Over the past two decades, the importance of global health, as an emphasis for diplomatic engagement, has grown. The 1994 United Nations Human Development Report heralded the potential to advance human security with "first, safety from such chronic threats of hunger, disease and repression." In 1996, following the first ever UN General Assembly focusing on a health issue, the Joint United Nations Programme on HIV/AIDS (UNAIDS) was launched to strengthen the way in which the world was responding to AIDS. And, just recently the second time the UN General Assembly convened on a health issue was in 2011 when a high level meeting on NCDs led to targets to address the global threat.
We have also seen global health diplomatic activities in such areas as the Framework Convention on Tobacco Control, response to pandemics, and in other post conflict environments.
Numerous countries have embraced health diplomacy. In Oslo in 2007, Brazil, France, Indonesia, Norway, Senegal, South Africa, and Thailand made a joint Declaration in which they declared global health to be a "pressing foreign policy issue of our time", and committed to making health a "defining lens" for shaping foreign policy. Just last month, in December 2012, the US announced an Office of Global Health Diplomacy with a mandate to influence global stakeholders, align donor investments with country resources, and oversight, maintenance, and improvement of country-focused technical support that expands capacity for global health priorities.
While much of this evolved in the traditional circles of diplomacy — namely state actors — as the world's largest diversified health company, we believe that an approach to address the global health challenges requires private sector engagement. Our commitment to advance global health success was amongst the first global companies to include global health diplomacy as a strategic imperative in our Government Affairs and Policy department, a role which I have led since 2008.
In 2010, I testified before a US Congressional Committee on Achieving the United Nations Millennium Development Goals: Progress through Partnerships and presaged the role that effective private sector engagement can offer: “We believe our efforts in global health diplomacy drive new ways of thinking that can help shape stronger, more sustainable approaches to benefit mothers and fathers around the world.”
We have been engaged in a number of global health diplomacy activities, pledging one of the first private sector commitments to theMDGs that included contributions from our pharmaceutical sector increasing access for HIV and TB medications. There are three examples that provide a glimpse into the promise of the novel global health approaches in this multipolar world.
Innovation Working Group
On of the unique areas of heath diplomacy is the United Nations Innovation Working Group (IWG) on Women and Children’s Health. It was created in 2010, by the Secretary General to be the global hub of innovation in the UN SG’s Every Woman Every Child Initiative.
Along with Tore Godal, Special Advisor on Global Health to the Prime Minister of Norway, I co-chair this broad network of governmental, non governmental, and intergovernmental organizations as well as the for profit and not-for-profit private sector. As everyone has equal footing, we have developed a number of activities and publications. This includes a guide, with examples, for private enterprise for public health, sustainable business models, mHealth communication, medical devices and diagnostic access, and the use of checklists to advance global health.
Some of these innovations, such as checklists, have been, subsequently, scaled into the UN Life Savings Commodities Implementation plan. More information is available at http:// everywomaneverychild.org/
Another example was our engagement with non-communicable diseases (NCDs) such as diabetes, cardiovascular disease, chronic obstructive pulmonary disease and some cancers now account for nearly 2/3 of deaths worldwide.
On the occasion of The United Nations High-Level Meeting on NCDs in September, 2011, there were many opportunities to demonstrate global health diplomacy with a multisectoral approach.
In my role at Johnson & Johnson, we looked at ways we could contribute to enhance the dialogue and, synergistically, offer innovation via the diplomatic milieu.
I had a role as chair of the International Pharmaceutical Manufacturers and Associations (IFPMA) NCD Tack Force. With the IFPMA, in official NGO Status to the United Nations, I represented the global pharmaceutical industry in the UN activities including development of a Framework for Action. These commitments included some unique ideas to build health literacy and prevention of disease.
One novel contribution related to the development of a “scorecard for chronic disease.” This idea dated back to a lecture I delivered in 2000 at the US National Institute of Health’s National Library of Medicine which hypothesized that we could employ the premise of Astrophysicist Sir Martin Rees’ book Just Six Numbers: The Deep Forces that Shape the Universe, to develop numbers that could predict an individual’s overall risk for chronic disease. If the universe itself could be governed by just six numbers, could we apply that same theory to human health? Could a simple set of numbers, ultimately, be the key to determining our personal health futures?
We further developed this idea though original research and ideation, some of which we brought forward via the US Institute ofMedicine and peer reviewed publications. During the UN process, the IFPMA supported the World Health Professions Alliance—an alliance representing 26 million health professions — the World Medical Association, International Council of Nurses and global dental, pharmacist and physical therapists groups. They adopted this idea with a health improvement card for use by their constituents to use as a tool for patients to see their risk factors in a traffic light system of green, yellow, and red and discuss a plan with their respective health professional to improve health and prevent disease.
