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On Global Health and Foreign Policy

by Christopher R. Albon on March 23, 2009

This week I review an article by David Fidler of Indiana’s School of Law addressing the growing nexus between health and foreign policy (PDF).

Traditionally, health has been categorized as a field of “low politics”, while national security is the realm of “high politics”. Under this perspective, health is a goal of normative humanitarianism and not a significant component in international security. Fidler demonstrates this point with the simple example of biological weapons. When biological weapons have been addressed by the international community, they have done so under the guise of arms control (high politics) rather than health (low politics). However, the position of health in the hierarchy of politics is changing.

Fidler posits health’s increasing importance, particularly in the Carter and Bush (II) administrations, and summarizes three conceptualizations of its role in foreign affairs.

Revolution – Health “collapses” high and low politics into a new paradigm where “health serves as a central objective of global policy” (Fidler 2005, 7). That is, health changes everything.

Remediation – This conceptualization argues that while health is no longer in the realm of “low politics”, it has become just another issue addressed by traditional foreign policy. Health’s role in “high politics” is furthermore limited to those diseases capable of disrupting the material, security, and power capabilities of states.

Regression – The regression conceptualization argues that health’s growing importance is a side effect of the worsening global health situation. As emerging and reemerging diseases threaten the population of states, the “conventional perspectives of health in foreign policy hold health hostage to the views of powerful states concerning their material interests and capabilities”. (Fidler 2005, 9). As a result, the regression conceptualization posits that health’s new connection to high politics has been done so without the normative goals traditionally associated with international health.

Regardless of their differences, Fidler argues that all the conceptualizations see health’s relationship with foreign policy as a “radical break” from the past, bringing up new challenges for the international community. Specifically, health is quickly becoming a key indicator of good governance at the domestic and international levels. That is, a population’s health is becoming a fundamental measure of the legitimacy of their governing political bodies.

P.S. Major hat tip to Gail Fisher for point out this article.

Christopher R. Albon is a political science Ph.D. specializing in armed conflict, public health, human security, and health diplomacy.

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