The recent decline in EU–LAC trade exchange and development co-operation occurred parallel to an increasing weakness of political dialogue forums. The three elements trade, development co-operation and political dialogue between the EU and Latin America followed the EU foreign policy doctrine of inter-regionalism, a group-to-group relationship between two integrated blocs. This “triangle model” came under stress from the backlash of globalisation and regionalism, and the emergence of external actors like China or India to the detriment of traditional partners like the US and the EU. To reactivate relations, the EU and Latin America should reduce political co-operation to those issues that are of real mutual interest and inter-regional convergence like drugs or climate policies. At the same time the “one size fits it all” approach does not work in a deeply divided region in terms of development, size, political ideology and external partners.

This chapter argues that the shift in world politics that commenced in 2016 has created the best momentum to further develop Latin American and European Union relations for political and economic reasons. For political reasons it is intended to reinforce an international arena where multilateralism and respect for international forums and international law continue to exist. For economic reasons it is a way of creating growth and redistributing economic power away from the two largest economies (the US and China) who have clear foreign policy goals regarding the projection of power in both Latin America and the European Union. They are dangerously taking everyone towards a bipolar world. The remainder of this chapter discusses the economic balance of power that has developed over time between the North and the South with a discussion of the BRICS as well as a discussion of the potential outcomes of those struggles, followed by the development of mega-regional agreements until 2016. In Latin America the election of Bolsonaro in 2018 with an individualistic agenda was expected to affect the negotiations with the other countries within Mercosur or with the European Union. Although the EU and Latin America have intended for years to review their links, Trump’s unilateral and conflictive measures against them have actually accelerated their agendas (Santander 2020). Therefore for some of them the counterbalancing exercise took place against Trump, or for others potentially against China or even against both.

In 2012 the EU signed a trade agreement with Peru and Colombia, to which Ecuador subscribed in 2016, having abandoned regional-to-region negotiations with the Andean Community in favour of finalising an agreement with the countries that had already completed agreements with the United States. This chapter explores how the long shadow of the US, so often used to describe the nature of the EU’s relation with Latin America, emerged again in the rationales and negotiations of this modern trade agreement. It traces the impact of the US and its commercial policy on the EU–Peru/Colombia negotiations and on the negotiated outcomes, portraying EU–US competition underlying the EU–Peru/Colombia trade agreement in shaping the context of negotiations as an exercise in geo-economic balancing. The chapter also examines the initial stages of implementation of the agreement, paying particular attention to the controversial Trade and Sustainable Development chapter. The analysis concludes that the trade agreement on its own has not driven major policy changes in the Andean countries but has bolstered broader international commitments to changes in labour laws and policy reforms by creating additional pressure and accountability mechanisms. In so doing the chapter highlights the importance of contextualising trade agreements as one aspect of broader international relations between the EU and Latin American countries.

Accounts related to private medical practices and held by the practitioners themselves are both a part of medical activity and vehicle of information about healers’ practices and outlooks. This chapter is based on the ledgers written by three healers active in the last decades of the eighteenth century in the Geneva region: a country surgeon, a physician established in a small town, and a physician working in Geneva itself. Each practitioner imagined a structure and a code in order to elaborate and keep information about his practice and payments made. In proceeding thus, he surrenders information relevant to the meaning the accounts had for him and the organisation of his practice. The items listed inform both on the services offered, the value given to them, the expediency of clients to pay, and the different medical strategies adopted. Sometimes bills and accounts are clearly related, elsewhere emphasis is on certain types of clientele and, in one case, accounts aimed to estimate the progression of practice and, ultimately, the physician’s success. Comparing accounting practices carries information on the varying nature of medical services from one practitioner to another, on the value of medical counsel, and the social uses of medicine. Town and country practices are complementary, and practitioners from each environment bill different types of services. Contrasting these account systems enables us to understand how practitioners adapted to the demand and reveals something of the nature of the relationship the practitioner established with his patients and the type of medicine he offered.

