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Dawson WD, Booi L, Pintado-Caipa M, Okada de Oliveira M, Kornhuber A, Spoden N, Golonka O, Shallcross L, Davidziuk A, Cominetti MR, Vergara-Manríquez M, Kochhann R, Robertson I, Eyre HA, Ibáñez A. The Brain Health Diplomat's Toolkit: supporting brain health diplomacy leaders in Latin America and the Caribbean. LANCET REGIONAL HEALTH. AMERICAS 2023; 28:100627. [PMID: 38046464 PMCID: PMC10689283 DOI: 10.1016/j.lana.2023.100627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 10/25/2023] [Accepted: 10/25/2023] [Indexed: 12/05/2023]
Abstract
Maintaining and improving brain health, one of the most critical global challenges of this century, necessitates innovative, interdisciplinary, and collaborative strategies to address the growing challenges in Latin America and the Caribbean. This paper introduces Brain Health Diplomacy (BHD) as a pioneering approach to bridge disciplinary and geographic boundaries and mobilize resources to promote equitable brain health outcomes in the region. Our framework provides a toolkit for emerging brain health leaders, equipping them with essential concepts and practical resources to apply in their professional work and collaborations. By providing case studies, we highlight the importance of culturally sensitive, region-specific interventions to address unique needs of vulnerable populations. By encouraging dialogue, ideation, and cross-sector discussions, we aspire to develop new research, policy, and programmatic avenues. The novel BHD approach has the potential to revolutionize brain health across the region and beyond, ultimately contributing to a more equitable global cognitive health landscape.
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Affiliation(s)
- Walter D. Dawson
- Global Brain Health Institute at University of California, San Francisco (UCSF), GBHI Memory and Aging Center, MC: 1207 1651 4th St, 3rd Floor, San Francisco, CA 94143, USA and Trinity College Dublin, Room 0.60, Lloyd Building, Dublin 2, Ireland
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Diagonal las Torres 2640, Peñalolén, RM, 7941169, Chile
- Layton Aging & Alzheimer's Disease Research Center, Department of Neurology, School of Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, CR131, Portland, OR, 97239, USA
- Institute on Aging, Portland State University, 1825 SW Broadway, Portland, OR, 97201, USA
| | - Laura Booi
- Global Brain Health Institute at University of California, San Francisco (UCSF), GBHI Memory and Aging Center, MC: 1207 1651 4th St, 3rd Floor, San Francisco, CA 94143, USA and Trinity College Dublin, Room 0.60, Lloyd Building, Dublin 2, Ireland
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Diagonal las Torres 2640, Peñalolén, RM, 7941169, Chile
- Centre for Dementia Research, School of Health, Leeds Beckett University, City Campus, Leeds, LS1 3HE, United Kingdom
| | - Maritza Pintado-Caipa
- Global Brain Health Institute at University of California, San Francisco (UCSF), GBHI Memory and Aging Center, MC: 1207 1651 4th St, 3rd Floor, San Francisco, CA 94143, USA and Trinity College Dublin, Room 0.60, Lloyd Building, Dublin 2, Ireland
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Diagonal las Torres 2640, Peñalolén, RM, 7941169, Chile
- Department of Neurology, Peruvian Institute of Neurosciences, Bartolomé Herrera 161, Lince, 15046, Lima, Peru
| | - Maira Okada de Oliveira
- Global Brain Health Institute at University of California, San Francisco (UCSF), GBHI Memory and Aging Center, MC: 1207 1651 4th St, 3rd Floor, San Francisco, CA 94143, USA and Trinity College Dublin, Room 0.60, Lloyd Building, Dublin 2, Ireland
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Diagonal las Torres 2640, Peñalolén, RM, 7941169, Chile
- Department of Psychiatry, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
- Cognitive Neurology and Behavioral Unit (GNCC), University of São Paulo, Butanta, São Paulo, Brazil
| | - Alex Kornhuber
- Global Brain Health Institute at University of California, San Francisco (UCSF), GBHI Memory and Aging Center, MC: 1207 1651 4th St, 3rd Floor, San Francisco, CA 94143, USA and Trinity College Dublin, Room 0.60, Lloyd Building, Dublin 2, Ireland
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Diagonal las Torres 2640, Peñalolén, RM, 7941169, Chile
| | - Natasha Spoden
- Layton Aging & Alzheimer's Disease Research Center, Department of Neurology, School of Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, CR131, Portland, OR, 97239, USA
| | - Ona Golonka
- Layton Aging & Alzheimer's Disease Research Center, Department of Neurology, School of Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, CR131, Portland, OR, 97239, USA
| | - Lenny Shallcross
- World Dementia Council, World Dementia Council Executive Team, Floor 2, 33 Cavendish Square, London, W1G 0PW, United Kingdom
| | - Alejandra Davidziuk
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Diagonal las Torres 2640, Peñalolén, RM, 7941169, Chile
| | - Márcia Regina Cominetti
- Global Brain Health Institute at University of California, San Francisco (UCSF), GBHI Memory and Aging Center, MC: 1207 1651 4th St, 3rd Floor, San Francisco, CA 94143, USA and Trinity College Dublin, Room 0.60, Lloyd Building, Dublin 2, Ireland
- Federal University of Sao Carlos, Rod. Washington Luís, Km 235, Monjolinho, São Carlos, SP, CEP 13565-905, Brazil
| | - Mayte Vergara-Manríquez
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Diagonal las Torres 2640, Peñalolén, RM, 7941169, Chile
- University of Udine, Via Monsignor Pasquale Margreth, 3, 33100, Udine UD, Italy
- Center of Social and Cognitive Neuroscience (CSCN), Universidad Adolfo Ibáñez, Diagonal las Torres 2640, Peñalolén, RM, 7941169, Chile
| | - Renata Kochhann
- Research Projects Office, Hospital Moinhos de Vento, Ramiro Barcelos 610, Porto Alegre, RS, 90035-000, Brazil
| | - Ian Robertson
- Global Brain Health Institute at University of California, San Francisco (UCSF), GBHI Memory and Aging Center, MC: 1207 1651 4th St, 3rd Floor, San Francisco, CA 94143, USA and Trinity College Dublin, Room 0.60, Lloyd Building, Dublin 2, Ireland
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Diagonal las Torres 2640, Peñalolén, RM, 7941169, Chile
| | - Harris A. Eyre
- Global Brain Health Institute at University of California, San Francisco (UCSF), GBHI Memory and Aging Center, MC: 1207 1651 4th St, 3rd Floor, San Francisco, CA 94143, USA and Trinity College Dublin, Room 0.60, Lloyd Building, Dublin 2, Ireland
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Diagonal las Torres 2640, Peñalolén, RM, 7941169, Chile
- Baker Center for Public Policy, Rice University, 6100 Main St, Houston, TX, 77005, USA
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, Health and Education Research Building (HERB) at Barwon Health Deakin University School of Medicine, PO Box 281, Geelong, Victoria, 3220, Australia
- Euro-Mediterranean Economists Association, C/ de St. Antoni Maria Claret, 167, 08025, Barcelona, Spain
- Meadows Mental Health Policy Institute, 2800 Swiss Ave, Dallas, TX, 75204, USA
- Department of Psychiatry, Baylor College of Medicine, 1977 Butler Blvd Suite E4.400, Houston, TX, 77030, USA
| | - Agustin Ibáñez
- Global Brain Health Institute at University of California, San Francisco (UCSF), GBHI Memory and Aging Center, MC: 1207 1651 4th St, 3rd Floor, San Francisco, CA 94143, USA and Trinity College Dublin, Room 0.60, Lloyd Building, Dublin 2, Ireland
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Diagonal las Torres 2640, Peñalolén, RM, 7941169, Chile
- Universidad San Andres, Vito Dumas 284, B1644BID, Victoria, Buenos Aires, Argentina
- National Scientific and Technical Research Council (CONICET), Godoy Cruz 2290 (C1425FQB), Buenos Aires, Argentina
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Campello CP, Menezes LBA, Lima MRAAD, Santos ASA, Buss PM. Global health postgraduate educational programs profile: a scoping review. CIENCIA & SAUDE COLETIVA 2023; 28:2433-2440. [PMID: 37531549 DOI: 10.1590/1413-81232023288.05622023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 05/04/2023] [Indexed: 08/04/2023] Open
Abstract
This study aimed to describe a set of global health postgraduate programs profile, emphasizing the importance of promoting education and training in this field to meet global health challenges and ameliorate health outcomes. The present review is in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews (PRISMA-ScR) checklist and the Scoping Review Methods Manual proposed by the Joanna Briggs Institute. Eligibility criteria were a set of lato sensu or stricto sensu postgraduate educational programs of global health or lato sensu or stricto sensu postgraduate programs of public health that present a global health concentration area. The search yielded 707 studies: MEDLINE/PubMed, Web of Science, and LILACS. A total of 441 studies and their authors' institutional affiliations were analyzed and 101 institutions that offer educational programs were identified. Most postgraduate programs in Global Health or Public health with a concentration area in Global health are master's degrees, and many of them are taught online. The majority of educational programs are offered by institutions in Europe and North America.
