This article analyzes the path that led the European Union from a somewhat accidental involvement in fighting AIDS to a new and sustainable policy of communicable disease control. It responds to three main questions: Why did an unexpected case lead to the organization of a new sustainable policy? How was this achieved despite national competency over the given policy sector? How did the new policy succeed in covering the enlarged EU? The explanation combines political factors and public health issues. European integration and eastern enlargement made transborder disease management a political necessity. Treaties gave legitimacy to EU policy, while the AIDS matrix furnished the practical procedures: networking, data harmonization, peer-conducted policy coaching, and participation. This pattern of public health management is compatible with national competency, and it is consistent with the democratic values the EU promotes throughout and beyond the enlarged EU. From a theoretical point of view, these patterns of activities constitute the empirically grounded content of the much used but less defined concept of cognitive Europeanization.

This content is only available as a PDF.

References

References
Altenstetter, C.
1994
.
“European Union Responses to AIDS/HIV and Policy Networks in the Pre-Maastricht era.”
Journal of European Public Policy
1
, no.
3
:
413
40
.
doi:10.1080/13501769408406967
.
———.
2008
.
Medical Devices: European Union Policymaking and the Implementation of Health and Patient Safety in France
.
New Brunswick, NJ
:
Transaction
.
Baldwin, P.
2005
.
Disease and Democracy: The Industrialized World Facing AIDS
.
Berkeley
:
University of California Press
.
Bergeron, H.
2010
.
“La force d'une institution faible: Le cas d'une agence européenne d'information” [“The Power of a Weak Institution: The Case of a European Information Agency”]
.
Politique Européenne
32
:
30
76
.
Berridge, V.
1996
.
Aids in the UK: The Making of Policy, 1981 – 1994
.
New York
:
Oxford University Press
.
Bremen Declaration on Responsibility and Partnership. Together against HIV/AIDS
.
2007
.
March
13
. ec.europa.eu/health/ph_threats/com/aids/docs/bremen_declaration_en.pdf.
Briatte, F.
2010
.
“The Europeanisation of Health System Performance: The EURO-CARE Study and Cancer Control in England.”
Paper presented at the Council for European Studies Seventeenth International Conference
,
Montreal
,
April
.
Bulletin Epidémiologique Hebdomadaire
2002
(
47
),
Paris
.
Clergeau, C.
2005
.
“European Food Safety: Between a Single Market and a Political Crisis.”
In
Health Governance in Europe: Issues, Challenges, and Theories
, edited by Steffen, M.,
113
33
.
Oxon, UK
:
Routledge
.
Commission of the European Communities (CEC)
.
2005
.
“Communication from the Commission to the Council and the European Parliament on Combating HIV/AIDS within the European Union and in the Neighbouring Countries, 2006 – 2009.”
Brussels
:
CEC
. ec.europa.eu/health/ph_threats/com/aids/docs/com_2005_654_en.pdf.
Dublin Declaration on Partnership to Fight HIV/AIDS in Europe and Central Asia
.
2004
.
February
24
. www.irishtimes.com/newspaper/special/2004/dublin_declaration/declaration.pdf.
European Centre for Disease Prevention and Control (ECDC)
.
2009
.
“HIV/AIDS Surveillance in Europe 2008.”
Surveillance Report
.
Stockholm
:
ECDC
. ecdc.europa.eu/en/publications/Publications/0912_SUR_HIV_AIDS_surveillance_in_Europe.pdf.
European Commission. Research Directorate-General
.
2000
.
BIOMED 2 Impact Assessment/Biomedical and Health Research Programme (1994 – 1998)
.
Brussels
:
European Commission
.
European Parliament and EU Council
.
1998
.
“Decision 2119/98/EC of the European Parliament and of the Council of 24 September 1998 Setting Up a Network for the Epidemiological Surveillance and Control of Communicable Diseases in the Community.”
Official Journal of the European Communities
,
L 268
.
October
.
———.
2004
.
“Regulation (EC) No. 851/2004 of the European Parliament and of the Council of 21 April 2004 Establishing a European Centre for Disease Prevention and Control.”
Official Journal of the European Union
,
L 142
. ecdc.europa.eu/en/aboutus/Key%20Documents/0404_KD_Regulation_establishing_ECDC.pdf.
Farrell, A. M.
2006
.
“Is the Gift Still Good? Examining the Politics of Regulation of Blood Safety in the European Union.”
Medical Law Review
14
, no.
2
:
155
79
. doi:10.1093/medlaw/fwl001.
Friedrich, D.; Heckmann, W., eds.
