Health Diplomacy – advancing health & foreign policy

“Health is today a growing concern in foreign policy” – Dr. Margaret Chan

Health is on the radar of foreign policy since it is connected to three global agendas i.e. security, economy, and social justice. Over the past decade, countries around the world have progressively acknowledged the significance of linking their foreign policy efforts and their work on health. Various events around the globe have contributed to the development of the field of “Health Diplomacy”, for instance the increase in global funding to fight HIV/AIDS, the treat of emerging and re-emerging infectious diseases, the need for virulent disease vigilance, fears about bioterrorism, and emerging focus on health system strengthening and universal health coverage.

In recent times, there has been an astonishing surge of interest in the topic of health diplomacy. It is worth noting that, even with this growing level of interest, there is modest accord on how to define health diplomacy. The notion of health diplomacy was introduced as early as 1978 by Peter Bourne, special assistant to the president for health issues during the Jimmy Carter administration. He argued that “the role of health and medicine as a means for bettering international relations has not been fully explored by the United States. Certain humanitarian issues, especially health, can be the basis for establishing a dialogue and bridging diplomatic barriers because they transcend traditional and more volatile and emotional concerns”.

As a developing country, Pakistan has largely been the recipient of various developmental aids from developed countries including that for health and also relied on such assistance to advance domestic health condition. Conversely, with its escalating national power, Pakistan is also anticipated to shoulder responsibilities and to make contributions to many other developing countries of the region, not just in the form of medical teams. As the 21^st century continues to emphasize the need for synchronized health actions between nations, the significance of health diplomacy has become obvious within foreign policy loop. Pakistan must have bilateral or multilateral health treaties and agreements with other countries through multi-year action plan, with particular emphasis on health system development, public health, prevention of disease, primary health services and global health.

In the modern globalized world today, health is too important and political to be left only to the ministry of health. Globalization requires that ministers of health act with other countries in order to ensure the health of the residents at home. In this regard the government should:

1. ·         Integrate a global health perspective into its general foreign policy and create an information platform for health diplomacy,
2. ·         Harmonize general foreign policy and other policies to highlight the health effects of foreign policy, and improve the promotion of public health nationally and globally,
3. ·         Establish the coordinating office for health foreign policy to highlight the connection between health and well-being, social development and security,
4. ·         Produce policy papers on subjects arising in health foreign policy and strengthen academic proficiency,
5. ·         Continue its efforts to strengthen good governance, with emphasis on institutional development and the rule of law,
6. ·         And, give priority to fight against corruption and nepotism throughout development and foreign policies, with targeted efforts in the health diplomacy.

It is an eminent fact that health is a global public good and national public health cannot be safeguarded by any state in isolation. Almost all world leaders have committed themselves to ensuring that all individuals enjoy the right to health. They have also agreed to cooperate to realize this right for people all over the world. In Pakistan, foreign policy must take health issues into account, and health issues must have a diplomatic dimension. Foreign policy practitioners need to become aware of impact of policy options and decisions on health outcomes and must back these words with their actions. This is how foreign policy can make a difference to health and this is a task by which they are likely to be judged by future generation.

Who will rise against corruption?

In his historic speech delivered to the first Constitution Assembly of Pakistan on 11th August 1947, Mohammad Ali Jinnah identified the first duty of his government as the maintenance of law and order and defined his second priority in the following words:  “One of the biggest curses from which India is suffering is bribery and corruption. That really is a poison. We must put that down with an iron hand and I hope that you will take adequate measure as soon as it is possible for this Assembly to do so.” 

Regrettably for Pakistan, these intelligent words have not been heeded to in the last 68 years and corruption has become a virus infecting every aspect of political, social and economic activities. Corruption and bad governance is not only threatening our national security, economic prosperity but also, international reputation. In Pakistan, bad governance is perceived as widespread and systemic and deeply embedded in society and in government divisions at all levels. Moreover, bureaucratic corruption taking place in public administration at the implementation end of public policies. At this end, citizens experience corruption daily in their dealing with public administrators and services, like education, health, licensing authorities, police, customs, taxing authorities, and many other government agencies.

The recent report of Transparency International (2015) ranked Pakistan (Corruption Perception Index: 117) among the most corrupt countries and corruption has become a multibillion dollar industry. Corruption is a result of poor governance as it is a social epidemic and major constraint to good governance. To protect the democracy from this epidemic, accountability and transparency have become important element of governmental reform. Unfortunately, there is a lack of transparency and accountability in every public sector of Pakistan. In various literatures, corruption has been shown as the result of lack of transparency and accountability which is dangerous for democratic setup. It is also widely accepted and proved that transparency and accountability are major determinants in the fight against corruption. 

