Intended for healthcare professionals


Global health diplomacy: how foreign policy can influence health

BMJ 2011; 342 doi: (Published 10 June 2011) Cite this as: BMJ 2011;342:d3154

Taiwan's health diplomacy: time to move forward

In a recent article, Ilona Kickbush explained how foreign policy and
health interact in four main ways: 1) negatively, when diplomatic tensions
arise or when economic and commercial concerns become priorities, 2)
strategically, when health diplomacy is used as a tool to reach other
goals, 3) in a integrative way, when health is considered as an essential
part of foreign policy and, 4) for the benefit of health, when foreign
policy supports health goals.

These insights are relevant to any state that seeks to develop health
diplomacy with the goal of using foreign policy to support the improvement
of global health. One such state is Taiwan.

Taiwan was among the first state in Asia to engage in medical
diplomacy when in 1962 its government decided to send health professionals
to Libya and Saudi Arabia. Since then, Taiwan's government had developed a
sophisticated model of health diplomacy, with parallels to that
implemented by the USA, France and Japan, but also with specificities that
reflect its particular status in international politics.

Taiwan's government, in cooperation with local universities,
hospitals and NGOs had sent medical and humanitarian missions to several
developing countries, including Malawi, Swaziland and Sao Tome and
Principe [1], to support their efforts to combat HIV/AIDS, malaria, dengue
fever and neglected diseases, to improve food safety, and to strengthen
primary health care as a contribution to achieving the MDGs. Taiwan has
also developed partnerships with some of the least developed countries to
strengthen their health systems by construction of health facilities,
training of local health professionals, and donation of medical devices
and medicines.

Recently, Taiwan's government has supported the Global Fund,
initiated health projects under the Asia Pacific Economic cooperation
(APEC) [2], joined international consortia for health and medical research
funded by the European Commission, and has sent delegations to attend
conferences and workshops organized by the WHO or UN agencies when these
institutions agreed to invite Taiwanese professionals.

In short, Taiwan has become more deeply involved in global health and
a growing number of actors in this domain are aware of this reality. It
seems that there are numerous opportunities for Taiwan to make its foreign
policy contribute even more to global health.

First, Taiwanese public health experts must to work more closely with
its diplomats to achieve global health goals. In fact, Taiwan was a
pioneer in cooperation between diplomats and health professionals, with
the establishment in 2006 of the platform Taiwan International Health
Action (Taiwan IHA) [3] which engaged the Department of Health (DOH), the
Ministry of Foreign Affairs (MOFA) and civil society "to cooperate on
issues of international health" as a "partner for global health". As Ilona
Kickbusch underlined, governments should "insist on inter-sectoral
mechanisms that create coherent policy between government departments".
TaiwanIHA offers a model that can be emulated.

Secondly, the need for strong international health departments within
the ministries of health, proposed by Ilona Kickbusch, also applies to
Taiwan. It could be useful for the DOH to invite local and foreign
advisors with backgrounds in health diplomacy or research in global health
to keep it updated on developments in global health governance, to
brainstorm with officials to identify new initiatives to encourage
opportunities for cooperation and to make Taiwan's health diplomacy even
more beneficial for global health in accordance with the Paris Declaration
on aid effectiveness (2005).

Lastly, like Japan, Norway, the UK and Switzerland, Taiwan would
benefit from a national strategy for global health. This would create a
vision that would help Taiwan to play an effective role in global health
and to have an impact on health through its foreign policy.

[1] Website of the medical mission in Sao Tome and Principe:

[2] APEC Health working group:

[3] Taiwan International Health Action:

Competing interests: No competing interests

24 June 2011
Vincent Rollet
Advisor on European Affairs
Peter Chang, Dean, International Office
Taipei Medical University,Taiwan