1995
.
AIDS in Europe — the Behavioural Aspect
.
5 vols
.
Berlin
:
Rainer Bohn Verlag
.
Gilmore, A.; Kee, M..
2004
.
“Tobacco-Control Policy in the European Union.”
In
Unfiltered: Conflicts over Tobacco Policy and Public Health
, edited by Feldman, E. A.; Bayer, R.,
219
54
.
Cambridge, MA
:
Harvard University Press
.
Greer, S. L.
2006
.
“Uninvited Europeanization: Neofunctionalism and the EU in Health Policy.”
Journal of European Public Policy
13
, no.
1
:
134
52
.
doi:10.1080/13501760500380783
.
———.
2008
.
“Choosing Paths in European Union Health Services Policy: A Political Analysis of a Critical Juncture.”
Journal of European Social Policy
18
, no.
3
:
219
31
.
doi:10.1177/0958928708091056
.
———.
2009
.
The Politics of European Union Health Policies
.
Maidenhead, UK
:
Open University Press
.
Guigner, S.
2003
.
“L'odyssee de l'administration européenne de la santé: La quête d'un leadership” [“The Odyssey of European Health Administration: The Search for Leadership”]
.
Politique européenne
11
:
31
55
.
———.
2007
.
“L'européanisation cognitive de la santé: Entre imposition et persuasion.”
In
L'Europe telle qu'elle se fait: Européanisation et sociétés politiques nationales [Europe as It Develops: Europeanization and National Political Societies]
, edited by Baisnée, O.; Pasquier, R.,
263
81
.
Paris
:
CNRS Editions
.
Haggard, S.; Kaufman, R. K..
2008
.
Development, Democracy, and Welfare States: Latin America, East Asia, and Eastern Europe
.
Princeton, NJ
:
Princeton University Press
.
Hauray, B.
2006
.
Europe du medicament: Politique, expertise, intérêt privés [Europe and Medicine: Policies, Expertise, and Private Interests]
.
Paris
:
Presses de Science Po
.
Héritier, A.
1999
.
“Elements of Democratic Legitimation in Europe: An Alternative Perspective.”
Journal of European Public Policy
6
, no.
2
:
269
82
.
doi:10.1080/135017699343711
.
Hervey, T. K.; McHale, J. V..
2004
.
Health Law and the European Union
.
Cambridge
:
Cambridge University Press
.
doi:10.1017/CBO9780511617553
.
Kirp, D. L.; Bayer, R., eds.
1992
.
AIDS in the Industrialized Democracies: Passions, Politics, and Policies
.
New Brunswick, NJ
:
Rutgers University Press
.
Krasner, S. D.
1984
.
“Approaches to the State: Alternative Conceptions and Historical Dynamics.”
Comparative Politics
16
, no.
2
:
223
46
.
doi:10.2307/421608
.
Laffan, B.
2002
.
“The European Commission: Promoting EU Governance.”
In
Participatory Governance: Political and Societal Implications
, edited by Grote, J. R.; Gbikpi, B.,
121
39
.
Opladen, Germany
:
Leske and Budrich
.
Lamping, W.
2009
.
“European Union Social Policy: Towards a Post-National Welfare State?”
In
European Welfare Systems
, edited by Schubert, K.; Hegelich, S.; Bazant, U.,
495
510
.
London
:
Routledge
.
Lamping, W.; Steffen, M..
2009
.
“European Union and Health Policy: The ‘Chaordic’ Dynamics of Integration.”
Social Science Quarterly
90
, no.
5
:
1361
79
.
doi:10.1111/j.1540-6237.2009.00659.x
.
Levintova, Marya; Novotny, Thomas.
2004
.
“Noncommunicable Disease Mortality in the Russian Federation: From Legislation to Policy.”
Bulletin of the World Health Organization
82
, no.
11
:
875
80
.
Mbaye, E. M.
2009
.
“Contradictions in Public Policies: Immigration and the Struggle against AIDS in France.”
International Journal of Migration, Health and Social Care
5
, no.
3
:
29
39
.
doi:10.5042/ijmhsc.2010.0050
.
Moatti, J. P. et al, eds.
2000
.
AIDS in Europe: New Challenges for the Social Sciences
.
London
:
Routledge
.
Mossialos, Elias et al, eds.
2010
.
Health Systems Governance in Europe: The Role of European Union Law and Policy
.
Cambridge
:
Cambridge University Press
.
doi:10.1017/CBO9780511750496
.
Pasteur Institute
.
1997
.
“Sexually Transmitted Disease in Border Areas: North-Western Russia and Finland.”
