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Global Health as Smart Power

Smart Global Health Policy

by Tom Paulson

Smart Global Health Policy meeting

Someday, perhaps it will be enough to say that making people healthy worldwide is just good for all of us.

But, apparently, we’re not there yet.

A blue-ribbon panel called the Commission on Smart Global Health Policy met in Seattle last week and, to a crowd of several hundred people, presented its pitch that global health has political and foreign policy value.

The first sentence of the commission report says:

“As the United States applies smart power to advance U.S. interests around the world, it is time to leverage the essential role that U.S. global health policy can play.”

It goes on to recommend in detail how a more strategic approach to global health  — a so-called “smart power” approach — will “advance America’s core interests.”

I wonder: Is it really a good idea to cast global health efforts as a means to advance U.S. interests?

And if this is smart global health policy, what’s the dumb kind?

“Calling it smart does make you want to ask the question, okay, so what’s dumb global health policy?” laughed Dr. Helene Gayle, CEO of Care, former chief of HIV/AIDS for the Gates Foundation and co-chairperson of this commission.

Helene Gayle

by Tom Paulson

Helene Gayle, CEO of CARE

The idea here, Gayle said, is to move beyond the well-motivated but fragmented, short-term and uncoordinated approach taken in many global health efforts to a more comprehensive, long-term strategy — one that is essentially humanitarian but can also serve the national interest.

“The reality is that’s how you get more people to care about these issues, by first demonstrating how they serve our own interests,” Gayle said. Yet she agreed that her own organization, CARE, operates solely according to the needs of poor or otherwise disenfranchised people — and that it would be inappropriate to tailor its operations to serve American interests abroad.

But Gayle said global health issues have moved to a level of influence where they need to be considered within the broader context of American foreign policy and development.

Dr. Anne-Marie Slaughter, director of policy planning for the U.S. State Department, said at the Seattle meeting: “This (Obama) Administration recognizes that human well-being is not just a moral end in itself but also as a key part of our national security.”

Gov. Christine Gregoire spoke as well, but mostly about how global health is a major, emerging regional industry.The Washington Global Health Alliance co-sponsored the meeting, which was held at PATH’s Seattle headquarters.

Gregoire compared it to Microsoft, Boeing and Starbucks as an example of the region’s talent for innovation and entrepreneurship. The Governor talked about how global health efforts dovetail with our state’s emphasis on foreign trade.

“I don’t want to make you think it’s only about money and jobs for us,” said Gregoire. She noted that pandemic flu is one, non-economic, reason to also care about global health.

For many people like Gayle, who for years have struggled to get policymakers to pay attention to the health problems of the developing world, it is perhaps gratifying to now see global health viewed as a critical part of foreign policy or even the economy.

But this means the field of global health is also now at greater risk of having its primary mission — which, arguably, is supposed to be about helping the poorest people on the planet — diverted or compromised to serving more powerful and competing interests.


About Author

Tom Paulson

Tom Paulson is founder and lead journalist at Humanosphere. Prior to operating this online news site, he reported on science,  medicine, health policy, aid and development for the Seattle Post-Intelligencer. Contact him at tom[at] or follow him on Twitter @tompaulson.