Foreign policy and the Indo-Pacific, what role for health diplomacy?

Health diplomacy in the Indo-Pacific region represents a critical point where public health initiatives intersect with the dense web of geopolitical interests and economic disparities. As nations across this vast and dynamic region grapple with common challenges, from emerging infectious diseases to non-communicable diseases, health diplomacy can serve as a pivotal force to advance public health goals and ensure equitable access to healthcare , while promoting regional collaboration and mitigating the impact of epidemics on the stability of the area. The emphasis on health in foreign policy discussions has grown, as demonstrated by several international declarations and resolutions, which highlight the interdependence between the two issues to achieve positive global health outcomes.

PANDEMICS: LESSONS LEARNED

In the late 20th and early 21st centuries, significant changes have occurred in the landscape of health diplomacy in the Indo-Pacific driven by globalization and the emergence of new threats to public health. The region has been at the forefront of responding to global crises such as the Sars epidemic in 2003, the H1N1 pandemic in 2009 and, more recently, the Covid-19 pandemic. These events have underlined the need to react effectively, for a coordinated international response and have brought health diplomacy to the center of geopolitical discussions. The Indo-Pacific region has also been a key player in global health initiatives, contributing to discussions on intellectual property rights, vaccine equity, and the integration of traditional medicine into mainstream healthcare.

In recent years, initiatives such as the Quadrilateral security dialogue (Quad) have expanded their focus on health diplomacy, underlining the strategic importance of health in foreign policy, particularly in light of the challenges posed by the Covid-19 pandemic. One of the Quad’s key efforts has been to ensure equitable access to vaccines globally, especially for low- and middle-income countries that face access barriers. Initiatives such as the Quad vaccine partnership and support for the Global pandemic radar highlight the group’s focus on collaborative vaccine research. Additionally, the Quad has addressed vaccine hesitancy and misinformation through public awareness campaigns and scientific engagement, promoting vaccine confidence. The Quad has also sought to streamline policy alignment among member countries, supporting global health equity and addressing issues such as vaccine shortages and distribution inefficiencies. Despite facing challenges, such as shortages of promised vaccines, the Quad has recalibrated its goals towards enhancing vaccine production capabilities for future emergencies and endemic diseases in the Indo-Pacific. As a “global pharmaceutical warehouse”, which produces 60% of the world’s vaccines and plays a significant role in the distribution of Covid-19 ones, New Delhi’s health diplomacy also extends to defending equitable access to health resources . Under the Vaccine Maitri programme, India has leveraged its considerable pharmaceutical manufacturing capabilities to produce vaccines not only for domestic use but also for global distribution. The initiative was instrumental in providing millions of vaccine doses to more than ninety countries across several continents, including Indian Ocean states, Africa, Latin America and the Caribbean. However, the initiative has also faced challenges including nationwide vaccine shortages following the rise in Covid-19 cases in India, which temporarily affected exports. Despite these obstacles, the program has adapted and continued to contribute to global vaccine supplies, while also supporting the Covax facility to ensure more equitable distribution.

THE EXPERIENCE OF OTHER COUNTRIES

Other Indo-Pacific countries, such as South Korea, Taiwan, New Zealand and Vietnam, have provided effective responses to the Covid-19 pandemic, demonstrating the importance of timely action supported by technology, public trust and transparent communication in the management of health crises. South Korea’s response was characterized by extensive testing, an innovative contact tracing system and its avoidance of a full lockdown by relying on its robust health system and public cooperation. Taiwan’s proactive measures, including tough travel restrictions, effective public health messaging, and integration of health and immigration data, have helped keep the pandemic at bay. New Zealand took a decisive and timely stance with its “go hard, go early” strategy, which included one of the strictest lockdown and border control measures globally. Vietnam’s strategy has included similar border closure measures, clear public health communication, and the use of grassroots networks for community mobilization, which has kept the number of cases and deaths remarkably low despite proximity to origin of the pandemic.

RESILIENT HEALTH SYSTEMS

These nations have demonstrated that a combination of preventative border controls, public health preparedness, and agile use of testing and tracing technology can significantly mitigate the impact of global health threats. The pandemic has highlighted the interconnection between health and foreign policy, underpinning the need for a collaborative and multilateral approach to future challenges. The experiences of these Indo-Pacific countries provide a roadmap for building resilient health systems capable of responding to pandemics, underscoring the need for global solidarity, preparedness, and a willingness to learn from the successes and challenges of others.

Health diplomacy in the Indo-Pacific region is challenged by its diversity, geopolitical tensions, economic disparities, and a wide range of cross-border health threats. Political differences and historical tensions between countries can potentially hinder unified action on health issues, while economic disparities create unequal access to resources. The region’s susceptibility to infectious diseases, environmental risks, and the effects of climate change, combined with disparities in health system infrastructure and capacity, further complicates the implementation of cohesive strategies.

Strengthening regional cooperation through platforms such as ASEAN, WHO regional offices and the Quad is crucial to promoting health initiatives that can not only address immediate crises but also ensure the long-term sustainability of health systems. Capacity-building efforts, including training health workers and investing in infrastructure and technology, are essential to uplift weaker systems and promote universal health coverage. Developing regional data sharing frameworks and early warning systems, while ensuring respect for national sovereignty and data privacy, will enable timely responses to health threats. Furthermore, the involvement of local communities, respect for traditional practices and the use of effective communication strategies are fundamental to improve awareness and health education of different populations.

CORNERSTONE FOR GLOBAL HEALTH SECURITY

Ultimately, health diplomacy in the Indo-Pacific can not only address specific health challenges, but also contribute to broader goals of sustainable development and social inclusion. By prioritizing vulnerable populations and addressing disparities, health diplomacy can serve as a cornerstone for regional cohesion and global health security.