Foreign policy and global health
Dr Margaret Chan
Director-General of the World Health Organization
Distinguished colleagues, ladies and gentlemen,
I am pleased to open this session on the way forward, and am eager to hear the reports from the six working groups.
I will make five points. This short list is highly personal and selective, as these are issues that I have encountered in my job. They are personally important to me.
First, health needs to be given a high profile in foreign policies for its own sake. Bioterrorism, emerging diseases, and pandemics are readily understood as direct threats to national and international security. But health needs to be taken seriously as a worthwhile objective, and a worthy arena for foreign diplomacy for many other reasons.
Second, some of the biggest problems in public health today can be solved only through sustained political and financial commitment. Political regimes and foreign policy objectives shift quickly, and this is a problem.
Sustained commitment is especially important for a disease like HIV/AIDS, where patient survival depends on life-long access to drugs. But it is also important for broader issues such as strengthening health systems and dealing with the critical shortage of health care workers.
My third point is straightforward. Countries of geopolitical strategic interest are not always the countries where health needs are greatest and the most good can be done. Public health is strongly driven by the principle of fairness in access to essential care, with first priority going to those in greatest need.
Fourth, health problems all around the world are increasingly shaped by the same powerful forces. The globalization of food production, distribution, and marketing is just one example. Affluent countries have abundant evidence of what improper diet and lack of physical exercise mean in terms of chronic diseases, like heart disease, cancer, and diabetes.
Why are health consequences so rarely considered when international policies are set? Where is the foresight?
If we take health seriously at the international level, should we not craft policies that take into account the benefits for health, or at the very least, strive to minimize the harm to health? As I have said before, we must argue strongly for policies that include a health impact assessment.
This brings me to my final and perhaps most important point. Public health is all too often placed in a reactive role, dealing with the consequences of policies it had no say in shaping. This is true for climate change. This is true for the current crisis caused by soaring food prices. For both, public health will bear the brunt.
Many foreign policies are understandably driven by economic interests, and these interests can also include growth in the developing world. Let me ask you: what is it going to cost the international community to deal with the consequences of more droughts, famines, floods, storms and hunger? Again, where is the foresight?
Let me conclude by referring to the May resolution on Public Health, Innovation, and Intellectual Property. This achievement, and I think it is a great one, places health in a proactive role.
It allows us to shape some of the factors that influence gaps in health outcomes. It allows us to be more proactive in our quest for fairness in access to life-saving and health-promoting interventions.
This is the true intersection of public health and policy.
I will leave you with these thoughts.