Health Imperatives in Foreign Policy: The Case of Malaysia/Imperatifs Sanitaires et Politique Etrangere : Le Cas De la Malaisie/Los Imperativos Sanitarios En la Politica Exterior: El Caso De Malasia

By Barraclough, Simon; Phua, Kai-Lit | Bulletin of the World Health Organization, March 2007 | Go to article overview

Health Imperatives in Foreign Policy: The Case of Malaysia/Imperatifs Sanitaires et Politique Etrangere : Le Cas De la Malaisie/Los Imperativos Sanitarios En la Politica Exterior: El Caso De Malasia


Barraclough, Simon, Phua, Kai-Lit, Bulletin of the World Health Organization


Introduction

Health has increasingly become a significant element in foreign policy for both major and smaller countries, extending beyond their formal membership in global health agencies to feature more prominently in regional and bilateral relations. In this article, this phenomenon is explored through a case study of Malaysia that examines the motivations for health diplomacy, and illustrates the institutions and mechanisms for its conduct. It is argued that the narrow imperatives of national security imposed by fears of contagious diseases are giving way to a broader, more positive and collaborative diplomacy of health, with the potential for increased altruism. This study's conclusions are applicable to other middle-income countries of similar size.

In exploring connections between health and foreign policy, Fidler has suggested a useful hierarchy of functions. (1) The principal goal of foreign policy is to ensure national security; this is followed by a concern with serving economic interests through promoting trade, commerce and investment. These goals are, in turn, furthered by the fostering of order and stability. Finally, human rights may be served through the provision of humanitarian assistance.

Elements of this hierarchy are reflected in Malaysia's international health relations. Its professed foreign policy priorities include socioeconomic and political linkages within its immediate geographical region, and in particular with the Association of Southeast Asian Nations (ASEAN); self-identifying as an Islamic country; and undertaking a broad commitment to global citizenship through membership in the United Nations and other international bodies, including the Commonwealth of Nations. While seeking an engagement with, and openness to, the global economy, Malaysia also reserves the right to criticize what it sees as the unjust consequences of economic globalization, many of which have ramifications for human health. (2)

Malaysia and WHO

Malaysia is actively involved in WHO and is affiliated to the Western Pacific Region. The country office for Brunei Darussalam, Malaysia and Singapore is located in Kuala Lumpur. There are seven WHO collaborating centres in Malaysia, most of which are government agencies. They are concerned with research into health systems, pharmaceuticals and tropical contagious diseases. Such collaborations provide valuable international linkages and recognition for Malaysian technical leadership in these specialized areas.

Malaysia's regional role in assisting the development of WHO's Framework Convention on Tobacco Control illustrates the importance of international health diplomacy in furthering public health and the influence that such international agreements can have upon public policy in individual countries. A meeting in Penang in 2001, hosted by the Malaysian Government, WHO and the National Poison Centre of Universiti Sains Malaysia, not only galvanized regional support for the framework but also helped strengthen domestic efforts to engage the Malaysian Government with this global initiative. The meeting decided that regional meetings would be based upon membership of ASEAN groupings, rather than those of WHO. This decision to bypass WHO regional arrangements highlights a longstanding logistical problem for Malaysia and other ASEAN countries in their participation in WHO. Indonesia, Myanmar and Thailand are grouped within the South-East Asia Region, while the other members of ASEAN are in the Western Pacific Region.

The 2001 meeting resulted in the Penang Declaration, which called for the establishment of "mechanisms for regional cooperation to facilitate a consolidated global response to the tobacco menace". (3) The Declaration, forwarded to the 2002 meeting of ASEAN health ministers in Vientiane, also urged ASEAN countries to seek assistance from WHO and other UN and international bodies to implement the framework convention. …

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