Foreign policy and global health: A genuine couple

The expression is rather off-putting but it looks like it’s here to stay. It certainly has clarity on its side: “the health lens of foreign policy”. The two terms of the paradigm are closely interconnected and a growing number of international institutions have acquired the expertise and legal instruments needed to focus on the impact of diplomatic initiatives on world health and vice versa.

A key legal instrument is Resolution 63/33 of the United Nations General Assembly, adopted in November 2008 when the global financial bubble burst, which took the view that “foreign policy and global health are closely linked and inter-dependent”. Reflection on the subject has brought taxonomic, terminological and conceptual changes to two worlds destined to communicate to an increasing extent, those of health and diplomacy, two worlds that did not in any way share the same philosophical approach. 

Foreign policy had always been involved in the field of health, but for a long time it was not perceived as such. Three of the eight Millennium Development Goals (MDGs) relate to health. The alarm was sounded by a succession of serious global crises - oil, food, financial and climatic – which resulted in many countries neglecting health when making their budgetary choices.  

Impact of health on foreign policy

The health issues that emerged during the last two decades of the 20th century – AIDs, the threat of biological terrorism, risk of new viruses – could only be resolved through a diplomatic approach. 

Only diplomacy, at the UN, in the respective G8 and G20 groups of nations, as well as via legal instruments such as the Paris Declaration on aid efficiency, could force states to support the three health MDGs. There were also agreements on access to medicines, especially for the most poverty-stricken, the sharing of information on viruses and access to vaccines, in particular for avian flu A (H5N1). Diplomats were already speaking of the notion of global health governance. 

Diplomatic challenges for global health

These are problems beyond health that pose risks to global health, hence the need for diplomats to acquire the health lens and to seek coherence between the two poles. Increasingly, the World Health Organisation and national institutions are regarding the right to health as a human right. Many problems that, in theory, relate to a country’s security can have an impact on local or global health. Examples are armed conflicts, the management of natural disasters, the global economic and financial crisis, climate change, food insecurity and migration. We know how the latter can facilitate the circulation of pathogenic agents but one of the most detestable effects is the deterioration in the social determinants of health when, for example, it robs a country of its qualified personnel trained at such cost, especially in the field of medicine.

Hegel Goutier