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Affiliation(s)
- Camilla Porto Campello
- Programa de Pós-Graduação em Saúde Global e Diplomacia em Saúde, Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz. R. Leopoldo Bulhões 1.480, Manguinhos. 21041-210 Rio de Janeiro RJ Brasil.
| | | | - Mara Rúbia André Alves de Lima
- Programa de Pós-Graduação em Saúde Global e Diplomacia em Saúde, Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz. R. Leopoldo Bulhões 1.480, Manguinhos. 21041-210 Rio de Janeiro RJ Brasil.
| | - Acácio Sidinei Almeida Santos
- Programa de Pós-Graduação em Saúde Global e Diplomacia em Saúde, Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz. R. Leopoldo Bulhões 1.480, Manguinhos. 21041-210 Rio de Janeiro RJ Brasil.
| | - Paulo Marchiori Buss
- Centro de Relações Internacionais em Saúde, Fundação Oswaldo Cruz. Rio de Janeiro RJ Brasil
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Pattanshetty S, Inamdar A, Bhatt K, Dsouza VS, Prem A, Brand H. Mapping capacity building programs in health diplomacy: Relevance and application in an uncertain world. F1000Res 2023; 12:820. [PMID: 37928171 PMCID: PMC10620483 DOI: 10.12688/f1000research.134689.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/05/2023] [Indexed: 11/07/2023] Open
Abstract
Background: Health diplomacy is one of the emerging avenues for academics where foreign policy dynamics and global health meet. Its relevance has augmented especially after the COVID-19 pandemic that brought the world to a halt. International organization and national entities that are responsible for health governance as well as its socio-economic determinants have been increasingly involved in the negotiations for a collective action towards a better health infrastructure and preparedness. However, the approach to health diplomacy seems to vary with whether health is looked through diplomacy lens or vice versa. Thus, inculcating adequate and appropriate competencies of both fields to conduct negotiations for health while keeping national interests and international commitments intact is imperative. Methods: This study investigates 50 programmes/courses that have been currently offered around the globe to understand the competencies that have been identified as essential for a health diplomat. We examined four aspects: i) geographical distribution of programme/course (ii) the type of global health diplomacy programme being offered and their duration (iii) mode of teaching and (iv) cross-cutting themes that the programme offers. Results: We found that the courses/programmes have been mostly provided by the countries of the Global North who play a key part in international negotiations. Although there were diverse types of certifications identified, they can be classified into two groups - core health diplomacy and inclusive health diplomacy programmes. The health diplomacy training is preferred to be provided in-person due to the nature of the work. Conclusions: While competencies for health governance and international relation have been dominant among the current programmes, other cross-cutting themes such as economics, politics, law, public policy, crisis management, environment and public health have been considered essential. The article concludes with a proposal of a framework to streamline the sectors and the competencies that is required in health diplomats.
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Affiliation(s)
- Sanjay Pattanshetty
- Centre for Health Diplomacy, Department of Global Health Governance , Prasanna School of Public Health (PSPH), Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
- Department of International Health, Care and Public Health Research Institute – CAPHRI, Faculty of Health Medicine and Life Sciences, Universiteit Maastricht, Maastricht, Limburg, The Netherlands
| | - Aniruddha Inamdar
- Centre for Health Diplomacy, Department of Global Health Governance , Prasanna School of Public Health (PSPH), Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Kiran Bhatt
- Centre for Health Diplomacy, Department of Global Health Governance , Prasanna School of Public Health (PSPH), Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Viola Savy Dsouza
- Centre for Regulatory Science, Department of Health Information, Prasanna School of Public Health, Manipal, Karntaka, 576104, India
| | - Anirudh Prem
- Centre for Health Diplomacy, Department of Global Health Governance , Prasanna School of Public Health (PSPH), Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Helmut Brand
- Department of International Health, Care and Public Health Research Institute – CAPHRI, Faculty of Health Medicine and Life Sciences, Universiteit Maastricht, Maastricht, Limburg, The Netherlands
- Department of Health Policy, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Etemadi M, Shahabi S, Lankarani KB, Heydari ST. Financing of health services for undocumented immigrants in Iran: common challenges and potential solutions. Global Health 2023; 19:26. [PMID: 37072839 PMCID: PMC10111301 DOI: 10.1186/s12992-023-00924-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 03/30/2023] [Indexed: 04/20/2023] Open
Abstract
INTRODUCTION Iran is host to one of the largest urban refugee populations worldwide, about two million of whom are undocumented immigrants (UIs). UIs are not eligible to enroll in the Iranian health insurance scheme and have to pay out-of-pocket to access most health services. This increases the likelihood that they will delay or defer seeking care, or incur substantial costs if they do seek care, resulting in worse health outcomes. This study aims to improve understanding of the financial barriers that UIs face in utilizing health services and provide policy options to ensure financial protection to enhance progress towards UHC in Iran. METHODS This qualitative study was conducted in 2022. A triangulation approach, including interviews with key informants and comparing them with other informative sources to find out the complementary findings, was applied to increase data confirmability. Both purposive and snowball sampling approaches were used to select seventeen participants. The data analysis process was done based on the thematic content analysis approach. RESULTS The findings were explained under two main themes: the financial challenges in accessing health services and the policy solutions to remove these financial barriers, with 12 subthemes. High out-of-pocket payments, high service prices for UIs, fragmented financial support, limited funding capacity, not freeing all PHC services, fear of deportation, and delayed referral are some of the barriers that UIs face in accessing health care. UIs can get insurance coverage by using innovative ways to get money, like peer financing and regional health insurance, and by using tools that make it easier, like monthly premiums without policies that cover the whole family. CONCLUSION The formation of a health insurance program for UIs in the current Iranian health insurance mechanism can significantly reduce management costs and, at the same time, facilitate risk pooling. Strengthening the governance of health care financing for UIs in the form of network governance may accelerate the inclusion of UIs in the UHC agenda in Iran. Specifically, it is necessary to enhance the role of developed and rich regional and international countries in financing health services for UIs.
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Affiliation(s)
- Manal Etemadi
- The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Saeed Shahabi
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Kamran Bagheri Lankarani
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Taghi Heydari
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
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Razumov AN, Mokina NA. [The modern role of the resort medicine in medical diplomacy and national humanitarian policy]. VOPROSY KURORTOLOGII, FIZIOTERAPII, I LECHEBNOI FIZICHESKOI KULTURY 2023; 100:7-17. [PMID: 36971667 DOI: 10.17116/kurort20231000117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Health care in general and medicine in particular play an important role in the geopolitical landscape and the political positioning of the state in the modern world. The health of the citizens of the country is the most important resource of national security. This article, based on a SWOT-analysis, highlights the strengths and weaknesses of the foreign and national resort industry as a part of medical diplomacy, with decomposition to its individual participants. The undoubted advantage of our country in terms of humanitarian policy, on the world stage is shown, specifically in the context of national key success factors, including the technological capabilities of domestic medical science and practice, regarding the availability of trained staff, specialized variable climatic sanatorium and resort institutions network with unique technologies and natural healing resources, coupled with international experience in humanitarian cooperation, developed healthcare system and sanitary and epidemiological supervision of the country. Medical diplomacy and national resort medicine as an active participant of the branch, are strategically important areas in public diplomacy, having the ability to play an important role in achieving national goals in geopolitics.
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Affiliation(s)
- A N Razumov
- First Moscow State Medical University named after I.M. Sechenov (Sechenov' University), Moscow, Russia
| | - N A Mokina
- Samara regional children's sanatorium, Samara, Russia
- Samara State Medical University, Samara, Russia
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Lee ST. Vaccine diplomacy: nation branding and China’s COVID-19 soft power play. PLACE BRANDING AND PUBLIC DIPLOMACY 2023; 19:64-78. [PMCID: PMC8259554 DOI: 10.1057/s41254-021-00224-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Revised: 06/18/2021] [Accepted: 06/30/2021] [Indexed: 05/19/2023]
Abstract
As a global crisis, COVID-19 has altered how nation-states project influence. Public health has risen to the top of every agenda as individuals, societies, and nation-states focus on a common goal. With the advent of COVID-19 vaccines, home-grown national vaccines when distributed all over the world can play an integral role in nation branding as a technique for projecting soft power. This paper applies the theoretical lenses of nation branding and soft power to examine China’s bilateral vaccine diplomacy efforts, specifically the motivations and outcomes. The findings suggest that Chinese vaccines are used not only for image repair and for expanding Beijing’s great power ambitions, but also to reinforce and leverage existing soft power programs, and to capitalize on new economic and geopolitical opportunities. Vaccine diplomacy is a natural extension of Chinese soft power including prior engagement in health diplomacy. Sentiment analyses of social media and international media coverage suggest that where vaccines go, influence may follow. Although international sentiments are not all positive—with concerns over Chinese vaccines’ efficacy, safety, and data availability, Beijing reaped substantial soft power dividends through its ability to project influence in scientific prowess and civic virtue by providing the vaccines as International Public Goods through aid and gifts to countries left behind by the vaccine inequity.
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Affiliation(s)
- Seow Ting Lee
- Department of Advertising, Public Relations, and Media Design, University of Colorado at Boulder, 1511 University Avenue, UCB 478, Boulder, CO 80309 USA
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Karačić Zanetti J, Brown M, Viđak M, Marušić A. Diplomatic response to global health challenges in recognizing patient needs: A qualitative interview study. Front Public Health 2023; 11:1164940. [PMID: 37124832 PMCID: PMC10136764 DOI: 10.3389/fpubh.2023.1164940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 03/16/2023] [Indexed: 05/02/2023] Open
Abstract
Background Global health diplomacy is the applied practice of foreign affairs to further national goals that focus on health issues requiring international cooperation and collective action. We aimed to determine how international diplomats and health policy-related professionals in the EU understand the concept of health diplomacy, which impacts both diplomatic relations as well as patients' rights. Methods In a qualitative interview study, we used a heterogeneous stratified purposeful sampling to reach participants from different countries and different practitioners from the Pyramid of Health Diplomacy: core, multi-stakeholder, and informal. Reflexive thematic analysis was used to identify the main themes. Findings We contacted 131 practitioners of GHD, of which 37 responded, and nine agreed to be interviewed. From 11 interview questions, four main themes emerged from the analysis of the individual interview. The participants reported limited knowledge about the definition of GHD but also that they engaged in daily activities and decisions of inter-governmental bodies. They were not aware of existing special education and training for health attachés and made suggestions for improving the field and practice of GHD. They were not fully familiar with the European Charter of Patients' Rights. There was a consensus from all participants that patient rights need to improve as a fundamental right. They stressed the fact that the hospital lockdown and the right access to healthcare were impaired during the COVID pandemic. Interpretation The role of health diplomacy in linking public health and foreign affairs is key to respecting patients' rights. Health over other interests is becoming an increasingly critical element in foreign policy. Establishing a clear career path for health attachés is necessary to foster effective global health agreements and coordination across countries.
