Conceptual Basis of International Cooperation and International Relations in Health

1. Conceptual Basis of International Cooperation and International Relations in Health Dr. Carlos Arósquipa PAHO/WHO

2. Health and Diplomacy Foreign Policy functions • What is the relationship between health and diplomacy? • Health • Diplomacy • Evolution of Diplomacy • Bilateral Diplomacy Multilateral Diplomacy High politics Hard Power National security Economic interest Development Human dignity Low politics Soft Power Adapted from Fidler

3. Diplomacy in a Globalized World • The world is now: • Multi-polar • Multi-level • Multi-dimensional • And diplomacy now…. • Is not only run by professional diplomats • Does not only manage relationships between States

4. What does all this signify? • The introduction of new topics in the diplomatic agenda, in addition to economic development and trade • Evolution of health diplomacy

5. Global Health Diplomacy • “Global Health Diplomacy refers to the multi-level and multi-actor negotiation processes that shape and manage the global policy environment for health in health and non-health forums” (llona Kickbusch) • Oslo Ministerial Declaration • Launched in September 2006 in New York and 20 March 2007, in Oslo.

6. Rapid increase in global health actors MSF BONO PHA 250 PPPH WEF World Bank

7. Complexity at the Country Level

8. Growing trend in the volume of official development aid 1990-2010 Incremento requerido para alcanzar las metas actuales del 2010 0.35 0.33 0.33 0.28 ODA como % del PBI 0.22 Total ODA Fuente: Base de datos de la OECD

9. Aid in health by source. 2010 Sources* Cooperation in Health Channels Governmental Sources 71.7% Bilateral Agencies 45.3% USD 12,161 (millions) Development Banks 6.5% USD 1,742 (millions) Private Sources 19.2% UN Agencies 14% USD 3,776 (millions) International Health Cooperation 100% USD 26.867 (millions) European Union 2.5% USD 681 (millions) Debt relief 2.8% Global Health Partnerships 15.0% USD 4,049 (millions) Philanthropic Institutions 8.6% USD 2,321 (milions) Other and non-classifiable 6% NGOs 8% USD 2.160 (million) Source: author, using data from the Health Metrics and Evaluation. University of Washington

10. Extraordinary growth of cooperation for the development of health at the global level Health Development Aid (HDA) by channels of support. In billions of constant US$ 2008 Tomado de: Financing Global Health 2010: Development Assistance and Country Spending in Economic Uncertainty. Institute of Health Metric and Evaluation. University of Washington. 2010 Pan American Health Organization 2

11. Aid is increasing in Latin America and the Caribbean; however, it has been decreasing relative to global aid DAH por regiones del mundo en billones de dólares Taken from: Financing Global Health 2010: Development Assistance and Country Spending in Economic Uncertainty. Institute of Health Metric and Evaluation. University of Washington. 2010 Pan American Health Organization

12. Groupings of Latin American and Caribbean Countries World Bank – 2010

13. Latin America and the CaribbeanHealth Development Aid (HDA)US$ (millions; constant dollars) 2008 De los Rios, R; Vigil-Oliver W. ERP/OPS

14. Latin America and the Caribbean (HDA)by groups of countries and yearUS$ (millions; constant dollars) 2008 De los Rios, R; Vigil-Oliver W. ERP/OPS

15. ODA for Health as a % of public health spending (2007) PAHO/WHO Priority Countries % Pan American Health Organization Pan American Health Organization Source: PAHO/WHO, CRS Database (OECD.Stats) and World Bank Development Indicators

16. Top 10 Partner Countries for Health in Latin America and the Caribbean by Year. Pan American Health Organization De Los Rios, R; Vigil-Oliver W. PAHO/HO Source: OECD-DAC (CRS) Database

17. Latin America and the Caribbean: Top 15 Recipient Countries of ODA and Donor Participation Accumulated between 2002-2009 - Volume and Percentage Share

18. In Conclusion……..

19. Foreign Policy