Negotiating Health in the 21st Century: Global Health Governance in Fragile States Fourth High-Level Symposium on Global Health Diplomacy to be held on 29 November 2010


The governance role of the modern nation-state is not only to ensure a well functioning democracy and the security of the country but also to provide access to public goods and social welfare, such as education and health. In weak or failed states, these ‘traditional' state functions very often cannot be guaranteed and, consequently, new forms of provision emerge. Non-governmental and hybrid actors become important players and often take over typical state functions to ensure that basic services are delivered.

The international community has a critical impact on these governance regimes. This often complex landscape of very different actors leads to a multitude of cooperation models among stakeholders which are not hierarchically determined but rather characterized through ‘bargaining' and negotiation. The activities of the involved actors may also be influenced by their social, economic, and political interests and thereby reinforcing rather than resolving conflicts, with dramatic consequences for health care delivery, for example.

Nevertheless, negotiation processes in conflict and other crisis situations take many forms and are present at all levels. These include formal and informal; open and hidden; local, national, regional and international - be it for example between the conflict parties, local and international mediators or facilitators, donors or civil society. The success of these negotiations depends on, inter alia, the balance of power, the political will, the structure and actors of the negotiation process. The negotiations may have a direct positive impact on the health status of the population but could also lead to further weakening the state, its administrative processes, or to a case-to-case approach benefiting a few rather than a ‘universal right for all' approach.

The symposium will focus on
The political process towards more security and stability needs to involve a wide range of players and represent a broad range of interest. The symposium will introduce a new approach to crisis management, which is referred to as "metaleadership" - "overarching leadership that strategically links the work of
different agencies and levels of government".

The pioneer of this approach, Leonard J. Marcus, will deliver the keynote address, presenting his experiences in health care negotiation and conflict resolution. He is also founding Co-Director of the National Preparedness Leadership Initiative, a collaborative effort of HSPH and the Kennedy School of Government, developed in collaboration with the Centres for Disease Control and Prevention, the White House, and the Department of Homeland Security, and the Department of Defence. He has directed numerous projects intended to advance development of the negotiation, collaborative problem solving, and conflict resolution field applied to health related issues (More information about the speaker)

This keynote address will be complemented by other prominent speakers, among others Mary Amuyunzu-Nyamongo, Executive Director of the African Institute for Health and Development, reflecting on the forces that are shaping health in fragile states and how global health diplomacy must respond to these challenges.
(More information about the speaker)

Representatives of different agencies will also elaborate on their perspectives on how to negotiate improved health governance in fragile states.
Both country-based experiences and theoretical concepts will frame the symposium so that it is relevant for diplomats, health experts and academics.

Useful documents
Global Fund Investments in Fragile States: Early Results


| 10.00 - 10.15 | Welcome

Elisabeth Prügl, Deputy Director of the Graduate Institute
Rifat Atun, Director of Strategy, Performance and Evaluation Cluster, The Global Fund to Fight AIDS, Tuberculosis and Malaria
Ilona Kickbusch, Director of the Global Health Programme

| 10.15 - 11.30 | Keynote Address

Meta-Leadership and the Global Health Challenge: Negotiating Connectivity of Strategy & Operations
Leonard J. Marcus, Director of the Program for Health Care Negotiation and Conflict Resolution at the Harvard School of Public Health (HSPH)

| 11.30 - 12.30 | Panel

Negotiating Improved Health Governance in Fragile States: Agencies' Perspectives
Rifat Atun, Director of Strategy, Performance and Evaluation Cluster, The Global Fund to Fight AIDS, Tuberculosis and Malaria
Daniel Eduardo López-Acuña, Director, Health Action in Crisis, World Health Organization
Angela Gussing-Sapina, Deputy Director of Operations, International Committee of the Red Cross
Paul Spiegel, Chief Public Health and HIV Section, United Nations High Commissioner for Refugees

| 12.30 - 14.00 | Lunch Reception hosted by the Swiss mission to the UN Geneva

| 14.00 - 14.30 | Website Launch

Global Health Diplomacy Net -
Chantal Blouin, Associate Director, Centre for Trade Policy and Law, Carleton University

| 14.30 - 15.30 | Panel

Negotiating Health in Fragile States: Country experiences from different perspectives
Somalia: Ann E. Claxton, Sr. Technical Advisor - Global Health, World Vision International
Sudan: Ambassador Philip Mwanzia, Director, Foreign Service Institute
Afghanistan: Lt.Gen (Rtd) Louis Lillywhite, Focal Point Health in Fragile States, Centre on Global Health Security, Chatham House
Timor Leste: Anthony Zwi, Convenor, Global Health, University of New South Wales
Burundi: Jean-Louis Arcand, Professor of International Economics and Development Studies, Graduate Institute

| 15.30 - 16.00 | Keynote Address

Negotiating Health in Fragile States: An African Perspective
Mary Amuyunzu-Nyamongo, Executive Director, African Institute for Health and Development

| 16.00 - 16.15 | Concluding Observations
Ilona Kickbusch, Director of the Global Health Programme


This Conference is organised by the Global Health Programme

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Free online registration required here
Auditorium Jacques-Freymond, 132 rue de Lausanne, Site Barton
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