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Affiliation(s)
- Jasna Karačić Zanetti
- International Council of the Patient Ombudsman, Health Diplomacy Unit, Bruxelles, Belgium
- University of Zagreb, Zagreb, Croatia
- *Correspondence: Jasna Karačić Zanetti
| | - Matthew Brown
- Global Health Policy Institute, University of California, San Diego, San Diego, CA, United States
| | - Marin Viđak
- Department of Research in Biomedicine and Health, Center for Evidence-Based Medicine, University of Split School of Medicine, Split, Croatia
| | - Ana Marušić
- Department of Research in Biomedicine and Health, Center for Evidence-Based Medicine, University of Split School of Medicine, Split, Croatia
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Roberts S, Kelman I. Governing digital health for infectious disease outbreaks. Glob Public Health 2023; 18:2241894. [PMID: 37620749 DOI: 10.1080/17441692.2023.2241894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 07/24/2023] [Indexed: 08/26/2023]
Abstract
ABSTRACTHow can governing digital health for infectious disease outbreaks be enhanced? In many ways, the COVID-19 pandemic has simultaneously represented both the potential and marked limitations of digital health practices for infectious disease outbreaks. During the pandemic's initial stages, states along with Big Data and Big Tech actors unleashed a scope of both established and experimental digital technologies for tracking infections, hospitalisations, and deaths from COVID-19 - and sometimes exposure to the virus SARS-CoV-2. Despite the proliferation of these technologies at the global level, transnational and cross-border integration, and cooperation within digital health responses to COVID-19 often faltered, while digital health regulations were fragmented, contested, and uncoordinated. This article presents a critiquing reflection of approaches to conceptualising, understanding, and implementing digital health for infectious disease outbreaks, observed from COVID-19 and previous examples. In assessing the strengths and limitations of existing practices of governing digital health for infectious disease outbreaks, this article particularly examines 'informal' digital health to build upon and consider how digitised responses to addressing and governing infectious disease outbreaks may be reconceptualised, revisited, or revised.
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Affiliation(s)
- Stephen Roberts
- Institute for Global Health, University College London, London, UK
| | - Ilan Kelman
- Institute for Global Health, Institute for Risk and Disaster Reduction (IRDR), University College London, London, UK
- University of Agder, Kristiansand, Norway
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Jindal RM, Baines LS, Mehjabeen D. Reimagining diaspora diplomacy during the COVID-19 crisis in India. Int Health 2022; 15:93-100. [PMID: 35460224 PMCID: PMC9808521 DOI: 10.1093/inthealth/ihac019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 03/01/2022] [Accepted: 03/18/2022] [Indexed: 01/07/2023] Open
Abstract
Diasporas are organized groups motivated by common cultural, ideological, political and religious values and common concerns for their countries of origin. Diaspora diplomacy has gained prominence worldwide, particularly in India, spurred by harrowing images of deaths and devastation due to the COVID-19 pandemic. A new generation of diaspora professionals modeled as social entrepreneurs uses collaborative and non-profit models to establish relationships with their counterparts to facilitate medical services and research. Teleradiology and telepsychiatry facilitate communication between diaspora members and their counterparts. We propose a common telehealth platform to standardize advice given by the Indian diaspora in the Global North as protocols change rapidly in acute pandemics. Consideration should be given to the well-known digital divide in India and other low- and middle-income countries. We advocate for diaspora members to train themselves in the art of global health diplomacy, to promote transparency and accountability in the collection of funds and a mandatory provision of outcome measurement by independent monitors rather than through social media. In the long run, Indian-Americans should play an active role in strengthening the domain of public health, which has historically been neglected in India, by focusing on the country's long-term infrastructure needs. The lessons learned from various diaspora efforts should be independently evaluated and recorded as best practice for future pandemics and humanitarian crises.
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Affiliation(s)
| | - Lyndsay S Baines
- Department of Health & Social Care, Anglia Ruskin University, London EC1N 6RA, UK,Global Health Diplomacy Working Group, University of Oxford, Oxford OX1 2JD, UK
| | - Deena Mehjabeen
- Translational Health Research Institute, Western Sydney University, Penrith NSW 2751, Australia
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Thompson KM, Kalkowska DA, Badizadegan K. Polio health economics: assessing the benefits and costs of polio, non-polio, and integrated activities of the Global Polio Eradication Initiative. Gates Open Res 2022; 6:5. [PMID: 35280345 PMCID: PMC8881365 DOI: 10.12688/gatesopenres.13524.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2022] [Indexed: 01/03/2023] Open
Abstract
Background: Investments made by countries and donors to support polio eradication and the Global Polio Eradication Initiative (GPEI) over the past 35 years provided financial support for significant health interventions beyond the prevention of polio. Prior economic analyses that sought to quantify the economic benefits of some interventions encountered insufficient data and evidence associated with non-polio-specific activities. The 2022-2026 GPEI Strategic Plan explicitly identified integration and gender equity as funded mandates that must move forward in parallel with polio eradication, but these goals remain vaguely defined from a health economic perspective. Methods: To ensure unambiguous and full accounting for all financial investments in the GPEI, polio eradication, and other desirable objectives, we identify the health economic analysis methods and inputs needed to ensure transparent financial accountability and cost-effective use of funds. Results: Sufficient inputs and methods exist to characterize the health and economic benefits of polio-specific activities, but we identified the need for additional information and method development for some non-polio-specific and cost-sharing activities. Donors who seek to support non-polio-specific objectives as part of the GPEI may want to provide dedicated support financing for which it may be difficult to apply typical health economic criteria and to expect net health and/or net economic benefits. Conclusions: Given the mixture of funding sources provided to the GPEI, which includes support by governments and private donors, we recommend that the GPEI separately account for financial needs that represent necessities for polio eradication from those used for other stated objectives. An added layer of specificity that identifies all funds according to each activity, the accountable party and/or parties, and the associated measurable health or other outcome(s), will enable improved health economic analyses and reporting to donors who seek to track returns on their investments.
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Fisayo T. Science in action? A critical view of UK blood donation deferral policy and men who have sex with men. Int J Health Plann Manage 2021; 36:1207-1222. [PMID: 33834528 DOI: 10.1002/hpm.3167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 01/30/2021] [Accepted: 03/21/2021] [Indexed: 11/06/2022] Open
Abstract
The rules that govern blood donation vary globally. Some potential blood donors are ineligible for immediate blood donation, and as such are deferred until such time that they become eligible. This practice, the blood donation deferral period, is intended to reduce the risk of blood-borne infections being transfused into a blood product-recipient. As blood screening technologies improve, the risk of an infected blood product remaining undetected decreases-and so too have the deferral periods for certain donors. Much has been made of the importance of an evidence-based, scientific approach to protecting blood product-recipients. However, these deferrals are controversial. What exactly determines the blood donation deferral period? This article argues that blood donation deferral periods are not merely the result of enacting empirical data. Instead, the deferral periods represent a negotiation between scientific evidence, experts, politically expedient narratives, institutionalised risk aversion, as well as more mundane concerns such as operational feasibility. As a case study, I examine how the UK Advisory Committee on the Safety of Blood, Tissues and Organs changed the 12-month deferral period for blood donation from men who have sex with men to a 3-month deferral period.
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Affiliation(s)
- Temitope Fisayo
- King's College London School of Medicine, Guy's Campus, London, UK
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12
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Ruckert A, Almeida C, Ramírez J, Guerra G, Salgado de Snyder VN, Orozco E, Alvarenga AA, Nassim de Saboya A, Martins Dos Santos R, Sepúlveda D, Rivera Vivian EDC, Santos MDS, Doriani K, Labonté R. Global Health Diplomacy (GHD) and the integration of health into foreign policy: Towards a conceptual approach. Glob Public Health 2021; 17:1041-1054. [PMID: 33736572 DOI: 10.1080/17441692.2021.1900318] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Since the end of the Cold War, health has gone from a peripheral concern in foreign policy negotiations to a prominent place on the global political agenda. While the rise of health onto the foreign policy agenda is by now old news, the driving forces behind its expansion into new political spheres remain understudied and undertheorized. This article builds on empirical findings from a four-country study of the integration of health into foreign policy, and proposes a conceptual approach to GHD to improve understanding of the conditions under which health is successfully positioned on the foreign policy agenda. Our approach consists of three dimensions: features of institutions and the interest various actors represent in GHD; the ideational environment in which GHD operates; and issue characteristics of the specific health concern entering foreign policy. Within each dimension, we identify specific variables that, in combination, make up the explanatory power of the proposed approach. The proposed approach does not relate to, or build upon, a single social sciences, public health, or international relations (IR) theory, but can be seen as a heuristic device to identify dimensions and variables that may shape why certain health issues rise onto the foreign policy agenda.
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Affiliation(s)
- Arne Ruckert
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Celia Almeida
- National School of Public Health (ENSP), Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
| | - Jorge Ramírez
- School of Public Health, Faculty of Medicine, University of Chile, Santiago de Chile, Chile
| | - German Guerra
- National Institute of Public Health of Mexico, Global Health Program, Cuernavaca, Mexico
| | | | - Emanuel Orozco
- National Institute of Public Health of Mexico, Global Health Program, Cuernavaca, Mexico
| | | | - André Nassim de Saboya
- National School of Public Health (ENSP), Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
| | | | - Dino Sepúlveda
- School of Public Health, Faculty of Medicine, University of Chile, Santiago de Chile, Chile
| | | | | | - Kara Doriani
- School of Public Health, Faculty of Medicine, University of Chile, Santiago de Chile, Chile
| | - Ronald Labonté
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
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Shahabi S, Jalali M, Lankarani KB. Global health diplomacy: a solution to meet the needs of disabled people in Yemen. Confl Health 2020; 14:66. [PMID: 32989382 PMCID: PMC7512209 DOI: 10.1186/s13031-020-00310-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 09/18/2020] [Indexed: 02/08/2023] Open
Abstract
People with disabilities (PWD) are one of the most vulnerable groups in society during armed conflicts. According to the statistics, four million persons with disability live in Yemen. Lack of access and the use of rehabilitation services make PWD unable to retrieve their social and economic roles, which would have substantial negative impacts both on their families and community. The conflict escalation, an increase in the number the of displaced, COVID-19 pandemic, an increase in non-communicable diseases, and the exacerbation of poverty and malnutrition have rapidly enhanced the population at risk of disability in Yemen. Accordingly, effective and comprehensive approaches such as global health diplomacy (GHD) should be considered to meet the emerged needs. GHD seeks to address the common challenges in the global health system by involving all key stakeholders and establishing negotiations and diplomatic dialogue among official actors. Given the presence of various regional and international actors in Yemen and the examples of the successful use of GHD under conflict and post-conflict conditions in Iraq and Afghanistan, the use of diplomacy is crucial to respond to the needs of PWD in this war-torn country appropriately.
