Demographic And Health Analysis: Country Report & Analysis Overview
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Module5GlobalHealthDiplomacy.pdf
Global Health Diplomacy
Sara Bennett, PhD Johns Hopkins University
Learning Objective
Describe the components of health diplomacy and its relevance for negotiating improvements in health
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The material in this video is subject to the copyright of the owners of the material and is being provided for educational purposes under rules of fair use for registered students in this course only. No additional copies of the copyrighted work may be made or distributed.
Components of Health Diplomacy
Section A
Globalization and Health
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Health Diplomacy: A Working Definition
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Health Diplomacy: A Working Definition
Diplomacy— The art and practice of conducting international relations An “instrument that international actors use to implement their foreign policy”
Source: Feldbaum, H., Lee, K., & Michaud, J. (2010). Global health and foreign policy. Epidemiologic Reviews, 32, 82–92. http://doi.org/10.1093/epirev/mxq006 6
Health Diplomacy: A Working Definition
Diplomacy— The art and practice of conducting international relations An “instrument that international actors use to implement their foreign policy”
Health diplomacy— Dialogue, negotiation, conflict resolution, and communication on international
agreements on health
Source: Feldbaum, H., Lee, K., & Michaud, J. (2010). Global health and foreign policy. Epidemiologic Reviews, 32, 82–92. http://doi.org/10.1093/epirev/mxq006 7
Health Diplomacy: A Working Definition
Diplomacy— The art and practice of conducting international relations An “instrument that international actors use to implement their foreign policy”
Health diplomacy— Dialogue, negotiation, conflict resolution, and communication on international
agreements on health 1. Efforts to promote the role of global health in foreign policy 2. Use of health interventions to promote foreign policy objectives
Source: Feldbaum, H., Lee, K., & Michaud, J. (2010). Global health and foreign policy. Epidemiologic Reviews, 32, 82–92. http://doi.org/10.1093/epirev/mxq006 8
Global Health Diplomacy and Foreign Policy
Shared health diplomacy and foreign policy objectives: Advancement of human rights Promotion of good governance Prevention of violent conflict Regional cooperation Conflict resolution
Additional foreign policy objectives: Security Economic gain
Different starting points: Global health starts from underlying concern for health equity and justice
• All people have an equal opportunity to realize their health potential Foreign policy is concerned with the “enlightened self-interest” of nation-states
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Links and Tensions Between Health and Foreign Policy
Dimension Role for diplomacy in international health
Risks
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Links and Tensions Between Health and Foreign Policy
Dimension Role for diplomacy in international health
Risks
Security Need to prevent destabilizing health events (e.g., epidemics)
Priorities of wealthy nations over low- and middle-income countries; can be polarizing through military’s role
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Links and Tensions Between Health and Foreign Policy
Dimension Role for diplomacy in international health
Risks
Security Need to prevent destabilizing health events (e.g., epidemics)
Priorities of wealthy nations over low- and middle-income countries; can be polarizing through military’s role
Trade Trade regimes designed to lead to innovation and growth
Can benefit rich rather than poor and inhibit access to life-saving technologies
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Links and Tensions Between Health and Foreign Policy
Dimension Role for diplomacy in international health
Risks
Security Need to prevent destabilizing health events (e.g., epidemics)
Priorities of wealthy nations over low- and middle-income countries; can be polarizing through military’s role
Trade Trade regimes designed to lead to innovation and growth
Can benefit rich rather than poor and inhibit access to life-saving technologies
Global public goods
Promote goods that benefit all and do not diminish in use (e.g., pandemic prevention)
Often difficult to support/enforce rules associated with global public goods
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Links and Tensions Between Health and Foreign Policy
Dimension Role for diplomacy in international health
Risks
Security Need to prevent destabilizing health events (e.g., epidemics)
Priorities of wealthy nations over low- and middle-income countries; can be polarizing through military’s role
Trade Trade regimes designed to lead to innovation and growth
Can benefit rich rather than poor and inhibit access to life-saving technologies
Global public goods
Promote goods that benefit all and do not diminish in use (e.g., pandemic prevention)
Often difficult to support/enforce rules associated with global public goods
Human rights Health as a fundamental human right Soft law—difficult to enforce
Ethics Underpins arguments for health equity Moral arguments often neglected
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The material in this video is subject to the copyright of the owners of the material and is being provided for educational purposes under rules of fair use for registered students in this course only. No additional copies of the copyrighted work may be made or distributed.
