Nicola Yeates - Open

1 Poverty reduction and regional integration reducci n de la pobreza e integraci n regional PRARI Policy Brief 8. September 2017. southern regionalisms, Global agendas: Innovating inclusive access to health, medicines and social protection in a context of social inequity Nicola Yeates This Policy Brief highlights key findings from an ESRC (Economic and Social Research Council) Department for International development -funded international social policy research project examining the scope for enhancing the contributions of southern multilateral regional organisations to inclusive social development in low-income contexts.

2 Questions guiding the project were: PRARI Policy Briefs aim to 1 Are social policies and programmes of action on a regional scale by present accessible information on current issues in regional social southern regional groupings of countries instituting approaches for policy and poverty. Readers are accessing health and medicines that meet the needs of all? encouraged to use and quote from them. 2 What scope is there for strengthening regional health and social This Brief may be cited as policy in the interests of poverty reduction, social equity and inclusive Nicola Yeates (2017) southern development ?

3 Regionalisms, global agendas: innovating inclusive access to 3 What needs to be done to strengthen regional approaches and policies in health, medicines and social support of equitable access to health, medicines and social protection? protection in a context of social inequity' PRARI Policy Brief No. The principal focus of research was the regional health policies of the 8, The Open University, Milton southern african development community (SADC) and the Union of South Keynes. American Nations (UNASUR). This is because SADC and UNASUR have The full series of PRARI.

4 Clear mandates in relation to health (and other social policies), and include publications, think pieces and blogs are freely available at http:// many of the world's most impoverished populations, for whom unfavourable access to basic health care and medicines is both a persistent obstacle and a prari/ key social determinant of morbidity and mortality. For all enquiries please contact: This work was carried out with support from the Economic and The rise of regional social policy Social Research Council (ESRC), Grant Ref. ES/L005336/1, and The global system that has emerged in the early 21st century has generated from The Open University.

5 It vigorous debates among scholars, policy makers and activists worldwide about does not necessarily reflect the how to enhance social standards, extend the coverage of social provision, opinions of either organisation. strengthen health systems, and improve population health, well-being and security. These debates, long present in national spheres of governance, are also now being taken to regional forums where state and non-state actors are mobilising around a set of policy agendas that ask how regional integration can be harnessed to support social equity in development , including through health improvements.

6 Regional perspectives and regional-level actions are emerging in response to questions such as: What kinds of social innovations are needed to Regional initiatives on access to support the means of social participation and health and social protection inclusive social development ? Multilateral regional associations of nations are of How can a socially responsible and sustainable substantial and growing significance for international relationship between economic and social integration, development cooperation and social standards be forged and sustained?

7 Policy. To varying degrees, they act as knowledge How can national and international social brokers, training hubs, industrial coordinators and solidarity, standards and rights be maintained in global players. Reaching beyond the traditional the face of international competition? concerns of trade, finance, investment and security, regional organisations have been active in identifying Regional organisations are serving as forums for a range of social policy issues of common concern to exchanging information, discussing ideas, pooling their member states, and have developed mandates, resources and developing collective responses on plans of action and initiatives to realise regional a wide range of fronts.

8 The take-up of social policy health, social protection and education goals (Box 1. issues in regional spheres of governance, long and Table 1). studied in relation to the Northern regionalisms such as the European Union, is also occurring in the Global South where regional organisations across Africa, South America and Asia are Box 1 Examples of regional initiatives on mandated to address issues of poverty, health and access to health and medicines social development . ASEAN: improving capability to control Poverty reduction is a stated goal of regional communicable diseases; promoting regional integration frameworks in these and other contexts.

9 Trade in healthcare goods and services through Yet too little is known about how these agendas harmonised standards, registration, cross are taken up in region-building projects in practice, border provision of healthcare services, mutual and how the commitments by regional associations recognition agreements. of governments as regards poverty reduction and CARICOM: institutional and human resource social equity are being pursued in practice. capacity-building to address communicable This matters because without such information diseases; development of a regional approach existing good practice cannot be identified and to the management of human resources for shared.

10 Improved knowledge of whether and health including cross-border migration of health how regional integration projects are capable of workers. translating their mandates into concrete action MERCOSUR: regional harmonisation of will help all stakeholders (locally, nationally and pharmaceutical legislation and regulations in order internationally) to know how to support policies and to facilitate economies of scale in the production programmes of concerted social action effectively, of generic drugs. to eliminate poverty, reduce social inequality and improve health, educational attainment, housing, SADC: cooperation on communicable diseases working conditions, food and water security.