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This paper reports on the process used to embark on one of the core strategies of Abu Dhabi’s Department of Health, which was to develop a roadmap for HTA implementation and institutionalization, based on the aspirations and needs of local stakeholders and making use of the evidence-informed deliberative processes framework. The paper also highlights the main features of the road map that may be expected to address some of the current challenges.
Methods
A series of activities were undertaken that informed the subsequent development of the roadmap. They comprised a situation analysis using a combination of desk research and semistructured (group) interviews with 45 stakeholders. The findings were discussed in two workshops; face-to-face with nonindustry stakeholders from Abu Dhabi, and online with industry representatives.
Results
Guided by the EDP framework, the roadmap provides instructions how to organize stakeholder involvement, how to identify and operationalize decision criteria, and how to ensure that the decision-making process is transparent. Specific guidance is given on establishing an HTA structure with an appropriate policy framework, the formulation of an HTA program, a communication strategy, as well as building and leveraging HTA expertise.
Conclusion
Broad stakeholder consultation has been instrumental toward the establishment of a comprehensive HTA framework in Abu Dhabi, and the development of a road map. The interest raised during stakeholder consultations and the commitments made hold promise for the adoption and establishment of EDP principles to support HTA in Abu Dhabi that have potential to contribute to a sustainable high-quality healthcare system.
This chapter first develops a theoretical framework on the behavioral dynamics behind voters’ responses to different mobilization strategies and their different effects on voter preferences and party identification. It then goes on to explore why these different strategies are available to new parties in the first place. It develops a theoretical model that focuses on the period before a new party contests its first major election to show how the intra-elite dynamics during these founding moments shape early on which mobilization strategies the party adopts.
Collaborative climate governance has emerged as a promising approach to address the urgent need for decarbonization. Here, we summarize the book’s findings on the complex interplay between states and non-state actors in the pursuit of climate goals, using Sweden as a case study. Collaborative governance can effectively engage industry, cities, and other stakeholders in climate politics, yet it falls short in achieving transformative change. The success of collaborative climate governance is influenced by broader political, economic, and social context and calls for a critical examination of its applicability in diverse settings. Looking beyond Sweden, we identify three main research avenues. Firstly, we emphasize the need to engage with the challenge to institutionalize and sustain climate commitments. Secondly, we encourage scholars to explore democratic innovations to address contestation within collaborative governance. Finally, we call for a deeper exploration of how external shocks and crises serve as catalysts or barriers to decarbonization.
This chapter discusses the way international law aims to help protect the environment (or does not), by focusing on relevant legal instruments and relevant instances
Policy piloting has become a popular form of organization in implementing public policies. However, the current literature surprisingly discusses little about its management. This study investigates how two policy-pilot attributes – ambiguity and compatibility – shape policy-pilot management. To accomplish this, we developed an analytic framework consisting of four management strategies: experimentation, refinement, upscaling, and institutionalization. We chose a representative policy pilot in Chinese health governance, the New Rural Cooperative Medical Scheme, to examine the adoption of these four strategies. Our finding that, at various junctures, the Chinese state adopted these four strategies to manage policy piloting demonstrates the applicability of the analytic framework constructed in this study. This study contributes to the existing public policy literature by providing new insights into policy implementation in temporary organizing settings.
This article seeks to extend the theoretical discussion of interstitial emergence to an authoritarian context. An interstitial space is a space whose relations with the dominant power structure are not yet institutionalized. In analyzing interstitial emergence in an authoritarian context, it is necessary to examine the interaction between interstitial space and the state as an institutionalizing force and recognize that 1) institutionalization is an ongoing process that spans over a period and 2) a state’s intervention may induce unintended consequences. The rise and fall of labor NGO activism in China between 1996 and 2020 are used as a case to illustrate the theoretical discussion. Labor NGOs emerged out of the interstices of state control since the 1990s. Although the state started to regulate these organizations since the late 2000s, its intervention lacked consistency. Before the state finally gained the capacity to enforce rules, which was around 2015, labor NGOs had already launched a series of advocacy activism and cultivated a group of activists who identified with the value of social movement. Hence, although the activism was eventually incorporated, it had successfully thematized labor issues and produced enduring impact on the culture of public discussion.
While many scholarly works are concerned with how social protests promote democratization, this article addresses the causally reverse question: how democratization shapes the landscape of street protests. We use a unique database of 31 years of protest events in Taiwan, a smooth and successful case of authoritarianism-to-democracy transition, to engage in a dialogue with political transition theory, the institutionalization thesis and networked movement theory. The logistic regression analysis indicates that protest violence persists under consolidated democracy, but it is marginalized. We find an indirect effect from the growth of social movement organizations that foster the adaptation of festive and performative tactics, which are less confrontational in nature. Politicians' involvement, however, remains a constant source of disruptiveness. Our conclusion of contentious institutionalization finds that late-democratizing countries also gravitate towards becoming a ‘social movement society’ as advanced democracies do, but in a highly compressed period of time.
