Public Health Global Health Diplomacy
by
Ilona Kickbusch, Thorsten Behrendt, Erica Di Ruggiero, Jenny Gong, Ece Karaman, Ophelia Michaelides, Frederique Watulo
  • LAST REVIEWED: 26 January 2021
  • LAST MODIFIED: 27 June 2022
  • DOI: 10.1093/obo/9780199756797-0101

Introduction

Global health diplomacy is an interdisciplinary field that bridges global public health, international relations, and multisectoral public policy with a goal to achieve global health. It enables global cooperation to promote health and manage a range of global health threats, such as noncommunicable and infectious diseases, climate change, environment health, food security, and persistent health inequities, to name a few. While health is not always on the agenda of other sectors, there has been increasing recognition of its significance across other domains. Health is influenced by complex social, economic, and political landscapes, demonstrating the importance of global health diplomacy now more than ever. Global events and initiatives, such as the COVID-19 pandemic, the Paris Climate Agreement, the Framework Convention on Tobacco Control, and the International Health Regulations, illustrate the multitude of issues and instruments used in global health diplomacy, requiring complex interactions between various sectors and state and nonstate actors. Coordinated action for health requires collaboration at all levels of governance inclusive of regional, bilateral, and multilateral alliances. This not only requires policy coherence and coordination between sovereign states but also among other major global players such as civil society organizations and intergovernmental and nongovernmental organizations, as well as public-private partnerships. Furthermore, to effectively manage these global health threats and promote health and health equity worldwide, it is necessary for foreign diplomats to recognize and navigate the intersections of health with other sectors. Considering other non-health-related disciplines such as the impact of economics, trade, and social influences on global health, there have also been calls for the inclusion of multisectoral approaches to global health diplomacy. As a global health leader, it can be difficult to navigate these complex conditions. An understanding of the fundamentals of diplomacy and global health governance is needed to effectively negotiate health processes. However, this is not always straight forward, as health diplomats must also consider the foreign political interests of their allies to effectively integrate health and promote coherence across foreign policy agreements in alignment with global health goals. Diplomats play a vital role in the formation of global partnerships, and while the importance of health is becoming more relevant to diplomats today, the need for global health leaders with diplomacy skills is essential to facilitate global cooperation and policy coherence for global health.

General Overviews

In an era of globalization, there is an urgent need to broaden the scope of foreign policy to recognize global health and its intersections with other non-health-related sectors. While health is arguably one of the most important considerations in foreign policy decision-making, it is still largely overlooked. Global health diplomacy seeks to resolve these shortcomings by positioning health as a key issue in foreign policymaking. Using global health diplomacy as an integral tool in international relations is crucial to enable foreign policymakers and global health experts to improve joint efforts toward a common goal, global health. The general overviews presented here highlight key resources, which convey the importance of global health diplomacy and how it can be used to strengthen global health systems and improve global health. The Oslo Ministerial Declaration (see Ministers of Foreign Affairs 2007) is a crucial reference work signed on 20 March 2007, advocating for health goals through foreign policy. The statement has been quoted as a paradigm shift in many key articles on global health diplomacy and argues that health is one of the most important, yet still broadly neglected, long-term foreign policy issues of our time. Kevany 2019 illustrates that although there has been a focus on providing development health aid to countries in need, there is still a lack of inclusion of health in conjunction to other non-health-related global policies. The author argues that international approaches and strategies must expand their horizons to include health diplomacy and recognize the intersections of health with other sectors, which need to work in collaboration with one another. Similarly, Poku and Sundewall 2018 discusses the need to consider global health in politics, especially in a world that is becoming more and more globalized. From a global health perspective, the authors contend with the political responsibilities and complexities of states and international systems to strengthen global health diplomacy. Labonté and Gagnon 2010 expands on this notion by presenting an analysis of the policy-related literature using six policy frames: security, development, global public goods, human rights, trade, and ethical/moral reasoning, concluding that while foreign diplomats recognize the importance of health, there is an urgent need to strengthen global health diplomacy to achieve these global health commitments.

  • Kevany, Sebastian. 2019. A vision for global heath diplomacy in the foreign policy process: Using smart power to prevent and resolve international conflict. Global Public Health 14.1: 147–151.

    DOI: 10.1080/17441692.2018.1471147Save Citation »Export Citation » Share Citation »

    This commentary critically examines global health as a tool for diplomacy, where the focus, design, and delivery of certain health programs can have dramatic effects on international relations. As there is often a disconnect between global health needs and foreign policy, the author argues that strategies and approaches must be strengthened to improve collaboration between foreign policymakers with global health diplomats, to better integrate global health priorities within foreign policy institutions.

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  • Labonté, Ronald, and Michelle L. Gagnon. 2010. Framing health and foreign policy: Lessons for global health diplomacy. Globalization and Health 6.1: 14.

    DOI: 10.1186/1744-8603-6-14Save Citation »Export Citation » Share Citation »

    This paper analyzes policy-related documents and academic literature, highlighting arguments that incorporate health within foreign policy. The authors organize these arguments into six main policy frames, including security, development, global public goods, human rights, trade, and ethical/moral reasoning, each of which describes a particular empirical or theoretical basis for incorporating health within foreign policy agendas. Although political commitments to include global health in foreign policy exist, the authors illustrate there is still a need for policy leaders to strengthen engagement in global health diplomacy to achieve these goals.

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  • Ministers of Foreign Affairs. 2007. Oslo Ministerial Declaration—global health: A pressing foreign policy issue of our time. The Lancet 369.9570: 1373–1378.

    DOI: 10.1016/S0140-6736(07)60498Save Citation »Export Citation » Share Citation »

    The Oslo Ministerial Declaration, signed in 2007 by the Ministers of Foreign Affairs from seven countries (Brazil, France, Indonesia, Norway, Senegal, South Africa, and Thailand) recognizes that, in the 21st-century era of globalization, there is an urgent need to broaden the scope of foreign policy to consider health. An “Agenda for Action” with concrete steps to increasing the priority of health in foreign policy decision-making, serves as a useful document for policymakers and scholars within the field of health and international relations.

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  • Poku, Nana K., and Jesper Sundewall. 2018. Political responsibility and global health. Third World Quarterly 39.3: 471–486.

    DOI: 10.1080/01436597.2017.1369034Save Citation »Export Citation » Share Citation »

    Globalization has wide-ranging and pervasive impacts on population health. With increased globalization and complex issues that transcend national borders, states must adapt to accept increased political responsibility, particularly from the perspective of global health. The authors note the importance of health diplomacy as a tool during health negotiations between states and acknowledge the key role that health plays in political agenda setting between states.