Institut Pasteur Working Paper
.
Saint Petersburg, Russia
:
Institut Pasteur
.
Pimenov, A.; Lavochkin, V..
1998
.
“The AIDS Situation in the Republic of Belarus.”
Paper presented at the European AIDS and Social Science Conference
,
Paris
,
January
.
Pinell, P.
2002
.
Une épidémie politique: La lutte contre le SIDA en France, 1981 – 1996 [A Political Epidemic: Fighting AIDS in France, 1981–1996]
.
Paris
:
Presses Universitaires de France
.
Putman, R. D.
1988
.
“Diplomacy and Domestic Politics: The Logic of Two-Level Games.”
International Organization
42
, no.
3
:
427
60
.
doi:10.1017/S0020818300027697
.
Rajevska, F.
1996
.
“Beyond the Health Care State: New Dimensions in Health Politics in Europe.”
Paper presented at the Joint Sessions of Workshops of the European Consortium for Political Research
,
Oslo
,
March 29 – April 3
.
Saurugger, S.
2005
.
“Europeanization as a Methodological Challenge: The Case of Interest Groups.”
Journal of Comparative Policy Analysis
7
, no.
4
:
291
312
.
doi:10.1080/13876980500319337
.
Saurugger, S.; Radaelli, C. M., eds.
2008
.
“The Europeanization of Public Policy: New Research Directions.”
Special issue, Journal of Comparative Policy Analysis
10
, no.
3
.
Simon, H. A.
1973
.
“The Structure of Ill-Structured Problems.”
Artificial Intelligence
4
, nos.
3–4
:
181
201
.
doi:10.1016/0004-3702(73)90011-8
.
Steffen, M.
1999a
.
“The Nation's Blood: Medicine, Justice, and the State in France.”
In
Blood Feuds: AIDS, Blood, and the Politics of Medical Disaster
, ed. Feldman, E.; Bayer, R.,
95
126
.
Oxford
:
Oxford University Press
.
———.
1999b
.
“The Response to AIDS in Eastern and Western Europe.”
In
Public Administration and Social Policies in Central and Eastern Europe
, edited by Jabes, J.,
201
20
.
Prague
:
NISPAcee Press
.
Steffen, Monika.
2004
.
“AIDS and Health Policy Responses in European Welfare States.”
Journal of European Social Policy
14
, no.
2
:
165
81
.
doi:10.1177/0958928704042008
.
———.
2005a
.
“Comparing Complex Policies: Lessons from a Public Health Case.”
Journal of Comparative Policy Analysis
7
, no.
4
:
267
90
.
doi:10.1080/13876980500327926
.
———, ed.
2005b
.
Health Governance in Europe: Issues, Challenges, and Theories
.
Oxon, UK
:
Routledge
.
Steffen, M.; FitzSimon, D..
1994
.
“AIDS in the Former USSR and Russia: Conference Report, St. Petersburg.”
AIDS Newsletter
9
, no.
10
:
2
5
.
Trubek, L.; Nance, M.; Hervey, T..
2008
.
“The Construction of Healthier Europe: Lessons from the Fight against Cancer.”
Wisconsin International Law Journal
26
, no.
3
:
804
43
.
UNAIDS
.
2010
.
Global Report: UNAIDS Report on the Global AIDS Epidemic, 2010
.
Geneva
:
UNAIDS
.
UNAIDS and World Health Organization (WHO)
.
2005
.
AIDS Epidemic Update, December 2005
.
Geneva
:
UNAIDS/WHO
.
Utyasheva, Leah.
2007
.
“Russian Federation: Inhuman Conditions in Drug Treatment Facilities Led to Tragedy.”
HIV/AIDS Policy and Law Review
12
, no.
1
:
32
33
.
Vågerö, D.
2010
.
“The East-West Health Divide in Europe: Growing and Shifting Eastwards.”
European Review (Chichester, England)
18
, no.
1
:
23
34
.
doi:10.1017/S106279870999010X
.
“ ‘Vilnius Declaration’ on Measures to Strengthen Responses to HIV/AIDS in the European Union and in Neighbouring Countries.”
2004
.
Presented at the conference Europe and HIV/AIDS: New Challenges, New Opportunities, Vilnius
,
September
17
. ec.europa.eu/health/ph_threats/com/aids/docs/ev_20040916_rd03_en.pdf.
Vobruba, G.
2003
.
“The Enlargement Crisis of the European Union: Limits on the Dialectics of Integration and Expansion.”
Journal of European Social Policy
14
, no.
2
:
159
75
.