This article draws on the Programmatic Action Framework (PAF) to tackle the question of how the dominance and decline of a specific policy programme in a policy sector can be explained. It starts from the observation that visionary policy programmes, defined as a set of policy goals and instruments that find their expression in subsequently adopted and interconnected policy reforms, may shape a sector’s policies over several decades. Linking policy programmes to programmatic groups that promote these programmes in search of boosting their careers and authority, the programme’s rising and declining dominance can be explained by the career trajectories of programmatic actors. By displaying empirical evidence for the argument from German health policy, the article shows that proponents of today’s change are opponents of tomorrow’s change since individual careers depend on the dominance of policy programmes.