The potential however seemed larger. Using the metaphor of a “credit score for health” and leveraging WHO burden of disease data, we developed a new single health metric that, we believe, will not only be predictive but will help individuals become more literate about their health and, ultimately better able to seek out and understand information about changing behaviors?
We have linked the release of the new health score concomitant with the World Health Organization agreement to galvanize world leaders with the selection of a 25 percent reduction in NCDs by 2025 that advance the UN proclamations. Furthermore, with the world embracing mobile technology for health and with over five billion devices on the planet, the vehicle for NCD could be advanced with a new metric via a Digital Health Scorecard.
In the theoretical and practical reality of advancing mutual interests with diplomacy, a promising driver with this scorecard is that is in sync with the global objectives of our basic mission at Johnson & Johnson – helping people live longer, healthier, happier lives. We share with all partners engaged in the globalmission of preventing diseases before they affect individuals, families, and our healthcare system.
We believe this power of health information can create a more health literate world where people are empowered to make good decisions about their behaviors and their health. This scorecard is free of charge and provides a new health metric advancing the impact of public health via diplomacy.
The Digital Health Scorecard is not our first foray into the mHealth arena. We had been able to spearhead the first national text messaging service for pregnant women in the US and Russia with Text4Baby. We also have developed the Mobile Alliance for Maternal Action with the US State Department and UN Foundation’s mHealth Alliance for programs in multiple countries.
Global Smokefree Worksite Challenge
The final example of global health diplomacy, related to the UN NCD activities, was through the development of the “Global Smoke-free Worksite Challenge”.
Launched as a Clinton Global Initiative, ‘Commitment to Action’, concurrently with United Nations High Level Meeting on Non-Communicable Diseases in September 2011, the initiative that included the Mayo Clinic, American Cancer Society, US Dept. of Health and Human Services, and Johnson & Johnson aims to expand the number of employees that are covered by smoke-free worksites and support smokefree policies in the wider society. Since the launch, events have taken place in Russia, the Middle East, USA, and China that have brought together companies, NGOs, and government to share experiences and join in committing to smoke-free worksites and support strengthened smoke-free legislation.
In Russia, on April 19, 2012, a business leaders Forum included international best practices on creating smoke free workplace environments, the health benefits and positive impact on business profitability of these policies, and the importance of national legislation as a means to ensure universal protection, for all citizens, from the harmful effects of second-hand smoke. Forum participants adopted a resolution to express support for smoke-free workplaces as a simple, effective tool to promote public health and to express support for the draft federal law “On protection of public health from the effects of tobacco consumption”, developed by the Russian Ministry of Health and Social Development.
In China, on September 7, 2012, Dr. Huang Jiefu, Vice Minister of Health in the People’s Republic of China and Dr. Howard Koh, Assistant Secretary for Health at the United States Department of Health and Human Services, launched the China-US Smoke-free Worksite initiative along with 73 private sector companies as a multi-sectoral, public-private partnership that combines the health expertise of Chinese and US health agencies with the workplace experience of businesses to create and support smoke-free workspaces. This initiative will support companies as they take steps to go smoke-free during the next year.
The hope and promise of global health diplomacy — employing new “ambassadors” that include the private sector can help create new ground in advancing health literacy in the complicated world. Health Diplomacy presents an opportunity for all of us in all sectors—public and private— whom have multiple roles such as fathers, mothers, siblings, members of our community, and employees to advance a shared mission for caring for the world one person at a time.
We are all ambassadors for health as this is truly the only common currency of humankind. We all have opportunities to integrate health diplomacy into our activities.
The December 15th 2012, Economist article on global health suggested the “time may have come for a review of the world’s approach to public health, for vaccination, antibiotics, insecticides and the like are useless against heart disease, diabetes and cancer. New ways of thinking about the problem are needed – both because chronic disease requires continuous treatment, and because many of the answers to the question “How can people in the 21st Century have healthier lives, is not strictly medical at all.” P. 77 Global Health – Lifting the burden
One of the first efforts, supporting the agreed UN political declaration on NCDs, is from the private sector —the digital health scorecard launched by J&J and Microsoft on Windows 8 “………The September 2011 UN declaration challenges us to “Develop, strengthen and implement as appropriate, multisectoral public policies and action plans to promote health education and health literacy, including through evidence-based education and information strategies and programmes in and out of schools, and through public awareness campaigns. September 16, 2011…”