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Affiliation(s)
- Saeed Shahabi
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Jalali
- Rehabilitation Research Center, Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Kamran Bagheri Lankarani
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
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14
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Ternes K, Iyengar V, Lavretsky H, Dawson WD, Booi L, Ibanez A, Vahia I, Reynolds C, DeKosky S, Cummings J, Miller B, Perissinotto C, Kaye J, Eyre HA. Brain health INnovation Diplomacy: a model binding diverse disciplines to manage the promise and perils of technological innovation. Int Psychogeriatr 2020; 32:955-979. [PMID: 32019621 PMCID: PMC7423685 DOI: 10.1017/s1041610219002266] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Brain health diplomacy aims to influence the global policy environment for brain health (i.e. dementia, depression, and other mind/brain disorders) and bridges the disciplines of global brain health, international affairs, management, law, and economics. Determinants of brain health include educational attainment, diet, access to health care, physical activity, social support, and environmental exposures, as well as chronic brain disorders and treatment. Global challenges associated with these determinants include large-scale conflicts and consequent mass migration, chemical contaminants, air quality, socioeconomic status, climate change, and global population aging. Given the rapidly advancing technological innovations impacting brain health, it is paramount to optimize the benefits and mitigate the drawbacks of such technologies. OBJECTIVE We propose a working model of Brain health INnovation Diplomacy (BIND). METHODS We prepared a selective review using literature searches of studies pertaining to brain health technological innovation and diplomacy. RESULTS BIND aims to improve global brain health outcomes by leveraging technological innovation, entrepreneurship, and innovation diplomacy. It acknowledges the key role that technology, entrepreneurship, and digitization play and will increasingly play in the future of brain health for individuals and societies alike. It strengthens the positive role of novel solutions, recognizes and works to manage both real and potential risks of digital platforms. It is recognition of the political, ethical, cultural, and economic influences that brain health technological innovation and entrepreneurship can have. CONCLUSIONS By creating a framework for BIND, we can use this to ensure a systematic model for the use of technology to optimize brain health.
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Affiliation(s)
- Kylie Ternes
- School of Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Vijeth Iyengar
- U.S. Administration on Aging/Administration for Community Living, U.S. Department of Health and Human Services, Washington, DC, USA
| | - Helen Lavretsky
- Department of Psychiatry, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, California, USA
| | - Walter D Dawson
- Memory and Aging Center, School of Medicine, UCSF, San Francisco, California, USA
- Global Brain Health Institute, San Francisco, California, USA
- Trinity College Dublin, Dublin, Ireland
- School of Medicine, Oregon Health and Science University, Portland, Oregon, USA
- Institute on Aging, School of Urban and Public Affairs, Portland State University, Portland, Oregon, USA
| | - Laura Booi
- Global Brain Health Institute, San Francisco, California, USA
- Trinity College Dublin, Dublin, Ireland
| | - Agustin Ibanez
- Memory and Aging Center, School of Medicine, UCSF, San Francisco, California, USA
- Global Brain Health Institute, San Francisco, California, USA
- Trinity College Dublin, Dublin, Ireland
- Institute of Cognitive and Translational Neuroscience (INCYT), INECO Foundation, Favaloro University, Buenos Aires, Argentina
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
- Center for Social and Cognitive Neuroscience (CSCN), Universidad Adolfo Ibanez, Santiago, Chile
- Universidad Autónoma del Caribe, Barranquilla, Colombia
- ARC Centre of Excellence in Cognition and its Disorders, Sydney, Australia
| | - Ipsit Vahia
- McLean Hospital, Belmont, Massachusetts, USA
- Harvard Medical School, Cambridge, Massachusetts, USA
| | - Charles Reynolds
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Steven DeKosky
- McKnight Brain Institute and Department of Neurology, College of Medicine, University of Florida, Miami, Florida, USA
| | - Jeffrey Cummings
- Department of Brain Health, School of Integrated Health Sciences, Cleveland Clinic Lou Ruvo Center for Brain Health, UNLV, Las Vegas, Nevada, USA
| | - Bruce Miller
- Memory and Aging Center, School of Medicine, UCSF, San Francisco, California, USA
- Global Brain Health Institute, San Francisco, California, USA
- Trinity College Dublin, Dublin, Ireland
| | - Carla Perissinotto
- Division of Geriatrics, School of Medicine, UCSF, San Francisco, California, USA
| | - Jeffrey Kaye
- School of Medicine, Oregon Health and Science University, Portland, Oregon, USA
| | - Harris A Eyre
- Innovation Institute, Texas Medical Center, Houston, Texas, USA
- Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
- IMPACT SRC, School of Medicine, Deakin University, Geelong, Victoria, Australia
- Brainstorm Laboratory for Mental Health Innovation, Department of Psychiatry, Stanford University School of Medicine, Palo Alto, California, USA
- Discipline of Psychiatry, School of Medicine, The University of Adelaide, Adelaide, South Australia, Australia
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The role of external actors in shaping migrant health insurance in Thailand. PLoS One 2020; 15:e0234642. [PMID: 32614845 PMCID: PMC7332068 DOI: 10.1371/journal.pone.0234642] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Accepted: 05/30/2020] [Indexed: 11/19/2022] Open
Abstract
The role of external actors in national health policy in aid-independent countries has received relatively little attention in the literature, despite the fact that influence continues to be exerted once financial support is curtailed as countries graduate from lower income status. Focusing on a specific health policy in an aid-independent country, this qualitative study explores the role of external actors in shaping Thailand’s migrant health insurance. Primary data were collected through in-depth interviews with eighteen key informants from September 2018 to January 2019. The data were analysed using thematic analysis, focusing on three channels of influence, financial resources, technical expertise and inter-sectoral leverage, and their effect on the different stages of the policy process. Given Thailand’s export orientation and the importance of reputational effects, inter-sectoral leverage, mainly through the US TIP Reports and the EU carding decision, emerged as a very powerful channel of influence on priority setting, as it indirectly affected the migrant health insurance through efforts aimed at dealing with problems of human trafficking in the context of labour migration, especially after the 2014 coup d'état. This study helps understand the changed role external actors can play in filling health system gaps in aid-independent countries.
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16
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Afshari M, Ahmadi Teymourlouy A, Asadi-Lari M, Maleki M. Global Health diplomacy for noncommunicable diseases prevention and control: a systematic review. Global Health 2020; 16:41. [PMID: 32375804 PMCID: PMC7201808 DOI: 10.1186/s12992-020-00572-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 04/22/2020] [Indexed: 02/08/2023] Open
Abstract
INTRODUCTION The prevention and control of noncommunicable diseases (NCDs) are one of the main challenges of healthcare systems around the world. In addition to the technical level, it requires political negotiations and solutions, such as global health diplomacy (GHD), which involves the participation of a wide range of actors and stakeholders and innovative international health partnerships. This review aimed to draw lessons for strengthening linkages with a wide range of actors and stakeholders from the GHD literature for NCDs, and how policymakers and political leaders can effectively use international health partnerships to beat NCDs. METHODS This research was a systematic review of the literature on GHD for NCDs. All relevant articles published in English were identified by searching PubMed, Web of Science, Scopus, and Embase databases, Google and Google Scholar search engines, and the reference lists of identified articles as well as a number of special journals. 30 articles that met the inclusion criteria were analyzed using content analysis in MAXQDA 10. The Global Health Diplomacy Pyramid and Blouin and Dubé's (2010) analytical framework for examining negotiations were used to classify the data. FINDINGS 30 articles have been published on GHD for NCDs. Five key themes, i.e. the specific problem requiring global collective action, key actors, their interests in the problem, potential negotiation process, and potential scenarios for collective action and 46 sub-themes were identified. Moreover, given the importance of collaboration on NCDs in the international arena, actors were categorized into three groups based on the GHD Pyramid: (1) core diplomacy, (2) multi-stakeholder diplomacy, and (3) informal diplomacy. CONCLUSION Development and adoption of a global policy to tackle the rise in NCDs in developed and developing countries require policymakers and political leaders that participate in GHD. Successful developments in global health policy depend on the performance of and respectful relationships among the stakeholders, and global health diplomats need to understand the complexities of the institutional structures and functional relationships of the international institutions involved in health.
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Affiliation(s)
- Mahnaz Afshari
- Department of Health Service Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Ahmad Ahmadi Teymourlouy
- Department of Health Service Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
| | - Mohsen Asadi-Lari
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Maleki
- Department of Health Service Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
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17
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Borges LC, Menezes HZD, Souza IMLD. Dilemmas in the implementation of the World Health Organization Framework Convention on Tobacco Control. CAD SAUDE PUBLICA 2020; 36:e00136919. [PMID: 32130317 DOI: 10.1590/0102-311x00136919] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 12/02/2019] [Indexed: 11/22/2022] Open
Abstract
The article analyzes some dilemmas related to the implementation of the Framework Convention on Tobacco Control, underscoring the States parties' difficulties in adopting public policies with proven cost-benefit and aimed at reducing tobacco's supply and demand. Specifically, the article examines the recommendation to adopt policies for plain cigarette packaging, as provided in the guidelines for implementation of the Convention's Articles 11 and 13. Based on case analysis, we identified political and legal factors that hinder the Convention's implementation, including the regulatory chill produced by legal claims filed by the tobacco industry, which uses investor-State arbitration clauses from bilateral investment agreements. The article concludes that despite the costs imposed on States and the delays in the adoption of such policies, in the medium and long term the rulings handed down by the arbitration courts and the World Trade Organization's Dispute Settlement Body can consolidate the understanding of the legality and effectiveness of policies that adopt the model.
