The Politics of Culture: The Case for Universalism
Drawing on firsthand accounts of the people wrestling with these issues, Achieving Access documents efforts to institutionalize universal healthcare and expand access to life-saving medicines in three major industrializing countries. In comparing two separate but related policy areas, Harris finds that democratization empowers elite professionals, such as doctors and lawyers, to advocate for universal health care and treatment for AIDS. In light of the growing interest in health insurance generated by implementation of the Affordable Care Act as well as the coming changes poised to be made to it , Achieving Access will also be useful to policymakers in developing countries and officials working on health policy in the United States.
Joseph Harris. Achieving Access. The book is a major contribution to the study of professionals in health politics and timely given the ongoing struggle for universal coverage models in global health institutions. In an innovative twist, Joseph Harris highlights how heightened political competition empowers progressive professional movements, which manage to promote poor people's medical needs and interests against considerable resistance.
His book explains both successes and failures in six case studies. He focuses attention on a new idea: the critical role of professional movements in driving policy reforms to expand access. The book offers both theoretical and practical lessons, and will be welcomed by policymakers, academics, and activists.
It is an important and readable addition to the literature on achieving access. The reader feels intimately connected to the events that Joseph Harris describes. This is not just an account of lawyers and doctors, but of individual people. Title Achieving Access. Author Joseph Harris. Publisher Cornell University Press. Imprint ILR Press. Title First Published 15 September Format Hardcover. However, the conception of institutions in NIS reports is narrow, mainly focusing on formal law enforcement and corruption-combating agencies.
It also has a rather shallow theoretical underpinning. It is important to remember that institutions are rooted in specific contexts, and moreover that they can also encompass unwritten codes of conduct, norms of behaviour, beliefs and customs that influence and shape behaviour [ 16 ]. The objective of this approach is often unclear; while it can be used to assess how the same or comparable functions are being fulfilled even in the absence of a particular pillar, the tendency is to establish a case for the creation of any missing institution.
Thus, in Cambodia, for instance, there is no national level ombudsman; however there are two sub-national complaints-handling mechanisms. Whilst the NIS framework does allow for such nuances, the implicit assumptions about the proper institutional form of a country are strong. Also problematic is the fact that an excessively institutional approach makes key assumptions about what factors shape political behaviour and outcomes. Whilst, as has been noted, institutions likely have an important role to play in conditioning behaviour, or at least in framing the range of appropriate responses [ 19 , 20 ], it is unrealistic to see institutional settings as the sole, or most important, determinant of individual actions.
Thus, we do not expect the individuals who work within any given institution to be uniformly corrupt, or uniformly to act with integrity, despite operating within an identical institutional framework. Assuming that the most effective solutions to the problem of corruption revolve around institutional design will almost always lead to sub-optimal outcomes, precisely because such assumptions are based on a reduction of human behavior to little more than an algorithm that evaluates actions against a series of probabilities in a discrete choice model.
In reality, the complex mixture of societal norms and values has a significant role to play in determining the probability that any individual will engage in corruption, and thus also has a highly significant effect upon the likelihood of a specific type of institutional structure being able to promote integrity.
A result is that dedicated anti-corruption policies and procedures remain the primary means through which integrity is to be ensured. Whilst they do also take account of the practical application of rules, narrow rules-based evaluations are not only more easily manipulated, but may also miss any pro-integrity actions of public officials which are guided more by their personal values than formal rules. Buddhist leaders are highly respected in society and are considered to be conveyors of morality, promoting societal level values that reject narrow materialistic accumulation in favour of social integrity.
Not only do the Buddhist leaders represent a strong potential contributor to social change towards greater integrity WFDD, [ 22 ]: 6 , they also provide a set of values that shape reactions to institutional incentives.
Universalist or relativist? These are the U and non-U of modern manners
In this context, the notion that any one particular configuration of institutional design will be universally appropriate, despite differences in values-systems, is surely untenable. As has been noted, it was one of the hopes of the NIS approach that lessons from one country could be applied to others see [ 8 ]: In part, this was based upon an understanding of the fundamental similarities of countries; and thus, as we have just seen, the NIS methodology treats countries as if they are all essentially comparable, with the default expectation being that the same institutional pillars will be the most important elements through which integrity systems can be evaluated.
