Governing the Global Antimicrobial Commons: Introduction to Special Issue.

Antimicrobial resistance is one of the greatest public health crises of our time. The natural biological process that causes microbes to become resistant to antimicrobial drugs presents a complex social challenge requiring more effective and sustainable management of the global antimicrobial commons-the common pool of effective antimicrobials. This special issue of Health Care Analysis explores the potential of two legal approaches-one long-term and one short-term-for managing the antimicrobial commons. The first article explores the lessons for antimicrobial resistance that can be learned from recent climate change agreements, and the second article explores how existing international laws can be adapted to better support global action in the short-term.

International treaties have mostly failed to produce their intended effects.

There are over 250,000 international treaties that aim to foster global cooperation. But are treaties actually helpful for addressing global challenges? This systematic field-wide evidence synthesis of 224 primary studies and meta-analysis of the higher-quality 82 studies finds treaties have mostly failed to produce their intended effects. The only exceptions are treaties governing international trade and finance, which consistently produced intended effects. We also found evidence that impactful treaties achieve their effects through socialization and normative processes rather than longer-term legal processes and that enforcement mechanisms are the only modifiable treaty design choice with the potential to improve the effectiveness of treaties governing environmental, human rights, humanitarian, maritime, and security policy domains. This evidence synthesis raises doubts about the value of international treaties that neither regulate trade or finance nor contain enforcement mechanisms.

Comparing the regulation and incentivization of e-cigarettes across 97 countries.

E-cigarette use continues to increase globally despite uncertainty regarding their long-term health impacts and around their effectiveness for tobacco smoking cessation. This uncertainty creates unique challenges for governments as they attempt to optimally regulate and positively or negatively incentivize these products in a way that maximizes the public's health. Current approaches to e-cigarette regulation and incentivization fall within a spectrum of options ranging from a singular focus on health protection, whereby policies intend to prevent the dangers of e-cigarettes, to a singular focus on using e-cigarettes for harm reduction, whereby policies intend to reduce the more harmful effects of smoking tobacco. Regulation options include prohibition, component ban, and regulation as medicinal products, poisons, tobacco products, consumer products, and/or unique products. Incentivization options include taxation, subsidization, and providing a financial reward. Through comparative public policy analysis, this study describes, compares and assesses the variety of approaches that 97 countries have taken to regulate and incentivize e-cigarettes. The goal is to inform future decisions by governments on how they approach the public health challenge posed by e-cigarettes, building on a nuanced understanding of the complexities of this challenge and what other jurisdictions have already implemented and learned.