This volume has shown how inter-regional relations have evolved over time, and how they have been mediated by exogenous factors, mainly US policies, economic crises and, more recently, the perceived crisis in globalisation. President Barack Obama’s approach to trade policy, with his desire to engage in mega-regional agreements in the Pacific and Atlantic spaces in order to set the global trade rules, bypass the WTO and stagnating Doha Round negotiations, and counter Chinese economic power, helped to encourage MERCOSUR states to re-engage in negotiations with the EU (Gomez-Arana 2017). Even more importantly, since the election of President Donald Trump in November 2016, the EU took on the baton of promotion of a liberal trade agenda and redoubled efforts to conclude ongoing trade negotiations with partners across the globe, in symbolic defiance of the US stance. In the 2020s EU–Latin American co-operation for a united front in defence of the liberal order, exemplified in the conclusion of EU–MERCOSUR negotiations and motivated by the need to respond to Donald Trump’s presidency, shows a renewed spirit of co-operation amongst two regions united by common values and goals. However, as in past decades, each side’s complicated domestic political and economic situations, which the Covid-19 outbreak has exacerbated, threatens to once again relegate EU–Latin American relations in the hierarchy of foreign policy priorities.

This chapter investigates the characteristics of a successful voluntary sickness fund in early twentieth-century Sweden. The practices of the Seamstresses Sickness and Burial Fund reveal how a working-class organisation functioned in improving the living conditions of its members. When it was first founded in 1898, it was a small all-female and marginal sickness fund, but by the 1930s it had developed into one of the largest in the city of Gothenburg, with good financial reserves. While successfully attracting new members and retaining its old, the fund also proved to be effective in reducing the costs of long-term sickness cases, one of its greatest concerns. Moreover, the social nature of the fund, its emphasis on mutual aid, and its economic decision-making practices, which went beyond mere capital accumulation, holds much of the explanation for the fund’s success. The fund also took part in initiating discussions on maternity benefits and participated actively in the general women’s rights movement, while also playing a part in the male-dominated sickness fund movement at large. Members’ engagement and willingness to remain members was likely reinforced by how the fund in this way gave a voice for working-class women.

Three processes – pharmaceutical revolution, drug regulation, and new methodologies – radically changed clinical research after the Second World War. The existing historiography highlights the first two. This chapter addresses the shift in research methodology with special emphasis on accounting. Accounting – understood as tools of knowledge – is thus neither restricted to financial transactions nor to any kind of administrative transactions within enterprises, hospitals, and other health organisations.This chapter argues for an extended meaning of accounting as the activity of preparing and comparing lists, used in a second step to define different forms of value and construct markets. An invisible bookkeeper has therefore emerged in the world of clinical research who holds together the fields of knowledge and economy. To explore such accounting, the chapter presents the two forms of accounting involved in the research and marketing of Ciba-Geigy’s antidepressants since the 1970s. The first focuses on the accounting technologies that balanced clinical features with the effects of drugs in order to document efficacy and build a hierarchy of uses and putative prescription motives; the second focuses on the market-based accounting involved in scientific marketing that integrates data on sales, prescriptions, and market-shares in order to build a hierarchy of targets and promotional investments.We therefore propose to understand the blending of clinical research and marketing as the rise of a medico-economic mode of accounting which is bringing together ‘the counter’ and ‘the bedside’ for managing what are massively private, for profit, investments in research and marketing.