Tools of Global Governance
Section B
An Example: Sharing Samples of H5N1
Source: Walsh, B. (May 10, 2007). Indonesia’s bird flu showdown. Time. Available at: http://content.time.com/time/health/article/0,85 99,1619229,00.html. Accessed June 23, 2015. 2
The H5N1 Story and Indonesia
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The H5N1 Story and Indonesia
Between 2005 and 2007, the “Bird Flu” H5N1 outbreak spread from 17 to 60 countries
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The H5N1 Story and Indonesia
Between 2005 and 2007, the “Bird Flu” H5N1 outbreak spread from 17 to 60 countries
Most human cases and clusters of human-to-human transmission took place in Indonesia
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The H5N1 Story and Indonesia
Between 2005 and 2007, the “Bird Flu” H5N1 outbreak spread from 17 to 60 countries
Most human cases and clusters of human-to-human transmission took place in Indonesia
For much of 2007, Indonesian officials refused to share samples of H5N1 with WHO This had major implications for the ability of vaccine manufacturers to produce
effective vaccines
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The H5N1 Story and Indonesia
Between 2005 and 2007, the “Bird Flu” H5N1 outbreak spread from 17 to 60 countries
Most human cases and clusters of human-to-human transmission took place in Indonesia
For much of 2007, Indonesian officials refused to share samples of H5N1 with WHO This had major implications for the ability of vaccine manufacturers to produce
effective vaccines
Of the 250 to 300 million flu vaccine doses produced annually, the large majority go to high-income countries, and capacity to scale up production is limited
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The H5N1 Story and Indonesia
Between 2005 and 2007, the “Bird Flu” H5N1 outbreak spread from 17 to 60 countries
Most human cases and clusters of human-to-human transmission took place in Indonesia
For much of 2007, Indonesian officials refused to share samples of H5N1 with WHO This had major implications for the ability of vaccine manufacturers to produce
effective vaccines
Of the 250 to 300 million flu vaccine doses produced annually, the large majority go to high-income countries, and capacity to scale up production is limited
Explaining the refusal to share samples, the Indonesian minister of health said, “We feel let down by the WHO. We only demand fairness.”
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Which Aspects of Global Diplomacy Does This Case Illustrate?
Principle Applied to H5N1
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Which Aspects of Global Diplomacy Does This Case Illustrate?
Principle Applied to H5N1
Security High-income countries saw H5N1 as a security risk that affected them directly, though it was concentrated in southeast Asia. This put it high on their agendas.
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Which Aspects of Global Diplomacy Does This Case Illustrate?
Principle Applied to H5N1
Security High-income countries saw H5N1 as a security risk that affected them directly, though it was concentrated in southeast Asia. This put it high on their agendas.
Trade The Indonesian Minister’s primary concern was that there was nothing in trade laws that would ensure that his country’s population benefitted from H5N1 vaccines. Without global intervention, private for-profit pharmaceutical firms will sell vaccines to whoever can pay most.
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Which Aspects of Global Diplomacy Does This Case Illustrate?
Principle Applied to H5N1
Security High-income countries saw H5N1 as a security risk that affected them directly, though it was concentrated in southeast Asia. This put it high on their agendas.
Trade The Indonesian Minister’s primary concern was that there was nothing in trade laws that would ensure that his country’s population benefitted from H5N1 vaccines. Without global intervention, private for-profit pharmaceutical firms will sell vaccines to whoever can pay most.
Global public goods
Knowledge of H5N1 was a global public good, but the vaccine based on it was not; it was a private good going only to those who could afford it.
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Which Aspects of Global Diplomacy Does This Case Illustrate?
Principle Applied to H5N1
Security High-income countries saw H5N1 as a security risk that affected them directly, though it was concentrated in southeast Asia. This put it high on their agendas.