Of course, the current NIS methodology does allow for some adaptation to local contexts, in the ways mentioned above. Questions can also be carefully interpreted or altered to ensure they are culturally relevant, although if this is done without being systematised it risks creating methodological inefficiencies and could undermine the lesson-learning capacity that was originally envisaged.
Indeed, pillars can be modified or new ones added to reflect the core governance institutions in a country, and various national assessments have seen adaptation of the NIS methodology to include additional institutions considered important in the governance system. The role of traditional leaders i. The problem is whether this potential for readjustment goes far enough to ensure the NIS study takes appropriate account of the cultural context under assessment, especially in light of the strong assumptions of comparability inherent in the NIS approach.
The main concern is that there might be a fundamental bias in the methodology that means the results of NIS assessments are also systematically more positive for countries that have attained certain levels of development. Again, the Cambodian example is instructive.
A senior government official later reiterated this feedback when Transparency International Cambodia presented the final draft of the report to the Ministry of Interior in May The common theme highlighted was that the methodology did not take sufficient account of the cultural and historical specificities that have contributed to the limitations of the Cambodian governance system in its current formation.
This history is unique and complex. This situation was obviously compounded when the Khmer Rouge emerged victorious and came to power from until [ 27 ]: , The Khmer Rouge killed the police, military and bureaucratic elite of the old society, as well as teachers, doctors, engineers, and intellectuals [ 26 ]: It is estimated that during the four years of the regime two million people — or one in four of the population — died as a result of overwork or maltreatment, or were executed [ 27 ]: The public sector was obliterated.
Conflict continued in Cambodia until settled by the Paris Peace Agreements in , leading to the first post-conflict elections only in [ 28 ]: xiv; [ 27 ]: — The subsequent two decades saw the government, donors and civil society work to build the capacity of public institutions, provide adequate basic services, and uphold a stable governance system.
Whilst democracy remains limited, and corruption remains deeply embedded, Cambodia has certainly made commendable gains in a challenging post-conflict setting. Yet the qualitative findings and scores of the Cambodia NIS assessment are not particularly encouraging. All but 3 of the 13 pillars fall into the weak or very weak category. The problem is that, whilst some of the shortfalls in the Cambodian governance system are undeniably due to the unaccountable structures enacted and upheld by existing power-holders, historical events and cultural context almost certainly have an even larger role in defining its continuing limitations.
Essential to consider here is whether the NIS scoring and indicator questions overlook or downplay some of the arguably more fundamental and incremental achievements made by countries in transition. For instance, whilst the Cambodian public sector has not yet reached a stage in which its institutions can be considered to operate accountably and effectively on the level expected of global-standard democracies, significant achievements have none the less been made, given that the public sector had to be reconstructed almost from scratch [ 29 , 30 ].
This included the re building of hospitals, schools and ministries. Likewise, after the Khmer Rouge fell, very few trained and educated individuals were left to occupy administrative positions.
Multiculturalism (Stanford Encyclopedia of Philosophy)
Only an estimated teachers survived the Khmer Rouge of an estimated existing prior to the regime; likewise only 50 doctors remained out of an estimated [ 31 , 32 , 33 ]. Moreover, only 10 legal graduates, including 5 judges are estimated to have survived when the Khmer Rouge period ended in [ 34 ]: Concerted efforts have been made to establish training centres, and provide public officials with necessary skills to undertake their roles. For instance, the Police Academy was established only in , and is now central to building the capacity of the national police and provides various courses from short, department or skill-specific training courses, to longer Bachelor and Master degree programmes Police Academy of Cambodia, [ 35 ]; CNP, [ 36 ].
These efforts have been implemented on limited budgets — Cambodia remains a low-income economy, even though the country has experienced notable economic growth [ 37 ] and has received sustained overseas development aid [ 38 ]. Yet despite such dramatic improvements, it is easy for evaluation or indicator questions such as contained in the NIS method to overlook some of the more baseline achievements that have been made by governance institutions.