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Issue Diplomacy

Global health diplomacy is used as tool to achieve global health. However, global health is complex as it encompasses a range of health topics, such as managing disease outbreaks, environmental health, and fair access to health services. This requires a closer examination of more specific issues or topics of diplomacy as it relates to global health. For example, vaccine diplomacy has become a focus of international debate with concerns of emerging infectious diseases. Hotez 2021 provides a comprehensive overview of vaccine diplomacy by summarizing lessons learned during vaccine-related negotiations to highlight the importance of coordination among foreign policy leaders for the prevention of emerging diseases. Expanding on this is the notion of fair access to medicines and services such as vaccines. Emanuel, et al. 2020 considers this and proposes the Fair Priority Model as a useful framework to guide the equitable and ethical distribution of vaccines. Additionally, health diplomacy is not only used in the context of new and emerging infectious diseases but also in addressing long-lasting public health challenges, such as migrant and refugee health. In World Health Organization 2019, the authors argue that health diplomacy is intrinsically tied to refugee and migrant health and acknowledge the complexity of issues related to migration, but the authors also suggest policy solutions that can be implemented by governments as well as nonstate actors and nongovernmental organizations. This is also related to the topic of planetary health diplomacy, discussed in Paula 2021, which illustrates the close intersections of planetary health diplomacy with global health. The author argues that better intersectoral collaboration and multilateralism is needed to protect human health and environmental sustainability, illustrating some of the more specific issues related to global health diplomacy. Another important topic of global health is humanitarian diplomacy, or advocating for issues related to humanitarian principles, such as reducing global human suffering and preventing loss of life. Minear and Smith 2007 provides a broader overview of this topic by describing theories and negotiation of humanitarian diplomacy. The author discusses humanitarian operations in low- and middle-income countries (LMIC) such as Somalia, Cambodia, Lebanon, Colombia, and Iraq, and illustrates the intersections and common goals between humanitarian principles and global health diplomacy such as providing basic human needs including food, water, shelter, and health.

  • Emanuel, Ezekiel J., Govind Persad, Adam Kern, et al. 2020. An ethical framework for global vaccine allocation. Science 369.6509: 1309–1312.

    DOI: 10.1126/science.abe2803Save Citation »Export Citation » Share Citation »

    The COVID-19 pandemic has raised ethical concerns regarding the distribution of vaccines globally. This article addresses these concerns, as authors propose the Fair Priority Model as a useful tool to inform vaccine diplomacy. The authors consider three fundamental values to develop the framework and demonstrate its relevance toward achieving global equitable access to vaccines.

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  • Hotez, Peter J. 2021. Preventing the next pandemic: Vaccine diplomacy in a time of anti-science. Baltimore: Johns Hopkins Univ. Press.

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    This book discusses lessons to be learned in vaccine diplomacy by addressing the shortcomings of countries when dealing with infectious diseases. The author highlights the geopolitical and sociopolitical factors that influence vaccine diplomacy and emphasizes the need for better coordination among global health actors and foreign policy leaders to prevent outbreaks of emerging diseases.

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  • Minear, Larry, and Hazel Smith, eds. 2007. Humanitarian diplomacy: Practitioners and their craft. Tokyo and New York: United Nations Univ. Press.

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    Humanitarian professionals often interact with politicians and diplomats to negotiate access and reach civilians in need. This book provides an overview of humanitarian operations in various countries such as the Balkans, Somalia, East Timor, Cambodia, Lebanon, Colombia, and Iraq. In addition to describing theories related to humanitarian diplomacy, this volume provides a comprehensive resource for practitioners, policy communities, and students of humanitarian diplomacy.

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  • Paula, Nicole de. 2021. Planetary health diplomacy: A call to action. The Lancet Planetary Health 5.1: e8–e9.

    DOI: 10.1016/S2542-5196(20)30300-4Save Citation »Export Citation » Share Citation »

    Planetary health acknowledges how man-made environmental consequences impact overall human health. The field also emphasizes that the protection of both human health and environmental sustainability requires global collaboration and multilateralism. The authors argue for the need to establish a concrete action plan for planetary health diplomacy that includes a focus on collaboration between scientists, states, and citizens.

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  • World Health Organization. 2019. Health diplomacy: Spotlight on refugees and migrants. Copenhagen: World Health Organization.

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    This book will be relevant to students particularly interested in migration and refugee assistance. The book highlights important aspects of good governance such as multi-sectoral approaches and negotiations and provides a close examination of global, regional, national, and subnational perspectives on the topic of migration and refugee assistance.

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Foundational Concepts Theories and Practices

As an emerging field of practice, limited academic work had been completed to comprehensively examine and synthesize the theorization of global health diplomacy. However, the literature is beginning to recognize the intersections between health, foreign policy, diplomacy, and the relationship between health and other sectors more and more. Therefore, exploring foundational concepts, theories, and practices of these distinct fields can be applied and are relevant to theorizing global health diplomacy. For example, Katz, et al. 2011 highlights key foundations of global health diplomacy such as the close intersection between global health experts and the field of foreign policy. The authors attempt to define the field of global health diplomacy and illustrate the need for both diplomatic and public health skills. McInnes and Lee 2012 expands on this notion by exploring theories and practices of health diplomacy, foreign diplomacy, the global economy, global health governance, and health security to demonstrate how the previously distinct fields of global health and international relations are becoming increasingly relevant to one another. This trend also supports the importance of multisectoral approaches to global health diplomacy to enable policy coherence not just between states and organizations, but also between the global health community and non-health sectors, which influence health. Despite this, Friel 2017 illustrates that lack of collaboration between sectors, which has contributed to global health inequalities, and argues for better approaches for intersectoral policy coherence. Leppo 2013 highlights the history and the uses of the Health in All Policies approach, which is a key concept in global health diplomacy that considers health across all sectors to promote coordination for global health. The interdisciplinary nature of global health diplomacy illustrates why it is important for global health leaders to be knowledgeable in the field of diplomacy. Thus, works such as Berridge and Lloyd 2012, which provide a comprehensive resource of key definitions and terms in the field of diplomacy, as well as Kerr and Wiseman 2018, which explores the history and evolution of the field, provide unique insights and address concepts that are relevant and applicable to global health diplomacy. Brown, et al. 2014 explores current practices and competencies of health attachés, illustrating their role in shaping the field of global health diplomacy. Ruckert, et al. 2016 attempts to bridge these fields together by explicitly theorizing and explaining the field of global health diplomacy by examining approaches to international relations in the context of global health. Kickbusch, et al. 2021 provides a comprehensive overview of global health diplomacy, discussing its uses, foundational concepts, dimensions, and achievements of the growing interdisciplinary field.

  • Berridge, Geoff R., and Lorna Lloyd. 2012. The Palgrave Macmillan dictionary of diplomacy. 3d ed. Basingstoke, UK: Palgrave Macmillan.

    DOI: 10.1057/9781137017611Save Citation »Export Citation » Share Citation »

    Like all professions, diplomacy has developed its own specialized terminology, and this lexicon consists of a comprehensive collection of relevant terms. It also includes entries on legal terms, political events, international organizations, and major diplomatic figures. This book is particularly useful for students of diplomacy and related subjects as well as for members of diplomatic services worldwide.

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  • Brown, Matthew D., Tim K. Mackey, Craig N. Shapiro, Jimmy Kolker, and Thomas E. Novotny. 2014. Bridging public health and foreign affairs: The tradecraft of global health diplomacy and the role of health attachés. Science and Diplomacy 3.3.

