Good Morning. It is a pleasure to be here today for this important discussion on health diplomacy. I would like to thank the conference organizers for the invitation to share some of my observations from the Department of State.
The term “Health Diplomacy” emphasizes the integral relationship between two traditional areas of national and international concern -- diplomacy and global health. While in earlier times diplomacy had been predominantly focused on issues of political, military and commercial affairs, and global health had been perhaps more narrowly included in a development perspective – today the two areas have both broadened to recognize the far greater expanse of health issues in foreign policy and national security.
At the Department of State the emergence of health diplomacy and the increased importance of global health reflect three points:
1) the growing convergence of health challenges facing the developing and the developed world ;
2) the growing importance of development as a key element of foreign policy; and
3) the increasing recognition that to address global health challenges requires approaches built on global partnerships.
Infectious diseases are a challenge to the entire globe. Our current influenza pandemic is the most obvious example that the emergence of new strains is a problem not limited to the developing world. Chronic diseases, formerly defined as diseases of the developed world, have emerged as significant threats more broadly across nations. And the health challenges related to stress and trauma are seen in areas of conflict and sites of natural disaster around the world. We are faced with truly global health challenges.
In a recent speech Secretary Clinton stated as one of her policy approaches and a personal priority for her, and I quote– “to elevate and integrate development as a core pillar of American power. We advance our security, our prosperity and values by improving the material conditions of peoples’ lives around the world. These efforts also lay the ground work for greater global cooperation, by building the capacity of new partners and tackling share problems from the ground up.”[i] End quote. Health is a central element of this approach.
The U.S. government sees improving public health and health systems around the world as both a humanitarian and a national security imperative. Better global health promotes stability and growth, which can deter the spread of extremism, ease pressure for migration, reduce the need for humanitarian and development assistance and create opportunities for stronger political alliances and economic relations. Health diplomacy is an element of foreign policy that enhances U.S. and global security and builds strong partnerships.
To address the global health challenges we face requires global partnerships. The research and development that is essential for developing new technologies, treatments and health system innovations are rooted in the international science and technology community. The coordination of development efforts and strengthening of multilateral organizations is a technical and a diplomatic undertaking.
Let me highlight two specific examples where health diplomacy has been front and center in our recent work at the Department of State. The first example is the Global Health Initiative (GHI), announced by President Obama on May 5. This is a six-year $63 billion initiative – a commitment to address some of the most serious health problems facing the world. The initiative maintains our funding and strong commitment to existing programs including the fight against HIV/AIDS, but will also address broader health challenges, including child and maternal health, family planning infectious diseases and neglected tropical diseases. In addition, the GHI will provide a specific new focus on strengthening health systems through integration and coordination.
The GHI is under development with the State Department leading an active interagency process. The Initiative has identified core principles that include:
- Adopting a women-centered approach
- True country partnerships
- Increasing sustainability through health system strengthening
- Strengthening key multilateral institutions
- Improving metrics, monitoring and evaluation
- And leading the way in research and development and innovation.
The GHI is building on programs and investments directed at specific diseases to develop an integrated approach that works to improve health systems around the world, focusing on child and maternal health and ensures that best practices drives funding investments.
The second example is our work with influenza. Years before the current H1N1 pandemic the Department of State began addressing pandemic preparedness, working with international and interagency partners. This included high-level U.S. government participation in ministerial conferences addressing avian pandemic concerns. In 2005 the Department launched the International Partnership for Avian and Pandemic Influenza – whose mission is to raise awareness and to address unmet needs.
In September 2009, President Obama announced that the United States will make as much as 10% of our H1N1 vaccine supply available to other countries through the World Health Organization. The State Department was involved in the planning process for this initiative and has been at the forefront of working with other nations who are also donating funding and vaccine. These joint efforts are working to ensure that donations will have most significant health impact possible.
In closing allow me to make three further observations. First -- The State Department is not a health agency. We do work very closely with the agencies of the Department Health and Human Services (HHS) in Washington and in the field. The partnership between the State Department, Health and Human Services and the U.S. Agency for International Development is growing stronger. Staff members move between departments and joint efforts are apparent everywhere. We are working as team – recognizing the expertise and cultures of each group.
Second -- The State Department does have a cadre of offices who work on health issues. These are our Environment, Science, Technology and Health officers. They are posted around the world and as the title suggests, they deal with a range of issues. These officers combine diplomatic and technical skills in the field, working with counterpart Ministries. The Foreign Service is building its capabilities in both science and health diplomacy.
Third -- While not a health agency, the Department of State works in the diplomatic world and uses diplomatic forums and occasions to pursue health issues, to carry out health diplomacy. The Department provides connectivity across Ministries and regional networks. From a public diplomacy perspective the State Department and its embassies around the world are engaged in active and visible way on health issues. In 2009 multiple embassies around the world participated in World TB Day and World AIDS Day. Embassies report regularly on health topics. Most importantly, our Secretary is a champion of improving health conditions around the world.
Foreign policy has evolved to deal with the world we live in. As Secretary Clinton has stated, “In approaching our foreign policy priorities we have to deal with the urgent, the important and the long-term all at once.”[ii] Today we face a range of the issues that confront our nation and the world and that must be addressed to ensure stability and security. Health is such an issue.