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Health Diplomacy and America’s ‘Soft Power’

by Fred Fortin

Reading DHHS Secretary Mike Leavitt’s new blog, and his accounts of his travels through Rwanda and South Africa, has reinforced in my mind the humanitarian and strategic value of health care as a positive focus for the projection of America’s ’soft power’ in the world (see my previous posts here and here).

Leavitt’s sensitive descriptions of visits to U.S. supported programs in these two countries — funded through the President’s Emergency Plan for AIDS Relief (PEPFAR), Malaria initiative, and Columbia University’s TRACnet — like Rwanda’s Rubengara Health Center or the local Twubakane Project or South Africa’s Hope for Life Program — gives you a sense of how important these programs are to people as they struggle in getting the basic necessities of everyday life.

According to Leavitt, the United States has invested nearly $600 million in South Africa this year alone working with nearly 400 NGOs to deliver care.The goal is to spend a promised $30 billion over the next 5 years on these programs in 15 countries, 12 of which are in Africa. He reaffirms that,

” The US needs to emphasize this kind of effort. I refer to it as health diplomacy. It is an incredible, generous, and aggressive initiative in my judgment, and something a nation as strong as ours ought to be doing.”

This is certainly a humanitarian undertaking. But can we really call it ’strategic’, that is, in the pursuit of America’s foreign policy interest as well?

In Robert Kaplan’s disturbing book, The Coming Anarchy, he makes a strong case that the fall out of environmental degradation, surging populations, scarcity of resources and consequently the spreading of disease, incite group conflicts, and at some point become serious regional and national security issues.

He argues that foreign aid should be

“targeted at bread-and-butter region-wide programs that seek to slow societal deterioration gradually, in order to create an environment for the emergence of a healthier politics.”

This is in contrast to “making a particular country democratic in the face of a low literacy rate, the absence of a middle class, and a history of ethnic or regional strife.”

While health diplomacy is only one component of an effective foreign policy (and certainly not the savior of our image and values in a world increasingly in conflict) it is critically important in demonstrating who we are as a nation, and who we want to be as global citizens. Given the proper level of economic, technological and political support, health diplomacy could become symbolic of a new American ’soft power’.

We need a foreign aid strategy for health diplomacy that is worthy of the name and worthy of people like Mike Leavitt.