Global Health Diplomacy -- A Survey on Training Programmes & Courses

Transcription

1 Glbal Health Diplmacy -- A Survey n Training Prgrammes & Curses Prf. Dr. Ilna Kickbusch & Christian Erk Glbal Health Prgramme May 2008

2 The Graduate Institute f Internatinal and Develpment Studies (GI) The Graduate Institute s missin as an institutin f higher educatin and research is t prvide independent and rigrus analyses f current and emerging wrld issues with a duble emphasis n internatinal relatins and develpment studies. It has a particular cncern fr prmting internatinal cperatin and bringing an academic cntributin t less advanced natins. The Institute is active at theretical and applied levels f research and brings plicy-relevant expertise t cntemprary wrld issues. It als ffers executive educatin aiming at meeting in a flexible manner the demands f public and private internatinal actrs fr prfessinal develpment. Ideally lcated in Geneva, it benefits frm the envirnment f internatinal, gvernmental and nn-gvernmental rganisatins as well as diplmatic missins and cntributes t intellectual debate and prspective reflectin n all internatinal and glbal issues. The Glbal Health Prgramme at the Graduate Institute Prgramme Directr: Prfessr Dr. Ilna Kickbusch Thrugh its Glbal Health Prgramme (GHP), the Graduate Institute will cntribute t shaping the emerging field f interface between freign plicy, ecnmics, develpment and health. It will build capacity by engaging in research, knwledge translatin and diffusin fr and with majr glbal health stakehlders, particularly thse present in Geneva. It will examine which characteristics and mechanism define successful glbal health gvernance at the beginning f the 21st century. In particular, it will engage in three key areas: Innvatin in glbal health diplmacy and gvernance THE GHP will further develp the mdel f executive educatin in Glbal Health Diplmacy fllwing the successful first executive summer curse in It is nw invlved with partners in the USA, Brazil and Canada in establishing similar learning pprtunities. The 2008 executive summer curse, a Page 2 f 141

3 Dictinary f Glbal Health Diplmacy and an verview f training initiatives in health and freign plicy are in preparatin. The pwer shift in glbal health The GHP will prvide a better understanding f the shifting pwer balance in glbal health fr example the increasing influence f emerging ecnmies and the pwerful rle played by new fundatins, the private sectr and nn gvernmental rganizatins. The 2008 sympsium f the GHP will discuss the cnsequences f this shift. Anther area f study is the cntributin f the Eurpean actrs in the glbal health arena. The rle f Switzerland in glbal health gvernance The GHP will t cntribute t a strnger interface between Swiss academia and internatinal rganizatins. In particular, it will analyse and make mre visible the rle f Switzerland in glbal health gvernance and prduce a series f directries n glbal health activities in Switzerland, beginning with a Geneva Glbal Health Directry. The prgramme is als a partner and cntributr t glbal health events in Geneva. The GHP has already established cperatin fr example with the Wrld Health Organizatin, the Swiss Federal Office f Public Health, the Eurpean Fundatin Center and the Glbal Frum n Health Research. The Prgramme als plays a leading rle in the new initiative fr a Eurpean Cuncil n Glbal Health and is building partnerships with academic institutins and rganizatins in emerging and develping ecnmies. Cntact Infrmatin: Prf. Dr. Ilna Kickbusch The Graduate Institute f Internatinal and Develpment Studies Glbal Health Prgramme 132, rue de Lausanne P.O. Bx 136 CH 1211 Geneva 21 Ilna.Kickbusch@graduateinstitute.ch Page 3 f 141

4 Table f Cntents 1. Intrductin The Need fr Health Diplmacy Educatin Abut this survey What the survey tells us General Findings & Observatins Recmmendatins & Indicated Actin Steps Survey Data Degree Prgrammes Jint Degree Prgrammes Specializatin/ Cncentratin/ Fcus / Certificates Curses/Mdules Research Initiatives Executive, Summer & Online Curses Diverse/ Similar Appendix Accmpanying Letter Article: Glbal health diplmacy: the need fr new perspectives, strategic appraches and skills in glbal health Article: Glbal health diplmacy: training acrss disciplines Prgramme f the Graduate Institute s Executive Curse n Glbal Health Diplmacy Page 4 f 141