Sixteenth-century physicians were a major group among the rising class of urban professionals whose economic fortunes rested almost entirely on their academic training and their skills. But little is known so far about their financial situation and economic aspects of sixteenth-century medical practice. Michael Stolberg’s chapter will follow these issues by using the example of the German practitioner Hiob Finzel (c. 1526–89). Finzel, a town physician in Weimar and later in Zwickau, left three heavy folio volumes of his practice journal where he recorded for a period of almost twenty-five years more than 10,000 consultations and the fees his patients paid in return for his services. The practice journal, called Rationarium praxeos medicae, functioned foremost as an account-book, recording the fees paid by thousands of patients, but it also offers a wealth of information on Finzel’s diagnostic and therapeutic practices. At the end of each year, Finzel balanced the accounts to sum up his income and, at the same time, to justify his own work before God. Stolberg’s chapter provides a brief sketch of Finzel’s biography, describes the practice journal and the recorded payments in detail, and highlights the striking religious elements and connotations of Finzel’s Rationarium. Finally, Stolberg analyses the economics of Finzel’s practice and of the relative importance of the payments he received from patients of different social and economic status.

This chapter scrutinises the role of accounting in the expansion of academic health care in the mid-twentieth century. Taking the hospitals run by the Catholic University of Leuven (Belgium) as a case study, it analyses the impact of a professionalising administration – accountants, economists, and managers included – on hospital governance. Its main argument is that accounting practices proved crucial for the establishment of the modern academic health centre as they enabled a centrally directed redistribution of means and responsibilities, in line with the health policies of the Belgian postwar welfare state and academic educational reforms. The chapter shows how the aggregate budgets, preprinted forms, and ‘strength reports’ designed by postwar bookkeepers effectively shaped new hospital realities. While new specialised medical services received more (financial) autonomy, the opportunities for expansion of other services were limited. The chapter further shows how such top-down and performative accounting differed from (and clashed with) professors’ prewar managerial roles. The autonomy of the latter as the directors of their own medical institutes was gradually limited. A heated debate over a centralised accounting department of the Leuven hospital for collecting the fees stemming from Belgian Social Security in 1944 illustrated the erosion of prewar hospital governance. Henceforth, centralised accounting became key to setting in motion the wheels of medical expansion.

This chapter explores the practices and institutions that have allowed the EU–Mexico relationship to increase the political and economic interconnections between the countries since the early 1990s. After both parties negotiated the 1997 Global Agreement, the first of its kind between the EU and a Latin American country, the bilateral relationship has been characterised by a convergence of public policy visions, which has benefited both parties to address the shifts in the international order since the late 2000s: the 2008 financial crises, the rise of China in global trade, the technological revolution and questions about the durability of US global leadership. In order to face such a context, the EU and Mexico agreed to modernise the GA in 2016 and conclude negotiations in 2020. One of the main goals of this chapter, along the lines of the premises of this book, is to explain and discuss the complexity of EU–Mexican trade relations considering the challenges the global trade system is facing today. After reviewing the literature about the study of the EU–Mexico relationship and the contribution of the gridlock concept to explain its existence, this chapter examines three significant points in the EU–Mexico relationship. First, it provides a contextual overview about the main trends of the world trade system and the potential effects on Latin America. Second, it explains the conditions that facilitated the negotiation of the GA, its evolution and the subsequent Strategic Partnership (SP). The final section discusses the rationale for the modernisation of the GA and some of its unique details.

Accounting is about ‘how much’ and is usually assumed to be about money, the administration of finances and the calculation of efficiency. This introduction suggests a broader understanding of accounting, especially in relation to health, medicine, and medical knowledge; and elaborates its characteristics by using the example of poor boxes in front of hospitals: money going in and out. But donations were made for a certain purpose and laden with moral or social intentions. Therefore, treasurers had to provide information about the donor’s gift to account for its efficient and legitimate use. Accounting for health involved information being collected, listed, and compiled in order to demonstrate good medical practice. Thus, monetary income is correlated with medical outcome. More generally, accounting for health is described as a set of calculative practices and administrative techniques in which money, goods, and other countable objects or patients, detached from their physical materiality, are transformed in specific codes and formats that appear in ledgers, account-books, or tables. Such an expanded meaning of accounting allows to trace the entwined monetary, moral, and epistemic dimensions of accounting (for health) and illuminates the linkage of accounting, health, and medical knowing and its deeply entangled history for over five centuries.The introduction summarizes the various strains of sociological and historical research and literature on the history of (hospital) accounting and paper technologies. Discussing methodological issues, the introduction elaborates the longue durée perspective and the praxeological approach of the volume’s chapters and gives an overview about the structure of the book.

