No abstract

Recent scholarship posits that ambiguous ('polysemic') ideas are effective for coalition building between diverse stakeholders: their capacity to be interpreted differently attracts different interests. Hence, in search of political solutions to 'wicked' and similarly complex problems, deploying polysemic ideas would be critical to effective policy-making. This paper scopes the policy-making potential of polysemic ideas by examining the impact of an ambiguous concept known as 'One Health' on responses to antimicrobial resistance (AMR) in Australia and the UK. It offers two primary arguments. Firstly, polysemic ideas can help mobilise broad attention to complex problems: since One Health became associated with AMR, political and administrative attention has grown more intense and coordinated than previously. Secondly, however, a polysemic idea alone may be insufficient to generate effective action: the contrast between Australian and UK AMR policies illustrates that polysemic ideas do not suspend interests, institutions, or ideas that can be readily deployed.

Background: Vaccine hesitancy is a global problem with diverse local policy responses, from voluntaristic to coercive. Between 2015 and 2017, California, Australia, France, and Italy increased the coerciveness of their childhood vaccine regimes. Despite this apparent convergence, there is little evidence of imposition, policy learning, or diffusion – the drivers that are usually discussed in scholarly literature on policy convergence. The fact that the four governments were oriented across the political spectrum, with quite different political and institutional systems, further indicates an empirical puzzle. Methods: To better understand the drivers of enhanced vaccine mandates, a crucial issue during the COVID-19 global rollout, this article engages with four case studies assembled from qualitative analysis of semi-structured in-country interviews and document analysis between November 2018 and November 2020. Key informants had specific expert knowledge or played a role in the introduction or implementation of the new policies. Interview transcripts were coded inductively and deductively, augmented with extensive analysis of legal, policy, academic and media documents. Results: The case analysis identifies two key and interacting elements in government decisions to tighten vaccine mandates: functional and political pressures. Policymakers in Italy and France were primarily driven by functional challenges, with their vaccination governance systems under threat from reduced population compliance. California and Australia did not face systemic threats to the functioning of their systems, but activists utilised local opportunities to heighten political pressure on decision makers. Conclusion: In four recent cases of high-income jurisdictions making childhood vaccination policies more coercive, vaccine hesitancy alone could not explain why the policies arose in these jurisdictions and not others, while path dependency alone could not explain why some jurisdictions with mandates made them more coercive. Explanation lies in restrictive mandates being attractive for governments, whether they face systemic functional problems in vaccine governance, or political pressures generated by media and activists. Mandates can be framed as targeting whole populations or localised groups of refusers, and implemented without onerous costs or policy complexity.

No abstract

Understanding of the role of ideas in non-paradigmatic policy change has been advanced by the introduction of the concept of bricolage, which suggests that reformers are likely to piece together ideas from disparate sources. However, the current literature is limited in several ways. As such, this article proposes three main contributions to the field. First, the use of bricolage as a pragmatic strategy is perfectly compatible with actors being motivated by relatively fixed policy goals or seeking to imitate policies from elsewhere. Second, the creative use of ideas can be limited by the imposition of narrow frames or problem definitions by the victors of agenda-setting battles. Third, the use of bricolage comes with more potential for conflict and unintended consequences than has been recognised. This argument is illustrated through an analysis of healthcare reform in the United States in 2009/10, focusing particularly on the fate of the ‘public option’.