5 1. Intrductin 1.1. The Need fr Health Diplmacy Educatin There is slid evidence that many determinants f individual and ppulatin health extend beynd the cntrl f what is cmmnly understd as health sectr activities and are t a large extent determined by ther scietal and ecnmic factrs. A variety f plicies influence and shape the cnditins in which we live and wrk and these cnditins may have psitive r negative cnsequences fr the health f a given ppulatin and its individuals. This intercnnectedness is nt nly acknwledged by the Wrld Health Organizatin (WHO) which states that health is a state f cmplete physical, scial and mental well-being and nt merely the absence f disease r infirmity 1 but als agreed upn in the academic wrld 2. Mst f the mdels f health determinants see health influenced by macr level (e.g. scial, ecnmic, cultural, and envirnmental) and middle level cnditins and plicies (wrking cnditins, educatin, sanitatin, health care services, unemplyment, fd prductin, husing, neighburhd and cmmunities). These determinants are cmplemented by micr level, i.e. individual factrs (lifestyle, behaviur, cnstitutin) which in return heavily depend n the availability f and supprt fr healthy chices in everyday envirnments n the macr and middle level. This cnceptualisatin f Health in All Plicies is sund but needs t be expanded. Glbalisatin, the prcess f reducing the barriers f time, space and ideas between peple, has taught us t understand the macr level in a way which extends beynd the frntiers and interests f natin states and requires us t think n a glbal scale. This implies that the cncept f Health in all plicies needs t be mved beynd methdlgical natinalism t include areas f plicy nt usually cnsidered, When it cmes t health, in tday's glbalised and still glbalising wrld there is n such place as abrad: Prblems and slutins reach acrss natinal brders resulting in the need fr internatinal cllabratin and ablishing the distinctin between internal and external natinal respnses. 3 As we have seen with the utbreak f avian flu r SARS but as can als be seen with nninfectius diseases such as besity, health risks are internatinal. 4 In a nutshell: glbalisatin has a significant influence n the health f a given ppulatin and n cuntry can islate itself frm crss-brder risks and threats t their natinal health. In ur glbal wrld health is becming increasingly interdependent. As a cnsequence f glbalisatin natinal health prblems can n lnger if ever be dealt with in splendid islatin but rather call fr crdinated and cperative internatinal health effrts. We must begin t under- 1 Preamble t the Cnstitutin f the Wrld Health Organizatin as adpted by the Internatinal Health Cnference, New Yrk, June, 1946; signed n 22 July 1946 by the representatives f 61 States (Official Recrds f the Wrld Health Organizatin, n. 2, p. 100) and entered int frce n 7 April Cf.: Dahlgren, G. & M. Whitehead. Plicies and strategies t prmte scial equity in health. Stckhlm: Institute f Futures Studies, ; Bartn, Hugh and Marcus Grant. "A health map fr the lcal human habitat." Jurnal f the Ryal Sciety fr the Prmtin f Health (2006): ; Keating, Daniel P. & Clyde Hertzman (Eds.). Develpmental Health and the Wealth f Natins: Scial, Bilgical, and Educatinal Dynamics. New Yrk: Guilfrd Press, ; Institute f Medicine (IOM). Prmting Health: Interventin Strategies frm Scial and Behaviral Research. Washingtn D.C.: Natinal Academy Press, p. 43. ; Evans R. G. & G. L. Stddart. "Prducing health, cnsuming healthcare." Scial Science and Medicine 31 (1990): ; Cmmittee n Assuring the Health f the Public in the 21st Century (Bard n Health Prmtin and Disease Preventin (HPDP) & Institute f Medicine (IOM)). The Future f the Public's Health in the 21st Century. Washingtn D.C.: Natinal Academic Press, p Owen, Jhn Wyn. "Frewrd." In : Kickbusch, Ilna & Graham Lister. Eurpean Perspectives n Glbal Health. A Plicy Glssary. Brussels: Eurpean Fundatin Centre, p cf. Kickbusch, Ilna. The lessn f SARS: A wake-up call fr glbal health. Internatinal Herald Tribune. Tuesday, April 29, Available at: Page 5 f 141

6 stand health as a glbal public gd (GPG) 5 which all cuntries are respnsible fr prducing, sustaining, and prtecting frm material harm. The state f glbal health has a fundamental effect n all cuntries develped as well as develping. It is thus in the best interest and t the benefit f all cuntries t secure glbal health in an internatinally cncerted way. Glbal health actin is therefre driven by many appraches and interests: it is a critical develpment issue, a cmmitment t human rights, a frm f public diplmacy as well as an investment in self-prtectin and natinal security which cincides with the need fr cncerted reginal and glbal actin. The way t natinal health security leads thrugh glbal health security - which in return depends n the critical public health capacity in all cuntries, cmbined with a cmmitment t cllabrate. There are thus cmpelling reasns fr any natin state - may it adhere t a realist r liberal cnceptin f internatinal relatins - t partake in and further glbal health actin. The prblem is that, s far, health has nt been at the heart f freign plicy thery r practice and perhaps nt even at the margins 6 althugh tday s extent f freign plicy attentin devted t health is histrically unprecedented. Despite actin steps taken by sme cuntries (e.g. Switzerland r Brazil; cf. Appendix 3.2), the recgnitin f the need fr plicy cherence, strategic directin and a cmmn value base in glbal health is nly just beginning t emerge at the level f natin states. What is thus needed is a plitical revlutin that reflects a transfrmatin f freign plicy fr the benefits f health, r a transfrmatin f health fr the benefits f freign plicy 7. This apprach has cme t be described as health freign plicy and/r health diplmacy, which is defined as a plitical activity that meets the dual gals f imprving glbal health while maintaining and strengthening internatinal relatins, particularly in cnflict areas and resurce-pr envirnments 8. Glbal Health Diplmacy (GHD) refers in particular t the multi-level and multi actr negtiatin prcesses that shape and manage the glbal plicy envirnment fr health and ideally results in and aims at: Better health security and ppulatin health utcmes fr each f the cuntries invlved (thus serving bth the natinal and the glbal interest). Imprving the relatins between states and strengthening the cmmitment f a wide range f actrs t wrk t imprve health thrugh internatinal agreements A cmmn endeavur t ensure health as a human right and a glbal public gd and delivering results that are deemed fair fr all (i.e. reducing pverty, increasing equity). In rder t be able t meet these bjectives ambassadrs, diplmats as well as any freign service fficial have t be sensitised t understand the cmplexity f public health, its interdependencies with ther plicy areas, its actrs 9 and the idea that impact n health shuld be a starting pint and verall ratinale fr develping 5 I.e. a gd which is nn-rival in cnsumptin and nn-excludable thrughut the whle wrld. Cf.: Kaul, Inge, Isabelle Grunberg & Marc Stern (Eds.). Glbal Public Gds: Internatinal Cperatin in the 21st Century. New Yrk: Oxfrd University Press, as well as: Kaul, Inge & Michael Faust. "Glbal public gds and health: taking the agenda frward." Bulletin f the Wrld Health Organizatin 79 (2001): Fidler, David P.. Reflectins n the revlutin in health and freign plicy. Bulletin f the Wrld Health Organizatin 85.3 (March 2007): Fidler, David. Health as Freign Pwer: Between Principle and Pwer. Maly Lecture. Washingtn, Gergetwn University, Octber 5th, Nvtny, Thmas, Hannah Leslie, Vincanne Adams & Ilna Kickbusch. Health Diplmacy: A Literature Review. UCSF/IGCC Prject n Health Diplmacy p Increasingly the negtiatins n glbal health matters are nt nly cnducted between public health experts representing health ministries f natin states but include a grwing array f ther natinal actrs as well as majr players in the glbal arena such as NGOs, the private sectr, academia and fundatins. Page 6 f 141