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    This article focuses on the role of health attachés as key global health diplomacy practitioners who employ the tools of diplomacy and tradecraft to bridge governments’ public health and foreign policy objectives. It describes current practices and competencies of health attachés and proposes a tradecraft model for a modern health attaché to help shape the training and professional development of future global health diplomacy practitioners.

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  • Friel, Sharon. 2017. Governance, regulation and health equity. In Regulatory theory. 1st ed. Edited by Peter Drahos, 573–590. Acton: Australian National University Press.

    DOI: 10.22459/RT.02.2017.33Save Citation »Export Citation » Share Citation »

    This book chapter explores the complex causes of health inequities and related political, economic, and social factors. The authors argue that persistent poor governance at national and global levels, indifferent policy choices and suboptimal regulations underpin and perpetuate health inequities. The authors argue that the use of multiple, intersectoral policy instruments, involving a broad range of actors, is necessary to address the upstream determinants of health equity.

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  • Katz, Rebecca, Sarah Kornblet, Grace Arnold, Eric Lief, and Julie E. Fischer. 2011. Defining health diplomacy: Changing demands in the era of globalization; Defining health diplomacy. Milbank Quarterly 89.3: 503–523.

    DOI: 10.1111/j.1468-0009.2011.00637.xSave Citation »Export Citation » Share Citation »

    The authors examine key foundations and approaches to global health diplomacy, including the close intersections between the field of foreign diplomacy and global public health. They highlight the need for strong foreign policy and legal and diplomatic skills among global health professionals to achieve the goals of global health diplomacy.

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  • Kerr, Pauline, and Geoffrey Wiseman, eds. 2018. Diplomacy in a globalizing world: Theories and practices. 2d ed. New York: Oxford Univ. Press.

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    Within this introductory work, twenty-three well-known scholars provide a comprehensive analysis of past and current theoretical concepts and practices of diplomacy. The book’s premise is that diplomacy is becoming more and more important globally. It is an essential instrument for managing the differences between countries in the face of major power shifts and new global challenges.

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  • Kickbusch, Ilona, Haik Nikogosian, Michel Kazatchkine, and Mihály Kökény. 2021. A guide to global health diplomacy: Better health—improved global solidarity—more equity. Geneva, Switzerland: Global Health Centre.

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    This guide provides a comprehensive overview of key concepts within global health diplomacy. It also outlines major actors and key events that have shaped this field of study. By incorporating practical negotiation tips and suggestions, this document is particularly useful for students of global health diplomacy, as well as current health diplomats and negotiators.

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  • Leppo, Kimmo, ed. 2013. Health in all policies: Seizing opportunities, implementing policies. Helsinki: Ministry of Social Affairs and Health, Finland.

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    This book provides a compressive overview of the Health in All Policies approach and its role in achieving global health by promoting health across all sectors. The authors discuss the emergence and history of the concept, how it has influenced achievements in global health, and considerations for policymakers to strengthen intersectoral action for global health.

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  • McInnes, Colin, and Kelley Lee. 2012. Global health and international relations. Cambridge, UK, and Malden, MA: Polity.

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    This classic textbook examines key intersections between health and international relations such as global health security. The authors illustrate how global health has been socially constructed, shaped in theory and practice by particular interests and normative frameworks, and how the wide range of new social actors in global health has contributed to shaping the global agenda.

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  • Ruckert, Arne, Ronald Labonté, Raphael Lencucha, Vivien Runnels, and Michelle Gagnon. 2016. Global health diplomacy: A critical review of the literature. Social Science & Medicine 155 (April): 61–72.

    DOI: 10.1016/j.socscimed.2016.03.004Save Citation »Export Citation » Share Citation »

    This critical literature review explores what health concerns enter into diplomatic and foreign policy negotiations, and how they are framed and theoretically grounded. Given the fragmentation of the global health diplomacy literature as a relatively new field, this review suggests the application of international relations theoretical concepts to better analyze and explain global health outcomes and provide more of a theoretical grounding to global health diplomacy scholarship.

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Understanding Geopolitical Interests

Global health diplomacy seeks to facilitate global coordination and policy coherence for health. This includes international collaboration between states, which requires an understanding of foreign policy processes to effectively negotiate policies. Important aspects of this to consider are the geopolitical factors and drivers, which influence the implementation of foreign policies as they relate to global health. This section features key articles, which discuss current approaches and practices of international diplomacy, including some of the nuances to consider in the geopolitics of global health to inform global health diplomacy practices. For example, Alhashimi 2021 presents an analysis of the global cooperation in response to the COVID-19 pandemic and points out important lessons to be learned, such as the slow global response and insufficient political leadership. This book provides important insights for the future of international diplomacy and approaches to strengthen multilateralism relevant to global health diplomacy. Niche diplomacy is an approach to international relations, which involves concentrating on a specialized area, often practiced by small and middle powers, to advance political agendas. Fourie 2013 explores this approach to international diplomacy by specifically looking at the history of South African international relations and how niche HIV/AIDS diplomacy was used to strengthen South-South multilateralism and strengthen policy coordination for health. Shadow diplomacy is another practice. Shadow diplomacy consists of informal networks or channels, which work in the “shadows” to influence in global politics. Anderson 2018 conceptualizes this idea of shadow diplomacy and its impact on global health diplomacy through an analysis of African health diplomacy and the role or influence of Western powers, illustrating important nuances of shadow diplomacy to consider in global health diplomacy. Smart power adopts and combines the practices of both hard power (or the utilization of military and/or economic means) and soft power (or the use of attraction and persuasion tactics) to influence international relations and diplomacy. By examining US health assistance in Iraq and Afghanistan, McInnes and Rushton 2014 assesses the uses of smart power and its impact on global health diplomacy. Through this analysis, the authors uncover the uses of smart power in global health diplomacy, illustrating that global health diplomacy is sometimes used as a smart power means for political gains rather than for global health. Additionally, by exploring China’s participation in foreign health assistance in Africa, Killeen, et al. 2018 develops and illustrates the uses of three analytical frameworks to identify a country’s motivations, initiatives, and approaches to global health diplomacy to inform effective negotiations for global health.

  • Alhashimi, Hana, ed. 2021. The future of diplomacy after COVID-19: Multilateralism and the global pandemic. Abingdon, UK, and New York: Routledge.

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    Written by a team of international policy experts, this book examines how the COVID-19 pandemic has shaped the current state of international diplomacy, creating both challenges and opportunities for the future of multilateralism. This book touches upon various aspects of global cooperation and provides practical guidance for both students and professionals working in policy.

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  • Anderson, Emma-Louise. 2018. African health diplomacy: Obscuring power and leveraging dependency through shadow diplomacy. International Relations 32.2: 194–217.

    DOI: 10.1177/0047117817751595Save Citation »Export Citation » Share Citation »

    This article explores the concept of shadow diplomacy or the informal networks that influence diplomacy by drawing on field work to provide a critical analysis of the role Western powers play on African health diplomacy. This contribution draws attention to important nuances of shadow diplomacy and the complexity of global health diplomacy by looking at how health is used to leverage or persuade power structures.