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Affiliation(s)
- Luciana Correia Borges
- Secretaria de Estado da Educação e da Ciência e Tecnologia da Paraíba, João Pessoa, Brasil
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18
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Romeu B. Cuban health diplomacy: Focused on international cooperation. A comment on Chattu et al. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2019; 8:189. [PMID: 31807581 PMCID: PMC6852279 DOI: 10.4103/jehp.jehp_459_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
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19
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KHODAYARI-ZARNAQ R, ALIZADEH G, KABIRI N. Global Health Diplomacy: A Closer Look. IRANIAN JOURNAL OF PUBLIC HEALTH 2019; 48:1549-1550. [PMID: 32292747 PMCID: PMC7145921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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20
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Chattu VK, Knight AW, Kevany S, Sehovic AB. Global health diplomacy, health and human security: The ascendancy of enlightened self-interest. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2019; 8:107. [PMID: 31334259 PMCID: PMC6615119 DOI: 10.4103/jehp.jehp_391_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Accepted: 02/12/2019] [Indexed: 06/10/2023]
Abstract
The political, social, economic, and security implications of health-related issues such as emerging infectious diseases or the epidemic of Non Communicable Diseases offer a rare opportunity for professionals in foreign policy and international relations to engage with the health arena and at the same time for global health experts to enter into and intersect with the domain of diplomacy. The aim of this review is to understand and explore the concepts of global health diplomacy (GHD), health security, and human security. For this narrative review, a literature search was done in PubMed, Scopus, and EBSCO for the "global health diplomacy," "health security," and "human security," and full-texts were reviewed. The recent outbreaks of Ebola in West Africa and Zika in South America are pertinent examples of the nature of the human security crisis and the imminent and severe threat posed to human life across the globe as a result of these epidemics. The Commission on Human Security defines human security as the protection of the vital core of all human lives from critical and pervasive threats. We highlight the ways in which health has now become an issue of national security/global concern and also how GHD can aid in the development of new bilateral or multilateral agreements to safeguard the health and security of people in our globalized world. The paper provides a prospective about, and overview of, health and human security that essentially emphasizes the growing interlinkages between global health, diplomacy, and foreign policy.
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Affiliation(s)
- Vijay Kumar Chattu
- Department of Paraclinical Sciences and Institute of International Relations, The University of the West Indies, St. Augustine, Trinidad and Tobago AND Global Institute of Public Health, India
| | - Andy W Knight
- Department of Political Science, Faculty of Arts, University of Alberta, Edmonton, Canada
| | - Sebastian Kevany
- Department of HIV/AIDS, University of California, San Francisco, CA, USA
| | - Annamarie Bindenagel Sehovic
- Department of Politics and International Studies, Faculty of Social Sciences, University of Warwick, Coventry, CV4 7AL, United Kingdom
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21
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Reid M, Goosby E, Kevany S. Leveraging health diplomacy to end the tuberculosis epidemic. LANCET GLOBAL HEALTH 2019; 7:e561-e562. [PMID: 30904523 DOI: 10.1016/s2214-109x(19)30058-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 02/13/2019] [Indexed: 10/27/2022]
Affiliation(s)
- Michael Reid
- Division of HIV, Infectious Diseases and Global Medicine, University of California, San Francisco, CA 94158, USA; Institute for Global Health Sciences, University of California, San Francisco, CA 94158, USA.
| | - Eric Goosby
- Division of HIV, Infectious Diseases and Global Medicine, University of California, San Francisco, CA 94158, USA; Institute for Global Health Sciences, University of California, San Francisco, CA 94158, USA
| | - Sebastian Kevany
- Institute for Global Health Sciences, University of California, San Francisco, CA 94158, USA
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22
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Eagan SM. Global health diplomacy and humanitarian assistance: understanding the intentional divide between military and non-military actors. J ROY ARMY MED CORPS 2018; 165:244-247. [PMID: 30317217 DOI: 10.1136/jramc-2018-001030] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 08/23/2018] [Indexed: 11/03/2022]
Abstract
Often known as ' global health diplomacy ', the provision of medical care to accomplish strategic objectives, advance public diplomacy goals and enhance soft power is increasingly emphasised in international affairs and military policies. Despite this emergent trend, there has been little critical analysis and examination of the ethics of military actors engaging in this type of work. This type of mission represents the most common form of military medical deployment within the International Security Assistance Force in Afghanistan and is now explicitly emphasised in many militaries' defence doctrine. The growth of these programmes has occurred with little analysis, examination or critique. This paper examines the history of global health diplomacy as directly related to humanitarian assistance, focusing on the difference in intention to highlight ethical dilemmas related to military involvement in the humanitarian sphere. The relationship between non-military humanitarian actors and military actors will be a focal point of discussion, as this relationship has been historically complicated and continues to shift. Relevant differences between these two groups of actors, their motivations and work will be highlighted. In order to examine the morally important differences between these groups, analysis will draw on relevant international doctrine and codes that attempt to provide ethical guidance within the humanitarian sphere.
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Affiliation(s)
- Sheena M Eagan
- Department of Bioethics and Interdisciplinary Studies, Brody School of Medicine, East Carolina University, Greenville, NC 27858, USA
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Whittaker C, Frühauf A, Burthem SJ, Parry RS, Kotikalapudi M, Liang Y, Barker MM, Patel PR, Kelman I. A disaster diplomacy perspective of acute public health events. DISASTERS 2018; 42 Suppl 2:S173-S195. [PMID: 30080259 DOI: 10.1111/disa.12306] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Conceptions of acute public health events typically assume that they are tackled exclusively or principally through technical and medical solutions. Yet health and politics are inexorably linked. To better understand this link, this paper adopts a disaster diplomacy perspective for analysing and assessing the impacts of acute public health events on diplomatic outcomes. Two gaps in understanding disaster-health-politics connections are addressed: (i) how health interventions can impact diplomatic endeavours, especially for (ii) acute public health events. Three diverse case studies are interpreted from a disaster diplomacy perspective: Cuba's medical diplomacy, China and Severe Acute Respiratory Syndrome (SARS), and polio vaccination. Disaster diplomacy permits deeper investigation and analysis of connections amongst health, disaster, and diplomatic activities by viewing efforts on acute public health events as being political through disaster risk reduction (beforehand) and disaster response (during and afterwards). Understanding improves how health interventions affect diplomacy and on disaster diplomacy's limitations.
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Affiliation(s)
- Charlie Whittaker
- PhD student at the School of Public Health, Imperial College London, United Kingdom
| | - Anna Frühauf
- MSc Public Health student at the Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, United Kingdom
| | - Samuel John Burthem
- MSc student at the School of Public Policy, University College London, United Kingdom
| | | | - Meghana Kotikalapudi
- MBBS MSc student at the Faculty of Medical Sciences, Newcastle University, United Kingdom
| | - Yihui Liang
- MPH student at the School of Public Health, Imperial College London, United Kingdom
| | - Mary Moffett Barker
- PhD student at the Department of Health Sciences, University of York, United Kingdom
| | - Parth Rohit Patel
- MB BChir student at the School of Clinical Medicine, University of Cambridge, United Kingdom
| | - Ilan Kelman
- Reader at University College London, United Kingdom, and Professor II at the University of Agder, Norway
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24
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Tluczek A, Twal ME, Beamer LC, Burton CW, Darmofal L, Kracun M, Zanni KL, Turner M. How American Nurses Association Code of Ethics informs genetic/genomic nursing. Nurs Ethics 2018; 26:1505-1517. [PMID: 29708024 DOI: 10.1177/0969733018767248] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Members of the Ethics and Public Policy Committee of the International Society of Nurses in Genetics prepared this article to assist nurses in interpreting the American Nurses Association (2015) Code of Ethics for Nurses with Interpretive Statements (Code) within the context of genetics/genomics. The Code explicates the nursing profession's norms and responsibilities in managing ethical issues. The nearly ubiquitous application of genetic/genomic technologies in healthcare poses unique ethical challenges for nursing. Therefore, authors conducted literature searches that drew from various professional resources to elucidate implications of the code in genetic/genomic nursing practice, education, research, and public policy. We contend that the revised Code coupled with the application of genomic technologies to healthcare creates moral obligations for nurses to continually refresh their knowledge and capacities to translate genetic/genomic research into evidence-based practice, assure the ethical conduct of scientific inquiry, and continually develop or revise national/international guidelines that protect the rights of individuals and populations within the context of genetics/genomics. Thus, nurses have an ethical responsibility to remain knowledgeable about advances in genetics/genomics and incorporate emergent evidence into their work.
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25
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Brown MD, Bergmann JN, Novotny TE, Mackey TK. Applied global health diplomacy: profile of health diplomats accredited to the UNITED STATES and foreign governments. Global Health 2018; 14:2. [PMID: 29325574 PMCID: PMC5765610 DOI: 10.1186/s12992-017-0316-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 12/01/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Global health diplomacy (GHD) is a burgeoning field bridging the priorities of global health and foreign affairs. Given the increasing need to mobilize disparate global health stakeholders coupled with the need to design complex public health partnerships to tackle issues of international concern, effective and timely cooperation among state actors is critical. Health Attachés represent this coordination focal point and are key diplomatic professionals at the forefront of GHD. Despite their unique mandate, little is published about this profession and the perspectives of those who work in the field. METHODS Through purposive sampling, we performed in-depth qualitative interviews with seven Health Attachés: three foreign Health Attachés accredited to the United States and four U.S. Health Attachés accredited to foreign governments. Our interviews explored four key topics: the role and mission of Health Attachés, skills needed to perform GHD, examples of successes and challenges in accomplishing their respective missions, and suggestions for the future development of the diplomatic profession. RESULTS We identified several lessons to apply to the growing field of GHD. First, GHD actors need to receive appropriate training to successfully negotiate the intersection of global health and foreign affairs. Participants suggested several areas of training that would benefit GHD actors: diplomacy and negotiation, applied science, and cross-cultural competency. Second, participants articulated the need for a career path for GHD practitioners, increased opportunities for on-the-job training and mentored experiences, and GHD competencies with defined levels of mastery that can be used in occupational evaluation and career development. CONCLUSIONS Our findings indicate that skills in diplomacy and negotiation, applied science, and cross cultural competency are essential for the statecraft of Health Attachés. Additionally, establishing a clear career pathway for Health Attachés is critical for future maturation of the profession and for fostering effective global health action that aligns public health and foreign diplomacy outcomes. Achieving these goals would ensure that this special cadre of diplomats could effectively practice GHD and would also better position Health Attachés to take the lead in advancing shared global health goals among nation states in a new era of twenty-first century diplomacy.
