Overcoming the enlargement deadlock: An action plan for the incoming EU Leadership

EU enlargement policy appears to have reached a deadlock. Following years of stagnation and relative neglect, the European Commission’s attempts in 2018 to reinvigorate the EU’s engagement with the Western Balkans and to provide a credible enlargement perspective to the region have been thwarted by a lack of commitment on the part of (some) EU member states.The October 2019 European Council decision to once again postpone the opening of accession negotiations with Albania and North Macedonia is but the latest in a long series of delays in the enlargement process over the past years. This latest stunt has left the region reeling, with local leaders alternately endorsing a rapprochement with Russia and China or calling for snap elections to confirm their countries’ European path.The new BiEPAG brief which was presented during the policy event in European Policy Centre on November 14, offers recommendations on:Overcoming the enlargement deadlock: An action plan for the incoming EU Leadershi

The Europeanisation of contested states : comparing Bosnia and Herzegovina, Macedonia and Montenegro

This paper compares the European Union (EU) integration process in Bosnia and Herzegovina, Macedonia and Montenegro. The analysis centres on the different political systems and conflict-resolution mechanisms in these three countries in order to explain their different progress in EU accession. Our main argument is that consolidated statehood is not only key for effective democratization, but also a prerequisite for EU accession and functional EU integration. Systematically applying these concepts to Bosnia and Herzegovina, Macedonia and Montenegro, the paper unpacks the connection between internal contestation and a lack of general consensus on EU integration, as well as the connection between different nation-building projects and limited Europeanisation

Pancreatic surgery outcomes: multicentre prospective snapshot study in 67 countries

Background: Pancreatic surgery remains associated with high morbidity rates. Although postoperative mortality appears to have improved with specialization, the outcomes reported in the literature reflect the activity of highly specialized centres. The aim of this study was to evaluate the outcomes following pancreatic surgery worldwide.Methods: This was an international, prospective, multicentre, cross-sectional snapshot study of consecutive patients undergoing pancreatic operations worldwide in a 3-month interval in 2021. The primary outcome was postoperative mortality within 90 days of surgery. Multivariable logistic regression was used to explore relationships with Human Development Index (HDI) and other parameters.Results: A total of 4223 patients from 67 countries were analysed. A complication of any severity was detected in 68.7 percent of patients (2901 of 4223). Major complication rates (Clavien-Dindo grade at least IIIa) were 24, 18, and 27 percent, and mortality rates were 10, 5, and 5 per cent in low-to-middle-, high-, and very high-HDI countries respectively. The 90-day postoperative mortality rate was 5.4 per cent (229 of 4223) overall, but was significantly higher in the low-to-middle-HDI group (adjusted OR 2.88, 95 per cent c.i. 1.80 to 4.48). The overall failure-to-rescue rate was 21 percent; however, it was 41 per cent in low-to-middle-compared with 19 per cent in very high-HDI countries.Conclusion: Excess mortality in low-to-middle-HDI countries could be attributable to failure to rescue of patients from severe complications. The authors call for a collaborative response from international and regional associations of pancreatic surgeons to address management related to death from postoperative complications to tackle the global disparities in the outcomes of pancreatic surgery (NCT04652271; ISRCTN95140761)