This study examines institutional entrepreneurship in the emerging field of HIV/AIDS treatment advocacy in Canada. It analyzes how institutional entrepreneurs engaged in theorization and ensured institutionalization of new practices. The study finds that in emerging fields, legitimacy comes from representing diverse stakeholders, not dominant organizations. Institutional entrepreneurs framed issues to present flexible solutions, developed stable coalitions through negotiation, and integrated new practices into routines to create stable relationships and align with stakeholder values. This context-specific study provides insights into how institutional entrepreneurship occurs differently in emerging versus mature fields.

1. Houman Sanaei INSTITUTIONAL ENTREPRENEURSHIP IN EMERGING FIELDS: HIV/AIDS TREATMENT ADVOCACY IN CANADA October 2009 Course: L’action dans l’organisation

2. Authors Dr. Maguire [email_address] Associate Professor of Strategy and Organization at McGill University Research focus : on technological and institutional change Qualifications: BSc Queen's University, Chemical Engineering MBA University of British Columbia PhD École des Hautes Études Commerciales Prof. Cynthia Hardy [email_address] Mgt & Marketing department; University of Melbourne Research interest : Critical Management Studies, Organization Studies (focus on UK, CA, AUS) Dr. Thomas B. Lawrence [email_address] Weyerhaeuser Professor of Change Management Simon Fraser University Research area : power; institutional theory, change and institutions in organizations

4. Structure Objective: Examine Inst. Entrepreneurs in emerging fields ► Analyze the actions that constitute it ► Explore the distinctive reasons that differ from mature fields ► Qualitative study on an empirical case of HIV/AIDS advocacy in Canada Why? Because.. 1- I.E in emerging fields phenomena was not well understood 2- Conventional understanding of I.E. did not explain the situation (Individuals were not associated to traditionally dominant organizations) 3- Need for contextual understanding of constituent activities of I.E.

5. Institutional Entrepreneurship & Emerging fields New institutions arise when organized actors with sufficient resources (institutional entrepreneurs) see in them an opportunity to realize interests that they value highly” (DiMaggio; 1988) Interests agency institutions I.E. Mature fields : Established actors, aware of their activities, identifiable patterns of interaction ex. Domination, conflict, co-operation, highly accepted by actors VS Emerging fields: some mutual interest, little co-ordination, potential of network exists Uncertainty=Opportunity Rewards due to advantageous structuring Different challenges Dominant actors VS Dominated actors

6. Research Questions 1- In emerging fields what are the characteristics of subject positions that provide a basis for actors to engage in institutional entrepreneurship? 2- How do Institutional entrepreneurs in emerging fields engage in theorization when attempting to motivate the adoption of new practices? 3- How do institutional entrpreneurs in emerging fields ensure the institutionalization of new practices? Theorization = framing problems, justifying innovation, developing acceptable norms

7. Methodology Qualitative study of a case : - interviews, - observing meetings - documents - minutes, press release, brochures, annual reports - secondary sources Stages of Data analysis 1- Developed a narrative account in chronological order of emergence & institutionalization 2- Assess nature & degree of change as a result of new practices and info exchange 3- Identify the institutional entrepreneurs who started and led the process

8. 1981- 1982: First record of epidemic and recognition of AIDS 1983-1989: Fomation of different associations & groups (activists) such as CDC, ACT, BC-PWA, CAS, AIDS action now and etc. 1990: CAS creates committee to deal with treatment issues 1995: First meeting of pharmaceutical companies with HIV/AIDS community to create advisory board 1996: Second meeting Pharma companies and HIV community to create a national org. called Canadian Treatment advocates Council (CTAC) 1997: CTAC hold 1st Annual meeting, elects board and executives, publishes newsletter, establishes liason teams for Pharma companies 2000: CTAC is well funded from Pharma companies & Health Canada Institutional entrepreneurs Roberts & Turner

9. Question 1: Institutional Entrepreneurship & Subject positions Legitimacy : gay, HIV positive, not paid, with history in the movement Organisational features : Represented a broad & diverse constituency by leading PWA organizations Companies saw them as partners unlike activist organizations Wide geographic scope Result : Legitimacy between diverse stakeholders with different interests Bridge between stakeholder to access resources (funding by companies & credibility/political access from community) Mature field : dominant actor controls capital & are legitimate in one dominant community

10. Question 2: Institutional Entrepreneur & Theorization ►Proposition of single organization: Assemble wide array of arguments+ Present new practice as a flexible solution to answer multiple problem of different stakeholders ►Composition of CTAC structure & membership Developing stable coalitions of diverse stakeholder through political tactics such as : Negotiation, bargaining & compromise Theorization

11. Question 3: Institutional Entrepreneurship & Institutionalization Set up liaison teams to link CTAC to Pharmaceutical companies: Mechanism of information exchange & consultation integrated into day to day company routines Briefing & receiving feedback practices integrated into decision making of CTAC Integrated into government routines through strategy meetings with Health Canada Institutionalization Attach new practices to old routines you get stable relationships Allign new practices to values of stake holders to create new norms Mature field : strong relationships; success requires tearing down of old logics; old norms form basis for moral legitimacy

12. Implications of study ► Context that institutional entrepreneurship occurs : Which is based on characteristics of the emerging field that is different to mature fields ► Study of I.E. as a collective vs. individual phenomenon : The study focuses on individuals instead of organization’s unlike previous studies ► Role of power in organisational fields: Previous studies focused on dominant organisations such as professional association or state

13. Practical Implications Institutional entrepreneurs should consider: Wide array of capital & power at their disposal Not be afraid of attempting due to lack of size or material power Try to define a field by shaping relationships, practices & rules as they emerge & mature Between diverse stakeholders: Create stable relationships, understand cultural norms & practical routines

16. Thank You!