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  • Fourie, Pieter. 2013. Turning dread into capital: South Africa’s AIDS diplomacy. Globalization and Health 9.1: 8.

    DOI: 10.1186/1744-8603-9-8Save Citation »Export Citation » Share Citation »

    The authors explore the practices of niche diplomacy, which involve focusing on specific areas of health diplomacy, sometimes practiced by emerging middle powers to advance health agendas. This article reviews the history of South African international relations and the uses of niche diplomacy in HIV/AIDS to strengthen South-South multilateralism policy coordination.

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  • Killeen, Olivia J., Alissa Davis, Joseph D. Tucker, and Benjamin Mason Meier. 2018. Chinese Global health diplomacy in Africa: Opportunities and challenges. Global Health Governance: The Scholarly Journal for the New Health Security Paradigm 12.2: 4–29.

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    The authors develop three key analytical frameworks through an analysis of China’s role in advancing health assistance in Africa since the mid-20th century. A closer look at China’s motivations and its vertical and horizontal initiatives, as well as bilateral and multilateral approaches to foreign diplomacy, contribute to a better understanding of China’s foreign policy. The article illustrates the importance of these frameworks to provide a better understanding of a country’s motivations, initiatives, and approaches to inform global health diplomacy.

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  • McInnes, Colin, and Simon Rushton. 2014. Health for health’s sake, winning for God’s sake: US global health diplomacy and smart power in Iraq and Afghanistan. Review of International Studies 40.5: 835–857.

    DOI: 10.1017/S026021051400031XSave Citation »Export Citation » Share Citation »

    This case study examines the role of US health assistance in Iraq and Afghanistan to evaluate the use of smart power, which combines practices of hard and soft power, in advancing both political and health agendas. Authors shed light into the downside of such strategies and urge the use of a precautionary approach to avoid potential negative outcomes that may hinder global health.

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Examples of Geopolitics in Health

These examples and analyses of various countries or regional areas and their engagement with global health initiatives and international policies provide an overview to understand the role of geopolitical influences on global health diplomacy. Understanding particular countries’ or regions’ political interests and drivers of foreign policy, as well as how they participate in health diplomacy, can inform negotiations and approaches to collaborate and influence global health initiatives and policies. For example, Fidler 2010 provides an overview of Asia’s engagement in global health diplomacy and an analysis to understand how Asian countries view and participate in global health diplomacy. The author highlights the importance of the Five Principles of Peaceful Coexistence Approach in foreign policy and how it has influenced international health governance, providing important insights for health leaders practicing in these areas. Wenham 2018 also examines more closely the role of Thailand in global health diplomacy as a leader in disease control in Southeast Asia and explores why and how they have strengthened subregional coordination for disease control. Similarly, Hoffman 2010 provides an assessment of Canada’s engagement in global health diplomacy to highlight both shortcomings and opportunities for enhancing health in Canadian foreign policy, such as strengthening coordination across governmental departments and partnerships with key health organizations. An analysis of Chile’s international, regional, and domestic foreign policy, Ramírez, et al. 2018 reveals how traditional foreign policy interests such as national security at the international level, neoliberal reform at the regional level, and economic interests at the domestic level are the main drivers influencing global health diplomacy with Chile. Similarly, Loewenson, et al. 2014 provides African perspectives on how global health diplomacy is conceptualized to show that unity and liberation ethics are the main drivers in African foreign policy. Another important aspect to consider is how countries leverage their resources or focus on specific health objectives to engage in global health diplomacy. For example, Waller, et al. 2017 illustrates how Cuba has provided medical personnel to strengthen partnerships with over sixty countries, and similarly, Flynn 2013 shows how Brazil has focused on pharmaceutical diplomacy to strengthen international health partnerships. As these examples demonstrate, understanding how and why different countries and regions participate in global health initiatives can reveal key insights and geopolitical nuances, which can inform effective approaches to global health diplomacy when forming international, multinational, and even regional partnerships for health.

  • Fidler, David P. 2010. Asia’s participation in global health diplomacy and global health governance. Asian Journal of WTO & International Health Law and Policy 5:1674.

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    The author provides an in-depth analysis of Asia’s engagement and approaches in global health diplomacy. The effect of emerging powers—particularly of China and India, as well as Asian normative principles in international relations such as the Five Principles of Peaceful Coexistence and their influence on Asian participation in global health governance—are examined. Through this analysis, challenges and opportunities are identified to advance global health and inform negotiation.

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  • Wenham, Clare. 2018. Regionalizing health security: Thailand’s leadership ambitions in mainland Southeast Asian disease control. Contemporary Southeast Asia 40.1: 126–151.

    DOI: 10.1355/cs40-1fSave Citation »Export Citation » Share Citation »

    This article analyzes interviews with disease control policymakers in Thailand, Cambodia, Laos, and Vietnam to explore the relationship between regional governance and health security. The author shares insights into the ways Thailand has become a leader in disease control in Southeast Asia, and how this has improved regional health security, as well as their own economic and national security.

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  • Hoffman, Steven J. 2010. Strengthening global health diplomacy in Canada’s foreign policy architecture: Literature review and key informant interviews. Canadian Foreign Policy Journal 16.3: 17–41.

    DOI: 10.1080/11926422.2010.9687318Save Citation »Export Citation » Share Citation »

    The article provides an in-depth analysis of Canada’s engagement in global health diplomacy, based on twelve interviews with high-ranking Canadian government officials that explored health in Canadian foreign policy. It also highlights opportunities to enhance global health diplomacy by prioritizing health in foreign policies, strengthening coordination across government departments, and enhancing partnerships with key health organizations.

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  • Ramírez, Jorge, Leonel Valdivia, Elena Rivera, et al. 2018. Chile’s role in global health diplomacy: A narrative literature review. Globalization and Health 14.1: 108.

    DOI: 10.1186/s12992-018-0428-8Save Citation »Export Citation » Share Citation »

    Authors review Chile’s engagement in global health diplomacy through an analysis of the main driving forces behind international, regional, and domestic foreign policy. The authors illustrate that Chile is largely influenced by traditional foreign policy interests, however, highlight opportunities to enhance and influence health diplomacy using a regional approached by strengthening South-South alliances and regional cooperation for health.

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  • Loewenson, Rene, Moeketsi Modisenyane, and Mark Pearcey. 2014. African perspectives in global health diplomacy. Journal of Health Diplomacy (21 March).

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    This literature review examines African perspectives in global health diplomacy and highlights the importance of unity and liberation ethics in the history of African foreign policy. The authors argue that a focus on regional collaboration and the inclusion of African civil society as a key strategy are needed to inform effective negotiations in health diplomacy.

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  • Waller, Stephen G., Jane B. Ward, and Miguel A. Montalvo. 2017. Cuba’s 50-year health diplomacy program: Lessons learned for global health engagement. Military Medicine 182.1: 1451–1452.

    DOI: 10.7205/MILMED-D-16-00323Save Citation »Export Citation » Share Citation »

    This article examines various health diplomacy programs within Cuba, from medical brigades deployed to Algeria, to humanitarian aid programs in Latin America. Authors argue that policymakers within the Department of Defense can garner important lessons from this approach, such as a lack of capacity building generated from the multigenerational efforts of Cuban health diplomacy.