Globally, there is an ongoing debate in economics, political science and information technology over the best evaluation methods for transparency and accountability. Innovative technologies are opening up all kind of possibilities for improve and promote accountability and transparency. Information and communication technologies (ICTs) are progressively seen by governments, activists and civil society as an imperative tools to promote transparency and accountability, along with to identify and reduce corruption. There is a comprehensive accord that ICTs have the potential to make a meaningful contribution to the fight against corruption via facilitating the flow of information between government institutions, government and citizens, as well as among citizens. In the modern age, governments around the world are beginning to introduce ICT to the public sector reform in order transform governmental relations with citizens, good governance and curb corruption since new technologies can promote transparency, accountability and citizen participation.

Over the past few years, researchers have increasingly focused on the link between poor governance, corruption, and economic growth. Governance and corruption are multi-dimensional phenomena that affect different sectors and groups of citizens in any country. In Pakistan, cross-country evidence shows how poor governance and corruption may be harmful for standards of living and the distribution of income of citizens, reducing literacy and per capita income, while increasing infant mortality. Moreover, poor governance and corruption distorts public expenditure and increase poverty.

In poorly governed country, policymakers must face the challenge of designing and implementing effective reforms to improve governance and curb corruption. Policymakers need to approach governance and anti-corruption reforms in a novel way and integrate political commitment with technical measures and citizens’ participation. If an anti-corruption policy is to be viable, it must be designed as a multi-pronged venture that comprise a set of multifarious actions in different areas of society and sate institutions. More expressly, there is a substantial need to define all dimensions of the anti-corruption struggle and the role of ICTs can play in it, since ICTs hold the biggest potential for promoting the anti-corruption effort.

'Fighting the smokeless war' – Who will frame National Cyber Security Policy?

The 21st century is seeing more countries paying attention to asymmetrical threats as a new dimension in strategic defense. Although, traditional security issues will continue into the new century but threats such as terrorism and trans-boundary crime has also attracted attention and is given focus as parts of the national strategic perspective. It is alarming that, in recent years, together with the occurrence of new information and communication technology (ICT) and the development of the internet, new threats have appeared, such as cyber-crime, cyber-terrorism, cyber espionage and cyber-conflicts, with the participation of non-state entities, and cyber war understood as confrontation between countries in the cyberspace.

Current trends in the development of threats in the cyberspace clearly indicate an increasing influence of the level of security of the cyber domain on the general security of the country. The recent development in our region has pointed to a number of new challenges and uncertainties which impact Pakistan’s national defense. Various forms of extremism motivated by political, religious, ethnic or other reasons pose an important challenge for the national security. They are particularly dangerous when they are connected with the use of terrorism.

The rapid evolution of information and communication technology (ICT) is escalating the pace, capability, flexibility, efficiency and effectiveness of the current networks and systems, both within the civil and military scope. Information in conjunction with communication technologies are altering the way in which people interact between themselves and with their environment. This continual and accelerated progression of the ICT has led to cyber attacks becoming more and more sophisticated and numerous, leading to a cyber space that is ever more hostile, forcing those responsible for national and cyber security.

Security, in all its dimensions and spheres, is the first responsibility of any government. The government of Pakistan should assume leadership regarding cyber security in order to make its citizens aware of the need for protecting our cyberspace. Pakistan still does not have a solid capacity allowing the efficient administration, control and management of its cyber security. Therefore, the government and policy makers are accountable for setting the agenda for securing all national security domains including cyberspace. Ideally, the government may perform the following roles:

• Characterize of the role of cyberspace in achieving national development goals;

• Identify, analysis and mitigation of risks to achieving national interests;

• Develop cybercrime/cyber-terrorism legislation that is applicable and interoperable;

• Resource national cyber-security programs and institutional capacity building; 

• Formulate and defend cyber-security position at regional and global forums. 

In many countries, cyber-security has become a national policy priority supported by loyal and devoted leadership. They are approaching cyber-security in a holistic manner, including, economic, social, educational, technical, law-enforcement, diplomatic, military and intelligence-related aspects. A modern nation-state increasingly depends on cyberspace for its economy, public safety and defense. As a result, establishing a national policy for cyber-security is now and will continue to be an essential and critical element of the overall national security for the government. Another key aspect to bear in mind for the National Cyber Security Policy is the identification of cyber space as the new dimension of the operating environment. It will therefore be compulsory to provide our Armed Forces with cyber capabilities and human, technical and economic resources necessary for their exercise and functions.

There are certain areas of concern regarding the “National Cyber Security Act 2014” introduced in the Senate of Pakistan, for which the following recommendations are put forwarded for consideration in future reviews.

• Policy makers must first educate themselves better with respect to the internet, internet and cyber security together with its role in modern society,

• Government must get its own house in order and eliminate corruption and nepotism, 

• Government must support the necessary R&D to address issues,

• Government must overcome the obstacles to realistic, timely, actionable information sharing with industry,

• Policy makers must establish a program to educate citizenry about the nature of the problem and alleviation approaches,

• Cyber-security policy must be risk-based, outcome-focused, practicable and globally relevant.

To finish, the development of cyber-security policy is a long-lasting dedication for the security and stability of country and its cyberspace, and government must have a voice in international arena in this critical dot.