Sector brief on Foreign affairs

July 2015

Health 2020: Foreign policy and health

Synergy between sectors: ensuring policy coherence

Summary

The Health 2020 policy framework has also fostering healthy and resilient com- • support the mobilization of adequate been adopted by all Member States of the munities and economies in the European resources for global control, uni- WHO European Region in order to address Region and beyond. versal health coverage and joint action to Europe’s great social and health challenges, improve global health security; calling upon the health sector to reach out Foreign policy can help to create healthier • promote approaches within development to, and work with, all the various sectors people and communities by: financing that contribute to increasing and parties in the continuous work of • strengthening global mechanisms and health equity and address the social improving people’s health and well-being. processes to enable an informed and determinants of health; and Today’s greatest challenges are global and coordinated response by the international • working with the health sector to reduce require a common, coordinated response. community to major challenges affecting gender-based inequalities, including sexual, By working together, health and foreign people’s health and well-being, including reproductive health and rights, violence affairs can contribute to improving the living security issues; against women and in the humanitarian and working conditions of individuals, fam- • ensuring policy coherence between and security context. ilies and communities, reduce inequalities health, foreign policy and development, and support human development, not only including trade policies and commercial improving good health and well-being but determinants of health; Key messages The goal of Health 2020 is to significantly improve the health and well-being of populations, reduce health inequalities, strengthen and ensure people-centred health systems that are universal, equitable, sustainable and of high quality.

1 Health and wellbeing are public goods and assets for human development that contribute to strong, dynamic and creative societies.

5 2 Social progress is best mea- Health and well-being are sured by objective indicators best achieved if the whole of of health, health equity and works together, well-being, and this includes and Health 2020 promotes whole- the conditions in which people of-government and whole-of- are born, live and work. society approaches.

4 3 Different countries, cities Health and well-being and communities are at different can be improved and health starting-points; each is unique and inequalities reduced, through can pursue common goals through the right policies and working different pathways. with other sectors.

2 Health 2020: Foreignaffairs Strengthening the link between health and foreign policy

In 2012, all 53 Member States in the , including the rise of global European Region adopted Health 2020, trade in goods, environmental degradation the new common European health policy as well as conflict and human migration, framework, and committed themselves to has health as a key element. As unhealthy developing integrative policies that engage goods and lifestyles spread around the with all sectors in addressing the social globe, it takes a global response to coun- and economic determinants of health teract the increase in noncommunicable and well-being. This cannot be achieved . Foreign policy and diplomacy through domestic policy alone: health offer important instruments to address policy today requires joint action to address intersectoral, multilevel and multilateral collective problems facing all countries. The policy-making and can complement and link between health and foreign policy in support national policy efforts. Ensuring a globalized world has been most obvious that foreign policy supports health and in the response to communicable disease makes effects on health a key consideration outbreaks and builds on the historical tradi- for foreign policy, development and invest- tion of sanitary agreements between states. ment strategies is crucial. Bacteria, viruses and parasites do not stop at national borders regardless of political or diplomatic agreements.

World Health Organization 3 Health 2020: a framework for action

The goal of Health 2020 is to significantly improve the health and well-being of populations, reduce health inequalities, strengthen public health and ensure people-centred health systems that are uni- versal, equitable, sustainable and of high quality.

All Member States of the WHO European Region have What makes societies prosper and flourish can also agreed to monitor progress against six common targets: make people healthy, and policies that recognize this have more impact.

Building awareness and capacity to make health objec- 1. Reduce premature mortality in tives part of society’s overall socioeconomic and human the European Region by 2020 development is essential. All policy fields, including health, need to reform their ways of working and use new forms and approaches to policy at the global, 2. Increase life expectancy in national and local levels. the European Region

