The ease in which billions of people travel makes public health a security issue as major health events require coordination beyond national borders.
By Vijay Kumar Chattu, University of Toronto
If COVID-19 has taught us anything, it’s that major health events require coordination beyond national borders.
The pandemic, and others that will follow, has changed our understanding of health.
Chronic non-communicable diseases (NCDs), emerging infectious diseases and bioterrorism, are now clearly understood as direct threats to security.The ease with which billions of people travel, along with the emerging global threat of climate change makes global public health security a priority issue — stronger partnerships between nations and coordination between domestic ministries more important than ever.
The pandemic exposed various weaknesses of global partnerships. Geopolitics, nationalism and national wealth status discrimination took the lead over multilateral cooperation.
But setting the global health agenda has often been politicised. Health has also commonly taken a backseat to economic relations and security discussions which are seen as more pressing in diplomatic meetings.
For example, in 2018 the Trump Administration opted to reduce the size of the National Security Council’s global health security directorate, and in 2020 it stopped funding the WHO, leaving the United States less prepared for COVID-19.
But the pandemic also became a touchstone for international actors to work together to avoid future crises.
Global health diplomacy is what links health and international relations to address health security. It was this diplomacy that delivered political commitments from many corners of the world to push for COVID-19 medicines and essentials, the development of new partnerships and initiatives, and the creation of COVAX — the global scheme to vaccinate people in lower-income countries — and ACT-Accelerator, dubbed “the fastest, most coordinated and successful global effort in history to develop tools to fight a disease”.
Another example of effective global health diplomacy is the 2007 Port of Spain Summit Declaration where 15 Caribbean states worked together to fight a region-wide burden. The summit was the first in the world where the heads of government focused on prevention and control of NCDs — diseases that are not directly transmissible such as Parkinson’s, heart diseases and strokes — and created a clear roadmap for localised policy implementation and collective action.
Global health diplomacy promotes peace, improves health and wellbeing and strengthens global leadership and international cooperation. Despite moves toward more bilateral deals, global coordination is necessary in fighting a pandemic, and was useful for negotiating Trade-Related Aspects of Intellectual Property Rights (TRIPS) for COVID-19 vaccines, promoting vaccine equity and strengthening bonds between nations.
It has also addressed other health challenges, for example in the formulation of International Health Regulations, the Framework Convention of Tobacco Control and Universal Health Coverage. The evolution of the Global Health Security Agenda, the United Nations Political Declaration on the Prevention and Control of NCDs, and the WHO Global Action Plan for the Prevention and Control of NCDs are some excellent examples of successful health diplomacy in recent years.
Multi-nation blocs such as the G7, G20, BRICS, and the EU also play a critical role, particularly when it comes to any global action to meet developing countries’ needs for primary health care.
Although much of the agenda on these platforms focus on economics and finance, leaders have increasingly discussed a broader range of topics including security, development, health and climate change.
National representatives should be well prepared and coherent in their approach — it’s crucial they are trained in both health and diplomacy, as many seldom are.
Applying interdisciplinary knowledge and skills surrounding health threats can provide robust strategies to create better policies.
For example, the World Health Organization’s (WHO) One Health approach recognises that health is connected in humans, animals and its shared environment, which have been increasingly important due to the changing interactions accelerated by globalisation and deforestation.
The WHO should continue to apply this approach and work closely with the World Organization for Animal Health, the Food and Agriculture Organization and countries, to identify the source of the COVID-19 virus, and reduce further risks of emergence and transmission of zoonotic diseases. Addressing the challenges of non-medical factors that influence health, gender-sensitive programs, prioritising endemic neglected tropical diseases, can also reap benefits in global equity on an immediate and long-term basis.
However, progress can only be achieved with strong domestic political support.
Originally published under Creative Commons by 360info™.
Dr Vijay Kumar Chattu is a medical doctor with specialisations in Community Medicine, International Health Development, Health Management, and International Relations. He is Research Fellow- Digital Health and Occupational Medicine at the University of Toronto. Dr Chattu decalred no conflicts of interest in relation to this article.