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      Strengthening the COVID-19 pandemic response, global leadership, and international cooperation through global health diplomacy

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          Abstract

          The coronavirus disease 2019 (COVID-19) pandemic continues to claim lives around the world and, to some extent, reflects the failure of international cooperation. Global health diplomacy (GHD)can be a bridge for international cooperation for tackling public health crises, strengthening health systems through emphasizing universal health coverage for sustainable and equitable development, and rebuilding multilateral organizations. It can be a catalyst for future global health initiatives. Health should not be used as a political tool at the cost of people’s lives, nor should it become a proxy for geopolitics but can be used to diffuse tensions and create a positive environment for political dialogue. Health diplomacy’s focus should be to mitigate inequality by making available diagnostics, therapeutics, and vaccines as a global public good. The implications for the lack of international cooperation will lead to increased global disparities and inequities as the countries that cannot procure vaccines will find their population more vulnerable to the pandemic’s repercussion. Though the international cooperation on trade has suffered the impact of geopolitical shifts and competition, through engaging in GHD, the governments can align the trade and health policies. Amid this global health crisis, the World Health Organization (WHO) has faced an increase in International Health Regulations violations, limiting its influence and response during this COVID-19 pandemic. Nations need to develop a sense of cooperation that serves as the basis for a mutual strategic trust for international development. The priorities of all the countries should be to find the areas of common interest, common operational overlap on development issues, and resource allocation for this global fight against COVID-19.

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          Capacity building for global health diplomacy: Thailand’s experience of trade and health

          A rapid expansion of trade liberalization in Thailand during the 1990s raised a critical question for policy transparency from various stakeholders. Particular attention was paid to a bilateral trade negotiation between Thailand and USA concerned with the impact of the ‘Trade-Related Aspects of Intellectual Rights (TRIPS) plus’ provisions on access to medicines. Other trade liberalization effects on health were also concerning health actors. In response, a number of interagency committees were established to engage with trade negotiations. In this respect, Thailand is often cited as a positive example of a country that has proactively sought, and achieved, trade and health policy coherence. This article investigates this relationship in more depth and suggests lessons for wider study and application of global health diplomacy (GHD). This study involved semi-structured interviews with 20 people involved in trade-related health negotiations, together with observation of 9 meetings concerning trade-related health issues. Capacity to engage with trade negotiations appears to have been developed by health actors through several stages; starting from the Individual (I) understanding of trade effects on health, through Nodes (N) that establish the mechanisms to enhance health interests, Networks (N) to advocate for health within these negotiations, and an Enabling environment (E) to retain health officials and further strengthen their capacities to deal with trade-related health issues. This INNE model seems to have worked well in Thailand. However, other contextual factors are also significant. This article suggests that, in building capacity in GHD, it is essential to educate both health and non-health actors on global health issues and to use a combination of formal and informal mechanisms to participate in GHD. And in developing sustainable capacity in GHD, it requires long term commitment and strong leadership from both health and non-health sectors.
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            The Ebola Outbreak: Catalyzing a “Shift” in Global Health Governance?

            Background As the 2014 Ebola virus disease outbreak (EVD) transitions to its post-endemic phase, its impact on the future of global public health, particularly the World Health Organization (WHO), is the subject of continued debate. Criticism of WHO’s performance grew louder in the outbreak’s wake, placing this international health UN-specialized agency in the difficult position of navigating a complex series of reform recommendations put forth by different stakeholders. Decisions on WHO governance reform and the broader role of the United Nations could very well shape the future landscape of 21st century global health and how the international community responds to health emergencies. Discussion In order to better understand the implications of the EVD outbreak on global health and infectious disease governance, this debate article critically examines a series of reports issued by four high-level commissions/panels convened to specifically assess WHO’s performance post-Ebola. Collectively, these recommendations add increasing complexity to the urgent need for WHO reform, a process that the agency must carry out in order to maintain its legitimacy. Proposals that garnered strong support included the formation of an independent WHO Centre for Emergency Preparedness and Response, the urgent need to increase WHO infectious disease funding and capacity, and establishing better operational and policy coordination between WHO, UN agencies, and other global health partners. The recommendations also raise more fundamental questions about restructuring the global health architecture, and whether the UN should play a more active role in global health governance. Summary Despite the need for a fully modernized WHO, reform proposals recently announced by WHO fail to achieve the “evolution” in global health governance needed in order to ensure that global society is adequately protected against the multifaceted and increasingly complex nature of modern public health emergencies. Instead, the lasting legacy of the EVD outbreak may be its foreshadowing of a governance “shift” in formal sharing of the complex responsibilities of global health, health security, outbreak response, and managing health emergencies to other international structures, most notably the United Nations. Only time will tell if the legacy of EVD will include a WHO that has the full support of the international community and is capable of leading human society in this brave new era of the globalization of infectious diseases.
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              Global Health Diplomacy as a Tool of Peace

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                Author and article information

                Journal
                Health Promot Perspect
                Health Promot Perspect
                Health Promot Perspect
                TBZMED
                Health Promotion Perspectives
                Tabriz University of Medical Sciences
                2228-6497
                2020
                07 November 2020
                : 10
                : 4
                : 300-305
                Affiliations
                1School of Public Health, The University of Hong Kong, Hong Kong
                2Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, Canada
                3Institute of International Relations, The University of the West Indies, St. Augustine, Trinidad and Tobago
                Author notes
                [* ] Corresponding Author: Vijay Kumar Chattu, Email: vijay.chattu@ 123456mail.utoronto.ca
                Author information
                https://orcid.org/0000-0000-0000-0000
                https://orcid.org/0000-0001-9840-8335
                Article
                10.34172/hpp.2020.48
                7723006
                33312925
                db1bf61e-bce7-4412-a237-3bcf1625d319
                © 2020 The Author(s).

                This is an open access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 03 August 2020
                : 30 September 2020
                Page count
                References: 31
                Categories
                Perspective

                covid-19,global health,diplomacy,international cooperation,world health organization,pandemic,international health regulations

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