cooperation giving way to novel forms of diplomacy. In so doing, this article contributes to a broader understanding of the regional health diplomacy and the process of unasurization of health policies as the process of building a new health framework.

    Keywords: Global, regional health diplomacy, regional UNASUR, South America, social policy

  • Erica Penfold and Pieter Fourie (2015) 'Regional Health Governance: A Suggested Agenda for Southern African Health Diplomacy', Global Social Policy 15(3): 278-295. Read abstract

    Abstract: Regional organisations can effectively promote regional health diplomacy and governance through engagement with regional social policy. Regional bodies make decisions about health challenges in the region, for example, the Union of South American Nations (UNASUR) and the World Health Organisation South East Asia Regional Office (WHO-SEARO). The Southern African Development Community (SADC) has a limited health presence as a regional organisation and diplomatic partner in health governance. This article identifies how SADC facilitates and coordinates health policy, arguing that SADC has the potential to promote regional health diplomacy and governance through engagement with regional social policy. The article identifies the role of global health diplomacy and niche diplomacy in health governance. The role of SADC as a regional organisation and the way it functions is then explained, focusing on how SADC engages with health issues in the region. Recommendations are made as to how SADC can play a more decisive role as a regional organisation to implement South–South management of the regional social policy, health governance and health diplomacy agenda.

    Keywords: Global South, health diplomacy, health governance, regionalism, SADC, social protection

  • María Belén Herrero (2015). 'El surgimiento de una nueva diplomacia regional en salud en tiempos posteriores al neoliberalismo: el caso de UNASUR Salud' [ES; 'The emergence of a new regional health diplomacy in post-neoliberal times: The case of UNASUR Health' Comentario Internacional: revista del Centro Andino de Estudios Internacionales (CAEI). Universidad Andina Simón Bolívar/Corporación Editora Nacional. ISSN: 1390-1532, Quito, Ecuador.
  • Pia Riggirozzi and Jean Grugel (2015) 'Regional governance and legitimacy in South America: the meaning of UNASUR', International Affairs 91(4): 781-797. Read abstract

    Abstract: Over the last decade, rapid changes to development models and market rules have led—yet again—to a revision of the meaning of regionalism, bringing to the fore the role of regional organizations in anchoring democracy and supporting progressive social policies. This is particularly the case in South America, where the presence of regional organizations in public policy-making is a subject of increasing scrutiny. This article examines new forms of politically sensitive regional governance in South America, focusing in particular on the case of the Union of South American Nations (UNASUR). It shows how contemporary South American regionalism bypasses the questions of trade and investment that dominated earlier schemes of regionalism in order to focus on shoring up democracy and managing the regional social deficit. The article explores UNASUR's actions in two policy areas: supporting the regional democratic norm and health policy. UNASUR, this article argues, is developing a hybrid form of output-focused legitimacy that rests on a combination of credible commitments to welfare promotion, especially for the poor, and the pursuit of collective public goods, alongside a robust defence of quite minimal but uncontroversial standards of procedural democracy across the region. The analysis challenges the view that regionalism has failed in South America and identifies instead the emergence of a new sort of highly political regionalism. We call for UNASUR to be taken more seriously in the literature on comparative regionalism and, indeed, for a revision of how regionalism more widely is understood in Latin America.

Conferences, Workshops and Seminars

  • Ana B. Amaya Using participatory methods to develop indicators to measure pro-poor health policy success: Ongoing lessons from a regional comparative study, seminar presented at Global Health Seminar Series. January 15, 2015 Duke Kunshan University, China. Read abstract

    Participatory Action Research (PAR) is a reflective and concerted process of problem-solving where multiple actors collectively define the research problem and objectives and work towards solutions. Given that PAR is generally applied at the community level, there is little evidence of this approach being used at the supra-national level. The Poverty Reduction and Regional integration (PRARI) project, a two year ESRC/DFID-funded study, seeks to do this by using collaborative PAR with identified partners in South America (UNASUR) and Southern Africa (SADC) to build a toolkit of input, process, output and outcome indicators that capture regional policy change and pro-poor regional health policy success. The overall objective of this study is to understand what regional institutional practices and methods of regional policy formation are conducive to the emergence of embedded pro-poor health strategies, and what can national, regional and international actors do to promote these. This seminar will present preliminary results from this ongoing study.

  • Listen to Pia Riggorozzi discussing Regionalism, Advocacy and Rights through to health Diplomacy in South America at the Innovation, Knowledge and Development 2014-15 seminar series at The Open University in March 2015.
  • Erica Penfold (2015) 'SADC and regional health governance – what influence for the future?' WiSER Workshop Building Health in the Social Sciences, Malmesbury, Western Cape, South Africa.
  • Nicola Yeates (2015) 'Situating Regions in Global Worlds: Towards a 'New' Politics of Social Policy', Keynote Address to the Global Alliance for Educational Change and Social Development, Hong Kong Institute of Education, Hong Kong, 9-10 April 2015.
  • Pia Riggirozzi (2015) presentation to conference on 'Consolidation of Democracy in Regional Organisations: Lessons from Latin America and EU', Mercosur Building, Uruguay, 6-7th May 2015. See Pia interviewed on this topic.
  • Nicola Yeates and Pia Riggirozzi (2015) Globalisation, regionalism and social policy Social Policy Association Annual Conference, Belfast, 6th-8th July 2015. Read abstract

