Sarah Kornblet

Defining Health Diplomacy: Changing Demands in the Era of Globalization

CONTEXT Accelerated globalization has produced obvious changes in diplomatic purposes and practices. Health issues have become increasingly preeminent in the evolving global diplomacy agenda. More leaders in academia and policy are thinking about how to structure and utilize diplomacy in pursuit of global health goals. METHODS In this article, we describe the context, practice, and components of global health diplomacy, as applied operationally. We examine the foundations of various approaches to global health diplomacy, along with their implications for the policies shaping the international public health and foreign policy environments. Based on these observations, we propose a taxonomy for the subdiscipline. FINDINGS Expanding demands on global health diplomacy require a delicate combination of technical expertise, legal knowledge, and diplomatic skills that have not been systematically cultivated among either foreign service or global health professionals. Nonetheless, high expectations that global health initiatives will achieve development and diplomatic goals beyond the immediate technical objectives may be thwarted by this gap. CONCLUSIONS The deepening links between health and foreign policy require both the diplomatic and global health communities to reexamine the skills, comprehension, and resources necessary to achieve their mutual objectives.

Costing framework for international health regulations (2005)

Costs can be estimated by identifying functional pathways toward achieving all 8 core capacities and global indicators.

Comparative analysis of national legislation in support of the revised international health regulations: potential models for implementation in the United States.

In 2005, the World Health Organization adopted the revised International Health Regulations, or IHR (2005), to establish obligations for detecting and responding to public health emergencies of international concern. The success of the IHR (2005) rests on the ability of states to implement the objectives and to execute the regulations in a legal and politically acceptable manner. Implementation of the IHR (2005) may be challenging for federalist nations, where most public health regulatory power lies in local rather than in national governments. We examine the implementation strategies of 4 nations: Australia, Canada, Germany, and India. The methods currently being considered by these nations for executing the IHR (2005) are potentially applicable models for the United States to consider.

Mapping of Networks to Detect Priority Zoonoses in Jordan

Early detection of emerging disease events is a priority focus area for cooperative bioengagement programs. Communication and coordination among national disease surveillance and response networks are essential for timely detection and control of a public health event. Although systematic information sharing between the human and animal health sectors can help stakeholders detect and respond to zoonotic diseases rapidly, resource constraints, and other barriers often prevent efficient cross-sector reporting. The purpose of this research project was to map the laboratory and surveillance networks currently in place for detecting and reporting priority zoonotic diseases in Jordan in order to identify the nodes of communication, coordination, and decision-making where health and veterinary sectors intersect, and to identify priorities and gaps that limit information sharing for action. We selected three zoonotic diseases as case studies: highly pathogenic avian influenza (HPAI) H5N1, rabies, and brucellosis. Through meetings with government agencies and health officials, and desk research, we mapped each system from the index case through response – including both surveillance and laboratory networks, highlighting both areas of strength and those that would benefit from capacity-building resources. Our major findings indicate informal communication exists across sectors; in the event of emergence of one of the priority zoonoses studied, there is effective coordination across the Ministry of Health and Ministry of Agriculture. However, routine formal coordination is lacking. Overall, there is a strong desire and commitment for multi-sectoral coordination in detection and response to zoonoses across public health and veterinary sectors. Our analysis indicates that the networks developed in response to HPAI can and should be leveraged to develop a comprehensive laboratory and surveillance One Health network.

Linking funds to actions for global health emergencies

The International Health Regulations could help align and trigger World Bank and World Health Organization efforts The failings of the international communitys response to the Ebola virus disease outbreak in West Africa underscore the need for new mechanisms for governance and mobilization of resources for timely, coordinated responses to public health threats (1). Creating a global finance mechanism, ideally tied to existing global health frameworks, is a first step. The World Bank recently announced it would create a Pandemic Emergency Facility (PEF). The next necessary element is a trigger to release those funds to support rapid and effective responses during early phases of a public health event. With the World Health Assembly convening soon, we suggest how the World Health Organizations (WHOs) International Health Regulations (IHR) present such an initiator.

Information-Sharing and Disease Reporting in a New Era of International Frameworks and Communication Technology: Middle East Respiratory Syndrome Coronavirus and Ebola Virus Disease Outbreaks

Emerging infectious disease outbreaks amidst accelerating globalization have pressed policy-makers to reinvent the health systems and communication structures developed to protect people and nations during public health events. For over 150 years, nations have negotiated measures to prevent cross-border disease spread. Approaches that endured through the 20th century focused on notification procedures and information-sharing

Implementation of the International Health Regulations (2005) Through Cooperative Bioengagement

Cooperative bioengagement efforts, as practiced by U.S. government-funded entities, such as the Defense Threat Reduction Agency’s Cooperative Biological Engagement Program, the State Department’s Biosecurity Engagement Program, and parallel programs in other countries, exist at the nexus between public health and security. These programs have an explicit emphasis on developing projects that address the priorities of the partner country as well as the donor. While the objectives of cooperative bioengagement programs focus on reducing the potential for accidental or intentional misuse and/or release of dangerous biological agents, many partner countries are interested in bioengagement as a means to improve basic public health capacities. This article examines the extent to which cooperative bioengagement projects address public health capacity building under the revised International Health Regulations and alignment with the Global Health Security Agenda action packages.

Carol Anne Bond v the United States of America: How a Woman Scorned Threatened the Chemical Weapons Convention

The case of Carol Anne Bond v the United States of America stemmed from a domestic dispute when Ms. Bond attempted to retaliate against her best friend by attacking her with chemical agents. What has emerged is a much greater issue--a test of standing on whether a private citizen can challenge the Tenth Amendment. Instead of being prosecuted in state court for assault, Ms. Bond was charged and tried in district court under a federal criminal statute passed as part of implementation of the Chemical Weapons Convention (CWC). Ms. Bonds argument rests on the claim that the statute exceeded the federal governments enumerated powers in criminalizing her behavior and violated the Constitution, while the government contends legislation implementing treaty obligations is well within its purview. This question remains unanswered because there is dispute among the lower courts as to whether Ms. Bond, as a citizen, even has the right to challenge an amendment guaranteeing states rights when a state is not a party to the action. The Supreme Court heard the case on February 22, 2011, and, if it decides to grant Ms. Bond standing to challenge her conviction, the case will be returned to the lower courts. Should the court decide Ms. Bond has the standing to challenge her conviction and further questions the constitutionality of the law, it would be a significant blow to implementation of the CWC in the U.S. and the effort of the federal government to ensure we are meeting our international obligations.