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  • Flynn, Matthew. 2013. Brazilian pharmaceutical diplomacy: Social democratic principles versus soft power interests. International Journal of Health Services 43.1: 67–89.

    DOI: 10.2190/HS.43.1.fSave Citation »Export Citation » Share Citation »

    The authors examine health diplomacy efforts in Brazil during the preceding decade, particularly the role of pharmaceutical diplomacy. By drawing on literature reviews and interviews with Brazilian policymakers, authors identify health as a human right as the main driver in Brazilian foreign policy, revealing important nuances that inform Brazil’s global health diplomacy efforts.

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Key Global Health Actors, Alliances, and Venues

While sovereign states play significant roles in global health diplomacy, it is also important to consider the value of other collaborative partnerships that impact outcomes, such as civil society organizations and intergovernmental and nongovernmental organizations. Furthermore, careful consideration of how regional alliances influence global health diplomacy, and an exploration of key global health venues, is critical.

Global Health Actors

Pantzerhielm, et al. 2020 examines the history of international organizations, meta-governance norms, and their productive power on the global health field to illustrate how international organizations have transformed interorganizational partnerships throughout history and enhanced coordination and alignment to promote global health diplomacy goals. As highlighted in Storeng and de Bengy Puyvallée 2018, through global public-private partnerships, civil society organizations play a pivotal role by supporting, implementing, and advocating for health initiatives; however, their engagement could be further strengthened in the developmental of global health strategies and global health diplomacy. Through an analysis of the regional organization UNASUR (Unión de Naciones Suramericanas) and its contributions to health inequalities in Latin America, Riggirozzi 2015 illustrates the mechanisms by which these organizations strengthen regional alignment and how they can facilitate coordination of global health goals.

  • Pantzerhielm, Laura, Anna Holzscheiter, and Thurid Bahr. 2020. Power in relations of international organisations: The productive effects of “good” governance norms in global health. Review of International Studies 46.3: 395–414.

    DOI: 10.1017/S0260210520000145Save Citation »Export Citation » Share Citation »

    This article examines the productive power of international organizations on the global health field by developing a theoretical framework to explore the history of meta-governance norms since the 1990s. Authors illustrate the value of international organizations to facilitate vertical partnerships and collaboration to promote global health.

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  • Riggirozzi, Pía. 2015. Regionalism, activism, and rights: New opportunities for health diplomacy in South America. Review of International Studies 41.2: 407–428.

    DOI: 10.1017/S026021051400028XSave Citation »Export Citation » Share Citation »

    This article examines the role of regional organizations as key actors to strengthen regional and global health governance. Through an analysis of UNASUR’s contributions to health inequalities in Latin America, the author illustrates how regional organizations can facilitate coordination to promote health and highlights new opportunities to engage in global health by expanding their participation in new forms of regional health diplomacy.

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  • Storeng, Katerini Tagmatarchi, and Antoine de Bengy Puyvallée. 2018. Civil society participation in global public private partnerships for health. Health Policy and Planning 33.8: 928–936.

    DOI: 10.1093/heapol/czy070Save Citation »Export Citation » Share Citation »

    The authors critically examine the role of civil society (referred to as nongovernmental organizations or communities) within major global health partnerships. Although civil society is often underrepresented within discussions surrounding global partnerships for health, previous research has demonstrated the transformative power of civil society participation within global health discussions. The authors further outline the need for civil society participation within global health governance.

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Regional Alliances

The formation of regional alliances using global health diplomacy can also strengthen coordination toward a common health initiative. As illustrated in Chattu and Knight 2019, regional alliances in the Caribbean region have strengthened collective action to prevent and control noncommunicable diseases (NCDs). On the other hand, it is important to recognize that not all alliances that are formed have the same productive power. For example, Watt, et al. 2014 provides an analysis of Brazil, Russia, India, China, and South Africa (BRICS) countries and their engagement in global health diplomacy to illustrate that while these countries have established geopolitical alliances, their motivations for participating in global health negotiations are sometimes divergent. McBride, et al. 2019 also provides an interesting analysis to evaluate the influence of political clubs such as BRICS, G7, and G20 on global health diplomacy and global health.

  • Chattu, Vijay Kumar, and Andy W. Knight. 2019. Port of Spain Summit Declaration as a successful outcome of global health diplomacy in the Caribbean region: A systematic review. Health Promotion Perspectives 9.3: 174–180.

    DOI: 10.15171/hpp.2019.25Save Citation »Export Citation » Share Citation »

    This systematic review explores how global health diplomacy contributed to the Caribbean regional summit on the chronic noncommunicable diseases (NCDs) epidemic. Results demonstrate increased regional commitment to the prevention of NCDs. A notable example is the multi-sectoral summit aimed to prevent NCDs through policy and collaboration, demonstrating the value of global health diplomacy in managing global health issues.

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  • McBride, Bronwyn, Sarah Hawkes, and Kent Buse. 2019. Soft power and global health: The Sustainable Development Goals (SDGs) era health agendas of the G7, G20 and BRICS. BMC Public Health 19.1: 815.

    DOI: 10.1186/s12889-019-7114-5Save Citation »Export Citation » Share Citation »

    BRICS, G7, and G20 groups play a major role in influencing global health agendas and priorities within their member countries. This article analyzes health ministerial communiqués created by these groups after the establishment of the Sustainable Development Goals. Although all three groups prioritize issues such as emergency preparedness and universal health coverage, the groups differ on issues related to environmental protection, maternal health, and mental health.

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  • Watt, Nicola F., Eduardo J. Gomez, and Martin McKee. 2014. Global health in foreign policy—and foreign policy in health? Evidence from the BRICS. Health Policy and Planning 29.6: 763–773.

    DOI: 10.1093/heapol/czt063Save Citation »Export Citation » Share Citation »

    Although there exists abundant research examining the global health decisions of Brazil, Russia, India, China, and South Africa (BRICS), gaps remain in the literature regarding BRICS countries’ engagement in global health negotiations. Using an existing framework that links foreign policy with global health, the authors demonstrate that these countries often have different motivations for participating in global health negotiations, thus requiring a realistic analysis of global health diplomatic debates.

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Venues

Global health venues such as the World Health Organization (WHO) and the World Trade Organization (WTO) play key roles in the negotiation and implementation of global health diplomacy initiatives. A review of the WHO’s historical contributions to global health in Cueto, et al. 2019 and an analysis of the WTO’s role in global nutritional health in Ariansen, et al. 2020 highlight the impact of these health venues on global health diplomacy.

  • Ariansen, Anja M. S., Siri Gloppen, Lise Rakner, Kjell Arne Johansson, and Øystein A. Haaland. 2020. Time for global health diplomacy. The Lancet 395.10238: 1691–1692.

