Background
 Global
health diplomacy may be defined as a political change activity that meets the
dual goals of improving global health and maintaining and improving
international
relations abroad, particularly in conflict areas and resource-poor environments.
(Link to background paper.) Health diplomacy
training is needed to support the altruistic motivations of today’s
health-sciences students, residents, scientists, and faculty and to prepare
leaders in global health for the twenty-first
century.
Although
there are historical precedents for health diplomacy (examples are found
in early
missionary work, colonial and post-colonial development aid, various private-public
partnerships, and now the new global health philanthropies), we believe that
the imperatives of globalization, global conflict, and domestic security
call for further development of global health diplomacy as
an academic discipline for our times.
Health diplomacy begins with a recognition that the most effective international
health interventions are carried out ethically and with sensitivity to historical,
political, social, economic, and cultural differences. Health diplomacy focuses
on the interplay of health assistance, economic inequities, and the enlightened
self-interest of nations. While encompassing much of the social science, humanities,
political science, and international relations disciplines, health diplomacy
requires new, interdisciplinary, pedagogical approaches. Tomorrow’s health
professionals must grapple with the emergent problems of global health and
with the challenges of diplomacy in an increasingly complex world. We believe
that physicians, pharmacists, nurses, dentists, and researchers need to have
skills to understand and deal with globalization, multilateralism, resource
inequality, health disparities, and post-conflict health crises in order to
help assure global peace and economic stability. These skills are not taught
in standard health sciences curricula, but they bear directly on the success
of global scientific cooperation and foreign direct assistance. New opportunities
abound for global health cooperation through philanthropy, private sector collaboration,
and revitalized multilateral organizations.
In addition, global health diplomacy relates directly to national security
and sovereignty through good foreign service practices as well as through cooperative
approaches to transborder health problems. Recent outbreaks of SARS, avian
flu, and the threat of bioterrorism have galvanized interest and demand for
training in health diplomacy. The globalization of biomedical research and
the need to translate this research into cost-effective health interventions
for poor populations also demands attention to approaches that are ethically,
politically, and culturally sensitive to a multitude of inputs. We feel that
health diplomacy can be a critical pathway to assure good global governance
and sensible international relations both among the great powers and between
these powers and the developing world. Health diplomacy can be a mechanism
to avert
conflict and to augment peace, altruism, economic progress, and international
cooperation.
As government and non-governmental funding and investment expand in global
health, the need for leadership, appropriate program development, culturally
and ethically sound practices, and career development is clear. Health diplomacy
cannot be left to chance training. To this end, IGCC and UC San Francisco
Global Health Sciences (GHS) have begun a three-step
project aimed at development of training
activities across the health disciplines. The project is led by Dr. Thomas
E. Novotny, UC San Francisco; Vincanne
Adams, UC San Francisco; and IGCC Director Susan
Shirk. Funding for
project activities has been provided by UC San Francisco Global Health Sciences
(GHS), the UC
Institute on Global Conflict and Cooperation,
the U.S. Centers for
Disease Control and
Prevention (CDC), and the UC Office of the President.
Step One: An Agenda-Setting Workshop
 |
| UC
San Diego Chancellor Marye Anne Fox and Haile Debas of UC San Francisco's
Global Health Sciences. |
Health diplomacy is a “field in the making.” In their first
activity, planners held a workshop to define core topics,
develop priorities for training the next generation
of health professionals,
and examine pedagogical models, such as those presented
to the Institute of Medicine for its Healers Abroad project.
The March 2007 workshop provided an opportunity for global health experts
from epidemiology, the medical sciences, NGOs and aid agencies, and social
scientists
to present their ideas about health diplomacy in an open environment. Selected
participants prepared short presentations focusing
on three themes: knowledge, service, and pedagogy. Participants then met in
breakout groups to discuss, critique, and respond to the issues raised. A position
paper based on the meeting's conclusions is underway.
Step Two: A Global Health Council PanelThe workshop's findings will be presented during the Global Health Council
annual meeting in Washington, D.C., in June 2007. A
panel
of
experts
will
present the group's findings on global health diplomacy to an audience
including, among others, representatives from the Department of Health and
Human Services, the Department
of State, the United States Agency for International Development (USAID), and
Congressional staff offices with equity in international relations. The
model for teaching global health diplomacy also be rolled out. In addition,
a pilot training program, designed to teach emerging leaders and practitioners
about
implementing
global health in the field, will be announced.
Step Three: Model Summer Training Program
In Summer 2008, project organizers
will launch a pilot Training Program
in Global Health Diplomacy. The three-week residential intensive
program will cover
a broad
range of issues, including international relations, cultural anthropology,
history, international organizations, program planning and evaluation, and
related fields. The target participants for this interdisciplinary program
will be early-career professionals in both medical and social science/public
policy fields, as well as more senior professionals who are readying themselves
for careers in Global Health. Such training might eventually extend beyond academia
to government, for example within the Foreign Service Institute, the CDC’s
Epidemic Intelligence Service, and the NIH Fogarty-Ellison Fellowship program.
This project will bring government and non-government leaders and practitioners
together to launch a new multi-disciplinary health discipline.
Sustaining the Vision
A longer-term follow-up for implementing the proposed training program in
global health diplomacy might include development of one or more Centers of
Excellence
in Global Health
Diplomacy, where research, curriculum development, leadership training,
and evaluation projects could be integrated. A model for this might
be the CDC-sponsored
Prevention Centers programs at schools of public health.
Another model
might be a foundation-supported Center for Health Diplomacy at the
University of California with a coordinating
function for other training and grant-making activities, much like the
Robert Wood Johnson programs in tobacco control and clinical scholar
training.
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