HEALTH DIPLOMACY IN HUMANITARIAN ACTION

Lessons for Global Health Diplomacy?

•GHD: Little discussion or focus on humanitarian assistance;

•Humanitarians: little focus on diplomacy – norms not negotiable.

Multiple forums, Multiple actors

• Diplomacy, negotiation, and dialogue at international, national and local levels is integral to humanitarian action, including delivery of medical assistance.

• Example of diplomacy in Haiti . . .

. . . Clinton at Haiti UNSC Meeting

. . . Clinton at Haiti Donor Meeting

. . . Clinton at IHRC

. . . Clinton and Farmer

. . . Haiti health cluster discussions

. . . Haiti community level dialogue

Key Research Question• Does GHD provide insight into the factors that impede or facilitate cooperation – access to and delivery of medical assistance - during humanitarian crises?

Research Overview• Examined health diplomacy within humanitarian settings:

1. Identified determinants of cooperation from GHD;

2. Exploratory case study research;

3. Assessed lessons of these case studies for GHD research.

Case Studies• Haiti: Earthquake• Burma/Myanmar: ongoing civil strife and Cyclone Nargis;

• Pakistan: Ongoing civil strife and 2010 floods;

• Libya: Current internationalized civil war.

Access/Delivery Restricted

• Haiti least problematic; Pakistan more troublesome, Burma/Myanmar extremely difficult, and Libya almost impossible.

• Traditional arguments of humanitarian space and advocacy for norms does not explain why and how cooperation is impeded.

• GHD framework provides this insight.

Determinants of Cooperation

GHD

ContextActors

Process

Context Influences Cooperation

Political, Social, Economic Context

Unique Nature of Health

International Norms

✔

✖

✔

Actors Influence Cooperation

Nature of the state

International Organizations

Civil society/Non-state actors

Epistemic Communities

✔

✔

✔?

✔ ?

Process Influences Cooperation

Instrumentalization

Diplomatic Skills

Forum Shifting

✔

✔ ?

Significance for GHD

•Not all health issues provide unique opportunities for engagement;

• Importance but limitations of norms;•Role of international organizations as forum and actor;

•Civil society critical diplomatic actor;•Risks of instrumentalization;•Role of diplomatic skills.

Conclusions• GHD framework facilitated broader analysis of determinants of cooperation in humanitarian settings.

Future Research

• Health diplomacy in humanitarian settings appropriate case study for GHD:• Epistemic communities – what role do they play in humanitarian cooperation?

• Local civil society groups – positive and negative influences?

• Do humanitarian outcomes shift across forums – local/regional/int’l? Does this undermine norms?