Human rights in global health diplomacy: A critical assessment

There is no question that health has risen higher in foreign policy, with health aid quadrupling in the past 20 years and most Millennium Development Goals (MDGs) directly (or indirectly via determinants) addressing critical health inequities. The idea that governments should consider health seriously within their foreign policy became an official UN General Assembly Resolution in early 2009. Several countries have already issued formal statements on health as a foreign policy issue while others are crafting thought pieces that are nudging health forward in foreign policy discussions. There is even a new movement combining academia and bureaucracy under the rubric of global health diplomacy; the process by which government, multilateral, and civil society actors attempt to position health higher in foreign policy arguments. But for global health diplomacy (the "how") to have traction in foreign affairs, it needs a clear articulation of the "why." In looking more closely at country statements, what is apparent is the confusing mix of interconnections between wildly differing motives and drivers for the integration of health into foreign policy, not all of which cohere with one another. What arguments exist for why health (and notably health equity, the reduction of preventable inequalities in health within and between nations) should be a prominent foreign policy concern? Within the polyphony of possible arguments, where is there reference to human rights and have invocations to human rights by governments with stated commitments to health in their foreign policy mattered in how they actually behave? This article begins to address these questions.