This paper answers the question by identifying the roles of “programmatic elites”: networks of policymakers, based in member state governments and agencies, who can make beneficial alliances with entrepreneurial parts of the EU. Our approach is to compare policy areas where EU institutions’ initiatives had different degrees of success at constructing a competency and a policy. It compares three European Union health policy initiatives: communicable disease control, where the EU is constructing a supranational agency and continent-wide networks; the Platform on Diet, Nutrition, and Physical Activity, which attempts to reduce obesity; and Health in All Policies, an effort specified in the EU treaties to promote health through “non-health” policies such as agricultural or foreign aid policy.
The reason lies in the extent to which the EU institutions can mobilize and strengthen programmatic elites such as those responsible for disease control. Where there are existing weak networks, EU funding and intervention can strengthen them with resources, connections, and policy arguments. Where there are powerful existing interests, such as other established policy fields, any benefits from participation in EU public health networks are counteracted by existing bureaucratic structures.