    While much has been written about national social policy (and welfare regimes) worldwide, and regionalist economic and security processes, the significance of regional integration as a site and driver of social politics and policy has been rather more neglected within sociological and political science literatures on welfare. This paper is concerned with social policy in processes of region-building and with two inter-related issues: the linkages between regional integration and social policy in practice; and the ability of regional institutions to mobilise collective action in defence of social rights. We argue that regional integration is forging the development of 'new' regional platforms for collective action and contention politics of social policy. We identify three principal ways in which this is happening: (i) by creating normative frameworks structuring inter-governmental and expert networks model of regional social governance and policy; (ii) by facilitating the re-allocation of material and knowledge resources in support of public policy and policy implementation; and (iii) by enabling representation and claims-making of actors in global governance. There are however significant degrees of variance in the extent to which this is evident in practice and this is explored in the paper. Our focus is extensively international in that it goes beyond the experiences of regionalisms in the Global North to also include those in the Global South.

  • Nicola Yeates and Pia Riggirozzi (2015) Global social regionalism: Regional Organisations as drivers of social policy change, International Sociological Association RC19 conference Frontiers of Inequality, Social Policy, and Welfare. 26-28 August, 2015. Bath, UK. Read abstract

    While much has been written about national social policy (and welfare regimes) worldwide, and regionalist economic and security processes, the significance of regional integration as a site and driver of social politics and policy has been rather more neglected within sociological and political science literatures on welfare. This paper is concerned with social policy in processes of region-building, empirically and theoretically. Empirically, it is concerned with two inter-related issues: the linkages between regional integration and social policy in practice; and the ability of regional institutions to mobilise collective action in defence of social rights. It is also concerned with the bases and tenets of a revitalised theoretical understanding of the relationship between regionalisation processes and social policy. Our focus is extensively international in that it goes beyond the experiences of the Global North to also include those of the Global South.

  • Ana B. Amaya and Nicola Yeates (2015) Participatory Action Research as a methodology for achieving embedded pro-poor regional health, paper to ALARA 9th Action Learning Action Research and 13th Participatory Action Research World Congress Collaborative and Sustainable Learning for a Fairer World: Rhetoric or Reality? 4-7 November 2015, Centurion, South Africa. Read abstract

    Participatory Action Research as a methodology for achieving pro-poor regional health policy

    Dr Ana B. Amaya (UNU-CRIS, Belgium) and Professor Nicola Yeates (The Open University, UK), with Dr Themba Moetki (CEO Health Systems Trust, South Africa)

    Keywords: collaborative PAR, health, poverty, policy change

    Background: Participatory action research (PAR) is gaining greater attention within conventional policy-facing social sciences research due to the emphasis placed on research uptake for wider public benefit. In affirming stakeholders as agents bringing diverse knowledge and techniques to the research process, it is often claimed that PAR results in a commitment to ownership of research findings and outputs in ways that are more likely to be translated into action (Cornwall & Jewkes 1995; Bergold & Thomas 2012). This paper reflects on this claim by discussing experiences of using an innovative application of PAR among policy-makers working at the interstices of national and regional organisations in Southern Africa and South America.
    Methods: The research uses collaborative modes of PAR to construct pro-poor indicators of regional policy success and change with regard to access to health and medicines.
    Results: Increased interest in participatory research by funding councils gives rise to significant opportunities for researchers and policy-makers to collaboratively engage in research for wider public benefit, but all actors in the research process need to be sensitive to the tensions, dilemmas, and limits of PAR as a methodology for realising those benefits under conditions of social and political complexity and in the interests of sustainability and inclusivity.
    Conclusions: The 'problem' identified in PAR studies of transposing participatory approaches from the project context where they were developed to the policy one presents a challenge for funding councils and researchers alike. Funders and research teams using PAR need to be ever-mindful of the challenges that transposition presents to the non-extractive nature of methodology that PAR seeks to practice and the particular context in which it is practiced, while also ensuring that the connections between policy, power and poverty remain as foreground concerns throughout the collaborative research endeavour.

Book Chapters

  • Nicola Yeates (2019) 'World-regional social governance, policy and development', in James Midgley, Rebecca Surender and Laura Alfers (eds.) Handbook of Social Policy and Development. Cheltenham: Edward Elgar.
  • Nicola Yeates and Ana Amaya (2018) 'Making social policy internationally: a participatory research perspective', pp. 147-160, in P. Beresford and S. Carr (eds) Social policy first hand: an international introduction to participatory social welfare. Bristol: The Policy Press.
  • Pía Riggirozzi (2015) 'Regionalism and Health Policy in South America: Tackling germs, brokering norms and contesting power', in Andrea Hoffman and Andrea Bianculli (eds.) Regional Organizations and Social Policy in Europe and Latin America: A Space for Social Citizenship? (Palgrave) November 2015.

PRARI Toolkits of regional indicators

  • Measuring Regional Policy Change and Pro-Poor Health Policy Success: A PRARI Toolkit of Indicators for the Southern African Development Community (SADC) (December 2015) [English]
  • Measuring Progress and Success of Regional Health Policy: A PRARI Toolkit of Indicators for the Union of South American Nations (UNASUR) (December 2015) [Spanish] [English]
    Further information about these Toolkits

last Updated: 5 March 2019