In terms of NIS indicators, Cambodia inevitably scores poorly on this front. Yet, in itself, the mere fact that multiple courts and dozens of judges exist represents a significant achievement of the last two decades. Capacity building of those courts and legal professionals is a gradual and on-going process. How can the NIS indicator questions take better account of the elementary efforts that are necessary to rebuild a governance system in a post-conflict or transitional context?
The starting point is to recognise that the scoring framework already assumes a certain level of development, with transitioning democracies, who face multifaceted and specific challenges, receiving very critical analysis and lower scores because basic initiatives get overlooked. While the NIS approach aims to capture the absolute strength of the integrity system, the methodology leaves readers largely ignorant of the direction of travel.
If a country is starting from a low base, but building fast, this is surely a more positive picture than a country starting from a high base and declining. Even though it is possible to see corruption as the opposite of integrity, it is far from obvious that integrity is the opposite of corruption for a recent discussion, see [ 41 ]. Indeed, one can theoretically act wholly in a non-corrupt way, whilst still having only minimal levels of integrity [ 42 ].
This sort of circumstance may emerge in situations where the only reason people do not engage in corruption is because the structure of incentives presented to them makes corruption less appealing than being non-corrupt. However, as soon as a new situation emerges in which disincentives to engage in corruption do not exist, the individual decides their course of action without reference to moral concerns, instead attempting merely to maximize their own personal utility.
As such, anti-corruption measures alone do not, but also cannot, guarantee integrity. Thus, the overt focus on anti-corruption in the NIS is potentially misleading, and moreover reinforces pre-existing biases that favour formalized rules and codes. The difficulties posed by an inadequate understanding of integrity within NIS assessments are also of wider practical concern.
Integrity serves a wider role in ethical governance than anti-corruption. Where public officials have a strong anti-corruption ethos or regulations that enforce strong anti-corruption policies , citizens can trust public officials to not act corruptly in specific and pre-defined circumstances.
Yet integrity serves a wider purpose, including the general role of providing a foundation for citizens to trust their political systems. If public officials do not have integrity, it is difficult to see why citizens should trust them or why they should assume good faith in their activities in any situation where anti-corruption regulations cannot guarantee compliance.
In the real world, where regulations will always struggle to ensure compliance, a purely anti-corruption approach removes the rational basis for choosing to trust public officials; conversely, integrity in public life supports such trust. This links to a broader argument within public administration about the most effective way to build trust. Anti-corruption, and the evaluation of an absence of anti-corruption policies, are also especially problematic to define outside of Western-style liberal countries. In Cambodia, the NIS research team encountered several questions that had limited applicability to the local country context, including questions such as: Are there examples of attempted interference by external actors, particularly the government or judiciary, in the activities of the legislature?
Are there any examples of undue external interference in judicial proceedings? These questions already assume a certain level of separation between institutions. In Cambodia however, the entire public sector is centralised and controlled by a narrow group of ruling party-aligned power holders under the tight control of the Prime Minister. In this case, asking for examples of undue external interference in public bodies has limited relevance, since very little separation exists across institutions in the sector.
Such an institutional framework cuts against the anti-corruption assumptions of NIS evaluations, and indeed does theoretically make corruption easier for motivated people at the head of government. However, the specific institutional framework alone does not in itself guarantee that corruption is actually occurring.
Such a system could be compatible with high levels of integrity, to the extent that the leaders act with integrity. An anti-corruption focus therefore risks obscuring the actual level of integrity within systems. Of course, even if not entirely applicable, such evaluation questions did underscore how centralised the Cambodian governance system is compared to international democratic ideals — and to that extent, prompted useful considerations that were reflected in the report.
Whether a less centralised system would necessarily equate to a stronger integrity system is nevertheless not directly established. A further implication is that NIS evaluations, and thus also the recommendations for improvement that follow them, have a strong focus on compliance-based policies rather than values-based policies. Put simply, compliance-based policies are those routine anti-corruption policies that aim to create a system of rules and regulations that prevent corruption, whereas values-based policies are those that attempt to instil a culture such that corruption is not a preferred choice for a more detailed discussion, see [ 44 ].
