[MUSIC] We will be speaking at this point about global health diplomacy, an area of global health that is becoming more and more important. Of course, one can only understand global health diplomacy if one understands the relationship between health and foreign policy. Because diplomacy basically implements the strategic orientations and guidance from the foreign policy of a country. We see global health diplomacy as being one of the expressions of what is sometimes called the new diplomacy. Because we see that diplomacy and foreign policy are taking up new areas of concern. For example, the environment, the financial infrastructure, or as is important for us, health. So we've tried to define what are different types of relationship between health and foreign policy, and we are suggesting there are four such relationships, even though they cannot be differentiated very tightly. They sort of flow into each other, and it depends on the context and the timing, how one also interprets some of these relationships. Obviously foreign policy can be harmful to health, if it is not supportive of health matters. Think of negotiations around trade or intellectual property when countries think trade is more important than health. On the other hand health, can be instrumental for foreign policy. That means in order to achieve a foreign policy goal, you use health. For example, you want to have friendship with a certain country or you want their support in a certain political issue at the United Nations. So you might support them by financing a health project, building a hospital, working together with them to eradicate a disease. Some people see that the instrumental use of health in foreign policy to be a negative thing. We find that actually using health to build better relationships between countries can also be a very supportive enterprise. And we see that particularly the middle income countries and the so-called BRICS countries, the emerging economies, are using that soft power and that South-South Cooperation approach more and more. We also see that health has become an integral part of foreign policy. Think of security policy, countries more and more need to protect themselves against viruses that now travel very quickly around the world. They also see that in a number of areas that are important to them, like the economy, the health economy is one of the largest businesses worldwide. They see health as an integral part of their strategic intent. And finally, and I'll come back to that because that is the new paradigm of health and foreign policy, foreign policy actually serves health interests very consciously, so that one of the purposes of foreign policy is to also promote health. Now we can only think of those new relationships between health and foreign policy because foreign policy itself has changed. And we see that more and more, foreign policy is not just about having relationship with other states, but it is also about working together globally. So the differentiation between here is us and our interests, and here is them and their interests, Is not always easily defined. And actually, we see when we talk about global public goods for health, there are issues that are of the same importance to all countries, and therefore they are not domestic or foreign. They're actually global, and as you can see on this slide, they bring together the global, the domestic and the foreign. Another reason why health diplomacy is becoming so much more important is because health is more important in the global arena and in foreign policy. I've already mentioned the health economy is very important. It's very large, $6.5 trillion US dollars. That is the size of the global health economy. I've mentioned that it's important geopolitically to build alliances between countries. There is a security agenda, but also there's a very strong social justice agenda internationally, a human rights agenda that particularly civil society pushes. And there is a survival agenda. We have many fragile states, and in that context, health is very, very important also as a foreign policy issue. So because of that, we see that health is becoming more important, and that it's also becoming a part of other negotiations, like in terms of negotiating climate change, of negotiating food security, water security. All those have a health dimension, because to some extent they are determinants of health. Now global health diplomacy is not totally new. It's actually one of the areas of global and international action that is quite old. It started in the Middle Ages with quarantine, where many of the economic powers of the day, like Venice, tried to make sure that infections did not enter their cities. But when it really, really started was in the mid 19th Century with the sanitary conventions, again pushed by trade issues because many of the sea faring nations did not want health issues to interfere with trade issues. Health then became part of the League of Nations when that was created. And, big historical step in 1948, the global organization for health was created, the World Health Organization. There are other precedents in health diplomacy. One is medical diplomacy. Many of the socialist countries, when the world was still bipolar, used medicine to create better relationships between their countries. And particularly China and Cuba are well known for the fact that they have sent thousands of doctors abroad to help other countries, and have also welcomed students from other countries to study health and medicine. This is continuing and is actually an issue that's now being taken up by other countries as well. Another precedent is vaccination diplomacy. For many decades, particularly in Latin America, health has been used, vaccination has been used, to actually build a bridge for peace. And in some cases, particularly in the context of civil strife, weapons were laid down for a couple of days to enable the World Health Organization or the Pan-American Health Organization to vaccinate children. And finally, as I've mentioned, health has been seen by many of the big donor countries, by many of the world powers, as an instrument. An instrument as, and here is a quote from a former secretary of health at the United States. A means of winning hearts and minds, of strategically helping countries through medicine. But now there's a new paradigm. There's a new paradigm of the interaction between global health and foreign policy. It's came in 2006, 2007, with the Oslo Ministerial Declaration, where seven countries, developed countries, developing countries, and middle income countries came together and said, health must be a goal of foreign policy. Now that we have a globalized world, we need to work together for health. Not just in the health sector, but also as foreign ministries, as ministries of development. And that has been taken up also by countries who were not part of this initiative. Like here is a quote from the then US Secretary of State Hillary Clinton who says clearly that maternal health, immunization, the fight against HIV AIDS, all of those are part of foreign policy. And that is part of enlightened self-interest to invest in the health of other countries. So today, we have the role of a diplomat in duel responsibility, to work for their own country and for the global community. And that comes together with the role of health policy. A minister for health must have an interest in the health of his or her own country and in the health of the global community. And that's where health and diplomacy come together. Now, if we talk about health diplomacy, it's not only diplomats who do health diplomacy. There are many, many actors who are involved in lobbying and negotiating, in advocating, and you can see many of them here, in this picture. Civil society, strong individuals, then of course the established organizations, nation states. So there is a multitude of health diplomats. Some people say today everybody is a health diplomat. So, if we look at global health diplomacy, what does it do? It follows the changes in diplomacy. It manages globalization. It manages global change, and global crisis, and it manages relationship between the actors. And of course, especially, it is important for the negotiation of treaties and agreements that try to ensure global health. It works at three levels, at the multilateral level in international organizations, at the bilateral organizations, where countries negotiate with each other. And as I have indicated, in crises and humanitarian situations. What are the outcome goals of global health diplomacy? The goals are to have better health security and population for each and all countries. Remember, my health and the health of all others. An improved global health situation. An improved relationship between countries. And of course, that the outcomes of global health diplomacy contribute to equity. That they are fair outcomes and that they help reduce poverty. Like all diplomacy, global health diplomacy is a political process. Because if we negotiate for health equity and health as a human right, then we do so in the face of other interests. These can be economic interests. These can be trade interests. These can be political interests. And we have to be very aware of that when we negotiate. There are two very critical factors for global health diplomacy, which we always need to keep in mind. In health diplomacy, the role of science, the role of scientists, and the role of evidence is absolutely critical. Because many of the things we argue for when we want treaties, norms, or standards in the global health arena, we need to base them on evidence. And of course, in global health, we would always be keen to be firmly rooted in our value base of health equity and human rights. Finally, countries need to prepare well for global health diplomacy. You don't just fly in and negotiate. You have a lot of homework to do. And you need to have an infrastructure at home to prepare for global health diplomacy. We see that countries have health diplomacy departments in ministries of foreign affairs, that they have foreign affairs experts in ministries of health. Some countries have appointed global health ambassadors. They have health attachés in the representations in Geneva and in York. They have briefings for ambassadors so that the diplomats understand health better. There is much more interest in health in regional organizations, and in general. It has become absolutely critical and important to train people for global health diplomacy. So, probably if you get involved in global health, you will also get involved in global health diplomacy. And you, like all others, will also be a global health diplomat. [MUSIC]