    DOI: 10.1016/S0140-6736(20)30490-6Save Citation »Export Citation » Share Citation »

    The authors briefly outline key developments since the 2009 Lancet Trade and Health Series, which criticized the World Trade Organization’s harmful decisions to global health and nutrition. Since then, high-income countries have experienced reduced morbidity and mortality related to dietary risk. However, morbidity due to dietary risk has increased within middle-income countries. Authors emphasize the need for global health diplomacy efforts to influence trade policies and counteract decisions made by profit-driven corporations.

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  • Cueto, Marcos, Theodore M. Brown, and Elizabeth Fee. 2019. The World Health Organization: A history. Global Health Histories. Cambridge, UK: Cambridge Univ. Press.

    DOI: 10.1017/9781108692878Save Citation »Export Citation » Share Citation »

    This book provides a comprehensive history of the World Health Organization (WHO), through an examination of its origins and historical antecedents, while also considering its contemporary and future roles. The authors also reevaluate the relative successes and failures of critical WHO campaigns. This is particularly instructive in light of the current struggles faced by the WHO during the COVID-19 pandemic.

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Negotiation

Global health diplomacy is founded on the use of effective negotiations to implement policies and strategies that promote global health. This requires health experts to develop strong competencies in the art of negotiation, which occur not only between states but also among organizations. Fairman 2012 shares important insights directed toward health policymakers of the negotiation process specifically from a global health lens, useful for global health diplomacy students seeking to develop core competencies in negotiations. Although Saner 2008 does not explicitly study negotiations in the health arena, this book provides a comprehensive overview of negotiation practices and theories from a multistakeholder perspective, which support the development of negotiation skills. Exploring the nuances and informalities of negotiations are also important elements to consider to successfully navigate negotiation conditions. Through an analysis of negotiation customs at the World Health Assembly (WHA), Irwin and Smith 2019 shares strategies and normative behaviors to inform effective negotiations for global health. In addition, Heimer 2018 examines negotiated information orders between stakeholders during the 2003 SARS epidemic to show how informal information affects the processes of negotiation, which is a key aspect to recognize.

  • Fairman, David, ed. 2012. Negotiating public health in a globalized world: Global health diplomacy in action. Springer Briefs in Public Health. Dordrecht, the Netherland, and New York: Springer.

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    The goal of this guide is to provide health policymakers with practical information and insights from negotiation processes in order to help them create better international health agreements and programs. It can help health diplomats to develop the negotiation skills necessary to meet the challenges of global health diplomacy.

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  • Heimer, Carol A. 2018. The uses of disorder in negotiated information orders: Information leveraging and changing norms in global public health governance. The British Journal of Sociology 69.4: 910–935.

    DOI: 10.1111/1468-4446.12495Save Citation »Export Citation » Share Citation »

    This article examines negotiated information orders in the context of global public health, using the 2003 SARS epidemic as a salient example. Negotiated information orders within organizations such as the WHO, nongovernmental organizations, and government agencies help to ascertain knowledge gaps as well as useful information for diplomatic decision-making. “Non-knowledge” information sources such as suppressed data, rumors, or unofficial information create the need for renegotiation of information sources, but also highlight broader issues within the global public health governance landscape.

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  • Irwin, Rachel, and Richard Smith. 2019. Rituals of global health: Negotiating the World Health Assembly. Global Public Health 14.2: 161–174.

    DOI: 10.1080/17441692.2018.1504104Save Citation »Export Citation » Share Citation »

    Through participant observation and interviews with fifty-three delegates at the World Health Assembly (WHA), authors examine the ritualistic components of negotiations at the WHA. The article suggests that the WHA serves to adjust and refine the boundaries of global health and addresses issues in health through consensus building. Key dimensions of negotiation are presented, including to ensure neutral language and to forgo certain policy options to establish consensus.

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  • Saner, Raymond. 2008. The expert negotiator: Strategy, tactics, motivation, behaviour, leadership. 3d ed. Leiden, The Netherlands, and Boston: Martinus Nijhoff.

    DOI: 10.1163/ej.9789004165021.1-292Save Citation »Export Citation » Share Citation »

    In this book, the author draws on experiences as a negotiation teacher and researcher to explain the theories and processes of negotiation from a multi-stakeholder perspective. In addition, the book includes case studies and examples of negotiation processes that occur between states as well as international organizations, useful for students seeking to develop core competencies in negotiation practices.

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Global Health Instruments

Global health instruments are internationally agreed instruments that have a significant impact on health. The principal governing body of the World Health Organization (WHO)—the World Health Assembly (WHA)—can adopt various types of normative instruments, including recommendations, regulations, and conventions or agreements, all of which have varying degrees of legal status. Regulations and conventions are legally binding, while recommendations are legally nonbinding. Despite their varying legally binding natures, health instruments play pivotal roles in global health diplomacy. For example, the WHO Framework Convention on Tobacco Control (FCTC) was adopted in 2003 and is the first treaty negotiated by the WHO. It is a major milestone in global health by promoting stronger coordinated action to manage the negative global impacts of tobacco use. Nikogosian and Kickbusch 2016 introduces key health instruments such as the FCTC to provide a comprehensive overview to illustrate the legal power and uses of health instruments in global health diplomacy. Other examples of global health instruments include the Paris Agreement, as highlighted in Oberthür 2016, which has strengthened international interest and coordination to manage the threat of greenhouse gas emissions. Health instruments have also influenced health security and shaped the global response to public health emergencies. For example, Davies, et al. 2015 reviews the International Health Regulations (IHR) and discusses how it has strengthened coordination of global health systems to manage infectious disease outbreaks.

  • Davies, Sara E., Adam Kamradt-Scott, and Simon Rushton. 2015. Disease diplomacy: International norms and global health security. Baltimore: Johns Hopkins Univ. Press.

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    This book addresses the importance of the International Health Regulations (IHR) to manage and prevent infectious disease outbreaks and its role in global health. By providing a detailed analysis of the formation and implementation of the IHR, as well as its relevance in managing disease outbreaks, the authors demonstrate the need for negotiation instruments such as this one to ensure global health security.

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  • Nikogosian, Haik, and Ilona Kickbusch. 2016. The legal strength of international health instruments—what it brings to global health governance? International Journal of Health Policy and Management 5.12: 683–685.

    DOI: 10.15171/ijhpm.2016.122Save Citation »Export Citation » Share Citation »

    This commentary introduces various international health instruments and the role they play in global health governance. International legal instruments are key tools used during global health negotiations, especially given the adoption of treaties related to global public health, such as the WHO Framework Convention on Tobacco Control (FCTC). International health instruments can protect global health interests in the face of competing government priorities or agendas.

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  • Oberthür, Sebastian. 2016. Reflections on global climate politics post Paris: Power, interests and polycentricity. The International Spectator 51.4: 80–94.

    DOI: 10.1080/03932729.2016.1242256Save Citation »Export Citation » Share Citation »

    This article discusses the role of the Paris Agreement adopted in 2015 on global climate change action. The author provides an analysis of international climate politics following its implementation to illustrate how it has influenced power and interdependence, promote socioeconomic interests, and encourage multilateral cooperation to reduce greenhouse gas emissions and achieve global coordination for climate change action.

