York researchers explore gap between commitment and compliance in global health policy

two images of the earth taken from space
Two images of the earth taken from space

Despite the growing need for international cooperation on issues ranging from climate change to antimicrobial resistance (AMR), individual countries facing their own unique incentives and challenges do not always comply with the commitments they have made to the international community.

Five years after promising to enact bold action to address AMR – a process whereby antimicrobials, like antibiotics, stop working against infection-causing microbes, like bacteria – several countries have yet to deliver.

In a new study, York University researchers examine the international response to AMR in order to demonstrate how the international community can support countries in fulfilling their global health commitments.

Isaac Weldon
Isaac Weldon

Isaac Weldon, a PhD candidate in political science and research Fellow at the Global Strategy Lab based out of York University, along with his supervisor, Steven Hoffman, a professor and the Dahdaleh Distinguished Chair in Global Governance & Legal Epidemiology, shared their findings in the journal Global Public Health.

“In an era marked by increasing global interconnection,” Weldon explained “including through the escalating threat of AMR and the ongoing global circulation of COVID-19, studies that investigate how countries can work together to overcome political challenges in global health are more important than ever.”

In their paper, titled “Bridging the commitment-compliance gap in global health politics: Lessons from international relations for the global action plan on antimicrobial resistance,” the researchers reviewed international relations scholarship to understand why states may or may not comply with their global commitments.

They argue that because the challenge of overcoming the ‘commitment-compliance gap’ is not unique to global health and is common in other areas of international politics, global health policymakers can learn from theories of international relations and experience in other sectors.

By conducting a public policy analysis of three past international agreements on biological diversity, climate change and nuclear weapons, the researchers identified lessons for encouraging country compliance with global health agreements, with specific application to global AMR policies.

Steven Hoffman

To bridge the gap between commitment and compliance, Weldon and Hoffman suggest that international leaders should frame incentives for action to maximize their resonance with state interests; pursue enforcement mechanisms to induce state behaviour; emphasize building a culture of trust by providing mutual assurance for action; provide technical and financial assistance to poor-performing states; and find opportunities for continual social learning, such as data sharing and transparency mechanisms.

Weldon said that the strategies they uncovered are actually quite intuitive, and are important guides for how the world considers cooperation and compliance for future global health challenges, including COVID-19.

“We know that global challenges like AMR and COVID-19 require global responses to be effective,” Hoffman said. “Yet, we continue to see political actions that counter-productively divide the world and undermine the global solidarity needed for global cooperation. By investigating the strategies that guided other agreements to compliance, we can translate lessons to foster cooperation and achieve compliance within global health politics.”

Weldon and Hoffman hope that the study provides further evidence of the deep potential for interdisciplinary learning between global health and international relations.

“Bridging the commitment-compliance gap in global health politics: Lessons from international relations for the global action plan on antimicrobial resistance” can be read for free online.