Symposium 2010

4th High-Level Symposium on Global Health Diplomacy

"Fragile states - Analyzing the interface of health and diplomacy"

29 November 2010
Auditorium Jacques - Freymond, Geneva

On 29 November 2010, the Graduate Institute’s Global Health Programme (GHP), in cooperation with the Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund), held its fourth high-level symposium entitled ‘Fragile states – Analysing the Interface of Health and Diplomacy’. The list of 200 participants and guests included a diverse range of country representations and a mixture of affiliations – from international organisations, national public administrations, non-governmental organisations (NGOs) and academia. In addition, the event was webcasted live via the Graduate Institute’s website. At this year’s symposium, the new website of the Global Health Diplomacy Network (GHD.Net),, was launched.

Professor Ilona Kickbusch, Director of the Global Health Programme, moderated the event which highlighted the strategic opportunities and challenges that the dynamic relationship between health and foreign policy faces in the context of fragile states. In a system of multi-level, multi-actor health negotiations, meta-leadership was offered as a Harvard School of Public Health approach by Dr Lenny Marcus to multi-dimensional problem-solving, where responses to health challenges require efforts beyond silo thinking.

A panel discussion with representatives of different agencies featured the positive experience of the Global Fund for project evaluations within fragile states, and the complicated ‘persuasion’ process at different levels with diverse stakeholders – from nation states to NATO – which the International Committee of the Red Cross (ICRC) has to face in its strategic action and day-to-day business. Even in sensitive situations when health and human rights concerns – as well as issues such as security and national sovereignty – have to be balanced, health negotiations can lead to improved delivery for vulnerable groups, as underlined in the message from UNHCR. Against the background of chronic underdevelopment and the need for emergency action, the World Health Organisation’s perspective stressed the importance of coherence.

Careful preparation ‘at home’ ahead of international negotiations, broader engagement at the local and regional level as well as the need for capacity-building were emphasised by Dr Mary Amuyunzu-Nyamongo, Director of the African Institute for Health and Development. The dilemma between the need for immediate action and the desire for legitimacy also characterised the afternoon panel. The case study Negotiating health in a fragile state: a civil society perspective – A case study of the Global Fund tuberculosis project in Somalia, prepared by World Vision International together with the GHP, was taken as an entry point to analyse and debate the challenges and characteristics of health negotiations in fragile states.

Next year’s symposium will focus on the tenth anniversary of the Doha Declaration, with a public conference and high-level dialogue on the future agenda at the interface of global public health and intellectual property rights.