How did the new kind of deterritorialized, dematerialized, and individualized warfare ‒ extensive in both time and space ‒ become durable? To what extent can it be considered as part of the normal functioning of the states that use drones? This chapter finds that the development of the use of drones in the US, in comparison with the use of France in the UK and France, is best described as one of institutionalization. The institutionalization of drone programs is defined as the process whereby drone practices become stable and durable activities embedded in the normative fabric of the state. This process derives from a combination of factors, from the formation of a bureaucracy – narrowly defined as the structured, harmonized, and depersonalized interaction of agents – to the formulation of legitimizing legal rationales, and the stabilizing force of the technology itself. The US drone program was stabilized through the creation of structures and bureaucratic interactions, a highly legalistic mode of justification, and narratives about drones being tailor-made to fight a transnational and polymorphous enemy.
Joan Costa-Font, London School of Economics and Political Science,Tony Hockley, London School of Economics and Political Science,Caroline Rudisill, University of South Carolina
This chapter discusses how time preferences influence the importance of and actions regarding old age health as well as factors behind taking up protective measures against the financial risks of care at old age. We discuss the complexity of planning for old age including the challenges related to our imperfect ability to predict the future or what our preferences for the future will be when making decisions today. We include the role of social norms and family experience in decision-making as well as the cognitive demands required of old age planning. We also incorporate the roles of biases such as optimism and present bias as well as risk denial and procrastination into decision-making about ageing. The chapter finishes with a consideration of nudges appropriate to this context.
A current critique in international investment law is the presumed lack of democratic legitimacy: Investment tribunals exercise public authority and take indirect influence on public law-making. Awards might create a ‘regulatory chill’ on the respondent’s parliament in enacting legislation; the adjudicatory powers of investment tribunals might affect policy options and thereby democratic space. This contribution highlights different aspects to improve the legitimacy of international investment law. The need for legitimization refers to persons and institutions as well as to measures adopted by these persons or institutions. All of this results in different reference points of democratic legitimization which are examined separately: international investment agreements; investment contracts especially with stabilization clauses; adjudicators as well as tribunal’s powers and decisions adopted; appointment procedures of arbitrators; the consent to arbitration as well as the determination of the applicable law are generally based on agreements or contracts - these requiring inter alia democratic legitimization. Moreover, in the ongoing reform debate a further institutionalization of investment law, the appointment of permanent judges, a concretization of protection standards, a higher personal legitimization to counter a lack of material legitimacy are discussed.
Is the periodization of the Principate according to dynasties also valid for the history of the court? Was there continuous development of court life – such as increasing institutionalization – or were certain elements of court life linked to certain styles of rule, recurring occasionally but then disappearing again? In answering these questions, this chapter focuses on elements that are central in this book: place; composition; activity; and the institutionalization or ritualization of court life. The chapter finds that there were few neatly defined chronological developments of the court, other than changes which were directly related to the increasing absence of the emperors from Rome. There was, however, a consistent moralistic discourse, often created and perpetuated by courtiers, surrounding the emperor’s behaviour at court. This meant that the expectations of members of the Roman court could influence emperors just as they could influence life at their court.
Higher education in the United States is characterized by a decentralized organizational structure in both public and private colleges and universities across the fifty states and five major territories. Institutional diversity is distinguished by fundamental, self-identifying features that include but are not limited to mission and history, location, funding and endowment, architecture and facilities, campus culture, and degrees offered. The history of the US educational system is of interest to the development of undergraduate research in view of the early emergence of college student research in American higher education and US leadership in undergraduate research. In the US undergraduate research began through the senior capstone or honors thesis requirement. Beginning in the late 1990s the growing recognition of undergraduate research as a high-impact educational practice for student success resulted in expansion of undergraduate research across disciplines and institutions impacting curriculum design, academic culture, and student outcomes.
This chapter introduces the concept of the institutionalization of knowledge broadly, and its history within South African universities when radical curriculum changes were attempted in the past. How the institutionalization of knowledge works is described in relation to the scant literature on the subject including the writings of Sarah Ahmed and Larry Cuban. And the stability of curriculum’s ideological commitments is explained in relation to two prominent examples, the English language and formal assessment, both of which remain undisturbed as objects of radical criticism in institutional life.
Even at an abstract theoretical level, the power configuration in China after the 1969 9th Party Congress was highly unstable. On the one hand, Mao continued to be an active and powerful chairman of the party. On the other hand, Lin Biao, the anointed successor, had a great deal of control over the military. Without the possibility of other powerful factions in the party to check a potential fight between Mao and Lin, both sides had much temptation to eliminate the other if they believed they had sufficient power to do so (Acemoglu et al. 2008: 162). Fortunately for Mao, he had cultivated two disparate groups to help him govern China in the event of a purge of Lin Biao: the Fourth Front Army (FFA) and the surviving scribblers. Mao’s strategy of cultivating the tainted FFA paid off handsomely. Instead of having to concede to Lin Biao’s reluctance to carry out self-criticism or being forced to rely on Lin’s followers, Mao forced Lin’s hand, knowing that he could credibly threaten Lin with replacing the Lin Biao faction with FFA veterans. After Lin Biao fled, Mao carried out his threat and eradicated close associates of Lin Biao wholesale from the military, replacing them with veterans of the FFA. The Lin Biao incident on September 13, 1971, finally led to the full installation of the coalition of the weak.
