The politics of global immunization initiatives: can we learn from research on global environmental issues?

The number of institutions, representing different groups of stakeholders and organizations, aiming to coordinate global health policy is on the rise. Yet, as each have distinct interests and priorities, the political dimension becomes an important factor in understanding how institutions work, and how the coordination at the global level affects implementation in countries. This is already a topic for research on global environmental cooperation, inciting the question if one can transfer their analytical framework to the health field. This paper combines a presentation of lessons from research on environmental regimes with a review of global immunization policies and initiatives in order to explore that possibility. The paper describes cooperation on vaccines and immunization according the concepts of institutions and regimes, as defined by international relations research. This description emphasizes efforts to fulfill transnational agreements on objectives, the different ways stakeholders organize and the dynamics of such arrangements. An account of the research practice on global environmental cooperation leads to a discussion of how one could adapt the analytical framework. The paper makes the case for the development of a research program, where the analytical approach is modified to account for the interaction between technology production and public-led institutions. The conclusion proposes a number of entry points to research that have already yielded policy-relevant knowledge in the environmental field. These include the formation of new institutions, the contribution of institutional design to effective implementation, and the interplay between vaccine initiatives and other global institutions.