The workshop participants discussed the main findings of the political mapping analysis, regarding both the process of the analysis and the substance of the analysis. The following preliminary ideas emerged in the discussion.
(a) The process of political mapping analysis
Participants agreed that the analysis in six countries demonstrated that it is possible to examine policy-making processes, using a systematic step-by-step, method, and that the analyses yielded important benefits to both policy-makers and policy analysts. This finding supports the proposal that policy-making is not simply a technical process, but also a political process, and that policy-makers need both technical and political analysis in order to be effective. The method of political mapping is one form of applied political analysis, which can assist the development and implementation of national drug policies.
(b) Policy-making is a continuous process
Policy-making does not stop with the official adoption of a policy (such as the Generics Law in the Philippines), but continues on through the phase of implementation. To assure the effective implementation of a policy requires continuous tending, caring, revising, and weeding, much like a garden. Lack of attention during the phase of implementation can result in a policy falling into disrepair or even reversal. In many ways, the most difficult challenges occur during implementation, when the goals and mechanisms of a policy must be put into practice.
(c) Interest groups are not often monolithic
Several country teams reported instances where the ability to split or unite key interest groups affected the success or failure of adopting a major change in national drug policy. For example, the unification of the domestic and international drug industry in India significantly enhanced the chances of the major changes in the drug laws in that country. In Thailand as well, the proposal of the government united the domestic and international industry, which contributed to the reversal of the policy on drug labelling. Whether the physicians are unified in a single interest group or divided into specialists versus general practitioners can also affect the feasibility of a policy change. Policy advocates need to be aware of these potential splits in interest groups, and the impact on the feasibility of policy change or policy implementation. Often, these splits can be avoided (or created) through effective political strategies and negotiations by policy-makers.
(d) Policy-making has controllable and uncontrollable events
Policy-making involves a complex series of strategic choices about the substance of a policy, about processes for introduction and adoption, and about organizations and mechanisms for implementation. Inevitably, these choices are affected by both controllable and uncontrollable events in the local, national, and international political environments. Policy-makers can improve the likelihood of success of their policies by seeking to identify the controllable events and to use them effectively, and be sensitive to the uncontrollable events and present their policy appropriately. Strategic concessions in the substance of a policy can sometimes improve the chances of success; and the resistance to compromise can help create a coalition of opponents. Sometimes, the appeal to higher authorities can result in failure, as occurred when Thailand's FDA sought the opinion of the Council of State regarding its drug labelling act. The method of political mapping can help policy-makers in identifying both the controllable and uncontrollable events, and can suggest strategies for managing both.
(e) Some common strategies may exist
Some common strategies may exist that can help promote national drug policies. Additional comparative analysis of the six cases of political mapping will be necessary to identify these strategies and assess their effectiveness. Nonetheless, these common strategies would remain as suggestions. It is unlikely that a simple recipe exists for managing the formulation and implementation of all national drug policies. The approaches need to be developed and refined within specific national political contexts, and adapted over time to fit evolving political circumstances and the problems that emerge in transforming the policy into practice.