Global Health Policy and Diplomacy

The world currently faces a plethora of challenges that transcend national borders: economic upheaval, the spread of emerging pathogens like H1N1 influenza, the increasing global migration of people and goods, climate change, and the ever-widening gap between wealthy and vulnerable populations. Each of these impacts human health, and the speakers in this session each started with the premise that it is time to draw on the art of diplomacy to build coalitions to address these issues.

Sara Curran introduced the session by asking the question “Why do we need health diplomacy?” She was followed by Kelly Lee, from the London School of Hygiene and Tropical Medicine, who offered a historical perspective on the art of diplomacy and the emergency of what she calls “New Diplomacy.” She argues that there is a shift in the actors, agendas, and technologies in modern diplomacy, and a rise in the influence of human rights and social justice. “Maybe in the future,” she reflects, “ “Might makes Right’ will be replaced with ‘Right makes Might.’ ” She hopes that through the framework of global health diplomacy, people working in separate disciplines can start to work together in harmony.

Peter Lamptey, from Family Health International, added to the discussion with his arguments for why global health is in America’s interest. In addition to providing economic opportunities and promoting U.S. leadership and values broad, he stated that a global health framework is important to protect people from issues such as food safety, counterfeit pharmaceuticals, and biological terrorism that transcend national boundaries. He points out the successes that have already occurred as a result of U.S. funding of global health, but admits that there are many challenges ahead, including shrinking economic resources, the need for improved coordination and agenda-setting, and the need to better match funding to better reflect the global burden of disease. 

A representative spoke on behalf of Margaret Hamburg on the role that the FDA plays in the global sphere. In its vast mandate to oversee all imported food, drugs, cosmetics, and medical devices to the U.S., she feels that the FDA is able to help promote stronger international collaborations, scientific partnerships, and regulatory networks.

Lawrence Gostin pointed out the problems of the current donor-led approach to global health.  He feels that it undermines states’ responsibilities for the health of their own people, replacing national policy with a dizzying array of separate, uncoordinated, donor-led programs. “You may think that your own program has been a success,” he says, “but when you talk to health ministers in low income countries, you find out that they are in despair, because they are unable to know what is going on in their own country.” He proposes turning the traditional approach to global health on its head, and to begin by asking “What does each state owe to its own citizens?” He discussed the Joint Learning Initiative on National and Global Responsibilities, which calls for a bottom-up approach to global health led by the global South.

Prepared by David Roesel

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