Policy innovation from local governments in the Global South: the case of Popular Pharmacy in Chile

Policy innovation faces many obstacles. This article analyzes the factors that explain how it occurs in an unpropitious context. The case studied is the Recoleta Popular Pharmacy in Chile, an innovative local response to the national problem of access to affordable medicines. The research questions are: How does policy innovation emerge at the local level in unpropitious contexts, and what role do actors in different positions within a multilevel governance system play in its development? We answer these questions through a multilevel case study, using a process-tracing method based on interviews with key actors. The findings show that policy innovation occurred due to the interaction between visionary municipal leadership and the initiative of a municipal official who gained support both from within the municipality and from mid-level managers at the central government. The case contributes to the discussion of facilitators and obstacles to policy innovation at the local level, demonstrating that multilevel collaboration can overcome challenges such as centralism, a focus on rule compliance, and resource scarcity. Consequently, the results contribute to the broader discussion of the obstacles to policy innovation at the local level in the Global South.