7 freign plicy strategies. There is a need fr training prgrammes and initiatives which bring tgether diplmatic knwledge and negtiating skills with glbal public health expertise in rder t secure glbal public gds by means f cllective actin and which are aware f a diplmat s dual respnsibility: t prmte his r her cuntry s interest and t advance the interests f the glbal cmmunity 10. A first step in the strengthening f this interrelatinship has been made by the Osl Ministerial Declaratin n Glbal Health as a pressing Freign Plicy Issue f ur time 11 signed by the ministers f Freign Affairs f Brazil, France, Indnesia, Nrway, Senegal, Suth Africa, and Thailand n March 20th, Clsing with an agenda fr actin the signatries - inter alia - cmmit themselves t raising awareness amng diplmats and ambassadrs abut the impact f health and disease n ecnmies and t addressing the need t establish clser links between health and freign plicy by investing in human resurces, i.e. by furthering and implementing training and educatinal prgrammes Abut this survey In rder t make impact n health as stated in the Osl declaratin a pint f departure and a defining lens thrugh which t cnduct freign plicy, there needs t be a better understanding f health amng diplmats, freign affairs specialists as well as academics but als a better understanding f freign plicy by the public health cmmunity. As a first step in mving frward the "Osl Ministerial Declaratin" it is thus necessary t get a cmprehensive verview f this relatively yung field f research and the resulting training and educatinal prgrammes and initiatives. Addressing this gap and in the cntext f a wrking agreement with the WHO, the Glbal Health Prgramme f the Graduate Institute fr Internatinal and Develpment Studies Geneva has cnducted this survey f educatinal and training initiatives arund the wrld that aim t address the need t establish clser links between health and freign plicy, health and security, internatinal health law, health diplmacy and the like, i.e. links cmmnly subsumed by the terms health diplmacy r health freign affairs. Survey methdlgy Given the aim f cllecting as many educatinal prgrammes and initiatives as pssible and thus getting an as accurate idea f the state f the art f the field f health diplmacy training as pssible a multi-channel apprach was called fr. In rder t cver as much grund as pssible, we cnducted an extensive web survey/ internet research and als sent ut an electrnic infrmatin request including a letter 12 asking fr the recipient's cllabratin and the indicatin f any training/educatinal initiatives and prgrammes the recipient was aware f. In this we als asked the recipient t frward the t any relevant persns within their rganisatin. This was als distributed widely thrugh the PAHO Equity listserve. 10 Muldn et al. (Eds.). Multilateral diplmacy and the United Natins tday. Secnd Editin. Cambridge, Mass.: Westview Press, p Ministers f Freign Affairs f Brazil France, Indnesia, Nrway, Senegal, Suth Africa, and Thailand. "Osl Ministerial Declaratin - Glbal Health: a pressing freign plicy issue f ur time." The Lancet (21 April April 2007): (Als available at: Affairs-Jnas-Gahr-S/Speeches-and-articles/2007/lancet.html?id=466469) 12 This accmpanying letter which was sent as attachment t the in reprduced in the appendix t this survey. Page 7 f 141