According to the conviction that accounting isn’t necessarily subordinate to economics, the chapter does not deal with accounting practices in a classical sense but aims to highlight the use and value of calculative practices in treatment and research. By examining Elliott Joslin’s principles and practices of diabetes therapy, it shall be shown how he used calculative and administrative techniques as a tool to combine both therapeutic measures and scientific investigation. Drawing on archival materials of the Joslin Diabetes Center, as well as on Joslin’s published manuals, textbooks, and early seminal articles, it shall, first, be shown how Joslin systematised his patient files for comparing cases and evaluating new therapies. Second, it will be shown how Joslin begun to conceptualised diabetes in rather epidemiological and socio-medical terms at the same time, which subsequently led to new collaborations between physicians, government authorities, life insurance companies, and patients bound together by accounting practices. Finally, it is focused on Joslin’s relationship with his patients and how the qualitative and quantitative information he gathered could be used in therapy and research.

In the twenty-first century, the need for countries to reliably measure and compare how much they spend on health is somewhat obvious. By accounting for health expenditure, governments can identify how money flows through their health systems: who funds health care and who provides it, how much money is being spent, and on what. In this way, governments can adjust their priorities, evaluate the impact of interventions, improve health services, and address various structural problems.The complexity of health systems and methodological problems surrounding national health accounting, however, have undermined attempts to compare health expenditures globally over the last century. This chapter traces the history of international health accounting: organised attempts to measure and compare health spending across national boundaries, including the rules and conventions that ensure the coherence of this information. Although a comprehensive system of health accounts (SHA) has been established only recently, it has had various precursors over the twentieth century. This chapter traces its antecedents through the work of various international organisations, including the League of Nations Health Organisation (LNHO), the United Nations, the International Labour Organisation (ILO), the Organisation for Economic Co-operation and Development (OECD), and the World Bank. In presenting a genealogy of international health accounting, this chapter describes the evolving role the issue of health care financing has played in international health. It also highlights the development of accounting technologies, such as standardised tables and accounting manuals, which have facilitated international measurement and comparison.

This chapter focuses on the EU’s trade ties with the states of the Andean Community. Today these revolve around a combined Free Trade Agreement between the EU and three of the organisation’s members, Colombia, Peru and Ecuador. The chapter considers the complex dynamics that have led to the opening of trade negotiations with the region and which ensured their ultimate if only partial success. The chapter argues that, given the limited economic relevance of the Andean region for the EU, the complex ties between the two regions can be explained only through a consideration of external factors. Trade policy developments at the global level, such as the failure of the Doha Development Agenda, or the trade policy of the United States, have ultimately provided the setting for negotiations between the EU and the Andean Community. Rather than limiting the analysis to these exogenous developments, the chapter considers how these have impacted both the Andean region and institutional decision-making in the EU to explain the outcome of EU–Andean Community trade negotiations.

There are domestic politics in both Latin America and the EU that affect relations between them, such as Brexit on one side and the presidency of Bolsonaro and the crisis in Venezuela on the other. However, since 2016, the possibility of further developing their interdependence came to seem a desired outcome in order to overcome the decline in multilateralism at the international level, and in response to the protectionist and isolationist stances of the US as well as the rise of China. The book is intended to capture all of the recent changes at the international level and interpret how they would affect Latin America and the European Union. The book aims to discuss this interdependence in order to facilitate a discussion on how significant both regions have become for each other, as well as in relation to other international actors. The chapters discuss European Union–Latin America relations with all of this in mind.Overall, this book offers the different points of views of academics using different approaches to the question of how Latin America and the European Union have engaged with one another over time, considering the role of both domestic and international politics. It seems clear that the political aspect and economic aspect are interlinked. Since 2016 this has only become even more relevant.