The Way Forward in Global Health Diplomacy: Definitions, Research, and Training

Global Health Diplomacy, ‘Smart Power’, and the New World Order

“…2013, AMFAR, 2013; and decreasing opportunities for opponents with destructive agendas (Jaffe, 2013) 2 Nation-building and peace-keeping initiatives: Contributions to nation-building (Kevany et al, 2012a) and peace-keeping processes (Eldon, Waddington, & Hadi, 2008;Kevany, 2012), including resolution of conflict (Novotny & Adams, 2007); regional stability (Feldbaum, 2010); integration of peace-building concerns into global health programmes (Novotny & Adams, 2007;Macrae, 1997;Kickbusch & Buss, 2011); and advancing democratisation in the developing world (AMFAR, 2013) 3 Strategic alignment: Harmonisation between bilateral and multilateral global health and foreign policies (CSIS, 2007;Feldbaum, 2010) and inculcation of strategic awareness of relationships between global health and foreign policy goals (CSIS, 2010), including recognition of the capacity of global health programmes to advance or obstruct international relations objectives (Katz et al, 2011) 4 'High-profile' conditions: Responding to health needs that may have significant implications for donor security, health or economic well-being (CSIS, 2010;Feldbaum, 2010), including transnational epidemic diseases such as HIV/AIDS, tuberculosis and malaria (Michaud & Kates, 2013) 5 Human rights: Alignment between global health service delivery and the defence and advancement of human rights, including the abolition of slavery, freedom from tyranny, and access to health services, thereby contributing to the advancement of human dignity, both within and beyond health (WHO, 2012) 6 Accessing strategic markets and resources: Optimising the extent to which global health programmes assist, in a manner that is fair and transparent to recipients, in gaining access to strategic resources or markets (Feldbaum, 2010), including commodity resources from lowand middle-income countries (AMFAR, 2013;Novotny & Kevany, 2013), which, in turn, generate economic gains for both donors and recipients (Jaffe, 2013) 7 Inclusiveness: Leveraging global health programmes to unite opposing political factions, promoting reconciliation and peace (Rubenstein, 2013), including negotiation, mediation and 'public health persuasion' initiatives, through integration of former adversaries within the same health service (Kickbusch, 2012) regardless of affiliation (Rubenstein, 2013) 8 Prestige: Leveraging global health programmes to re...…”

“…This vision has drawn heightened attention to innovative roles for global health programmes in achieving security, defence and conflict prevention or resolution goals (Birdsall, 2013;Feldbaum, 2010;Michaud & Kates, 2013), with particular reference to the selection, design and delivery of appropriate interventions for (1) military stability operations and (2) 'partnership engagement' (Michaud, Moss, & Kates, 2012). Recognition of associated 'peace and stability' dividends (Brainard, 2006;Novotny & Kevany, 2013) through appropriate adaptations to programme design, selection and delivery considerations have, in turn, inculcated an awareness that the transcendent goals of both foreign assistance and foreign policy include the pursuit of international cooperation, conflict resolution and peace-keeping (Kickbusch & Buss, 2011).…”

“…There is, however, a 'lack of ability' to demonstrate effectiveness in this context, particularly in the absence of related programme assessment criteria (Bonventre, 2008), which would help to ensure that global health programmes attain even the minimum acceptable standards required in the diplomatic or foreign policy spheres. Policymakers have, therefore, called for a system of assessment that reflects these broader considerations (Royal Institute for International Affairs, 2010) both (1) in order to portray international development and foreign assistance expenditures as 'return-producing investments' (Jaffe, 2013) rather than costs; (2) to 'speak a language that people with power really understand' (Nye, 2004); while also (3) taking into account the realpolitik of a broader range of international affairs (Novotny & Kevany, 2013). Without the articulation of these benefits, global health programmes run the risk of being viewed as 'misplaced priorities' (Transcript of House Foreign Affairs Committee, 2011).…”

“…In turn, the establishment of (1) a 'taxonomy' for the integration of diplomatic and foreign policy values into global health (Katz et al, 2011), (2) 'diplomatically-sensitised' quantitative and qualitative outcome measures (Royal Institute for International Affairs, 2010) and (3) systems of measurement for global health programme impact on non-health outcomes and values (CSIS, 2011) have been called for. Current research questions around the coherence, effectiveness and legitimacy of global health diplomacy (Kickbusch & Buss, 2011) therefore include (1) how current and potential, explicit and implicit, national and international benefits of foreign assistance may more meaningfully serve foreign policy objectives when 'diplomatically-sensitised'; (2) how policymakers can determine if global health programmes are diplomatically effective (or harmful), contributing to or hindering foreign policy goals and (3) how to recognise, quantify and reward the value of these contributions (Novotny & Kevany, 2013).…”

James Bond and Global Health Diplomacy

“…Rather than advocating for greater delineation on this basis, fields such as GHD, under certain interpretations, 28 attempt to resolve these tensions by encouraging, leveraging and making explicit such overlaps from the "smart power" perspective, employing altruistic operations to pursue broader non-health goals including international security. 24 GHD can therefore be leveraged to pursue global "goods" unrelated to health programs -a benign force, as long as it is not manipulated into pursuing global "bads" via rapacious foreign policiesand, even then, remains a better route than violent conflict.…”