8 In cnsidering health diplmacy as a plitical change activity which aims t imprve health utcmes as well as internatinal relatins we restricted ur search activities n prgrammes in internatinal relatins, internatinal affairs, diplmacy etc. which feature sme kind f training element in health, glbal health, public health etc.. This means that this is NOT a survey f glbal health prgrams in schls f public health - but rather f innvative attempts either t cmbine freign affairs and public health expertise in jint prgrams r t bring glbal health int freign affairs prgrams. What is needed (at least in a first step) are ambassadrs, diplmats as well as freign service fficials wh are sensitised t understand the cmplexity f public health, its interdependencies with ther plicy areas and the idea that impact n health shuld be a starting pint and verall ratinale fr develping freign plicy strategies. The starting pint fr health diplmacy thus is diplmacy which is enriched by sme health expertise in rder t secure the glbal public gd which is health by means f cllective actin. We furthermre restricted ur search t graduate prgrammes as ppsed t undergraduate and PhD prgrammes but als included executive and diplmatic training. In a first step we did an extensive internet research based n the results f several engine queries with cmbinatins f wrds, terms and phrases related t the field f health diplmacy. The table belw shws sme f the (actualised) quantitative results f this research (which f curse nly depicts a fractin f the wrdings searched with this already gives an indicatin f the newness f the field): Term/ phrase Hits/ results (as f May 7th, 2008) "Glbal health" 3'390'000 "Glbal disease" 95'200 "Glbal health security" 26'700 "Glbal health diplmacy" 3'560 "Health diplmacy" 7'640 "Health diplmacy training" 112 "Health diplmacy" +training 3'270 "Health diplmacy educatin" 2 "Health diplmacy" +educatin 3'680 "Health diplmacy prgramme" 1 "Health diplmacy prgram" 7 "Disaster diplmacy" 268 "Disease Diplmacy" 267 "Envirnmental diplmacy" 32'800 "Envirnmental diplmacy training" 31 "Green diplmacy" 3'230 We then scanned the results fr any educatinal/training initiative r prgramme that wuld be useful fr ur survey. Apart frm this semi-structured search we als utilised sme pre-cmpiled catalgues f academic schls with prgrammes in internatinal relatins, diplmacy etc.: Internatinal Frum n Diplmatic Training (IFDT) We lked at all the academic prgrammes/training initiatives f the IFDT members as listed in their directry. The IFDT was established in 1972, as a yearly Meeting f Deans and Directrs f Diplmatic Academies and Institutes f Internatinal Relatins, at the Diplmatic Academy in Vienna. The directry currently cmprises 91 members all ver the wrld. Page 8 f 141

9 Eurpean Diplmatic Training Initiative (EDTI) We als lked at the academic prgrammes/training initiatives ffered by the members f the EDTI as well as the curses ffered by the EDTI itself. EDTI is a grup f currently seventeen institutins in twelve EU member states delivering training in diplmacy, Eurpean and internatinal studies t fficials f EU institutins and Member States and t ther gvernments and institutins. Freign Plicy Assciatin (FPA) We lked at all the universities/prgrammes n the FPA's "Tp Internatinal Relatins and Public Plicy Graduate Prgrams" list (abut 20 universities/prgrammes; restricted t the US). Assciatin f Prfessinal Schl f Internatinal Affairs (APSIA) We lked at every institutin in the Americas (39 schls), Eurpe (7 schls) and Asia (6 schls) affiliated with r member f APSIA as listed by a schl search n the APSIA hmepage. American Freign Service Assciatin (AFSA) We lked at the AFSA list f 9 universities/prgrammes (US, Canada, Eurpe) in the field f internatinal relatins and diplmacy. Internatinal.GradSchls.cm Last but nt least we analysed the universities/prgrammes listed by Internatinal.GradSchls.cm (abut 40; fcus n Eurpe). Given the glbal distributin f the members f the abve mentined netwrks and assciatins as well as the lack f natinal restrictins f ur cmplementing web research we think that it is permissible t say that we cvered the curricula f the mst prminent and imprtant schls f diplmacy, freign affairs, etc. wrldwide. The findings f this survey can thus be cnsidered representative in a qualitative sense. As far as the electrnic infrmatin request is cncerned we have sent ut abut 450 s. In rder t gather and select the addresses we utilised ur persnal netwrks and in a secnd step addressed urselves t a variety f academic, research, gvernmental, nn-gvernmental, internatinal, multinatinal and further institutins as well as persns we came acrss during ur web research. Amngst thers, we als wrte t all the health attaches at the Permanent missins t the United Natins ffice (cf. And we especially wrte again t the health attaches f the 7 signatry cuntries. Hwever, the spread might actually be much higher than 450 recipients as we asked the addressees t frward the t any interested persn, pst it n the intranet r circulate it with the respective institutin. Whereas the results f the manual internet research prvided us with much f the infrmatin fund belw the sending f s did nt prve very successful. The mail respnse rate was very lw (nt exceeding 10%). Page 9 f 141

10 1.3. What the survey tells us In what fllws we want t highlight the lessns learned and the mst imprtant general results f this survey. Whereas it is interesting t have a lk at the training prgrammes/initiatives as listed n the fllwing pages and have them speak fr themselves there are sme meta-level bservatins which nly becme evident in a cmparative perspective and as a result f the actual data gathering prcess itself General Findings & Observatins At first sight, there seem t be a lt f prgrammes and initiatives aiming t better the understanding f health amng diplmats, freign affairs specialists as well as academics. But if ne has a clser lk it becmes clear that the number f prgrammes dealing with health diplmacy in a truly integrated manner is rather lw. In rder t cnvey this finding we have thus decided t use a classificatin which structures ur findings accrding t their clseness t the ideal f an actual graduate curse devted cmpletely t "Health Diplmacy" (althugh it has t be anntated that these classes are smetimes verlapping and that sme classificatins are questinable and culd be handled differently as well). Degree prgrammes This class subsumes all academic, degree granting prgrammes which feature an integrated curse f studies devted t the tpic f health diplmacy. Althugh we added tw curses t this class we culd nt actually find an integrated curse which fulfils the ideal f an actual graduate curse devted cmpletely t "Health Diplmacy". Jint Degree prgrammes This class cntains all the prgrammes which cmbine an academic degree in the field f internatinal relatin with ne in public health r a similar field. This cmbinatin generally cmes in the frm f jint degree, dual degree and cncurrent degree prgrammes. While the terminlgy differs and the same term can mean different things at different universities the cmmn characteristic f this class f prgrammes is the cmbinatin f tw master s prgrammes. Specialisatins/ Cncentratins /Fcuses / Certificates This class features all the academic master s prgrammes in the field f internatinal relatins, diplmacy etc. which allw the student t actually specialise in and devte a nt incnsiderable part f their curriculum t the study f health, glbal health, etc.. It als cmprises certificate curses and a cllabrative but nt degree-granting MA, i.e. prgrammes which can be taken in additin t ne s chsen degree/ curse f studies. Curses / Mdules This class features all the academic master s prgrammes in the field f internatinal relatins, diplmacy etc. which ffer single curses n tpics related t health. Thus, ne cannt speak f a specialisatin r cncentratin as the student nly deals with health in a relatively marginal way. Research Initiatives This class cmprises initiatives academic and nn-academic which try t cmbine and further research in the fields f internatinal relatins, diplmacy etc. and health, glbal health, etc. and put the tpic n the agenda. Page 10 f 141

