Coalitions and Compliance traces the impact of three interrelated processes: the privatization of knowledge through an intellectual property regime, the internationalization and governance of knowledge through TRIPS (trade-related intellectual property rights), and the attendant impact on national development trajectories as a result of a focus on “knowledge-based” development. Detailed case studies of Argentina, Brazil, and Mexico are deployed in a comparative historical analysis that substantiates the thesis that state-level institutional legacies and subsequent path- dependent evolutions of social structures lead to differentiation in policy and associated state institutions; this analysis is conducted in the context of a transition from a world in which knowledge associated with medicines was a public good to a world in which such knowledge became privately owned and controlled (6). Coalitions and Compliance thus provides a welcome tonic to a steady diet of studies that (overly) focus on the inexorable logic of globalizing neoliberalism.

The book is split into nine chapters. After a general theoretical framework, a second chapter translates this into the context of pharmaceutical patents. Chapters 3 through 5 deal with the three countries and how they introduced their respective pharmaceutical regimes in the context of changing international patent governance. Chapters 6 through 8 then tackle how these same countries subsequently reformed their pharmaceutical patent regimes. A final chapter offers a synthesis of the previous analysis, as well as suggestions for further and future avenues of research.

Pharmaceutical patents present a particularly interesting case study for analysis of cross-national diversity in the context of the homogenizing forces of globalization. Kenneth Shadlen demonstrates that country-by-country differentiation occurred in two waves: first in the 1990s, when these policies were introduced after the Uruguay Round of the WTO talks; and second in the 2000s, when policies were progressively modified. The former came because of how industrial legacies present at the national level interacted with existing export profiles; the latter as a result of institutional path-dependencies created by form-determined condensations of how those original conflicts were resolved. In other words, existing social structures at the state level interacted with a change to governance at the global level to shape the contours of an initial insertion into the new regime, a process that led to a concomitant evolution in those same social structures, which, in turn, affected the subsequent pattern of compliance.

To understand that social structure shapes patterns of state-level compliance to changes in global governance regimes reveals Shadlen’s adherence to a form of historical institutionalism—although this is tempered with a significant dose of agent- focused analysis. This is because forms of compliance are not attributable directly to social structure; instead, they are “tied to characteristics of political coalitions that social structure both enables and encumbers” (25). Shadlen emphasiszs how political actors’ abilities to construct and sustain “supportive coalitions,” or “new constellations of actors” (229), are influenced by changes to social structure: while executives are key players, they do not build coalitions in a political vacuum, as they are intimately related to those very social structures. Thus, “executive agency remains conditioned by social structure” (58).

In Argentina, this manifests itself in what Shadlen terms “market preserving,” or a by-the-book approach. Coalitions evolved to facilitate regulatory changes that helped local firms to adjust to the new status quo of international dominance in the sector. In Brazil, there was a “neodevelopmentalist” response: an adoption of the TRIPS regime that put innovation at the heart of development policy. Coalitions that emerged in this context generated measures to ameliorate the effects of stronger protection. In Mexico, there was an “internationalist” regime: coalitions formed that incited an expanding embrace of new global norms and best practices to attract pharmaceutical FDI. Empirically, Shadlen concludes that

The book makes three interrelated contributions beyond the valuable empirical detail. First, it contributes to the agent-centered institutionalism literature by mapping the contours of change in social structure and how those changing constellations of interests create or foreclose opportunities for coalition building and subsequently, political action—in this context, Latin American patterns of (non)compliance with a changing international governance regime in pharmaceutical patents.

Second, it contributes to the governance debates that focus on the interaction between different levels of analysis by considering how domestic, state-level coalitions are affected by systemic-level variables. The analysis concludes that through “process tracing” (229), the relative roles of global and domestic spheres in shaping governance structures can be seen to be grounded in a mutually reconstitutive dialectic, with an element of path-dependency present, once the initial condensation of social structures and political coalitions has settled.

The third and final contribution of Coalitions and Compliance is the way it integrates the role of policy itself into shifting constellations of actors and interests. This can be understood as a revised formulation of Gourevitch’s infamous “second image reversed,” in which entire political economies can be transformed because of earlier external events. In the context of pharmaceutical patents in Latin America, “the explanatory framework links the outcome of conflicts over tailoring new patent systems to the resolutions of previous conflicts over introducing pharmaceutical patents” (23). This leads Shadlen to conclude that “the relevant question is not if countries comply with TRIPS but rather how they do so” (13).