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.

Global health risks present challenges to our regional security environment—to the unimpeded flow of travel and trade, to ensure humanitarian access, and to sustain the positive health trends across the Asia-Pacific region.

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, attention to regional health security facilitates the movement of people, goods and services.  Fundamentally, investment in health security has the capacity to improve health systems and health inequalities of individuals across the region.

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 to address them.

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 healthcare without discrimination.

Australia’s Health Aid Landscape

Within the Asia-Pacific region, Australia is regarded as a responsible international citizen and the promotor of good governance norms. 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.

From reviewing Australia’s aid sector investment priorities, governance and education are consistently the top investment spends in the Pacific and Southeast Asia regions. Where Australia’s aid spend is consistently low, however, is 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 the causality of savings measures by various governments 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 the Asia and Pacific region 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 twenty 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 healthcare, 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 affects, 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 the 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.

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.

 Sara E Davies is an Australian Research Council (ARC) Future Fellow and Associate Professor at the Centre for Governance and Public Policy, School of Government and International Relations, Griffith University, Australia. She is also an Adjunct Associate Professor at the Gender Peace and Security Initiative, School of Social Sciences, Monash University.
This article is an edited version of a paper in the 2018 State of the Neighbourhood report and is also published on the Committee for Economic Development of Australia (CEDA) website.