Abstract
Canada has been regarded as a model global citizen with firm commitments to multilateralism. It has also played important roles in several international health treaties and conventions in recent years. There are now concerns that its interests in health as a foreign policy goal may be diminishing. This article reports on a thematic analysis of key Canadian foreign policy statements issued over the past decade, and interviews with key informants knowledgeable of, or experienced in the interstices of Canadian health and foreign policy. It finds that health is primarily and increasingly framed in relation to national security and economic interests. Little attention has been given to human rights obligations relevant to health as a foreign policy issue, and global health is not seen as a priority of the present government. Global health is nonetheless regarded as something with which Canadian foreign policy must engage, if only because of Canada’s membership in many United Nations and other multilateral fora. Development of a single global health strategy or framework is seen as important to improve intersectoral cooperation on health issues, and foreign policy coherence. There remains a cautious optimism that health could become the base from which Canada reasserts its internationalist status.
Highlights
In 2007, the foreign ministers of seven countries (Norway, France, Brazil, Indonesia, Senegal, South Africa and Thailand) issued the Oslo Declaration identifying global health as ‘a pressing foreign policy issue of our time’ [1]
In 2009, the US Institute of Medicine issued the second of two reports on global health in foreign policy [9], the same year that the Annual Ministerial Review held by the UN Economic and Social Council devoted itself to global public health
While this paper focuses on Canada, its findings contribute to a still relatively sparse but growing body of literature focused on understanding how and why health is integrated into foreign policy
Summary
In 2007, the foreign ministers of seven countries (Norway, France, Brazil, Indonesia, Senegal, South Africa and Thailand) issued the Oslo Declaration identifying global health as ‘a pressing foreign policy issue of our time’ [1]. In November 2008 fifty-five nations sponsored a UN General Assembly Resolution on global health and foreign policy, urging member states ‘to consider health issues in the formulation of foreign policy’ [10]. Such developments serve to demonstrate a decadal trend in which health has risen to become an integral part of global policy discourse, accompanied by increased global financing for health, a proliferation of new health intervention initiatives (such as the Global Fund to Fight AIDS, Tuberculosis and Malaria and the GAVI Alliance), the implementation and discussion of innovative financing and taxation schemes (such as UNITAID’s airline tax and the International Finance Facility for Immunisation), and new private players (notably the Bill and Melinda Gates Foundation). Key questions generated from this study for further exploration include how to assess the impact of national global health strategies on global health practice and outcomes and the factors that appear to align with effective global health leadership at the country level, including, strong academic and civil society engagement, political will and leadership within the bureaucracy
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