Amir Mohammad Sayem
Of course, global health diplomacy, which involves political negotiations, diplomatic efforts and solutions with the incorporation of health and foreign affairs, is very important for improving health conditions in the world. It is more important especially for tackling health threats that cross national boundaries. Certainly, diverse communicable and non-communicable diseases including the ongoing COVID-19 pandemic need more reflection of global health diplomacy for securing medicines including vaccines. In addition, it can be effective in sharing health knowledge, technology and medical equipment needed to face diverse health threats across countries. Not only less developed and developing countries but also developed ones are benefited from such diplomacy. Consequently, its significance has been increasing in recent years, especially for the last decade.
Global health diplomacy usually involves multilevel processes and diverse actors: governments, foreign ministries, health ministries, international governmental and non-governmental organizations, public health professionals and others. Obviously, such diplomacy mainly takes the form of government to government diplomacy, but global institutions — both intergovernmental and non-governmental organizations —such as the United Nations, the world health organization or health-related INGOs bring controversial state and non-state actors that engage in harmful acts, businesses, or products into the diplomatic process. Moreover, such diplomacy —that can be formal and informal — is usually comprised of health attaché, diplomatic goals related to health and diplomatic activities for improving health situations across countries involving several disciplinary approaches such as public health, management, law, economics, trade policy, environmental policy and international affairs.
But an important question remains on whether global health diplomacy is effective as desired. If effective, then how much effective is it? To me, its effectiveness is obviously not as much as is desired. The failure of global health diplomacy has been clearly visible in the earlier pandemic in 2008. Even though some governments and non-government organizations made efforts to secure vaccinations to all across affected countries, such diplomacy failed, since these are sold based on the advanced payment made by rich countries. At this time too, many countries including some developed countries, intergovernmental organizations and non-government organizations attempted to make the intellectual property rights or production license easier so that other countries can go for mass production and to provide vaccines to less developed countries as quickly as possible. But vaccines are being produced by only a few countries and, consequently, it is taking more time to provide vaccines across counties.
What are, then, the reasons for less ineffectiveness of such diplomacy? There are obviously varied reasons that can be rendered from several viewpoints: less emphasis on global health diplomacy, lack of a strong global health diplomacy platform, extreme nationalist stance and an unacceptable capitalist version. Ideally, every country should have a health attaché in its foreign mission, but only a small number of countries have this indicating that states do not spend deserved time discussing bilateral efforts to curb the incidence of diseases. Health is not rendered as a crucial aspect of diplomatic affairs because countries provide much emphasis on hard power issues — economic, military war, trade and peace — that are traditionally considered crucial foreign policy goals, though health is an important part of everyone’s life. Consequently, most countries including developed ones that are more developed in medical sciences and pharmaceutical industries are less willing to put significant emphasis on global health issues unless affected.
Of course, the extreme nationalist viewpoint is another important cause for the ineffectiveness of global health diplomacy. To me, nationalism is not unacceptable since it is the responsibility of states to save the lives of people of their own. But when it turns to be at an extreme level, it creates trouble. Undeniably, the extreme nationalist stance was clearly visible in the producing and distributing of vaccines for Ebola virus disease and again in the current pandemic. Given that every country turns to be extremely nationalist, will it not be difficult for all countries including the developed ones to keep safe from health threats and improve global situations? This can obviously be the case, especially in the globalized world, in which transmission spreads quickly and every country somehow depends on some other countries for its own wellbeing.
Moreover, there is a lack of an effective global health diplomacy platform. On some occasions, some developed countries arrange meetings for tackling diseases especially pandemic-like threats. On some other occasions, different organizations including the WHO make efforts to diplomatically deal with countries for making efforts to tackle global health threats. Still, on some other occasions, some non-government organizations carry out diplomatic efforts to improve global health without any strong global or regional alliance. For example, the GAVI (Global Alliance for Vaccines and Immunizations) made some efforts to making COVID-19 vaccines as free as possible and providing vaccines to different countries as early as possible. But, undeniably, these efforts are haphazard from the diplomatic viewpoint since there is no globally acceptable —or the one that can effectively deal through diplomacy with some binding responses from states — platform across countries for successfully making such diplomacy.
Of course, capitalism, which is another important cause of repeated failure in effective global health diplomacy, is not bad altogether. In fact, earning profit is needed for the survival of business organizations including the big ones and capitalism supports innovations and contributes to development. But how much profit-making is acceptable when global health is at serious risk? As it is well-known, some renowned pharmaceutical companies that developed Covid-19 vaccines and are producing were less willing to make intellectual property rights easier, even though there were enormous diplomatic efforts for it to make sure that people across countries get vaccines earlier. More importantly, such a stance was directly and/or indirectly supported by several countries that have a diehard alignment to the extreme version of capitalism.
Much more efforts are, thus, needed for making global health diplomacy effective through making increased linkages with a wide range of actors for not only tackling pandemics and epidemics —that may be turned into pandemics —but also dealing with other health threats and improving global health conditions from a broader viewpoint. For this, the development of a stronger global health diplomacy platform is important. Of course, the WHO as a crucial intergovernmental organization of health or a new intergovernmental organization can be made an effective platform. Additionally, non-government organizations can make a stronger platform capable of pursuing pharmaceutical giants and their supportive countries to help tackle pandemics with global efforts in a genuine sense and make related licenses relaxed especially in the case of pandemic and should make sure that different products, environmental acts and laws do not put hindrances to global health.
Obviously, the roles of the developed and powerful countries are very important. Developed countries should look beyond traditional foreign policy goals, keep other needs including health needs as an important foreign policy goal, avoid making health issues geopolitical ones and play responsible roles for making global health diplomacy as institutionalized and effective as possible. But each country has the responsibility to make health-friendly laws and policies. Moreover, every country has the responsibility to prevent —and save its people from —health threats. For this, there is no alternative to strengthening health diplomacy with the appointment of health attaché to foreign missions and strengthening connections across countries regarding health threats of various sorts —epidemic, pandemic and other diseases.
