The foreign policies of the European Union and European countries have played an increasingly important role in the politics of global health. On the one hand, policies have defended rather narrow domestic economic interests, mostly in the context of WTO and TRIPS, and in relation to the migration of health workers from the South to Europe. On the other hand, Europe has also begun to address global health as a foreign policy issue in international agreements. For example, the WHO Framework Convention on Tobacco Control would be weaker without the support of European Comission directives on labelling and the Commission’s ability to bring all member states to the negotiating table.
Furthermore, in EU statements, health is often mentioned as an important factor for development and for managing globalization. The EU has made great strides in developing a common strategic approach to the management of the two dimensions of global health: development and interdependence. As a starting point, the 2008-2013 EU health strategy acknowledges these two dimensions in its call to strengthen the EU’s voice in global health issues; however, it remains to be seen whether all member states will follow suit.
European leaders and foreign ministries have also placed global health issues higher on the agenda and have begun building networks with partner countries outside Europe, such as in the case of the 2007 Oslo Ministerial Declaration on global health, which brought together the foreign ministers of Norway, Brazil, France, Indonesia, Senegal, South Africa and Thailand.
Member states have now agreed, in the European Security Strategy, to develop the EU’s civilian and military capabilities in conflict prevention and crisis management. While the details of such policies and their practical implications are still being formulated, joint EU forces, of one sort or another, have been involved in more than 30 international security actions. Most of these actions were in support of the ‘Petersberg Tasks’, which featured in the Treaty of Amsterdam and include humanitarian and rescue missions, peacekeeping and peacemaking, and combat forces in crisis management. Emerging EU security policy therefore has health and well-being as a founding principle for action and sees the development of civil society humanitarian and aid capability – through a network of such agencies – as closely allied to security tasks.
The security strategy also considers disease as a global challenge. It states: “In much of the developing world, poverty and disease cause untold suffering and give rise to pressing security concerns… AIDS is now one of the most devastating pandemics in human history and contributes to the breakdown of societies. New diseases can spread rapidly and become global threats.”
At European Union level, the need to address health as a foreign policy issue is, therefore, recognized, but this nevertheless raises the historical difficulties that the member states have had in agreeing to a common foreign and security policy. EU institutions have competence in trade, but not in all the other governance areas that foreign policy serves. For the EU, this arrangement creates a division between foreign and trade policies. In addition, EU institutions still have weak formal authority in many areas related to health, which makes integrating health into EU-wide foreign policies difficult, despite the policy directive to consider health in all EU policies, and the EU’s mandate to complement and coordinate member state health policies (which breach the increasingly blurred domestic-foreign policy divide).
More on the Common Foreign and Security Policy
Oslo Declaration on Health and Foreign Policy
The Oslo Declaration was issued by the Ministers of Foreign Affairs of Brazil, France, Indonesia, Norway, Senegal, South Africa, and Thailand on March 20, 2007.
It reads: In today’s era of globalisation and interdependence there is an urgent need to broaden the scope of foreign policy. Together, we face a number of pressing challenges that require concerted responses and collaborative efforts. We must encourage new ideas, seek and develop new partnerships and mechanisms, and create new paradigms of cooperation. We believe that health is one of the most important, yet still broadly neglected, long-term foreign policy issues of our time. Life and health are our most precious assets. There is a growing awareness that investment in health is fundamental to economic growth and development. It is generally acknowledged that threats to health may compromise a country’s stability and security. We believe that health as a foreign policy issue needs a stronger strategic focus on the international agenda. We have therefore agreed to make impact on health a point of departure and a defining lens that each of our countries will use to examine key elements of foreign policy and development strategies, and to engage in a dialogue on how to deal with policy options from this perspective.
As Ministers of Foreign Affairs, we will work to:
increase awareness of our common vulnerability in the face of health threats by bringing health issues more strongly into the arenas of foreign policy discussions and decisions, in order to strengthen our commitment to concerted action at the global level;
build bilateral, regional and multilateral cooperation for global health security by strengthening the case for collaboration and brokering broad agreement, accountability, and action;
reinforce health as a key element in strategies for development and for fighting poverty, in order to reach the Millennium Development Goals;
ensure that a higher priority is given to health in dealing with trade issues and in conforming to the Doha principles, affirming the right of each country to make full use of TRIPS flexibilities in order to ensure universal access to medicines; strengthen the place of health measures in conflict and crisis management and in reconstruction efforts.
For this purpose, we have prepared a first set of actionable steps for raising the priority of health in foreign policy in an Agenda for Action. We pledge to pursue these issues in our respective regional settings and in relevant international bodies. We invite Ministers of Foreign Affairs from all regions to join us in further exploring ways and means to achieve our objectives.