Intended for healthcare professionals


Learning from soft power

BMJ 2015; 351 doi: (Published 01 September 2015) Cite this as: BMJ 2015;351:h4645
  1. Dariush Mozaffarian, dean1,
  2. Jordan A Blashek, JD candidate2,
  3. James Stavridis, dean3
  1. 1Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA
  2. 2Yale Law School, New Haven, CT
  3. 3The Fletcher School, Tufts University, Boston, MA
  1. Correspondence to: D Mozaffarian dariush.mozaffarian{at}

A need for soft healing in the 21st century

The limitations of direct military intervention—“hard power”—for achieving foreign policy are increasingly highlighted by international events. Policy makers, military leaders, and intelligence experts now recognise the crucial role of preventive policy approaches—“soft power”—to tackle the multifaceted, upstream causes of conflict and instability.1 2 3 Soft power encompasses diplomacy, development, trade agreements, sanctions, foreign aid, and the promotion of education, women’s rights, and democracy. It prioritises prevention, the shaping of international affairs to pre-empt or minimise crises before they arise, and is supported by bipartisan commissions, independent agencies, and the military.4 Hard power is reserved as a last resort. Used early and efficiently, soft power not only provides effective and diverse policy options, but it costs far less and risks fewer lives.

These hard learnt lessons in national security provide eye opening parallels to a second, major industrial complex: the healthcare system. The modern approach to health emphasises “hard healing”—the reactive, individualised treatment of risk factors and diseases. Like the military, healthcare systems benefit from highly trained, dedicated personnel who use complex, advanced, and dizzyingly expensive technologies to achieve a proximal aim: treating a disease.

And they both primarily respond to, rather than prevent, major crises. This is expensive and inefficient. Just as military interventions may resolve acute crises but leave behind fragile or …

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