11 Executive, Summer and Online Curses This class features curses mainly ffered t executives and staff in internatinal and reginal rganizatins, NGOs, philanthrpies, and the private sectr health as well as internatinal relatins prfessinals in departments f internatinal health, in ministries f freign affairs and develpment cperatin with respnsibility fr health matters and health attaches. Others This class cntains curses/prgrammes/initiatives which d nt fit any f the ther classes. Fr cmparative purpses it als features several curses n envirnmental diplmacy. Lking at the data frm the web it becmes bvius that mst f what has been and is dne in the field f what is generally understd by health diplmacy is dne in the Angl-Saxn part f the wrld. Thus, there is a clear gegraphic cncentratin n the US and t a lesser extent the UK and Australia. This finding is als crrbrated by the fact that there is n widespread prpagatin f the German, Spanish r French equivalent f the term health diplmacy. 13 The new discipline f health diplmacy is dminated by Angl-Saxn institutins and initiatives and has nt yet arrived r gained grund (at least in an independent way) thrughut the rest f the wrld. During the research we culd bserve that many internatinal affairs and diplmacy prgrammes which hlds especially true in nn-eurpean r nn-angl-saxn cuntries ffer rather basic curricula, i.e. cncentrate n curses such as Internatinal Plitical Ecnmy, Internatinal Plitics, Theries f Internatinal Relatins, Plitical Thery, Macr Ecnmics, Micr Ecnmics and Develpment Ecnmics. This shws that the relevance and imprtance f health diplmacy has s far and mst unfrtunately nly been acknwledged by a rather selected circle f academics and institutins. This is als reflected in textbks f diplmacy. Furthermre, the distributin als reveals that in rder t ffer a prgramme cmbining health and diplmacy a nt incnsiderable amunt f resurces is needed. Fr example, mst f the dual degree prgrammes are ffered by universities with a variety f schls and departments, amngst them a public/glbal health r medicine department and an internatinal relatins/diplmacy department. The tpic f health diplmacy thus seems t be rather driven by develped cuntries as cntrasted with emerging ecnmies r less develped cuntries. When it cmes t health diplmacy, the ften quted nrth-suth divide is cmplemented by an east-west divide, with the nrth-west being the precursr and driver. Nevertheless, there are exceptins frm this general rule. The mst frward lking is an initiative by the Fundaçã Oswald Cruz (Ficruz) in Brasil, which ffers an executive curse ( Curs de especializaçã em saúde glbal e diplmacia da saúde ) exclusively devted t the intersectin f health and internatinal relatins as well as the challenges f health in a glbalised wrld and the diplmacy tls t vercme them. As far as the cntent is cncerned, it is striking that there is nt a single integrated academic and degreegranting prgramme devted t health diplmacy. There is a number f dual, cncurrent and jint degree prgrammes but these are rather an additin f tw existing curses than the result f a tailred integratin f health and diplmacy/internatinal affairs t health diplmacy. The curses d nt seem t result frm a prblem-driven perspective. If a university has a health and a diplmacy department (each ffering degrees in their respective field anyways), setting up a dual degree, i.e. an additin f these tw degrees, has almst n marginal csts. But the whle is mre than the sum f its parts this is why the develpment f a specialising curriculum which explicitly aims at addressing the challenges f health diplmacy wuld be very beneficial. S far, 13 A web research with the German phrase Gesundheitsdiplmatie resulted in 10 hits, with the Spanish phrase diplmacia de salud in 8 hits and with the French phrase diplmatie de la santé in 8 hits. Page 11 f 141

