Collective coordination and delivery of sustainable health aid investment will help address the three stated objectives of Australia’s health aid strategy: to reduce poverty, reduce gender inequality and reduce household expenditure on private health.
Given Australia’s extensive international travel and trade arrangements within the Asia Pacific, a strong interest in regional health affairs is vital.
Pandemics and the outbreak of serious infectious diseases have seen global health security rise to the forefront of Asia Pacific domestic and foreign policy over the past two decades.
Health is now tightly linked to regional security. Global health risks have the potential to impede the movement of people, goods and services, limit humanitarian access and adversely impact health trends across the region. Conversely, investment in health security facilitates the flow of travel and trade and has the capacity to improve health systems and reduce health inequalities.
Greater awareness of the importance of addressing health risks also presents an opportunity for expanded regional cooperation and enhanced focus on reducing health inequalities. This health-security nexus is particularly important for Australia’s positioning in the region. That is why health diplomacy is so important.
What is health diplomacy?
Health diplomacy is where foreign policy and the governance of health systems intersect. Health diplomacy is concerned with health issues that cross national boundaries and require coordinated global solutions.
Health diplomacy can be exercised through enhanced security and intelligence sharing in biosecurity and infectious disease pathogens; through civil-military cooperation in humanitarian emergencies; international legal frameworks to secure the sharing of viruses to develop vaccines; and trade in pharmaceuticals, health goods, and the education of health personnel.
At the core of health diplomacy is the recognition that health is a human right and the pursuit of sustainable universal health care is essential to achieve the right to health care without discrimination.
Australia’s health aid landscape
Within the Asia Pacific region, Australia is regarded as a responsible international citizen and promoter of good governance standards. Australia has a responsibility to contribute to global efforts to reduce poverty and promote development in accordance with the UN Sustainable Development Goals.
Health diplomacy, as a feature of Australia’s good governance program, has typically fallen into the overseas development assistance agenda – aimed at promoting the economic development and welfare of developing countries, particularly in the Asia Pacific region.
Governance and education are consistently Australia’s top aid spends in the Pacific and Southeast Asia regions. However, Australia’s aid spend is consistently low in the health aid sector.
Successive Australian governments have identified the Asia Pacific as a priority region for investment. Yet, Australia’s aid budget has been cut over the last decade. Australia is currently at a historical low in terms of its aid generosity, and cuts are particularly evident in the health aid sector.
Health and gender
Currently, Australia’s investment in health is guided by DFAT’s Health for Development Strategy 2015–2020. The strategy outlines three priority areas for Australia’s health aid investment – programs that engage the private sector, reduce poverty and reduce gender inequality.
These three priority areas are explicitly stated as being intimately linked to the health care burdens of Australia’s Asia Pacific neighbourhood.
The relationship between poverty, private sector care, and gender in Asia and the Pacific becomes clear when we consider women’s opportunity to gain income equivalent to men.
While health gains for men and women have improved significantly in the last 20 years, access to health care services is still very much determined by gender and income.
There are more women than men employed in low-paying and low-skilled jobs, and women bear more responsibility for care roles and domestic responsibilities. This affects women’s access to the formal health care economy in two ways: in their own individual access to health care, and in their access to senior management and research positions in the health care sector.
Poverty, gender, and high health care costs all contribute to ill health, disability and the continuation of cyclical poverty. The social and economic conditions that determine gender inequality in many Asian and Pacific countries affect, in turn, the participation of women and girls in politics, policy, and research.
Eliminating gender disparities is seen as key to increasing per capita incomes in Australia’s neighbourhood.
Financial investment in the health sector is also a commitment to gender equality. Addressing the social and economic causes that limit the participation of women, girls and those living with a disability, is an important foundation for a community that can be healthy and resilient in the face of inevitable infectious disease outbreak emergencies.
Why health diplomacy matters
In the 2017 Foreign Policy White Paper, the Australian Government recognised that global health crises have the potential to threaten economic and human development, and that good public health systems support productive societies and economic growth.
A focus on capacity building with local institutional and governance structures in the region can help foster social, economic and political stability.
Bilateral and regional partnerships help to advance human rights, improve governance and support health and education in Australia’s neighbourhood, particularly the Pacific.
Investment in the health sector – from the government, higher education, and private sector – is required to strengthen governance, promote sustainable economic development and to expand Australia’s trade and investment opportunities in the region.
In a climate of reduced government spending, more innovative approaches in how aid investment can be better coordinated in partnership with Australia’s private sector, university sector, civil society and philanthropy, is needed.