Health Diplomacy and the Enduring Relevance of Foreign Policy Interests

The rise of global health issues within the world of foreign policy is precipitating great interest in the concept and practice of health diplomacy. Much discussion of this new field, particularly within the global health community, has narrowly focused on how diplomatic negotiations and foreign policy can be used to support global health goals [1,2]. Recent articles claim, for example, that ‘‘foreign policy is now being driven substantially by health’’ [3], and that health can move ‘‘foreign policy away from a debate about interests to one about global altruism’’ [4]. New and unprecedented opportunities to bolster global health through diplomacy have emerged, but claims that health now drives foreign policy fail to appreciate how significantly traditional foreign policy interests continue to shape health diplomacy. Foreign policy interests play a critical role in determining which global health issues achieve political priority and attract funding. In addition, an important, but less analyzed trend involves the increasing use of health interventions as instruments to advance foreign policy interests. Countries are increasingly using health initiatives as a means to improve security, project power and influence, improve their international image, or support other traditional foreign policy objectives. This paper provides an introduction to the PLoS Medicine series on global health diplomacy. Our paper reviews recent research in the field of global health diplomacy, discussing why only select global health issues rise in political priority, examining health diplomacy initiatives driven primarily by foreign policy interests, and seeking to illuminate the constellation of interests involved in health diplomacy. The principal message is that, despite recent commentary to the contrary, foreign policy interests are of primary and enduring importance to understanding the potential and limits of health diplomacy.