"Health Diplomacy"--What is it? The NIC report "Strategic Implications of Global Health"

I went to an interesting round table last week and listened to a brief discussion about "health diplomacy" among other things. Most of the other people at the table were from DoD, State,NGOs and various academic-types. It was proposed that we take up the theme of "health diplomacy" at the next round table. Almost somehow in concert with this proposal, I see that the Chinese have revved up their hospital ship and are making some news. In fact, they even receive an honorable mention in the National Intelligence Council's assessment "Strategic Implications of Global Health" found here: http://www.dni.gov/nic/PDF_GIF_otherprod/ICA_Global_Health_2008.pdf.

Like most scary phrases, "health diplomacy" probably means something completely different to a DoD-person as compared to a USAID person, for example. And I wonder what an NGO person would think? The U.S. military's Mercy and Comfort ships are usually cited as "health diplomacy", whereas efforts in Iraq and Afghanistan and the Horn of Africa or even the Ukraine are not mentioned. While I'm not quibbling with the use of examples, I'm not comfortable letting it rest at merely the Mercy and the Comfort.

Although while "health diplomacy" is not defined in the NIC report, it is interesting to note that on page 7 of the report, the NIC assessment suggests that "More and better-publicized developed world medical diplomacy efforts -- for example, the U.S. Naval Ship Comfort's humanitarian tour of 12 Latin American countries in 2007 could mitigate such influence [of Cuba and Venezuela] while improving the health of citizens of poor countries. "

Using health as a commodity with which the U.S. (or other nations like Cuba, or even organizations with agendas like NGOs) can influence the world is not new. Much like Russia uses oil and the pipeline through the Caucasus as a commodity for manipulating the international order, the West is using health. I'm not sure that I have heard this discussed, since most of the people talking about the diplomacy-development and defense "health" triad are health people who really only want to make others happy and healthy members of the world. However there are some ethical implications, clearly, as well as "execution" and outcome implications. If the Mercy and the Comfort are merely symbols of the US' goodwill, for example, then I wonder if it would be better just to sail around with a bunch of pop stars--Britanny Spears and Bono maybe--making port calls giving free concers. Might be cheaper, and a better use of talent. Probably less ethically challenging anyhow.

In any case, "health diplomacy" is a topic of discussion in the NIC report, in spite of the lack of definition, or any evidence that using health as a diplomatic instrument is useful. But that's OK, it starts us all talking.