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The Creation of Global Public Goods

Expanding on the value of health instruments in global health diplomacy are its uses in the creation of global public goods to promote equitable access to common goods and information for global health. The Pandemic Influenza Preparedness (PIP) framework is considered a unique recommendation in that it contains some compulsory measures and is an important example of successful negotiations in global health diplomacy for the creation of global public goods. Abbott and Drager 2013 provides insights into the negotiation process of the PIP framework established in response to concerns regarding state participation in H5N1 influenza virus specimens sharing and securing access to vaccines. The authors show how it has influenced the way states have shared information and medical supplies to manage influenza virus outbreaks and promoted global health collaboration. Unfortunately, gaps in the global health governance system for managing pandemic threats and equitable allocation of pandemic materials still exist. For example, Akbarialiabad, et al. 2021 shows the negative impact that economic sanctions have on the Iranian health-care system during the COVID-19 pandemic as a result of insufficient access to pandemic materials such as vaccines and medical supplies. However, this has revealed opportunities to strengthen multi-sectoral coordination for health using global health diplomacy. For example, Zarocostas 2021 discusses the implementation of a temporary waiver on Trade-Related Aspects of Intellectual Property Rights (TRIPS) during the COVID-19 pandemic to illustrate how this health instrument could resolve shortages of medical supplies and promote equitable access to vaccines. Expanding on this idea, Fukuda-Parr, et al. 2021 argues the need for a pandemic treaty and demonstrates how it can generate stronger global health collaboration by mandating information and material sharing. Authors illustrate further the uses of health instruments in global health diplomacy for the creation of global public goods and how it could result in better multi-sectoral as well as international coordination for global health.

  • Abbott, Frederick, and Nick Drager. 2013. The “PIP” (Pandemic Influenza Preparedness) framework: Smart sovereignty to improve the sharing of influenza viruses with pandemic potential, while also moving towards more predictable and equitable access to vaccines in future pandemics; Annex 2. In Global public goods: A concept for framing the post-2015 agenda? Edited by Inge Kaul, 43–45. Discussion Paper, No. 2/2013. Bonn, Germany: Deutsches Institut für Entwicklungspolitik.

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    By utilizing the concept of smart sovereignty, the authors provide an overview and explanation of how countries achieved consensus on the establishment of the Pandemic Influenza Preparedness (PIP) framework. This discussion paper provides unique insights and highlights evidence-based understanding by diplomats and an understanding of the negotiation process by health experts.

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  • Akbarialiabad, Hossein, Asghar Rastegar, and Bahar Bastani. 2021. How sanctions have impacted Iranian healthcare sector: A brief review. Archives of Iranian Medicine 24.1: 58–63.

    DOI: 10.34172/aim.2021.09Save Citation »Export Citation » Share Citation »

    This article reviews the consequences of sanctions on the Iranian health-care system during the COVID-19 pandemic. Authors illustrate how economic sanctions impede access to health care and have detrimental effects on population health, demonstrating the need for multisectoral approaches in health governance.

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  • Fukuda-Parr, Sakiko, Paulo Buss, and Alicia Ely Yamin. 2021. Pandemic treaty needs to start with rethinking the paradigm of global health security. BMJ Global Health 6.6: e006392.

    DOI: 10.1136/bmjgh-2021-006392Save Citation »Export Citation » Share Citation »

    While a pandemic treaty is not yet established to date, this article discusses the need to implement an international framework for pandemic preparedness to effectively respond to global health emergencies, especially after the events of the COVID-19 pandemic have revealed gaps in the global health governance system. The authors discuss the need to strengthen global health security and argue that a pandemic treaty could achieve this by mandating the sharing of information and materials during pandemic threats.

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  • Zarocostas, John. 2021. What next for a COVID-19 intellectual property waiver? The Lancet 397.10288: 1871–1872.

    DOI: 10.1016/S0140-6736(21)01151Save Citation »Export Citation » Share Citation »

    This article discusses the implementation of a temporary waiver on Trade-Related Aspects of Intellectual Property Rights (TRIPS) to manage shortages of medical supplies during the COVID-19 pandemic. While it would facilitate global equitable access to vaccines and other medical supplies, authors also shed light into potential drawbacks such as insufficient capacity to scale up production and transportation of supplies, further illustrating the need for both international collaboration and partnerships between health leaders and non-health-related sectors.

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Governance

Global governance refers to a myriad of formal decision-making mechanisms that shape the way we identify and address issues of global significance. As the leading authority for matters related to international and global health, the World Health Organization (WHO) has historically played a large role in the governance of global health. However, other organizations and actors have started to engage in global health matters in recent years, pointing to the need for multi-stakeholder diplomacy. In addition to WHO, Frenk and Moon 2013 highlights other key actors such as civil society organizations, foundations, and academic institutions, as well as various multilateral agencies with health-related mandates. Authors also outline major governance challenges for global health, such as issues related to accountability and sovereignty. To demonstrate how global health governance has adapted to increasingly complex multilateral environments, Held, et al. 2019 draws upon concepts such as gridlock and meta-governance, as well as adaptive governance. Acknowledging the complexity of multi-stakeholder diplomacy and negotiations, Tosun 2017 suggests a polycentric approach to global health governance, whereby factors such as coalition building, internal governance, and political priority setting all contribute to governance processes. Ruger 2018 describes an alternative theoretical framework, Provincial Globalism and Shared Health Governance (PG/SHG), to emphasize the need to prioritize health equity within global health policy and legislation. Power, in its various forms, can also shape health-related negotiations, as well as governance processes. Thus, Moon 2019 expands upon preexisting frameworks to examine various conceptualizations of power, and how power both reinforces global health inequities and provides catalyst for change. Both Emerson 2018 and Bennett, et al. 2018 describe challenges during health-related multi-sectoral collaborations in low- and middle-income countries (LMIC); however, Emerson 2018 also provides recommendations for actors working within public health governance in LMIC contexts. Additionally, drawing from Ruger’s framework, Campos 2020 applies the principles of solidarity, subsidiarity, and stewardship to the COVID-19 pandemic.

  • Frenk, Julio, and Suerie Moon. 2013. Governance challenges in global health. New England Journal of Medicine 368.10: 936–942.

    DOI: 10.1056/NEJMra1109339Save Citation »Export Citation » Share Citation »

    In this article, the authors define and discuss the importance of good global governance for health, outline major challenges to such governance, and describe the necessary functions of a global health system. By elucidating the key functions of a global health system, the authors encourage global health leaders to innovate new global governance arrangements that meet these functions in order to better respond to urgent, complex, and serious global health challenges.

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  • Held, David, Ilona Kickbusch, Kyle McNally, Dario Piselli, and Michaela Told. 2019. Gridlock, innovation and resilience in global health governance. Global Policy 10.2: 161–177.

    DOI: 10.1111/1758-5899.12654Save Citation »Export Citation » Share Citation »

    Drawing from topics and theories such as gridlocks and meta-governance, as well as adaptive governance, the authors strive to conceptualize how global health governance adapts to varying multilateral orders. Using a qualitative, mix-methods research approach, the authors provide an in-depth comparison of three key case-studies in global health governance: the HIV/AIDS pandemic, the 2014 Ebola outbreak, and the issue of antibiotic resistance.