The favouring of compliance policies is not just a normative bias; it is a potentially problematic view of public life, especially because of the role of trust as facilitator of pro-social actions. There is little, if any, room for an evaluator to consider other factors, such as ethics training, culture or values inculcation. The same critiques could be leveled at the evaluation of the practical implementation of integrity mechanisms — the focus is almost exclusively upon the extent to which codes are adhered to see TI, [ 13 ]: 10 , rather than the extent to which high-integrity behavior is manifested.
However, even if NIS assessments do explicitly and systematically favour compliance-based policies, it may be objected that this is not normatively bad; indeed, it may be observed that compliance-based policies ought to be preferred. Modern states are enormous, highly complex, diverse, and powerful. Maintaining an adequate ethical climate in such circumstances, especially if coupled with fewer codes and less monitoring, can be extremely challenging. And, indeed, it may be argued that regulations can serve to create a positive ethical climate by constraining undesirable behaviours.
Yet compliance-based policies also have a number of disadvantages in certain situations. First, the size and diversity of public life is a problem not just for values-based systems; indeed, compliance-based systems can suffer even greater problems, in part because the size and complexity of the state means that unforeseen cases in which the regulations are not sufficient to ensure integrity can occur quite frequently. Moreover, because compliance systems largely remove personal discretion from public officials, the potential exists for situations in which both efficiency and justice are sacrificed in order to comply with the demands of formal policies on the inefficiencies of anti-corruption approaches, see [ 47 ].
On the other hand, if high personal ethical standards can be inculcated in public officials, in the manner suggested by values-based approaches, strict and potentially overbearing micro regulation will be far less necessary.
In turn, this implies the need for some discretion on the part of public officials, affording them the opportunity to select proactively the ethical course of action in the course of their duties. Such a system largely removes the need to develop a regulatory framework to handle every situation an official will encounter, which in turn allows their decisions to be informed by the specific context in which a decision is taken.
As might be expected, such a system can be more efficient and cost effective than a compliance-based system, as it dramatically reduces the administrative burden upon officials. Outside of theoretical archetypes, real world integrity systems will obviously never represent a pure values-based or pure compliance-based system; instead, each system contains elements from each type. However, that does not mean that each formulation works equally well in any circumstance, or that introducing more of one type of policy will have no consequences for the other type.
Indeed, because policies can create feedback loops and ultimately become self-reinforcing, introducing more of one type of regulation can imply less of the other — an observation that is especially true with compliance-based regulations, which can be particularly damaging to integrity values see [ 48 , 49 ]. Identifying the most helpful form of ethical regulation is a serious and difficult task, especially in a country like Cambodia, which is seeking to build its integrity system from such a low base. The question of how many compliance policies are necessary, which ones are the most important, and under what circumstances values-based policies are preferable, are vital.
Rather than striking an appropriate balance, the concern is that too great an emphasis upon compliance policies in NIS assessments may compromise the overall effectiveness of the integrity system. It is obvious that national circumstances differ between countries. Different histories, different cultures, different laws, different standards of governance, and different institutional settings are all in play.
Even small differences in these factors can dramatically alter not only what reforms are feasible, but also what reforms are possible. In this sense, the often largely ahistorical and acultural approach of NIS evaluations, with consequential assumptions about what reforms ought to be implemented, presents significant limitations relative to more culturally and context-sensitive analyses. As we have suggested, imposing a compliance-based regulatory structure on a system that already has a strong and well functioning values-based component to ethical regulation has the potential to do more harm than good.
The problem, then, is the extent to which evaluations such as the NIS approach are beset by an unhelpful universalism that reflects a specific set of cultural and institutional assumptions. Indeed, drawing on the experience of the NIS in Cambodia, there is a real risk that baseline achievements in transitioning countries may be overlooked by the NIS.
