Translating Foreign Ideas into Domestic Practices : Pharmaceutical Policies in Laos and Vietnam

Abstract: Similar policies may be found in different countries. This, in turn, is an indication that policies travel. But why are certain policies imitated while others are not? The author seeks to further our understanding of policy diffusion and its dynamics by investigating how foreign ideas are integrated and translated into new contexts, and how these imported ideas influence national policymaking and implementation. The National Drug Policies in Laos and Vietnam are studied in order to identify factors facilitating or restraining policy processes—and to discuss the effects of diffusion. In the 1980s reforms were initiated leading to far-reaching economic liberalisation in Laos and Vietnam. These reforms have affected all segments of society, including the health sector. The pharmaceutical sector was privatised, drugs became widely available, and self-medication as well as fake and sub-standard drugs proliferated. This was the setting when the Lao and Vietnamese governments had to consider the development of a National Drug Policy, as part of the development assistance from Swedish Sida to their health sectors. In 1993 the National Drug Policy was endorsed in Laos, and in 1996 the policy was adopted in Vietnam. Hence, the policy processes were initiated within the framework of bilateral cooperation between donors and the two Ministries of Health. In other words, there had been a spread of external ideas, or policy diffusion. Later on these ideas and NDP had to be translated into, and implemented in, the national context. Thus, the study covers the time from the development of the policies until present the time, 2001. Drawing on research in policy studies, constructivism, new institutionalism, and globalisation, the study aims to bridge the international/national divide in policymaking both theoretically and empirically. In an era of escalating globalisation and ever increasing flows of ideas, the author argues for the contextualisation of policymaking and problematisation of the often taken for granted rational actor approach inherent in much of the policy literature. The main findings indicate that although the formulation of the policies may be relatively trouble-free, it does not automatically mean that the translation of the policy into practice will follow as anticipated. In order to understand why new ideas are accepted and integrated into a new context and how this affects the implementation, one must look at the way new policies have been spread and translated into a new context. This, in turn, can provide insights as to why some policies are more successful than others, and why the policy process in Laos appears to have been more straightforward than in Vietnam.