Health in Diplomacy and Foreign Policy

Abstract

Conventionally, diplomacy has been known as the practice of power relations among independent states. From this conception, interstate relationships pursued by foreign ministries have been dominated by political and strategic interests, at the expense of social development, often farfetched from the routine concerns of the traditional diplomat. Because of this, health as a ‘standalone’ subject has tended to be peripheric as a foreign policy objective.

In this chapter, I review the emergence of contemporary health diplomacy with the end of the Cold War, the demise of the Soviet Union, and the rise of a unipolar world around the USA in terms of strategic, economic, and political power. This new order led to the emergence of a liberal political ideology that advocated state deregulation, an open society, civil rights and liberties, political freedoms, human rights, and liberal internationalism. Liberal internationalism advanced the frontiers of multilateral diplomacy by encouraging the participation of civil society actors, who became the principal proponents of social development leading to renewed importance of global health and international health. The proof of this is seen in the increased effervescence seen in the number and diversity of publications (books, journal articles) in global and international health in the past three decades.

Health has been conceptualised in foreign policy in three ways namely: regression, remediation, or revolution. As a regression, health is considered a security issue and prevails over public health rules and principles. As remediation, health issues are addressed through the conduits or hierarchies of conventional diplomacy and foreign policy but with no special role in international relations. In revolution, health is positioned as a right, goal, and shared global responsibility with a profound transformative role in diplomacy and foreign policy. The revolutionary perspective positions health as a global human right.

The African Union has also positioned health cooperation as an essential component of security, trade, and prosperity on the continent. To achieve intra-African health cooperation, the AU has created specialised departments and agencies and encouraged the formation of regional groupings to foster health cooperation for African populations. Notwithstanding the lack of political will and financing from many African countries remains the main obstacle to intra-African health diplomacy.