The most widely read and influential component of the IPCC’s practice of writing is the summary for policymakers (SPM), where the key messages of the underlying report are presented in short sentences and figures to facilitate travel into the media, ministers’ speeches and UNFCCC negotiations. The aim of this chapter is to describe the politics of approval. The chapter begins the historical emergence of this practice and documents the tactics and strategies available to co-chairs, authors and delegates to influence the final outcome. Documenting participation in the authorship and approval of the SPM again illuminates the asymmetries revealed in previous chapters, but also highlights the growing presence of some developing countries in the process. This is evident in the content that has initiated some of the greatest struggle – the categorisation of developing versus developed countries. This account reveals that the forces structuring the final stage of the IPCC’s practice of writing originate in the broader global struggle to determine the meaning of climate change and continue after the approval, only now with a new SPM to substantiate national positions in the negotiation of the collective response.

This chapter includes cases that are seen mainly in the developing world. The chapter is divided into five sections: conditions that present in childhood such as rickets and sickle cell disease; post-traumatic presentations such as malunion, non-union and physeal growth arrest; problems related to infection such as osteomyelitis; late presentation of tumors; neglected presentations such as osteoarthritis and congenital talipes equinovarus.

The interaction of developing states with investment treaty law and arbitration constitutes an important part of the ongoing debate about the legitimacy of the investment treaty regime. However, the authors contend that the concern is often sidelined and that developing states and their concerns are frequently lumped together under the broader rubric of investment treaty law as a threat to national sovereignty and a constraint on regulatory autonomy. By focusing on the formal equality between contracting state parties and the reciprocal nature of international investment agreements (IIAs), the chapter contends that such narratives tend to mask the presence of power disparities, which considerably shape the involvement of developing states in the creation, diffusion and internalization of investment treaty law. The authors seek to counter these narratives by drawing on new empirical data to expose a range of structural, normative and institutional power inequalities. By using the optics of power and focusing on how developing states learn from and internalize investment treaty law, the chapter peers behind the formal structures of investment treaties and ISDS to identify the underlying processes and actors and to question the legitimacy of the prevailing norms and institutional arrangements.