Negotiating Public Health in a Globalized World: Global Health Diplomacy in Action

202 Pages·2012·1.28 MB·English

by  David Fairman

SpringerBriefs in Public Health
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David Fairman Diana Chigas
•
Elizabeth McClintock Nick Drager
•
Negotiating Public Health
in a Globalized World
Global Health Diplomacy in Action
123
Prof.David Fairman Prof.Elizabeth McClintock
Consensus Building Institute CMPartners LLC
238MainStreet 50Church Street
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e-mail: [email protected] e-mail: [email protected]
Prof.Diana Chigas Prof.Nick Drager
CDA-Collaborative Learning Projects Professor ofPractice of Public Policy and
17DunsterStreet GlobalHealth Diplomacy
Cambridge,MA 02138 McGill University
USA 3430McTavish Street
e-mail: [email protected] Montreal, QCX3A 1X9
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e-mail: [email protected]
ISSN 2192-3698 e-ISSN 2192-3701
ISBN 978-94-007-2779-3 e-ISBN978-94-007-2780-9
DOI 10.1007/978-94-007-2780-9
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Preface
In our turbulent, interconnected and interdependent world, one person’s security
impacts another’s, and one person’s health or ill health can affect another’s.
Today’s global economy binds the prosperity of countries together like never
before, as seen in the sharp rise in food and energy prices worldwide, the decline
ofstockmarketsandtheglobalfinancialcrisis.These‘‘crisesofinterdependence’’
have important public health implications. The damage is sometimes direct, as
when climate change fosters the spread of communicable diseases or when rising
food prices contribute to malnutrition. The damage can also be indirect, as these
crises undermine the political and economic conditions necessary to promote and
protect health equitably within and among societies. In a globalizing world, even
local health decisions can have global impacts. At the same time, however,
globalization also provides us with the opportunity to spread knowledge and
resourcesacrosstheworldatamagnitudeandwithanefficacythatwasimpossible
in the past.
Health has long been considered an issue of great ‘‘international’’ importance,
but the recognition of health as a ‘‘global’’ concern is more recent. It is also
profound and significant. This recognition not only requires us to think about
health issues as global issues, but also alerts us to the necessity of making some
health policy decisions at the global level. This is not the level at which health
policy typically resides. Most health decisions have been made—and still should
be made—at the local and national levels. The context of local realities has been
andwillremainparamountinhealthdecision-making.Toaddressthemajorhealth
crises of today, however, and to prevent or mitigate them in the future, countries
mustseekcollectiveagreementandactionwithinandacrosstheirborders.Asthe
numberand frequencyof decisionsrequiringglobalcoordination and cooperation
increase, we find ourselves in a new era of global health diplomacy.
Inthisnewera,themostimportantandmostcommonlyusedtoolfordecision-
making is negotiation. Because the international system operates on the assump-
tions of sovereign equality, cooperation and collaboration, rule-making,
goal-setting and planning to address global health issues all require negotiation.
In fact, we are currently experiencing a ‘‘new wave’’ of global health-related
v
vi Preface
negotiations. Some of these negotiations directly address health-related issues,
such as infectious disease, while others address issues such as trade and envi-
ronmental policy that may have indirect but profound impacts on health policy.
Inourworkwithhealthpolicy-makersandpractitionersaroundtheworld,ithas
become evident to us that health decision-makers are not fully prepared for the
challenges of this new era of global health diplomacy nor as skilled in the tools
requiredtoparticipateeffectivelyinitastheywouldlike.Veryoften,theworldof
internationalnegotiationisnottheworldinwhichhealthdecision-makersresideor
are most comfortable. We believe, however, that negotiation skills are now a
critical part of any health policy-makers’ toolbox. Such skills are essential for
diplomats, ministers, foreign policy-makers and trade negotiators. They have
become equally essential for health policy makers, health practitioners and pro-
gram managers within donor, governmental and nongovernmental organizations.
The goal of this guide is thus to provide these actors—with particular focus on
health policy-makers in developing countries—with practical information and
insight into the negotiation process, so that they may be able to work toward
achieving better outcomes for public health.
Acknowledgments
We would like to thank David Hermann and Kate Harvey for their tremendous
workinpullingtogetherthetoolsandmaterialsforthebook.Wewouldalsoliketo
thank Anand Balachandran, Allison Berland, Kelly Sims-Gallagher, Mariya
Kravkova and C. Michael Roh for their thoughtful research and analysis that
resultedinthethreecasestudiesincludedinthisguide.Specialthanksgoestothe
WHO for its support for the research and writing of this guide, as part of its
commitment to strengthening the capacities of developing country healthofficials
to participate effectively in global health policy making processes. Finally, we
would like to thank Larry Susskind and Adil Najam for their support and advice;
the experience and wisdom they have offered to us has been invaluable.
vii

Contents
1 Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
1.1 Challenges for Developing Countries . . . . . . . . . . . . . . . . . . 4
1.2 The Importance of Negotiation Skills . . . . . . . . . . . . . . . . . . 6
1.3 Organization of This Guide. . . . . . . . . . . . . . . . . . . . . . . . . 8
Part I A Framework for Enhancing Leverage in Negotiations
2 Issue Framing: Making Your Concerns a Global Priority . . . . . . 13
2.1 Why Issue Framing is Important . . . . . . . . . . . . . . . . . . . . . 14
2.2 Strategic Challenges for Global Health Stakeholders. . . . . . . . 15
2.3 Framing Strategies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
2.3.1 Targeting the Right Stakeholders for Action . . . . . . . . 17
2.3.2 Crafting the Message for Maximum Influence. . . . . . . 17
2.3.3 Timing the Initiative to Build Momentum. . . . . . . . . . 22
2.3.4 Seeking a Favorable Forum for Negotiation . . . . . . . . 24
2.4 Conclusion. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
3 Managing the Negotiation Process. . . . . . . . . . . . . . . . . . . . . . . . 29
3.1 Establishing a Shared Understanding of the Facts:
Joint Fact-Finding. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
3.2 Developing Options and Packages: The Mutual
Gains Approach . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
3.2.1 Getting to the Table: Preparation. . . . . . . . . . . . . . . . 41
3.2.2 ‘‘Enlarging the Pie:’’ Value Creation
at the Negotiating Table . . . . . . . . . . . . . . . . . . . . . . 50
3.2.3 Reaching Agreement: Value Distribution . . . . . . . . . . 53
3.2.4 Inclusion of Outside Stakeholders in the Process . . . . . 59
3.2.5 Culture and Negotiation . . . . . . . . . . . . . . . . . . . . . . 60
3.3 Conclusion. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
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