Whilst such national systems may not have reached global democratic standards, they may none the less have made fundamental efforts that are not appropriately accounted for by the current NIS indicators and scoring framework. Since the bar against which institutions are measured is raised so high, less industrialised countries are likely to fare poorly in the NIS analysis and results. To counter this, we have noted that NIS evaluations may work better in situations where the local team goes beyond the standard set of institutions, and adapts and adds to the NIS temple pillars.
Moreover, it is sometimes necessary for local research teams to follow a more culturally sensitive interpretation of indicator questions in order to modify the NIS methodology in relation to national contexts. However, even with such adaptations, research teams can still face both criticism of and resistance to suggestions arising out of NIS evaluations, precisely because the underpinning NIS methodology does not take adequate account of context.
In Cambodia, the government rejected the report outright after publication. Officials argued that the report highlights all the shortfalls of the system without accounting for the historical challenges and achievements that have been made. Whilst no simple answer to this issue exists — a report on integrity and corruption is likely always going to be somewhat critical and confronting to any government — there could be ways to tailor the methodology to make it serve more clearly as a realistic and constructive call to action for the administration under assessment.
In turn, this may help to boost the cooperation of governance stakeholders to implement the NIS recommendations. With the aim of acknowledging the historical context, cultural challenges, and achievements not mentioned elsewhere in the NIS evaluation, the research team from Cambodia included a preface at the start of the report, reflecting on these issues in more detail. This does not address all of the above concerns, but can deflect some of the more obvious criticisms that a government may levy against a report once it is published.
The preface differed from the foundations in that it provided a short but unified space to link together some of the foundational elements that led to a system in which corruption is commonplace. It underlined the legacy of the Khmer Rouge in addition to mentioning some of the development achievements Cambodia has recently made. Going forward, these issues suggest considerable value in further evaluation of the experiences of undertaking the NIS in other countries.
If common themes and issues are found, a revision of the NIS methodology would be logical.
Different dimensions could be emphasized for countries at varying stages of development. The existing approach could be maintained for more established democracies, whilst alternative elements could be developed for transitioning democracies. Indicator questions could aim to recognize the more foundational efforts made by countries in earlier stages of development.
For instance, in the law enforcement agencies section, questions could include: Has a police academy been created? Have appropriate courses to train police at different levels and roles been developed? Such questions would capture some of the initial efforts required to set up a democracy. Indeed, more emphasis on the positive promotion of integrity, as opposed to anti-corruption measures, would be helpful.
Equally, a broader understanding of institutions and their functions, incorporating norms, beliefs and customs as an important dimension of how they motivate and constrain behavior, would make it more difficult for governments to dismiss NIS reports out of hand.
Even with such adaptations, the National Integrity System approach would remain an institutionally focused evaluation. There is nothing inherently wrong with that: as we know, institutions matter. However, experiences such as in Cambodia suggest that what is needed is a more sophisticated and flexible understanding of institutions, underpinned both by an approach that allows for analysis of transformations in institutions, and also by a more theoretically informed understanding of the concept of integrity.
That way, NIS reports will not only provide a more realistic and appropriate analysis of how integrity systems work in practice, but also be better placed to offer constructive and actionable guides to action that can support genuine reform. During this period she led the Cambodia NIS assessment, published in www. Skip to main content Skip to sections. Advertisement Hide. Download PDF. Open Access. First Online: 13 September Introduction Much of the work on anti-corruption over the last two decades has focused on identifying mechanisms to reduce the incentives for corrupt activity, or else on establishing institutional structures to enhance the capacity to detect and curb corruption.
In this paper, we nevertheless argue that in practice, the NIS approach is open to four major criticisms: a. They argued [ 8 ]: that while each country or region is unique in its own history and culture, its political system, and its stage of economic and social development, similarities in a national integrity system do exist and lessons learned are often transferable.
This core understanding of similarities between countries led Langseth et al. This list was not intended to be prescriptive [ 9 ]: , although in practice approaches since have largely followed the lead of Langseth et al. Rothstein, B. Good governance. Levi-Faur Ed.
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