3. Reduce health inequalities in the European Region

4. Enhance the wellbeing of the European Region population

5. Ensure universal health coverage and the right to the highest attainable level of health

6. Set national goals and targets related to health in Member States.

4 Health 2020: Foreignaffairs Synergy between sectors: using foreign policy to improve health

Strengthening the link between foreign policy and better health

Many areas of domestic health are strongly • The health component in foreign policy energy demand. In addition, the global influenced by global developments, such design to address security concerns could action to address the effects on climate as trade in goods and services, intellectual be seen as the most prominent interlink, change gives global health challenges an property, especially in relation to medi- particularly to mitigate and respond important position to be integrated into cines, migration of health professionals to the outbreak of infectious diseases foreign policy strategies. and climate change. Many determinants of such as HIV, tuberculosis, , SARS, • Many countries implement health pro- health are subject to international treaties influenza A (H1N1) and . grammes as part of their development that require ratification and implementation are more likely to originate in countries and humanitarian commitments. Health at the national level. This includes not only with a poor , thus posing a can also be an important instrument the explicitly health-related treaties such as threat to the international community. of and relationship-building the International Health Regulations and the • Foreign policy-makers have the opportu- between countries, especially when co- WHO Framework Convention on Tobacco nity to address the significance of health operating in other areas of foreign policy Control but also treaties, trade to economic and social development by is difficult. agreements and environmental regimes. designing and contributing to domes- One of the most important international tic and global socioeconomic policy The outcomes of foreign policy can signif- negotiations for health at present is the pro- frameworks. Good health is essential for icantly influence global health, the health cess to define the Sustainable Development human development. A strong health of low- and middle-income countries and Goals – given their role for all countries and system is crucial for national and interna- the domestic health of countries in the not only low- and middle-income countries. tional security. Given the increased global European Region. Health is an important Since foreign affairs ministries primarily interconnection, ensuring health is on the component of the global portfolio of negotiate these, it is critical that both health foreign policy agenda could ensure coher- foreign ministries and relevant for many and development ministries be involved in ence in economic discussions including dimensions from security to stability. It is preparing the negotiations so that health enhancing trade relationships. a part of science diplomacy as much as and health impact are considered through- • Health as a vital component in foreign commercial diplomacy and a feature in rela- out the goals. policy, when engaging in post-conflict tionship-building between countries when development and responding to natural it is difficult to cooperate in other areas and The nexus between foreign policy has disasters, has been increasingly acknowl- therefore a key partner for the health sector. become increasingly accepted in three edged, mainly through humanitarian key global agendas: security, social and action frameworks. The impact on health economic development and post-conflict or has been included in foreign policy to re- emergency action. spond to global crises including food and

World Health Organization 5 Synergy between sectors: creating policy coherence to put health high on the political agenda

How can the sectors work together?

Health 2020 provides a platform for such KEY AREAS TO EXPLORE TOGETHER INCLUDE: joint working between health and foreign affairs. Working together, we have the • fostering policy coherence across health, power to intervene to address some of foreign policy and development; today’s greatest health challenges, including • ensuring adequate preparedness and health inequalities, social exclusion and response for emergency and cross-border supporting sustainable development while health threats; ensuring that individuals and communities • strengthening global mechanisms and are able to fulfil their highest potential. processes to adequately address health and health equity; and • ensuring that health is represented in eco- nomic processes, including trade policies.

How can foreign policy • Strengthen global mechanisms and other measures for an informed and coordinated preparedness and rapid response system make a difference to health? • Contribute to global, regional and subregional health governance and enhance human and social development • Support the mobilization of adequate resources for global disease control, universal health coverage and global action on tackling shortages of hu- man resources for health • Affirm the interconnectedness of trade, health and development, including in formulating trade agreements • Explore innovative approaches to improve access to essential mediciness • Ensure that global policies do not undermine public health approaches

6 Health 2020: Foreignaffairs Collaborating to improve global health

THE CHALLENGE THE RESPONSE NEEDED

Responding to cross-border health Cooperating towards establishing a permanent and threats, disease outbreaks and efficient response to outbreaks through humanitarian disasters international agreements as well as well prepared rapid response

Addressing global health inequities and Providing leadership in international the determinants of health in many global negotiations that have significant health policy forums, including the Sustainable impact, including such areas as environment, trade, Development Goals process intellectual property, agriculture and fisheries, climate change, biodiversity and biofuel production

Ensuring social protection, universal health Jointly developing coherent investment strategies in na- coverage and health system strengthening, tional health and social protection systems for prevent- including access to medicines ing and responding to health challenges Contributing to developing a trade environment that is coherent with social and health objectives Developing joint approaches on human resources for health

Strengthening WHO and the global health Ensuring close cooperation and joint strategic goals architecture between health, foreign policy and development Working together to strengthen joint accountability for greater policy coherence between health, foreign policy and development Working together to strengthen training on health diplomacy