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  • Tosun, Jale. 2017. Polycentrism in global health governance scholarship comment on “Four challenges that global health networks face.” International Journal of Health Policy and Management 7.1: 78–80.

    DOI: 10.15171/ijhpm.2017.64Save Citation »Export Citation » Share Citation »

    This commentary contributes to the global health governance scholarship by suggesting a polycentric approach to the study of global health governance. Polycentric forms of governance mix scales, mechanisms, and actors. A polycentric approach to the study of global health governance should incorporate coalition-building tactics, internal governance, and global political priorities.

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  • Ruger, Jennifer Prah. 2018. Global health justice and governance. 1st ed. New York: Oxford Univ. Press.

    DOI: 10.1093/oso/9780199694631.001.0001Save Citation »Export Citation » Share Citation »

    The book presents a global justice theory—provincial globalism (PG)—and links it with the theory of shared health governance (SHG). The PG/SHG framework proposes an ethical demand for health equity as the criterion for evaluating global health policy and law. It examines the current actors in global health, assessing their strengths and weaknesses, and assigns responsibilities to actors at all levels according to their functions and capabilities.

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  • Moon, Suerie. 2019. Power in global governance: An expanded typology from global health. Globalization and Health 15.S1: 74.

    DOI: 10.1186/s12992-019-0515-5Save Citation »Export Citation » Share Citation »

    The author explores various conceptualizations of power and its role in global governance processes, a critical concept for understanding, explaining, and influencing the intersection of global governance and health. A typology of eight different types of power illustrated by examples from global health is proposed, and it offers a framework to identify different types of power in global governance, the actors who wield it, and how one type can be transformed into or amplify others.

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  • Emerson, Kirk. 2018. Collaborative governance of public health in low- and middle-income countries: Lessons from research in public administration. BMJ Global Health 3.Suppl. 4: e000381.

    DOI: 10.1136/bmjgh-2017-000381Save Citation »Export Citation » Share Citation »

    Multi-sectoral governance describes a collaborative approach to solving complex public health problems, often requiring the intersection of various policy arenas. This analysis paper highlights potential challenges encountered during cross-sector collaborations working within public health, in low- and middle-income countries (LMIC). The author also provides recommendations for those working within public health governance in LMIC contexts.

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  • Bennett, Sara, Douglas Glandon, and Kumanan Rasanathan. 2018. Governing multisectoral action for health in low-income and middle-income countries: Unpacking the problem and rising to the challenge. BMJ Global Health 3.Suppl. 4: e000880.

    DOI: 10.1136/bmjgh-2018-000880Save Citation »Export Citation » Share Citation »

    This article provides a comprehensive overview of multi-sectoral approaches for promoting health in low- and middle-income countries (LMIC). Authors highlight key frameworks, theories, and challenges of this approach to conceptualize multi-sectoral action for health in LMIC.

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  • Campos, Thana C. de. 2020. Guiding principles of global health governance in times of pandemics: Solidarity, subsidiarity, and stewardship in COVID-19. The American Journal of Bioethics 20.7: 212–214.

    DOI: 10.1080/15265161.2020.1779862Save Citation »Export Citation » Share Citation »

    This article considers the shared responsibility approach to global health diplomacy by expanding on the Provincial Globalism and Shared Health Governance model to global health threats in the wake of the COVID-19 pandemic. The author builds on this theory and proposes a useful framework for pandemic governance by exploring principles of solidarity, subsidiarity, and stewardship to advance global health diplomacy.

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Case Studies

While understanding the key foundational concepts, theories, and various approaches to global health diplomacy is essential, exploring examples of its application and uses in real-life global health challenges can facilitate the development of new skills for global health leaders. Managing infectious disease outbreaks, especially in today’s era where transportation has facilitated the spread of diseases, is a major topic of discussion for the uses of global health diplomacy. Vanderslott and Marks 2020 discusses these global health challenges related to infectious diseases by examining and comparing yellow fever and COVID-19 outbreaks in history to illustrate an interesting example of how vaccine diplomacy plays a key role in global health diplomacy. Similarly, Matlin and Kickbusch 2017 also demonstrates the uses of global health diplomacy through case studies of various topics such as polio, the Sustainable Development Goals, and tobacco control to focus on examples of negotiation in global health diplomacy. Similarly, Kickbusch and Kökény 2017 offers seventeen additional case studies by drawing on examples from the World Health Organization (WHO) European region. This book not only illustrates the application of global health diplomacy but also shares insights of different global health diplomacy perspectives. Additionally, Smith and Irwin 2016 examines the topic of food and nonalcoholic beverages to children in India as a case study to highlight not only an example of how global health diplomacy can be used, but also on the importance of implementing evaluation criteria to assess successes in global health diplomacy.

  • Kickbusch, Ilona, and Mihály Kökény, eds. 2017. Health diplomacy: European perspectives. Copenhagen: World Health Organization.

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    This book provides important examples of global health diplomacy in the WHO European Region through a compilation of seventeen case studies that bring attention to various global health topics such as the Sustainable Development Goals and the Paris Agreement for climate change action, as well as negotiations and global health diplomacy perspectives of different states.

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  • Matlin, Stephen, and Ilona Kickbusch. 2017. Pathways to global health: Case studies in global health diplomacy. Vol. 2. Hackensack, NJ, and London: World Scientific.

    DOI: 10.1142/10140Save Citation »Export Citation » Share Citation »

    This book serves as an extension that complements the case studies presented in the previous volume. Written by both academics and health diplomats, this latest volume examines health diplomacy negotiations involving or impacting the WHO. Each chapter dives into a particular global health negotiation example, such as polio, noncommunicable diseases (NCDs), or the WHO reform. Thus, this book will not only benefit students and researchers, but also serve as a tool of reflection for a broader audience.

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  • Smith, Richard, and Rachel Irwin. 2016. Measuring success in global health diplomacy: Lessons from marketing food to children in India. Globalization and Health 12.1: 28.

    DOI: 10.1186/s12992-016-0169-5Save Citation »Export Citation » Share Citation »

    This case study discusses the challenges in determining and evaluating the success of global health diplomacy. The authors investigate the role of the World Health Organization’s set of Recommendations of Food and Non-alcoholic Beverages to Children in India to illustrate the need for better methodologies by setting specific goals to identify how and when global health diplomacy has succeeded.

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  • Vanderslott, Samantha, and Tatjana Marks. 2020. Health diplomacy across borders: The case of yellow fever and COVID-19. Journal of Travel Medicine 27.5: taaa112.

    DOI: 10.1093/jtm/taaa112Save Citation »Export Citation » Share Citation »

    In an era where air travel has facilitated infectious disease outbreaks, the need for more effective health interventions to prevent and manage these global health threats has become more apparent. This case study provides a comparative analysis of the public health intervention measures, in particular the role of vaccine requirements, to contain yellow fever and COVID-19 outbreaks. Through this examination, authors also illustrate the importance of vaccine diplomacy to manage infectious disease outbreaks.

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