Trade The Indonesian Minister’s primary concern was that there was nothing in trade laws that would ensure that his country’s population benefitted from H5N1 vaccines. Without global intervention, private for-profit pharmaceutical firms will sell vaccines to whoever can pay most.
Global public goods
Knowledge of H5N1 was a global public good, but the vaccine based on it was not; it was a private good going only to those who could afford it.
Human rights Health as a fundamental human right could be interpreted as requiring distribution of the vaccine to those in need.
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Which Aspects of Global Diplomacy Does This Case Illustrate?
Principle Applied to H5N1
Security High-income countries saw H5N1 as a security risk that affected them directly, though it was concentrated in southeast Asia. This put it high on their agendas.
Trade The Indonesian Minister’s primary concern was that there was nothing in trade laws that would ensure that his country’s population benefitted from H5N1 vaccines. Without global intervention, private for-profit pharmaceutical firms will sell vaccines to whoever can pay most.
Global public goods
Knowledge of H5N1 was a global public good, but the vaccine based on it was not; it was a private good going only to those who could afford it.
Human rights Health as a fundamental human right could be interpreted as requiring distribution of the vaccine to those in need.
Ethics Ethical perspectives, particularly principles of beneficence or equity, suggest that those most in need should have access.
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Tools of Global Governance
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Tools of Global Governance
Category Definition Examples
Hard laws
Soft rules
Codes of conduct
Private actions
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Tools of Global Governance
Category Definition Examples
Hard laws
International treaties, formal agreements under international law, entered into by international actors (e.g., states and international organizations)
Framework Convention on tobacco control, International Health Regulations
Soft rules
Codes of conduct
Private actions
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Tools of Global Governance
Category Definition Examples
Hard laws
International treaties, formal agreements under international law, entered into by international actors (e.g., states and international organizations)
Framework Convention on tobacco control, International Health Regulations
Soft rules Formal agreements by international actors, not legally binding, constitute obligations
Millennium Development Goals, Abuja Declaration
Codes of conduct
Private actions
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Tools of Global Governance
Category Definition Examples
Hard laws
International treaties, formal agreements under international law, entered into by international actors (e.g., states and international organizations)
Framework Convention on tobacco control, International Health Regulations
Soft rules Formal agreements by international actors, not legally binding, constitute obligations
Millennium Development Goals, Abuja Declaration
Codes of conduct
Self-regulation entered into by states and nonstate actors
Commonwealth code of practice on international recruitment of health professionals
Private actions
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Tools of Global Governance
Category Definition Examples
Hard laws
International treaties, formal agreements under international law, entered into by international actors (e.g., states and international organizations)
Framework Convention on tobacco control, International Health Regulations
Soft rules Formal agreements by international actors, not legally binding, constitute obligations
Millennium Development Goals, Abuja Declaration
Codes of conduct
Self-regulation entered into by states and nonstate actors
Commonwealth code of practice on international recruitment of health professionals
Private actions
Actions by private actors that have international influence due to market power/position
Research funder rules on open-access data and publishing, UK Stem cell bank
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Concluding Thoughts: Global Health Diplomacy and Foreign Policy
Observations: National foreign policy typically gives precedence to security and economic (trade)
self-interest (“high politics / hard power”) • This gives advantage to existing political, military, and economic powers • National security tends to trump individual security
Global health’s strongest contributions are in global public goods, investment in development, protection of human rights, and moral reasoning (“low politics / soft-smart power”)
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Strengthening Global Health Diplomacy
Recognize linkages between interventions in health and foreign policy
Make diplomatic and foreign policy criteria explicit in health program design and assessment
Focus on improving development and health outcomes in health programs, particularly to promote equity
Promote cooperation and shared responsibility in decision making
Promote global public goods, moral and human rights arguments
Identify and try to influence inconsistencies between foreign policy and global health goals
Influence “high-power” politics in favor of health outcomes
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Lecture Evaluation
Your feedback is very important and will be used for future revisions. The Evaluation link is available on the lecture page.
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