Global health diplomacy: Barriers to inserting health into Canadian foreign policy

Abstract

Health opportunities and risks have become increasingly global in both cause and consequence. Governments have been slow to recognise the global dimensions of health, although this is beginning to change. A new concept – global health diplomacy (GHD) – has evolved to describe how health is now being positioned within national foreign policies and entering into regional or multilateral negotiations. Traditionally, health negotiations have been seen as ‘low politics’ in international affairs: however, attention is now being given to understanding better how health can increase its prominence in foreign policy priorities and multilateral forums. We sought to identify how these efforts were manifested in Canada, with a focus on current barriers to inserting health in foreign policy. We conducted individual interviews with Canadian informants who were well placed through their diplomatic experience and knowledge to address this issue. Barriers identified by the respondents included a lack of content expertise (scientific and technical understanding of health and its practice), insufficient diplomatic expertise (the practice and art of diplomacy, including legal and technical expertise), the limited ways in which health has become framed as a foreign policy issue, funding limitations and cuts for global health, and lack of cross-sectoral policy coordination and coherence, given the important role that non-health foreign policy interests (notably in trade and investment liberalisation) can play in shaping global health outcomes. We conclude with some reflections on how regime change and domestic government ideology can also function as a barrier to GHD, and what this implies for retaining or expanding the placement of health in foreign policy.

Keywords:

• global health diplomacy
• foreign policy
• population health

Acknowledgement

Ronald Labonté is supported through the Canada Research Chair Program of the Government of Canada.

Funding

This work was supported by the Institute of Population and Public Health of the Canadian Institutes of Health Research [grant number 2117981].

Notes

1. CIDA is the Canadian International Development Agency, which oversaw Canada's foreign aid envelope until April 2013 when it was rolled into the Department of Foreign Affairs and International Trade (DFAIT), which was renamed to Department of Foreign Affairs, Development and Trade (DFATD).

Additional information

Funding

Funding: This work was supported by the Institute of Population and Public Health of the Canadian Institutes of Health Research [grant number 2117981].