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Affiliation(s)
- Matthew D Brown
- National Institutes of Health, National Cancer Institute, Center for Global Health, Bethesda, MD, USA.
| | - Julie N Bergmann
- San Diego State University, Graduate School of Public Health, San Diego, CA, USA.,Department of Family Medicine and Public Health, University of California, San Diego School of Medicine, San Diego, CA, USA
| | - Thomas E Novotny
- Office of the Assistant Secretary for Health, U.S. Department of Health and Human Services, Washington, D.C., USA.,Global Health Policy Institute, San Diego, CA, USA.,San Diego State University, Graduate School of Public Health, San Diego, CA, USA.,Department of Family Medicine and Public Health, University of California, San Diego School of Medicine, San Diego, CA, USA
| | - Tim K Mackey
- Department of Medicine, Division of Global Public Health, University of California, San Diego School of Medicine, San Diego, CA, USA.,Global Health Policy Institute, San Diego, CA, USA.,Department of Anesthesiology, University of California, San Diego School of Medicine, San Diego, CA, USA
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Killeen OJ, Davis A, Tucker JD, Mason Meier B. Chinese Global Health Diplomacy in Africa: Opportunities and Challenges. GLOBAL HEALTH GOVERNANCE : THE SCHOLARLY JOURNAL FOR THE NEW HEALTH SECURITY PARADIGM 2018; 12:4-29. [PMID: 30956750 PMCID: PMC6447313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
China has become a key actor in global health diplomacy, particularly in Africa, but little attention has been given to the evolution of Chinese health assistance to African states. This paper conceptualizes Chinese health diplomacy in Africa over the past fifty years through three analytic frameworks: realist vs. constructivist motivations in international relations, vertical vs. horizontal initiatives for health assistance, and bilateral vs. multilateral approaches to global health. Drawing lessons from the evolution of American health assistance, we argue that a better understanding of these frameworks-recognizing why countries pursue health diplomacy, what vertical and horizontal strategies they use, and how they engage in this work bilaterally or multilaterally-could improve global health diplomacy.
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Affiliation(s)
- Olivia J Killeen
- medical resident in ophthalmology at the University of Michigan's Kellogg Eye Center
| | - Alissa Davis
- Postdoctoral Research Fellow at the HIV Center for Clinical and Behavioral Studies at Columbia University and the New York State Psychiatric Institute
| | - Joseph D Tucker
- Assistant Professor of Medicine and Director of UNC Project-China. He is a Term Member at the Council on Foreign Relations
| | - Benjamin Mason Meier
- Associate Professor of Global Health Policy and the Zachary Taylor Smith Distinguished Professor of Public Policy at the University of North Carolina at Chapel Hill
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Tobar S, Buss P, Coitiño A, Kleiman A, Fonseca LE, Rigoli F, Sealey K, Victoria V. [Health diplomacy: strengthening the international relations offices of health ministries of the AmericasDiplomacia da saúde: fortalecimento dos escritórios de relações internacionais dos ministérios da Saúde das Américas]. Rev Panam Salud Publica 2017; 41:e145. [PMID: 31391834 PMCID: PMC6660851 DOI: 10.26633/rpsp.2017.145] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 08/19/2017] [Indexed: 11/24/2022] Open
Abstract
Given the international dimensions of the social, economic, and environmental determinants of health and their manifestations, countries are increasingly negotiating with each other and actively participating in global health governance and global governance in general, which is unequivocally linked to health. This implies that health ministries need trained staff. This report is a reflection on how to strengthen this function in health ministries through training in health diplomacy. It analyzes the experience of the Program for Strengthening Cooperation for Health Development as part of Cooperation among Countries for Health Development (CCHD), developed by the Department of External Relations, Partnerships and Resource Mobilization of the Pan American Health Organization and the Center for International Relations in Health of the Oswaldo Cruz Foundation (CRS/FIOCRUZ). This analysis is based on feedback from participants and from facilitators and coordinators of CCHD, and it attempts to develop concepts stemming from their experiences, with the aim of explaining the current situation and reflect on the concepts and practices of health governance and cooperation between health ministries. Since health diplomacy is a concept still in construction, training experiences in health diplomacy should promote critical analysis and reflect identity, based on the conceptions and practices of stakeholders in the processes of global governance and cooperation between health ministries. This article also identifies the requirements and processes of human resources training in health diplomacy.
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Affiliation(s)
- Sebastián Tobar
- Centro de Relaciones Internacionales en SaludFundación Oswaldo CruzRío de JaneiroBrasilCentro de Relaciones Internacionales en Salud, Fundación Oswaldo Cruz, Río de Janeiro, Brasil.
| | - Paulo Buss
- Centro de Relaciones Internacionales en SaludFundación Oswaldo CruzRío de JaneiroBrasilCentro de Relaciones Internacionales en Salud, Fundación Oswaldo Cruz, Río de Janeiro, Brasil.
| | - Andrés Coitiño
- Organización Panamericana de la SaludDepartamento de Relaciones Externas, Alianzas y Movilización de RecursosWashington, DCEstados Unidos de AméricaOrganización Panamericana de la Salud, Departamento de Relaciones Externas, Alianzas y Movilización de Recursos, Washington, DC, Estados Unidos de América.
| | - Alberto Kleiman
- Organización Panamericana de la SaludDepartamento de Relaciones Externas, Alianzas y Movilización de RecursosWashington, DCEstados Unidos de AméricaOrganización Panamericana de la Salud, Departamento de Relaciones Externas, Alianzas y Movilización de Recursos, Washington, DC, Estados Unidos de América.
| | - Luiz Eduardo Fonseca
- Centro de Relaciones Internacionales en SaludFundación Oswaldo CruzRío de JaneiroBrasilCentro de Relaciones Internacionales en Salud, Fundación Oswaldo Cruz, Río de Janeiro, Brasil.
| | - Félix Rigoli
- Centro de Relaciones Internacionales en SaludFundación Oswaldo CruzRío de JaneiroBrasilCentro de Relaciones Internacionales en Salud, Fundación Oswaldo Cruz, Río de Janeiro, Brasil.
| | - Karen Sealey
- Organización Panamericana de la SaludDepartamento de Relaciones Externas, Alianzas y Movilización de RecursosWashington, DCEstados Unidos de AméricaOrganización Panamericana de la Salud, Departamento de Relaciones Externas, Alianzas y Movilización de Recursos, Washington, DC, Estados Unidos de América.
| | - Vanessa Victoria
- Organización Panamericana de la SaludDepartamento de Relaciones Externas, Alianzas y Movilización de RecursosWashington, DCEstados Unidos de AméricaOrganización Panamericana de la Salud, Departamento de Relaciones Externas, Alianzas y Movilización de Recursos, Washington, DC, Estados Unidos de América.
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Jones CM, Clavier C, Potvin L. Are national policies on global health in fact national policies on global health governance? A comparison of policy designs from Norway and Switzerland. BMJ Glob Health 2017; 2:e000120. [PMID: 28589007 PMCID: PMC5435252 DOI: 10.1136/bmjgh-2016-000120] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2016] [Revised: 01/17/2017] [Accepted: 01/18/2017] [Indexed: 12/03/2022] Open
Abstract
Background Since the signing of the Oslo Ministerial Declaration in 2007, the idea that foreign policy formulation should include health considerations has gained traction on the United Nations agenda as evidenced by annual General Assembly resolutions on global health and foreign policy. The adoption of national policies on global health (NPGH) is one way that some member states integrate health and foreign policymaking. This paper explores what these policies intend to do and how countries plan to do it. Methods Using a most similar systems design, we carried out a comparative study of two policy documents formally adopted in 2012. We conducted a directed qualitative content analysis of the Norwegian White Paper on Global health in foreign and development policy and the Swiss Health Foreign Policy using Schneider and Ingram's policy design framework. After replicating analysis methods for each document, we analysed them side by side to explore the commonalities and differences across elements of NPGH design. Results Analyses indicate that NPGH expect to influence change outside their borders. Targeting the international level, they aim to affect policy venues, multilateral partnerships and international institutions. Instruments for supporting desired changes are primarily those of health diplomacy, proposed as a tool for negotiating interests and objectives for global health between multiple sectors, used internally in Switzerland and externally in Norway. Conclusion Findings suggest that NPGH designs contribute to constructing the global health governance system by identifying it as a policy target, and policy instruments may elude the health sector actors unless implementation rules explicitly include them. Research should explore how future NPGH designs may construct different kinds of targets as politicised groups of actors on which national governments seek to exercise influence for global health decision-making.
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Affiliation(s)
- Catherine M Jones
- Chaire Approches communautaires et inégalités de santé, Montréal, Québec, Canada
- Institut de recherche en santé publique de l'Université de Montréal, Montréal, Québec, Canada
- Département de Médecine sociale et préventive, École de santé publique de l'Université de Montréal, Montréal, Québec, Canada
- Regroupement stratégique Politiques publiques et santé des populations, Réseau de recherche en santé des populations du Québec, Montréal, Québec, Canada
| | - Carole Clavier
- Regroupement stratégique Politiques publiques et santé des populations, Réseau de recherche en santé des populations du Québec, Montréal, Québec, Canada
- Département de Science Politique, de l'Université du Québec à Montréal, Montréal, Québec, Canada
| | - Louise Potvin
- Chaire Approches communautaires et inégalités de santé, Montréal, Québec, Canada
- Institut de recherche en santé publique de l'Université de Montréal, Montréal, Québec, Canada
- Département de Médecine sociale et préventive, École de santé publique de l'Université de Montréal, Montréal, Québec, Canada
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Wanderer EM. Bioseguridad in Mexico: Pursuing Security between Local and Global Biologies. Med Anthropol Q 2017; 31:315-331. [PMID: 27623675 DOI: 10.1111/maq.12339] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Revised: 07/05/2016] [Accepted: 08/17/2016] [Indexed: 11/29/2022]
Abstract
In the aftermath of the 2009 outbreak of H1N1 influenza, scientists in Mexico sought to develop bioseguridad, that is, to protect biological life in Mexico by safely conducting research on infectious disease. Drawing on ethnographic research in laboratories and with scientists in Mexico, I look at how scientists make claims about local differences in regulations, infrastructure, bodies, and culture. The scientists working with infectious microbes sought to establish how different microbial ecologies, human immune systems, and political and regulatory systems made the risks of research different in Mexico from other countries. In developing bioseguridad, the idea of globalized biology that animates many public health projects was undermined as scientists attended to the elements of place that affected human health and safety. Scientists argued for the importance of local biologies, generating tension with global public health projects and regulations premised on the universality of biology.
