ABSTRACT
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.
ABSTRACT
Scientifically-derived insights are often held as requirements for defensible policy choices. Scientific advisory committees (SACs) figure prominently in this landscape, often with the promise of bringing scientific evidence to decision-makers. Yet, there is sparse and scattered knowledge about what institutional features influence the operations and effectiveness of SACs, how these design choices influence subsequent decision-making, and the lessons learned from their application. The consequences of these knowledge gaps are that SACs may not be functioning as effectively as possible. The articles in this special journal issue of Global Challenges bring together insights from experts across several disciplines, all of whom are committed to improving SACs' effectiveness worldwide. The aim of the special issue is to inform future SAC design in order to help maximize the application of high-quality scientific research for the decisions of policymakers, practitioners, and the public alike. In addition to providing an overview of the special issue and a summary of each article within it, this introductory essay presents a definition of SACs and a conceptual framework for how different institutional features and contextual factors affect three proximal determinants of SACs' effectiveness, namely the quality of advice offered, the relevance of that advice, and its legitimacy.
ABSTRACT
BACKGROUND: Persons with psychosocial disabilities face disparate access to healthcare and social services worldwide, along with systemic discrimination, structural inequalities, and widespread human rights abuses. Accordingly, many people have looked to international human rights law to help address mental health challenges. On December 13, 2006, the United Nations formally adopted the Convention on the Rights of Persons with Disabilities (CRPD) - the first human rights treaty of the 21st century and the fastest ever negotiated. METHODS: This study assesses the CRPD's potential impact on mental health systems and presents a legal and public policy analysis of its implementation in one high-income country: Canada. As part of this analysis, a critical review was undertaken of the CRPD's implementation in Canadian legislation, public policy, and jurisprudence related to mental health. RESULTS: While the Convention is clearly an important step forward, there remains a divide, even in Canada, between the Convention's goals and the experiences of Canadians with disabilities. Its implementation is perhaps hindered most by Canada's reservations to Article 12 of the CRPD on legal capacity for persons with psychosocial disabilities. The overseeing CRPD Committee has stated that Article 12 only permits "supported decision-making" regimes, yet most Canadian jurisdictions maintain their "substitute decision-making" regimes. This means that many Canadians with mental health challenges continue to be denied legal capacity to make decisions related to their healthcare, housing, and finances. But changes are afoot: new legislation has been introduced in different jurisdictions across the country, and recent court decisions have started to push policymakers in this direction. CONCLUSION: Despite the lack of explicit implementation, the CRPD has helped to facilitate a larger shift in social and cultural paradigms of mental health and disability in Canada. But ratification and passive implementation are not enough. Further efforts are needed to implement the CRPD's provisions and promote the equal enjoyment of human rights by all Canadian citizens - and presumably for all other people too, from the poorest to the wealthiest countries.
