A new Yale initiative promotes health issues as a tool of diplomacy

In the summer of 2006, Youssra Marjoua experienced, as she puts it, an “aha” moment. Marjoua, a third-year medical student who was researching maternal health in Nigeria, saw how the field intersected with such issues as poverty, housing, education and women’s empowerment. “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 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 is one of about a dozen medical and public health students who, under the direction of Kaveh Khoshnood, M.P.H. ’89, Ph.D. ’95, assistant professor of epidemiology and public health, have formed the Health Diplomacy Initiative at Yale (HDI). Its aim is to promote dialogue within 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 MacMillan Center for International and Area Studies to host four health diplomacy seminars during this academic year.

Leading organizations and journals are taking the notion of health diplomacy seriously. The World Health Organization devoted its March 2007 bulletin to the subject of health and foreign policy, and such medical journals as The Lancet and JAMA: The Journal of the American Medical Association have editorialized in support of health diplomacy. The Aspen Institute devoted a session to global health diplomacy in a health forum last year, and the University of California, San Francisco, is planning to include health diplomacy in its Global Health Sciences program.

The AIDS epidemic, said Khoshnood, is the landmark event that showed that health threats don’t recognize borders and can destabilize the political, economic and social structures of countries. “AIDS shook up segments of the government that would otherwise be uninterested in health issues,” Khoshnood said.

Along with SARS and avian flu, the AIDS epidemic provides an opening for public health professionals to become significant players in international diplomacy. “We’re seen as being in the ‘caring’ profession,” Khoshnood said. “We come in with all these positive feelings and without any particular political agenda. Why can’t we use this standing as 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.”

Khoshnood shares her enthusiasm. The only downside he foresees is that health diplomacy could be co-opted by governments to advance political agendas. “I hate to think that health would be used that way,” he said. But so far, he believes that the potential benefits are worth the risk.