Juggling Demands: Canadian Health Aid to Latin America since World War II
Dmitrienko, Klaudia A., Birn, Anne-Emanuelle, Canadian Journal of Public Health
Background: Since the development of the Commonwealth's 1950 Colombo Plan (Canada's first official aid program), health-related development assistance has been an important instrument of Canadian foreign policy, allowing it to gain a presence in a range of countries and help to shape international affairs. This pattern is evident in the history of Canadian multilateral and bilateral health aid to Latin America.
Methods: This analysis draws on historical material from the Departments of External Affairs and National Health and Welfare held at the Library and National Archives of Canada regarding Canadian involvement with the Pan American Health Organization (PAHO), and program information from the Canadian International Development Agency's (CIDA) Corporate Reporting Services Group.
Findings: Canada was initially a tentative player in the region. However, as Canadian foreign policy interests shifted towards the region in the 1970s, Canada used both multilateral and bilateral health aid to establish a presence in Latin America that was independent from, yet unthreatening to, United States hegemony in the region.
Conclusion: The impact of Canada's provision of health aid to Latin America via PAHO and CIDA has been largely symbolic, allowing Canada to pursue an independent foreign policy in the region and to foster a positive international image for itself with minimal spending.
MeSH terms: Foreign aid; Canada; Latin America; PAHO; international cooperation; history
In 1980, the Canadian government was faced with the thorny question of which three Latin American countries to support for election to the Executive Board of the Pan American Health Organization (PAHO). A PAHO member for only nine years, Canada wished to develop a positive international image and balance its alliances in the region. The Department of National Health and Welfare supported Jamaica and Argentina for two of the positions, "on the grounds that diese candidates [were] best qualified in international health",1 leaving the third decision to the discretion of the Department of External Affairs.
External Affairs administrators debated the implications of filling the third spot with Uruguay, Nicaragua or the Dominican Republic, at first backing either the Dominican Republic, "a democratic country with which we have good relations" or Nicaragua, as "this would provide a modest signal ... that we are prepared to maintain cordial relations with that country"2 in the wake of the Sandinista revolution. However, concern regarding a possible "shift to the left" on the Executive Board and "Canadian judgment that the region would certainly benefit more if [non-Marxist] policies were pursued" led External Affairs to favour Uruguay.3
Despite this initial support, External Affairs ultimately dropped Uruguay, arguing that it was problematic to back two countries in die Southern Cone but none in Central America and also "awkward to cast two of our three votes for countries with such tarnished human rights records as Uruguay and Argentina" (although it was noted that none of the countries had unblemished records).4 Ultimately, Canada took the route of least political offence, and the Canadian delegation was instructed to vote for the Dominican Republic to fill the third seat.5
This episode illustrates Canada's position vis-à-vis health aid to Latin America as one of juggling a variety of foreign policy interests in the region. These include: forging a symbolic and independent foreign policy, being unwilling to challenge traditional United States (US) hegemony, developing cordial relations throughout the region, and supporting the general goals and values of the Canadian government. For a country like Canada, with limited economic or military clout, health aid has served as a diplomatic tool in the context of bilateral relations and allowed the country a voice in international affairs. Providing health and development assistance is thus a means of engendering international prestige and goodwill as well as securing national interests. …