12 there are curses in health and diplmacy but nne in health diplmacy (apart frm tw executive prgrammes f very shrt duratin). Althugh we did nt explicitly lk fr the funding surces f all the prgrammes r initiatives in this survey we nevertheless want t underline the pint that a new and innvative training in glbal health diplmacy is dependent n the willingness f funders and dnrs t invest in a new field and funders need t be familiarized with the cncept. Sme have been frward lking, fr example the Swiss Agency fr Develpment and Cperatin prvided financial supprt fr the DiplFundatin's Glbal Health Diplmacy curse in 2006 and fr the first executive training curse n Glbal Health Diplmacy at the Graduate Institute in Bill and Melinda Gates fund the SAIS Glbal Health and Freign Plicy Initiative. f Health and Human Rights, Center fr Disease Cntrl and Preventin (CDC) awarded the University f Califrnia San Francisc a grant t develp a Glbal Health Diplmacy curriculum in 2007 and t cnduct an executive training curse in Washingtn DC in July The Glbal Health Diplmacy Prgram (cf. Appendix 3.4) f the Graduate Institute f Internatinal and Develpment Studies is an exceptin, in that it has been develped with the funds f the Institute seeking t ffer an integrative apprach t health and diplmacy frm the very start. This is very much related t the lcatin f the institute in Geneva, a city which is frequently referred t as the glbal health capital. It has spearheaded executive training in glbal health diplmacy in 2007 and actively partners with ther academic institutins (UCSF, FIOCRUZ) and rganizatins (CSIH) t develp similar curses. The Graduate Institute als ffers a curse n The Changing Nature f Glbal Health Diplmacy fr Masters and PhD students every year and rganizes a yearly sympsium. Since the prgram has been established it is nw requested t cntribute Glbal Health Diplmacy t ther initiatives f the Graduate Institute, s fr example within ther summer curses and within the training f yung Swiss diplmats that the Graduate Institute cnducts. As has been nted befre, glbal health diplmacy is a field in the making, with a need fr bth cnceptual develpment and practical training prgrammes. The Graduate Institute s prgramme described abve is the first attempt t bring tgether diplmatic and health prfessinals t understand their cmmn interests in health as freign plicy (cf. Appendix 3.3). The primary gal f this survey was t give an verview f existing training initiatives and prgrammes cmbining health and freign affairs. It wuld need significant additinal wrk t prvide an in-depth analysis f the data including the quality f the educatin ffered. In summary we can say that Glbal Health diplmacy at least in a truly integrated and prblem-riented fashin is nt yet very prevalent in the realm f academic and diplmatic educatin. We interpret the very lw respnse rate f the schls f diplmacy and the permanent missins t the UN in Geneva as reflecting bth the lack f awareness and f prgrams. In sme cases we explicitly asked this questin as in the case f China and ur crrespndent cnfirmed that Glbal health Diplmacy was nt yet a field f training and research in this cuntry Recmmendatins & Indicated Actin Steps Based n the survey and the general remarks abve there are several recmmendatins we wuld like t prpse in rder t further develp the new and highly imprtant field f research and actin which is glbal health diplmacy: Page 12 f 141

13 1. Build a netwrk f innvatrs and leaders in the field f health diplmacy: Develp and establish a hub/ndal pint fr Glbal health diplmacy. Make arrangements fr an internatinal tracking system f curricula as well as any academic and nn-academic educatinal initiatives in the field f health diplmacy. (The Glbal Health Prgramme at the Graduate Institute in Geneva wuld be willing and well placed t take n this task based n this survey.) 2. Supprt capacity building activities fr health diplmacy especially in emerging ecnmies and develping cuntries this can be dne thrugh a cascading partnership system as develped by the Graduate Institute by multiplying existing initiatives/prgrammes which have already integrated the cmpnents f health and diplmacy int health diplmacy (e.g. the executive curses that have been develped). Als cnsider the invlvement f the WHO Reginal Offices. 3. Establish cntact with thse rganisatins which are respnsible fr educatin f diplmats and discuss with them hw health diplmacy t integrate GHD n the educatinal agenda. A first step t d s wuld be t set up sme srt f cperatin between the WHO and the signatries f the Osl Declaratin (Brazil France, Indnesia, Nrway, Senegal, Suth Africa, and Thailand). 4. Prmte the writing f detailed case studies fr the teaching f glbal health diplmacy. 5. Cnsider prducing a textbk n glbal health diplmacy and explre n line training. 6. Actively seek t include chapters n health diplmacy in diplmacy textbks. 7. Advance the integratin f existing jint/dual/cncurrent prgrammes. The quality f educatin is nt necessarily furthered by a mere additin f existing prgrammes int dual/jint/cncurrent degree r single curse fferings but rather by addressing the undeniable need fr educatin by prblemriented curricula. 8. Further the exchange between health diplmacy and envirnmental diplmacy prgrammes as the latter have already made the step f integratin and culd thus ffer help in addressing this challenge. Furthermre, a healthy envirnment is ne variable influencing public health. In rder fr a health diplmacy prgramme t be cmplete it wuld have t include envirnmental aspects as well. 9. Supprt the develpment f health diplmacy by identifying and appraching pssible funding surces (e.g. fundatins). Page 13 f 141

14 2. Survey Data While there are many ways t structure the survey data, i.e. the prgrammes, initiatives etc., we decided t use a classificatin which structures ur findings accrding t their clseness t the ideal f an actual graduate curse devted cmpletely t "Health Diplmacy" Degree Prgrammes Institutin Name f Prgramme Descriptin Princetn University Wdrw Wilsn Schl f Public & Internatinal Affairs M.P.P. fr Physicians The M.P.P. fr physicians (ne-year, residential prgram) aims t enrll medical dctrs in a ne-year training prgram in public plicy. M.D.s play an active rle in plicy issues related t health, and medical degrees are implicitly, if nt explicitly, a prerequisite fr many senir plicy psitins cncerned with health. The M.P.P. degree can be distinguished frm a Master s in Public Health (M.P.H.) degree by its fcus n ecnmics, plitics, scilgy, and statistics as tls fr plicy analysis. These skills are imprtant fr future health plicymakers. Outstanding prfessinals in the fields f medicine and science thus will have the pprtunity t develp and hne their plicy skills in rder t bring crucial expertise t bear n specialized public plicy issues. All M.P.P. students begin the M.P.P. degree prgram with a six-week summer prgram in ecnmics, mathematics, statistics, and leadership and plicy skills, designed t strengthen students skills in preparatin fr graduate-level curses. T qualify fr the degree, all candidates must successfully cmplete eight curses during the academic year, r fur curses per semester. M.P.P. candidates typically undertake prgrams f study that cmbine general curses in quantitative methds, plicy analysis, and public management, with mre specialized curses chsen frm amng the Schl s fur fields f cncentratin: Internatinal Relatins, Develpment Studies, Dmestic Plicy, and Ecnmics and Public Plicy. A typical curriculum might include tw curses each in ecnmics and/r statistics, tw curses that cver plicy analysis, negtiatin, r financial management, and three curses in ne f the fields f cncentratin. Cntact Hmepage Wdrw Wilsn Schl f Public and Internatinal Affairs Princetn University Rbertsn Hall Princetn, NJ Page 14 f 141