After Mao’s passing in September 1976, the coalition that Mao had put in place at the end of his life, which was composed Cultural Revolution radicals with little revolutionary experience, even more junior officials like Wu De and mass representatives, the tainted Fourth Front Army (FFA) group, and a handful of trusted First Front Army veterans like Ye Jianying and Wang Dongxing, took over the People’s Republic of China. An uneasy truce persisted for a very short time before the Gang of Four had alarmed Hua Guofeng by challenging his role as the anointed successor, which compelled him to seek more drastic solutions (Zhang 2008b: 263). In this decisive moment, the FFA swung behind Hua, thus sealing the Gang of Four’s fate, but Hua also became very dependent on FFA veterans. His dependence on military veterans with vastly more experience and greater networks ultimately also brought about his downfall. Within two years of Mao’s death, none of the potential successors Mao had put into place just prior to his death survived as powerful figures in the party. The Gang of Four had ended in jail, while Hua was sidelined at the third plenum in 1978. Even FFA veteran Li Desheng, who had served as vice chairman of the party for a short while, ended his career in the 1980s as the head of the National Defense University (Zhu 2007: 425). Except for key members of the FFA group, the vast majority of Mao’s coalition of the weak had ended in jail or in retirement by the early 1980s. His legacy of continuous revolution also was completely expunged from the party ideology in favor of a single-minded focus on economic development.
Although much of this book concerns political dynamics in the Mao Era, the tumults of the Cultural Revolution and the coalition rule that resulted from late-Mao politics indirectly led to an important political outcome by the 2010s, the survival of Xi Jinping as one of the few princelings among political leaders on the civilian side of the CCP. This created one of the preconditions for Xi to dominate the party soon after taking office as the head of the party in late 2012 – the relative absence of competition and oversight from other highly networked princelings. In the 1980s, two forces drove the selection of future leaders in the party. First, founding leaders such as Chen Yun and Deng Xiaoping had a genuine desire to promote a new generation of well-educated, loyal potential successors as their health began to fail them. Second, as the rest of the book has argued, the top leadership and even mid-level officials at the ministerial level did not want serious competitors to their power bases, and each pursued a coalition of the weak strategy within his own jurisdiction. Thus, besides a few senior veterans who had placed their children on accelerated paths for promotion, the vast majority of revolutionary veterans resisted the promotion of princelings due to their Red Guard activism during the Cultural Revolution and to fear of interference by well-networked princelings.
Authoritarian regimes must grapple with a fundamental source of instability that a significant redistribution of power, often unseen or only partially observed, can radically alter the incentives of regime insiders and overturn initially stable equilibria (Acemoglu et al. 2008). Although institutional features such as authoritarian legislatures and a ruling party can alleviate the incentives to usurp the incumbent leader to some extent, especially among lower-level officials (Gandhi 2008; Svolik 2012), they cannot fundamentally remove the incentives to grab power forcefully in the top echelon of these regimes. For one, one-party states by design entrust enormous power in the hands of the top few officials or even in the hands of one person. For ambitious officials just one layer below the very top facing a low probability of ordinary promotion, the reward for achieving an extra step upward can be enormous and can justify a risky gamble, especially if an external shock leads to a significant redistribution of power. Even for those who are already in the top echelon of the ruling party, a gamble to break the existing power-sharing equilibrium can reap enormous rewards as the power and resources of authoritarian colleagues are consolidated into one’s hands. Knowing the dangers of these possibilities, authoritarian leaders also have the incentives to preempt potentially threatening colleagues by removing them from power with coercive measures. In the absence of credible constitutional frameworks or electoral pressure to stop the actions of the top leadership, the stable façade of authoritarian politics can quickly descend into coups, purges, and assassinations.
In mid-1975, a sickly Mao had one of the last meetings with the Politburo. During the meeting, Mao shook hands with the entire Politburo, probably for the last time in his life. When he greeted alternate Politburo member and Vice Premier Wu Guixian, Mao confessed, “I don’t know who you are.” An embarrassed Wu said, “Chairman, we met in 1964 during the national day parade.” Mao compounded her embarrassment by responding, “I didn’t know that” (Mao 1975).
For the first time since Mao, a Chinese leader may serve a life-time tenure. Xi Jinping may well replicate Mao's successful strategy to maintain power. If so, what are the institutional and policy implications for China? Victor C. Shih investigates how leaders of one-party autocracies seek to dominate the elite and achieve true dictatorship, governing without fear of internal challenge or resistance to major policy changes. Through an in-depth look of late-Mao politics informed by thousands of historical documents and data analysis, Coalitions of the Weak uncovers Mao's strategy of replacing seasoned, densely networked senior officials with either politically tainted or inexperienced officials. The book further documents how a decentralized version of this strategy led to two generations of weak leadership in the Chinese Communist Party, creating the conditions for Xi's rapid consolidation of power after 2012.