December 3, 2007

A healthy response to global ills

Harnessing the spirit of cooperation that develops among nations during a health crisis to address non-health issues is an idea that is catching on globally—and at Yale.

Kaveh Khoshnood, assistant professor of epidemiology and public health, sees an opportunity for public health professionals to become significant players in international diplomacy. "We're seen as being in the caring profession. We come in with all these positive feelings and without any particular political agenda," he says.

In the summer of 2006, Youssra Marjoua was in Nigeria doing research on maternal health. Seeing the ways in which poverty, housing, education, women’s empowerment and other issues intersect with maternal health was, as she puts it, an “ah, ha!” moment. “No one global health challenge is an entity in and of itself,” she said. “You can’t talk about these things without including the whole.” That epiphany has led Marjoua, a third-year medical student, to focus on a new concept that is gaining currency in public health circles: health diplomacy—the idea that the networks and cooperation developed around health promotion and disease eradication could be leveraged to address problems traditionally considered outside the realm of public health—such as preventing or ameliorating conflicts and war. Marjoua and about 10 other medical and public health students, under the direction of Kaveh Khoshnood, assistant professor of epidemiology and public health, have formed a student-led Health Diplomacy Initiative at Yale (HDI).  Its aim is to promote dialogue with and beyond the Yale community on the value of having health considerations play a more prominent role in international relations and foreign policy. Khoshnood has received $10,000 from the McMillan Center for International and Area Studies to host four health diplomacy seminars during this academic year and is planning to invite prominent speakers to stimulate a cross-disciplinary discussion on this topic at Yale.  Using health as a diplomatic tool is starting to gain widespread credibility. The World Health Organization devoted its March 2007 bulletin to the subject of health and foreign policy, and there have been numerous recent editorials on the topic in prominent medical journals, such as the Lancet and JAMA.

The ASPEN Institute, a prominent think thank, devoted a session to global health diplomacy in its most recent health forum, and the University of California in San Francisco has started a new academic initiative to develop the field of global health diplomacy within its Global Health Sciences program. Thomas Novotny, one of the co-directors, will visit Yale this spring to discuss his program.

Khoshnood points to the AIDS epidemic as the landmark event that awoke people to the fact that health threats don’t recognize national borders and can have a destabilizing effect on the political, economic and social structure of countries. “AIDS shook up segments of the government that would otherwise be uninterested in health issues, such as the ministries of finance or justice,” Khoshnood said. As a result of the AIDS epidemic, as well as SARS, avian flu and climate change, Khoshnood sees an opportunity for public health professionals to become significant players in international diplomacy. “This is an incredible opportunity for us in public health,” Khoshnood says. “We’re seen as being in the caring profession. We come in with all these positive feelings and without any particular political agenda. Why couldn’t we use that to be a force for good?” Marjoua sees health diplomacy as a “novel and great idea.” She’s hoping HDI will explore ways in which health can be used to shape diplomatic decision-making for the better. “I’m interested in how the rise in health policy in foreign policy discussions can transform foreign policy,” she said.

Khoshnood shares her enthusiasm. The only downside he can foresee is that health diplomacy could be co-opted and used by governments to advance their own political agendas.  ”I hate to think that health would be used that way,” he said. But so far, he sees the potential benefits as being well worth the gamble.

—Jennifer Kaylin

Photo by John Curtis

Subscribe