Over the past 20 years, organizations and networks among groups of countries have played an important role in global diplomacy. They are now increasingly important in establishing the context for policy on global issues including international financial stability and global health. Broadly speaking, these collectives can be identified as those supporting cooperation amongst industrialized countries, groupings of middle-income and low-income countries, and regional organizations based on treaty or trade agreements.
However, these are not clear categories and groups arise and change to meet specific needs. For example, the Group of 20 developing countries comprised 23 middle- and low-income countries who took a joint position on agriculture and trade. Later, another G-20 group formed to bring together the ministers of finance of the world’s largest economies. The longest-standing and largest organization for cooperation is the Commonwealth. Some countries are participants in all three of these networks.
Organizations for cooperation among industrialized countries have assumed an increasingly important role in the coordination of interests among these countries and in the preparation of initiatives. The Organisation for Economic Co-operation and Development (OECD) has long played a role in monitoring health performance and coordinating aid efforts. Since the late 1990s, the G-7/G-8 has become an important actor in global health, driven by the growing awareness that poor health poses a risk to global security. Health plays an increasing role in G-8 meetings; the G-8 was instrumental in developing the proposal for a large global health fund to fight major infectious diseases (in particular HIV and AIDS) and in securing and coordinating the commitment of the most powerful industrialized nations to support global health activities, for example. in the context of supporting the achievement of the Millennium Development Goals.
In recent years, organizations of middle-income countries, like BRIC (Brazil, Russia, India and China) and BRICS (BRIC plus South Africa), have increasingly coordinated their stance in international politics and international organizations. To some degree, this involves taking a leading position in new groupings of Southern countries like the G-20 or G-21 in WTO negotiations or the Friends of Development at the World Intellectual Property Organization (WIPO). As far as global health governance is concerned, they play an increasingly important role, particularly when it comes to expanding the options for the development of local pharmaceutical research and development, and improving access to medicines in developing countries.
The World Health Organization established regional offices within six geographic regions to promote common public health strategies and to form a link with the organization’s global policies. However, other forms of regional organizations of states, such as the European Union, the Association of Southeast Asian Nations (ASEAN), the Organization of American States (OAS) and the African Union (AU) – and, in particular, its New Partnership for Africa’s Development (NEPAD) initiative – have become increasingly important in global diplomacy. The focus on trade as a central issue in diplomacy has encouraged regional alliances and treaties to strengthen trade links, resulting in further cooperation in economic and social policy. These groups have developed an increasing focus on health and health security issues. The European Union, as a regional organization, constitutes a special case as it coordinates the activities of its member states and – effectively through the European Commission – develops its own politics in global affairs. Owing to the absence of a common strategy in many fields of global health, and disagreement with member states over independent action by the Commission in global health matters, the impact of the EU has remained considerably below its potential.
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