Abstract

The importance of the regional dimension of health diplomacy is only gaining slow and uneven recognition. This is in many ways surprising. As demonstrated in the work of Deacon on the ‘globalization of social policy’, global social policy has been animated and debated not only at the multilateral level but at the regional level as well. But at least in the diplomatic literature, the importance of this regional dynamic (with a focus on diverse sites and actors and the pursuit of democratic control) has been missed. The objective of this article is to explore whether health diplomacy is catching up to this larger debate re-shaping the conceptualization and practice of diplomacy more generally. In some ways, the results may be counter-productive in that this shift may encourage an increasingly fragmented process. Yet, it may also point to some breakthroughs, with diplomats, acting as ‘go to’ personnel on the front lines of operational activity, enabling actors to integrate with one another to produce effective governance. In doing so, the regional dimension is given greater recognition as a component of health diplomacy, albeit in an uneven and sometimes awkward manner. Whereas global diplomacy generally emphasizes problem solving, the regional dimension is animated by a normative orientation.

Highlights

  • The importance of the regional dimension of health diplomacy is only gaining slow and uneven recognition. This is in many ways surprising given the animated debate to a large extent triggered by academic work on the ‘globalization of social policy’

  • The state-centric approach seemed resilient to the increasing role and presence of civil society organizations (CSOs), such as Médecins Sans Frontières/ Doctors without Borders (MSF) and other social organizations as well as philanthropies, operating autonomously on the front lines of epidemics, such as Ebola, compensating for measures and a focus beyond that of ‘protecting own borders’ (MSF, 2014)

  • Indonesia had borne the brunt of avian influenza (AI) in that it experienced the highest number of AI human infections, with a staggering case-fatality rate of over 80%

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Summary

Introduction

The importance of the regional dimension of health diplomacy is only gaining slow and uneven recognition. Global security interest can effectively work as a ‘pull’ effect when soft-binding negotiated clauses or outcomes accommodate reservations for national interest As showcased throughout this special issue, there is some strong evidence that regional actors are becoming more robust in animating new norms to improve health rights in international arenas engaging in new forms of regional diplomacy. Such a dynamic may accentuate the gap between the problem-solving approach favored by the core actors in the global system and, in so doing, reinforce the differences vis-a-vis the North and the Global South. Rather than defining normative objectives with a focus on specific (vulnerable and excluded) populations, or populations in high-risk areas – an approach associated with regional formations in Southern Africa where the presence of donors and philanthropies is significant in terms of agenda setting, funding, and implementation of projects (see Penfold and Fourie, this issue) – UNASUR focuses on structural issues affecting health provision and health governance, that is, social determinants of health and health promotion, leadership, and capacity building (Herrero and Tussie, this issue, Riggirozzi, 2015)

Conclusion
Findings
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