15 Institutin Name f Prgramme Descriptin Gergetwn University Gergetwn Law Master f Laws in Glbal Health Law General Infrmatin Health laws and plicies are increasingly transnatinal in the mdern era. Trade, cmmerce, travel, envirnment, war, and terrrism transcend bundaries and prfundly impact individual and cmmunal health. Prtecting the public s health and imprving individual health utcmes increasingly invlve natinal and internatinal innvatin and cllabratin thrugh legal systems. A cmprehensive apprach t glbal health law invlves multiple, interrelated fields including health, trade, ecnmics, intellectual prperty, human rights, ethics, and natinal security. The Glbal Health Law Prgram ffers lawyers wrking natinally and internatinally the pprtunity t advance their knwledge and skills thrugh fcused studies in cre legal and plicy curses n glbal health, individual and public health, human rights, biethics, internatinal ecnmics, bitechnlgy, and science. Additinal cursewrk (see belw) may fcus n ther areas f legal interest, including disabilities, envirnment, insurance, intellectual prperty, internatinal trade, patents, and refugees. Significant pprtunities fr independent student research als exist Degree Requirements Students must cmplete a ttal f 16 credits in curses in Glbal Health Law. As part f thse 16 credits, all students pursuing the Glbal Health Law LL.M. are required t take the 2-credit curse Glbal Health Law and the 2-credit curse Glbal Health Law Intensive, Prblem-Based Explratin r the 4-credit curse Glbal Health Law (Prfessr Taylr). Additinally, students must take tw cre curses frm the list belw in related credits in designated curses in the health fields. Biethics and the Law Seminar Biethics and the Law Seminar Health and Human Rights Health Law and Plicy Public Health Law and Plicy Internatinal Organizatins & Glbal Health Law Law and Regulatin f Drugs, Bilgics and Devices Pharmaceutical Intellectual Prperty Law Seminar Fd and Drug Law Remaining credits are elective based n the applicant s specific interests, backgrund, and gals and are chsen frm amng an array f ther health curses that may include required curses (nted abve) r the fllwing curses: Access t Health Care Cverage Advanced Health Law Seminar Advanced Patent Law Seminar Alternative and Cmplementary Medicine: Legal Issues Seminar Dispute Settlement in Internatinal Trade: Law, Plicy, and Prcedure Ecnmic Analysis f Health Care Law Genetics and the Law Page 15 f 141

16 Glbal and Natinal Appraches t Reprductive Health & the Law Human Rights at the Intersectin f Trade and Crprate Respnsibility Infrmatin Privacy Law Intellectual Prperty in Wrld Trade (frmerly Internatinal Intellectual Prperty Law) Internatinal Prtectin f Intellectual Prperty thrugh the WTO Internatinal Trade Internatinal Trade and the WTO Internatinal Trade, Investment and Sustainable Develpment Internatinal Trade Law & Regulatin Law and Psychiatry Seminar Law and Science Seminar Medical Malpractice Law fr Nn-Physicians Natinal and Glbal Health Law: O'Neill Cllquium Patent Law Accrding t Prf. Lawrence O. Gstin (Assciate Dean f the Gergetwn Law Center) Gergetwn University Law Centre and the Graduate Institute in Geneva will start a jint degree in glbal health law in Cntact Hmepage Gergetwn University Law Center 600 New Jersey Avenue, NW Washingtn, DC llmadmis@law.gergetwn.edu Page 16 f 141

17 2.2. Jint Degree Prgrammes Als includes dual and cncurrent degrees. Institutin Name f Prgramme Descriptin Cntact Hmepage Jhns Hpkins University Paul H. Nitze Schl f Advanced Internatinal Studies (SAIS) and Jhns Hpkins Blmberg Schl f Public Health (JHSPH) Jint-Degree Prgram in Internatinal Relatins (M.A.) and Internatinal Health (M.H.S.(Master f Health Science)) General Infrmatin This dual degree prgram cmbines the Master f Arts in Internatinal Relatins degree at the Paul H. Nitze Schl f Advanced Internatinal Studies (SAIS) in Washingtn, DC, and the Master f Health Science in Internatinal Health at the Schl f Public Health. Each tw-year prgram may be cmpleted in a ttal f three years, mainly thrugh the replacement f a perid f MHS field practice with curse wrk at SAIS. The first r secnd year f this three-year prgram must be spent at the Schl f Public Health. Students pursuing this jint degree prgram cmplete 4 semesters f curse wrk at SAIS. Separate applicatins must be submitted t each schl and admissin ffered in bth. The prgram is designed t prepare students fr careers that require a high level f health care expertise and a sphisticated understanding f internatinal, plitical, sciecnmic, and cultural issues. Emphasis is given t the synthesis f knwledge and experience essential fr planning and managing health services in a variety f settings arund the wrld. Curse Wrk Students in the cmbined degree prgram nrmally spend ne year at the Schl f Public Health during the first tw years f the prgram. The SAIS prtin emphasizes public plicy, develpment ecnmics, reginal studies, and freign language instructin. The Schl f Public Health cmpnent stresses the basic disciplines f epidemilgy, bistatistics, and health plicy and planning, alng with specialized training in public health. Students are admitted directly t ne f the department's fur prgram areas: Glbal Disease Epidemilgy and Cntrl, Health Systems, Human Nutritin, and Scial and Behaviral Interventins. The Paul H. Nitze Schl f Advanced Internatinal Studies Jhns Hpkins University 1740 Massachusetts Avenue NW Washingtn, DC Tel Fax admissins.sais@jhu.edu S.html Page 17 f 141