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Jones CM, Clavier C, Potvin L. Adapting public policy theory for public health research: A framework to understand the development of national policies on global health. Soc Sci Med 2017; 177:69-77. [DOI: 10.1016/j.socscimed.2017.01.048] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 02/04/2016] [Accepted: 01/22/2017] [Indexed: 10/20/2022]
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31
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Kyamanywa P, Mukara KB, Sewankambo NK. Academic Collaborations: Do’s and Don’ts. CURRENT ANESTHESIOLOGY REPORTS 2017. [DOI: 10.1007/s40140-017-0192-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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32
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Kevany S. Global Health Diplomacy, "San Francisco Values," and HIV/AIDS: From the Local to the Global. Ann Glob Health 2017; 81:611-7. [PMID: 27036717 DOI: 10.1016/j.aogh.2015.12.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND San Francisco has a distinguished history as a cosmopolitan, progressive, and international city, including extensive associations with global health. These circumstances have contributed to new, interdisciplinary scholarship in the field of global health diplomacy (GHD). In the present review, we describe the evolution and history of GHD at the practical and theoretical levels within the San Francisco medical community, trace related associations between the local and the global, and propose a range of potential opportunities for further development of this dynamic field. METHODS We provide a historical overview of the development of the "San Francisco Model" of collaborative, community-owned HIV/AIDS treatment and care programs as pioneered under the "Ward 86" paradigm of the 1980s. We traced the expansion and evolution of this model to the national level under the Ryan White Care Act, and internationally via the President's Emergency Plan for AIDS Relief. In parallel, we describe the evolution of global health diplomacy practices, from the local to the global, including the integration of GHD principles into intervention design to ensure social, political, and cultural acceptability and sensitivity. RESULTS Global health programs, as informed by lessons learned from the San Francisco Model, are increasingly aligned with diplomatic principles and practices. This awareness has aided implementation, allowed policymakers to pursue related and progressive social and humanitarian issues in conjunction with medical responses, and elevated global health to the realm of "high politics." CONCLUSIONS In the 21st century, the integration between diplomatic, medical, and global health practices will continue under "smart global health" and GHD paradigms. These approaches will enhance intervention cost-effectiveness by addressing and optimizing, in tandem with each other, a wide range of (health and non-health) foreign policy, diplomatic, security, and economic priorities in a synergistic manner--without sacrificing health outcomes.
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Affiliation(s)
- Sebastian Kevany
- University of California, San Francisco, San Francisco, CA; Centre for Global Health, Trinity College Dublin, Dublin, Ireland.
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Kevany S. Global health engagement in diplomacy, intelligence and counterterrorism: a system of standards. ACTA ACUST UNITED AC 2016. [DOI: 10.1080/18335330.2016.1161225] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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O'Flaherty M, Guzman M. Keeping Public Health Clean: Food Policy Barriers and Opportunities in the Era of the Industrial Epidemics. AIMS Public Health 2016; 3:228-234. [PMID: 29546157 PMCID: PMC5690349 DOI: 10.3934/publichealth.2016.2.228] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Accepted: 04/19/2016] [Indexed: 01/16/2023] Open
Abstract
Poor diet accounts for a larger burden of disability and death than tobacco, alcohol and physical inactivity combined.[1] The World Health Assembly has recognized this as a priority and has challenged member countries to reduce non-communicable disease (NCD) mortality by 25% by 2025 targeting their determinants.[2] Reaching these ambitious targets is possible, but it will require decisive action on diets and tobacco smoking if we want to make a difference.[1] Certainly diet can deliver these reductions rapidly, possibly in less than a decade, and particularly by reducing cardiovascular disease burden, still one of the most important cause of death globally. [3],[4] But the impact of these diseases can be substantially lowered. Several natural experiments have shown the dramatic changes in mortality can be observed after changes of risk factors at population level, many attributable to changes in food intake [5]
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Affiliation(s)
| | - Maria Guzman
- Department of Public Health and Policy, University of Liverpool
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35
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Ruckert A, Labonté R, Lencucha R, Runnels V, Gagnon M. Global health diplomacy: A critical review of the literature. Soc Sci Med 2016; 155:61-72. [DOI: 10.1016/j.socscimed.2016.03.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Revised: 11/17/2015] [Accepted: 03/06/2016] [Indexed: 10/22/2022]
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Penfold ED, Fourie P. Regional health governance: A suggested agenda for Southern African health diplomacy. GLOBAL SOCIAL POLICY 2015; 15:278-295. [PMID: 26635498 PMCID: PMC4639828 DOI: 10.1177/1468018115599817] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Regional organisations can effectively promote regional health diplomacy and governance through engagement with regional social policy. Regional bodies make decisions about health challenges in the region, for example, the Union of South American Nations (UNASUR) and the World Health Organisation South East Asia Regional Office (WHO-SEARO). The Southern African Development Community (SADC) has a limited health presence as a regional organisation and diplomatic partner in health governance. This article identifies how SADC facilitates and coordinates health policy, arguing that SADC has the potential to promote regional health diplomacy and governance through engagement with regional social policy. The article identifies the role of global health diplomacy and niche diplomacy in health governance. The role of SADC as a regional organisation and the way it functions is then explained, focusing on how SADC engages with health issues in the region. Recommendations are made as to how SADC can play a more decisive role as a regional organisation to implement South-South management of the regional social policy, health governance and health diplomacy agenda.
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Affiliation(s)
- Erica Dale Penfold
- Erica Penfold, The South African Institute of International Affairs, Jan Smuts House, Johannesburg, South Africa.
| | - Pieter Fourie
- University of Stellenbosch, Department of Political Science, South Africa
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Gómez EJ. Crafting AIDS policy in Brazil and Russia: State-civil societal ties, institutionalised morals, and foreign policy aspiration. Glob Public Health 2015; 11:1148-68. [PMID: 27564438 DOI: 10.1080/17441692.2015.1094112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
During the 1990s, Brazil and Russia diverged in their policy response to AIDS. This is puzzling considering that both nations were globally integrated emerging economies transitioning to democracy. This article examines to what extent international pressures and partnerships with multilateral donors motivated these governments to increase and sustain federal spending and policy reforms. Contrary to this literature, the cases of Brazil and Russia suggest that these external factors were not important in achieving these outcomes. Furthermore, it is argued that Brazil's policy response was eventually stronger than Russia's and that it had more to do with domestic political and social factors: specifically, AIDS officials' efforts to cultivate a strong partnership with NGOs, the absence of officials' moral discriminatory outlook towards the AIDS community, and the government's interest in using policy reform as a means to bolster its international reputation in health.
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Affiliation(s)
- Eduardo J Gómez
- a International Development Institute , King's College, University of London , London , UK
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Kevany S. James Bond and Global Health Diplomacy. Int J Health Policy Manag 2015; 4:831-4. [PMID: 26673467 PMCID: PMC4663086 DOI: 10.15171/ijhpm.2015.172] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 09/19/2015] [Indexed: 11/09/2022] Open
Abstract
In the 21st Century, distinctions and boundaries between global health, international politics, and the broader interests of the global community are harder to define and enforce than ever before. As a result, global health workers, leaders, and institutions face pressing questions around the nature and extent of their involvement with non-health endeavors, including international conflict resolution, counter-terrorism, and peace-keeping, under the global health diplomacy (GHD) paradigm.
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Affiliation(s)
- Sebastian Kevany
- University of California, San Francisco, CA, USA
- Center for Global Health, Trinity College Dublin, Dublin 2, Ireland
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Alaei K, Alaei A, Fox A. Strengthening US–Iranian relations through public health. Lancet Glob Health 2015; 3:e525-6. [PMID: 26275328 DOI: 10.1016/s2214-109x(15)00083-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Accepted: 06/11/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Kamiar Alaei
- Department of Public Administration and Policy, University at Albany, State University of New York, Albany, NY 12203, USA; Global Institute for Health and Human Rights, University at Albany, State University of New York, Albany, NY 12203, USA
| | - Arash Alaei
- Global Institute for Health and Human Rights, University at Albany, State University of New York, Albany, NY 12203, USA; Department of Health Policy, Management and Behavior, University at Albany, State University of New York, Albany, NY 12203, USA
| | - Ashley Fox
- Department of Public Administration and Policy, University at Albany, State University of New York, Albany, NY 12203, USA.
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Kevany S. Diplomatic advantages and threats in global health program selection, design, delivery and implementation: development and application of the Kevany Riposte. Global Health 2015; 11:22. [PMID: 26013278 PMCID: PMC4470080 DOI: 10.1186/s12992-015-0108-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 05/06/2015] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Global health programs, as supported by organizations such as the Global Fund to Fight AIDS, Tuberculosis and Malaria and the President's Emergency Plan for AIDS Relief (PEPFAR), stand to make significant contributions to international medical outcomes. Traditional systems of monitoring and evaluation, however, fail to capture downstream, indirect, or collateral advantages (and threats) of intervention selection, design, and implementation from broader donor perspectives, including those of the diplomatic and foreign policy communities, which these programs also generate. This paper describes the development a new métier under which assessment systems designed to consider the diplomatic value of global health initiatives are described and applied based on previously-identified "Top Ten" criteria. METHODS The "Kevany Riposte" and the "K-Score" were conceptualized based on a retrospective and collective assessment of the author's participation in the design, implementation and delivery of a range of global health interventions related to the HIV/AIDS epidemic. Responses and associated scores reframe intervention worth or value in terms of global health diplomacy criteria such as "adaptability", "interdependence", "training," and "neutrality". Response options ranged from "highly advantageous" to "significant potential threat". RESULTS Global health initiatives under review were found to generate significant advantages from the diplomatic perspective. These included (1) intervention visibility and associations with donor altruism and prestige, (2) development of international non-health collaborations and partnerships, (3) adaptability and responsiveness of service delivery to local needs, and (4) advancement of broader strategic goals of the international community. Corresponding threats included (1) an absence of formal training of project staff on broader political and international relations roles and responsibilities, (2) challenges to recipient cultural and religious practices, (3) intervention-related environmental concerns, and (4) a lack of prima facie consideration of intervention diplomatic and foreign policy consequences. CONCLUSIONS Global health interventions stand to generate significant diplomatic advantages for donor and recipient countries and organizations when appropriately selected, designed, targeted, and delivered. Conversely, in the absence of the application of standards such as those developed under the Kevany Riposte, threats to diplomacy and international relations may occur. With the application of related systems to other global health programmes and settings, comparative results on the relative worth of alternate approaches from the diplomatic perspective may be generated to better inform political, strategic, and global health policy and programmatic decisions.