How can health make a • Identify gaps in the availability of essential medicines and vaccines, equipment and health professionals, including states and countries difference to foreign policy? in conflict and crisis • Support gender health equity and general improvement of global health equity to strengthen national peace and security and pre- vent diseases, humanitarian crises and armed conflicts • Work together to overcome macroeconomic constraints to effec- tive health investment (prevention and treatment)

World Health Organization 7 Using Health 2020 as a platform for joint work: a political mandate and evidence base

The Health 2020 policy framework has a Senegal, South Africa and – de- political mandate. It has been adopted by all clared global health to be a goal of foreign Reducing health inequalities European Member States and can be adapt- policy in the Oslo Ministerial Declaration: To reduce health inequalities, addressing ed to the different settings and realities that “We believe that health is one of the most the following is a good start: make up the European Region. It describes important, yet still broadly neglected, long- how health and well-being can be advanced, term foreign policy issues of our time. ... sustained and measured through action that We believe that health as a foreign policy LIFE-COURSE STAGE creates social cohesion, security, a good issue needs a stronger strategic focus on the • Social protection for women, mothers- work–life balance, good health and good ed- international agenda. We have therefore to-be and young families ucation. It calls on the health sector to reach agreed to make impact on health a point • Universal, high-quality and affordable out to the many different actors within and of departure and a defining lens that each early-years education and care system outside government and provides inspiration of our countries will use to examine key • Eradication of unsafe work and access and direction on addressing the complex elements of foreign policy and development to employment and high quality work health challenges of the 21st century. The strategies, and to engage in a dialogue on • Coherent and effective intersectoral framework confirms values, is based on evi- how to deal with policy options from this action to tackle inequalities at older ages dence and identifies strategic directions and perspective”. This Declaration acknowledg- essential actions. It builds on the experiences es health as a global public good, bringing WIDER SOCIETY gained through previous Health for All poli- together the negotiation process for bilateral, • Improved social protection, according cies and guides the actions of both Member regional and multilateral cooperation as well to need States and the Regional Office. as a critical approach to ensure domestic • Co-creation and partnership with those health development. targeted, civil society and civic partners Several European have since • Action to reduce social exclusion established global health policies to ensure The Helsinki Statement on Health in All Poli- • Gender equity approach the collaboration between national sectors cies adopted t the 8th Global Conference on and to bring together common domestic Health Promotion in Helsinki in 2013 states BROADER CONTEXT and foreign policy concerns in order to that “In our interconnected world, health is • Promoting equity through tax and trans- set priorities and goals that also enhance shaped by many powerful forces, especially fer payments accountability between the sectors and to- demographic change, rapid urbanization, cli- • Long-term planning through links with wards civil society. Such policies can improve mate change and globalization … The health other policies domestic health, strengthen health as a pillar of the people is not only a health sector of development policy and ensure coherence responsibility, it also embraces wider political SYSTEMS with general foreign policy. Through such issues such as trade and foreign policy. Tack- • Greater coherence across sectors strategies, countries can be equipped with ling this requires political will to engage the • Comprehensive responses instruments and mechanisms to facilitate whole of government in health.” • Regular reporting and public scrutiny the cooperation between health, foreign policy and other sectors that are of particular Integrating Health 2020 through importance when negotiating within the whole-of-government and whole-of-society international arena, hosting major summits approaches in designing foreign policy will or holding a presidency. These policies and enhance precautionary measurements and frameworks define the country’s engage- a comprehensive response to global health ment in global health issues, outline the domestically and internationally. Appropri- value base and principles, set common objec- ate action should be taken to reduce the tives across sectors, create mechanisms and vulnerability of people around the world instruments of intersectoral consultation and to new, acute, or rapidly spreading risks to ensure information flow and consultation. health, particularly those threatening to cross international borders. A group of seven foreign ministers in Oslo in 2007 – Brazil, France, Indonesia, Norway,

WORLD HEALTH ORGANIZATION | REGIONAL OFFICE FOR EUROPE UN City, Marmorvej 51, DK-2100 Copenhagen ø, Denmark Tel.: +45 45 33 70 00 Fax: +45 45 33 70 01 E-mail: [email protected] Web site: www.euro.who.int