Global Health Diplomacy

by

Ilona Kickbusch, Thorsten Behrendt

• LAST REVIEWED: 05 May 2017
• LAST MODIFIED: 27 March 2014
• DOI: 10.1093/obo/9780199756797-0101

Introduction

Today’s debates on global health diplomacy are characterized by two major governance challenges in the global health domain that reflect a globalized and increasingly interdependent world. First, the last decade has witnessed the uncoordinated proliferation of a wide variety of global health actors with different interests, resource flows, principles and objectives. The exponential increase of actors and initiatives has resulted in a polylateral and fragmented global health domain that falls short in converging strategies and resources in a transparent and effective way. Second, the state of global health is increasingly affected by decisions made in sectors that are not part of the global health governance system. Protecting and promoting health governance processes such as trade, environment, and food security is difficult and has not yet received sufficient attention. This is increasingly referred to as global governance for health. New processes of health diplomacy are required to ensure an increased consideration of health impacts by other sectors. Traditional notions of diplomacy are also changing in response to the growing interdependence and complexity of many current global problems, and a shift to new spaces of negotiation and influence has taken place. This is reflected in a broad literature on international relations that cannot be referenced here. Health has entered the realm of foreign policy due to national security concerns and as a soft power mechanism to serve geopolitical interests. However, the foreign policies of countries also and increasingly serve the goals of health—this is beginning to be more recognized in the literature. For example, to enhance development, diplomats have negotiated international agreements such as the Millennium Development Goals and RIO+20; they have also contributed to the negotiation of major health agreements such as the Framework Convention on Tobacco Control and are instrumental in the creation of many major global health alliances. Today, diplomats play a critical role in the creation and management of global partnerships for health that cover a wide variety of actors. Global health diplomacy builds on this notion of diplomacy as being engaged in the management of globalization and tries to capture multi-level and multi-actor negotiation processes that shape and manage the global policy environment for health. Given the interdisciplinary nature of the young field, a literature review on global health diplomacy requires the consideration of introductions to diplomacy, global health, and global health governance.

General Overviews

Globalization has changed traditional ways of conceptualizing and organizing the medical, economic, political, and technological means to improve health. The rise of health as a foreign policy concern reflects this development and the challenge of moving toward a new global social contract for health. Global health diplomacy can be seen as a process of social involvement of a wide array of actors at different levels of governance. If well conducted, this process leads to better population health outcomes for all countries. For this purpose global health diplomacy seeks to position health in foreign policy negotiations with the aim of creating new forms of governance that either stimulate progress within the global health system (global health governance) or help to improve health through the actions of actors in other global policy-making arenas (global governance for health). The general overviews presented here take this two-fold governance challenge into account when describing the intersectoral and interdisciplinary nature of global health diplomacy as well as discussing its value base. They are only exemplary of the extensive literature that is now available in this field. Harman 2012 explores the various ways in which we can understand global health governance. The author provides an analysis on the most relevant actors in global health governance, their purpose, influence, and impact. Youde 2012 gives a similar overview of the messy landscape of institutions and actors. It describes the shifts implied in moving from international to global health governance and the impact and tensions between framing health as a security or a human rights issue. Parker and Sommer 2011 explores key public health challenges, conceptualizes the notion of global health, and highlights critical priorities in the rapidly evolving field. Schrecker 2012 provides a more political viewpoint and specifically analyses health as an element of many nations’ foreign policies. While some aspects of health, like the spread of easily transmitted communicable diseases, are self-evidently global in an age of rapid, low-cost air travel, others reflect the political and economic impact of globalization and its effects on national economies, societies, and health systems. Kickbusch, et al. 2013 describes global health diplomacy as a discipline with transformative potential that furthers the human rights dialogue and provides a framework for understanding global health issues and their negotiation in many different venues of global governance. According to Novotny, et al. 2013, the success of global health diplomacy efforts strongly depends on the recognition of the interplay of globalization, economic interdependence, social justice, and the self-interests of nations.

• Harman, Sophie. 2012. Global health governance. Routledge Series on Global Institutions. London and New York: Routledge.

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  Highlighting the wide variety of actors, issues, and approaches involved, this work shows the complex nature of global health governance and concludes that it is still highly hierarchical and highly conflictive. It does not yet function as an agreed regime for common action and agreement; the political will is still lacking.

• Kickbusch, Ilona, Graham Lister, Michaela Told, and Nick Drager, eds. 2013. Global health diplomacy: Concepts, issues, actors, instruments, fora and cases. New York: Springer.

  DOI: 10.1007/978-1-4614-5401-4E-mail Citation »

  This very first handbook on global health diplomacy sets out defining principles, presents the current agenda of the field, and examines the many venues and actors of global health diplomacy. In particular, it highlights the need for a value base of global health diplomacy and sees this in the provision of global public goods and a human rights perspective.

• Novotny, Thomas E., Ilona Kickbusch, and Michaela Told, eds. 2013. 21st Century global health diplomacy. Global Health Diplomacy 3. Hackensack, NJ: World Scientific.

  DOI: 10.1142/8178E-mail Citation »

  The contributions to this volume explore the challenges that emerge as health diplomacy enters a range of new arenas; chapters explore health diplomacy in the context of foreign policy, security, humanitarian action, as well as the military. It provides insights into the historical trajectory of global health diplomacy and proposes ways to strengthen global health diplomacy.

• Parker, Richard Guy, and Marni Sommer. 2011. Routledge handbook of global public health. London: Routledge.

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  The handbook describes global health within the context of a rapidly changing political and institutional landscape shaped by globalization. It gives an overview on contemporary global public health challenges, highlights critical priorities for action, and argues that today’s health threats require the attention not only of governments but also of a range of non-state institutions and actors.

• Schrecker, Ted, ed. 2012. The Ashgate research companion to the globalization of health. Farnham, UK, and Burlington, VT: Ashgate.

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  This volume of original contributed papers provides an excellent overview of the state of current global health scholarship, the multidisciplinary nature of the field, and the most significant issues for research and policy. It identifies two key challenges: the issue of resources and changing approaches to financing and development aid and the issue of institutions that can respond to the dynamics of globalization.

• Youde, Jeremy R. 2012. Global health governance. Cambridge, UK, and Malden, MA: Polity.

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  The comprehensive overview offers an introduction to the changing international legal environment, the governmental and non-governmental actors involved with health issues, and the current regime’s ability to adapt to new crises. It explains both the trajectory of global health institutions over the past century and their current operations and influence.