18 Institutin Name f Prgramme Descriptin Cntact Yale University Schl f Public Health (EPH) and Internatinal Affairs Cuncil (MacMillan Centre) Jint Degree Prgram in Public Health (M.P.H.) and Internatinal Relatins (M.A.) General infrmatin Graduating students will receive an M.A. in Internatinal Relatins frm the Graduate Schl f the Arts and Sciences and an M.P.H. frm the Schl f Public Health. The tw degrees are cnferred nly after the requirements f bth degrees are met. Candidates must apply t, and be admitted by, each schl separately accrding t each schl's admissin plicies. Admissin t ne schl is made independently f the admissin decisin f the ther schl The M.A./M.P.H. degree is designed fr students wh wish t use their knwledge f public health at an internatinal level. Duratin: Three years, with half f the time spent in each schl. Curse wrk T cmplete the jint degree, students must cmplete the requirements fr the IR degree, thugh nly a ttal f 12, nt 16, curses are required. The cre curriculum required f all MA candidates includes seven curses: the fundatins curse in internatinal relatins and tw graduate level curses each in histry, ecnmics, and plitical science. The rest f the curses is chsen frm amng the respective student's cncentratin. The m.a./m.p.h. degree may be pursued in Internatinal Relatins, African Studies, Eurpean & Russian Studies, r East Asian Studies. Fr the EPH cmpnent, jint degree candidates must cmplete all the nrmal departmental and divisinal required curses, thugh nly a ttal f 15, nt 20, curse units tward the M.P.H. degree are required. The Curriculum fr the M.P.H. Degree cmprises Cre Curses Intrductin t Statistical Thinking I & II Principles f Epidemilgy I One f the fllwing three: Applied Risk Assessment Fundamentals f Envirnmental Health Intrductin t Txiclgy One f the fllwing tw: Scial and Behaviral Influences n Health Psychscial and Behaviral Epidemilgy One f the fllwing tw: Health Plicy and Health Systems Health Ecnmics and Public Plicy In additin, students are required t satisfy the divisinal curse requirements f the chsen MPH subprgramme (Bistatistics, Chrnic Disease, Epidemilgy, Envirnmental Health Sciences, Epidemilgy f Micrbial Diseases, Health Management, Health Plicy, Scial and Behaviral Sciences) Page 18 f 141

19 Hmepage Page 19 f 141

20 Institutin The Gerge Washingtn University The Ellitt Schl f Internatinal Affairs & Schl f Public Health and Health Services Name f Prgramme Master f Arts and Master f Public Health Dual Degree Prgram Descriptin The Ellitt Schl f Internatinal Affairs cperates with the Schl f Public Health and Health Services in ffering a dual degree prgram leading t a Master f Public Health in cmbinatin with any f the fllwing Master f Arts degrees: Internatinal Affairs Internatinal Develpment Studies Asian Studies Eurpean and Eurasian Studies Latin American & Hemispheric Studies Students must apply and be accepted fr admissin by bth schls. Jint degree prgrams require students t cmplete the requirements f bth degrees befre receiving either. A dual degree prgram allws students t receive ne degree prir t the cmpletin f the secnd. A full-time student may be able t cmplete bth degrees within three years, r in tw and a half years if curses are taken in summer terms. Students accepted int the dual degree prgram may cmplete each degree separately Curse requirements Master f Public Health Glbal Health Track Required Cre Curse (Ttal Cre Credits 18) PubH 201 Bilgical Cncepts fr Public Health PubH 202 Bistatistical Applicatins fr Public Health PubH 203 Principles and Practice f Epidemilgy PubH 204 Envirnmental and Occupatinal Health PubH 205 Plicy Appraches t Public Health PubH 207 Scial and Behaviral Science Methds PubH 208 Management Appraches t Public Health Required PrgramSpecific Curses (17 Credits) PubH 321 Glbal Health Framewrks PubH 322 Cmparative Glbal Health Systems PubH 330 Qualitative Analysis and Evaluatin f Glbal Health Plicy and Prgrams PubH 331 Quantitative Analysis and Evaluatin f Glbal Health Plicy and Prgrams PubH 332 Reginal Appraches t Glbal Health and its Determinants PubH 335 Glbal Health Plicy and Practice: Washingtn Seminar PubH 336 Internatinal Health Organizatins Glbal Health Electives (select 3 curses frm the list belw; each 2 credits > 6 Credits) PubH 323 Glbal Health Ecnmics and Finance PubH 327 Glbal Family Health PubH 328 Glbal Health Prgram Develpment and Implementa- Page 20 f 141