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Affiliation(s)
- Sebastian Kevany
- University of California, San Francisco, 550 16th Street, 3rd Floor, San Francisco, California, 94158, USA.
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Responding to the public health consequences of the Ukraine crisis: an opportunity for global health diplomacy. J Int AIDS Soc 2015; 18:19410. [PMID: 25787347 PMCID: PMC4365104 DOI: 10.7448/ias.18.1.19410] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Revised: 01/09/2015] [Accepted: 02/20/2015] [Indexed: 01/05/2023] Open
Abstract
Introduction Peace and stability in Eastern Europe is now at a crossroads with the rapidly deteriorating foreign policy crisis continuing to unfold in the Ukraine. However, largely overlooked in the context of other foreign policy and diplomatic priorities are the serious public health consequences for the region following the annexation of Crimea and the subsequent decision to ban opioid substitution therapy in the disputed territory. Discussion On 1 May 2014, the Republic of Crimea officially announced it would end access to opioid substitution therapy, an essential harm reduction tool recognized by international organizations and virtually all other European countries. The policy development marks a critical reversal in the region’s fight against its growing HIV epidemic and also threatens years of public health gains aimed at providing evidence-based and integrated treatment approaches to combat drug dependence and HIV. Beyond these risks, the Ukrainian conflict could also negatively impact control of other infectious diseases that are converging with HIV and injection drug use, such as multidrug-resistant tuberculosis and hepatitis C virus. The continuing conflict is also likely to have a significant negative impact on Ukraine’s fragile public health system leading to even worse population health outcomes than currently experienced by the country. Conclusions In response to this crisis, the application of global health diplomacy principles represents a possible route of advocacy to ensure that HIV prevention, humane treatment of substance using populations, and improving public health outcomes in the region are pursued among concerned international stakeholders. In order to be effective, global health diplomacy efforts must be coordinated and advocated in all forms of diplomatic engagement, including at the core, multistakeholder and informal levels and through existing channels such as the different human rights bodies of the United Nations as well as amongst other actors. Hence, the Ukraine crisis represents a critical moment for the practice and advancement of global health diplomacy in order to ensure global public health priorities are given their rightful place in foreign policy making to hopefully help in bringing resolution to the current conflict.
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Hotez PJ. The NTDs and vaccine diplomacy in latin America: opportunities for united states foreign policy. PLoS Negl Trop Dis 2014; 8:e2922. [PMID: 25255437 PMCID: PMC4177742 DOI: 10.1371/journal.pntd.0002922] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Affiliation(s)
- Peter J. Hotez
- Sabin Vaccine Institute and Texas Children's Hospital Center for Vaccine Development, Departments of Pediatrics and Molecular Virology and Microbiology, National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas, United States of America
- James A. Baker III Institute for Public Policy, Rice University, Houston, Texas, United States of America
- Department of Biology, Baylor University, Waco, Texas, United States of America
- * E-mail:
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Kevany S. Global health diplomacy: a 'Deus ex Machina' for international development and relations: Comment on "A Ghost in the Machine? Politics in Global Health Policy". Int J Health Policy Manag 2014; 3:111-2. [PMID: 25114951 DOI: 10.15171/ijhpm.2014.67] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Accepted: 07/23/2014] [Indexed: 11/09/2022] Open
Affiliation(s)
- Sebastian Kevany
- Institute for Health Policy Studies, University of California, San Francisco, CA, USA
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Kevany S, Jaf P, Workneh NG, Abu Dalod M, Tabena M, Rashid S, Al Hilfi TKY. Global health diplomacy in Iraq: international relations outcomes of multilateral tuberculosis programmes. Med Confl Surviv 2014; 30:91-109. [PMID: 24968517 DOI: 10.1080/13623699.2014.890827] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND International development programmes, including global health interventions, have the capacity to make important implicit and explicit benefits to diplomatic and international relations outcomes. Conversely, in the absence of awareness of these implications, such programmes may generate associated threats. Due to heightened international tensions in conflict and post-conflict settings, greater attention to diplomatic outcomes may therefore be necessary. We examine related 'collateral' effects of Global Fund-supported tuberculosis programmes in Iraq. METHODS During site visits to Iraq conducted during 2012 and 2013 on behalf of the Global Fund to Fight AIDS, Tuberculosis and Malaria, on-site service delivery evaluations, unstructured interviews with clinical and operational staff, and programme documentary review of Global Fund-supported tuberculosis treatment and care programmes were conducted. During this process, a range of possible external or collateral international relations and diplomatic effects of global health programmes were assessed according to predetermined criteria. RESULTS A range of positive diplomatic and international relations effects of Global Fund-supported programmes were observed in the Iraq setting. These included (1) geo-strategic accessibility and coverage; (2) provisions for programme sustainability and alignment; (3) contributions to nation-building and peace-keeping initiatives; (4) consistent observation of social, cultural and religious norms in intervention selection; and (5) selection of the most effective and cost-effective tuberculosis treatment and care interventions. CONCLUSION Investments in global health programmes have valuable diplomatic, as well as health-related, outcomes, associated with their potential to prevent, mitigate or reverse international tension and hostility in conflict and post-conflict settings, provided that they adhere to appropriate criteria. The associated international presence in such regions may also contribute to peace-keeping efforts. Global health programmes may frequently produce a wider range of 'collateral benefits' that conventional monitoring and evaluation systems should be expanded to assess, in keeping with contemporary efforts to leverage development programmes from a 'global health diplomacy' perspective.
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Runnels V, Labonté R, Ruckert A. Global health diplomacy: Barriers to inserting health into Canadian foreign policy. Glob Public Health 2014; 9:1080-92. [DOI: 10.1080/17441692.2014.928740] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Affiliation(s)
- Peter J. Hotez
- Sabin Vaccine Institute and Texas Children's Hospital Center for Vaccine Development, Departments of Pediatrics and Molecular Virology and Microbiology, National School of Tropical Medicine at Baylor College of Medicine, Houston, Texas, United States of America
- Departments of Medical Humanities and Biology, Baylor University, Waco, Texas, United States of America
- James A. Baker III Institute for Public Policy, Rice University, Houston, Texas, United States of America
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Lencucha R. Cosmopolitanism and foreign policy for health: ethics for and beyond the state. BMC INTERNATIONAL HEALTH AND HUMAN RIGHTS 2013; 13:29. [PMID: 23829176 PMCID: PMC3717113 DOI: 10.1186/1472-698x-13-29] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/19/2012] [Accepted: 07/04/2013] [Indexed: 11/29/2022]
Abstract
Background Foreign policy holds great potential to improve the health of a global citizenship. Our contemporary political order is, in part, characterized by sovereign states acting either in opposition or cooperation with other sovereign states. This order is also characterized by transnational efforts to address transnational issues such as those featured so prominently in the area of global health, such as the spread of infectious disease, health worker migration and the movement of health-harming products. These two features of the current order understandably create tension for truly global initiatives. Discussion National security has become the dominant ethical frame underlying the health-based foreign policy of many states, despite the transnational nature of many contemporary health challenges. This ethical approach engages global health as a means to achieving national security objectives. Implicit in this ethical frame is the version of humanity that dichotomizes between “us” and “them”. What has been left out of this discourse, for the most part, is the role that foreign policy can play in extending the responsibility of states to protect and promote health of the other, for the sake of the other. Summary The principal purpose of this paper is to review arguments for a cosmopolitan ethics of health-based foreign policy. I will argue that health-based foreign policy that is motivated by security interests is lacking both morally and practically to further global health goals. In other words, a cosmopolitan ethic is not only intrinsically superior as a moral ideal, but also has potential to contribute to utilitarian ends. This paper draws on the cosmopolitanism literature to build robust support for foreign policies that contribute to sustainable systems of global health governance.
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Affiliation(s)
- Raphael Lencucha
- Faculty of Medicine, School of Physical and Occupational Therapy, McGill University, Hosmer House, 3630 Promenade Sir William Osler, Montréal, QC H3G 1Y5, Canada.
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Beckfield J, Olafsdottir S, Sosnaud B. Healthcare Systems in Comparative Perspective: Classification, Convergence, Institutions, Inequalities, and Five Missed Turns. ANNUAL REVIEW OF SOCIOLOGY 2013; 39:127-146. [PMID: 28769148 PMCID: PMC5536857 DOI: 10.1146/annurev-soc-071312-145609] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
This essay reviews and evaluates recent comparative social science scholarship on healthcare systems. We focus on four of the strongest themes in current research: (1) the development of typologies of healthcare systems, (2) assessment of convergence among healthcare systems, (3) problematization of the shifting boundaries of healthcare systems, and (4) the relationship between healthcare systems and social inequalities. Our discussion seeks to highlight the central debates that animate current scholarship and identify unresolved questions and new opportunities for research. We also identify five currents in contemporary sociology that have not been incorporated as deeply as they might into research on healthcare systems. These five "missed turns" include an emphasis on social relations, culture, postnational theory, institutions, and causal mechanisms. We conclude by highlighting some key challenges for comparative research on healthcare systems.
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Michaud J, Kates J. Global health diplomacy: advancing foreign policy and global health interests. GLOBAL HEALTH: SCIENCE AND PRACTICE 2013; 1:24-8. [PMID: 25276514 PMCID: PMC4168555 DOI: 10.9745/ghsp-d-12-00048] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/08/2012] [Accepted: 11/30/2012] [Indexed: 11/15/2022]
Abstract
Attention to global health diplomacy has been rising but the future holds challenges, including a difficult budgetary environment. Going forward, both global health and foreign policy practitioners would benefit from working more closely together to achieve greater mutual understanding and to advance respective mutual goals.
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