Rescaling Responsibilities and Rights: The Case of UNASUR Health
Regionalism can be defined as an instance of policy making of cross-border formation advanced through institutional arrangements, bureaucracies, political motivations, and social mobilization. State and non-state actors engage in political projects to relocate the governance of a particular issue or policy domain beyond the scope of national politics. This is a process by which regional projects move from one level of policy deliberation, negotiation, and implementation to another in what Hameiri identified as region-building (Hameiri, 2012). In the vast research field of regionalism that has flourished since 1993, expectations of what regional governance can deliver, however, have been evaluated primarily in terms of economic and security governance (Mansfield and Solingen, 2010). While much has been written about economic integration, regional institutions, and security communities, a discussion of how significant other policy domains have been in the process of regionalism has lagged behind. Specifically, a rather neglected issue in the account of contemporary forms of regionalism has been the extent to which regional integration can promote social development. This has been particularly the case in the study of regionalism in the Americas, where regional motivations have often been defined by an unrelenting path of political economic projects, often marked by the reach of the US as a regional hegemon (Fawcett in Fawcett and Serrano, 2009; Tussie, 2009). This has not been simply a matter of academic neglect, but a consequence of a political decoupling of economic integration and social policies in regional governance. As in Europe, advancing a “social agenda” has often been undermined by the task of removing barriers to trade. However, while Europe saw efforts to build practices of social inclusion become institutionalized in the open method of coordination (OMC) in the 1990s (Scharpf, 2007), Latin America is now experiencing a “social turn” where regional cooperation is reconnecting with social policy-making beyond a rhetorical aspect (Grugel, 2005). This chapter analyses the place of social policy as a driver of current dynamics (re)defining region-building in South America.