Background: Workforce and leadership development is imperative for the advancement of public health along the U.S./Mexico border. The Leaders across borders (LaB) program aims to train the public health and health-care workforce of the border region. The LaB is a 6-month intensive leadership development program, which offers training in various areas of public health. Program curriculum topics include: leadership, border health epidemiology, health diplomacy, border public policies, and conflict resolution. Methods: This article describes the LaB program evaluation outcomes across four LaB cohort graduates between 2010 and 2014. LaB graduates received an invitation to participate via email in an online questionnaire. Eighty-five percent (n = 34) of evaluation participants indicated an improvement in the level of binationality since participating in the LaB program. Identified themes in the evaluation results included increased binational collaborations and partnerships across multidisciplinary organizations that work towards improving the health status of border communities. Approximately 93% (n = 37) of the LaB samples were interested in participating in future binational projects while 80% (n = 32) indicated interest in the proposal of other binational initiatives. Participants expressed feelings of gratitude from employers who supported their participation and successful completion of LaB. Discussion: Programs such as LaB are important in providing professional development and education to a health-care workforce along the U.S./Mexico border that is dedicated to positively impacting the health outcomes of vulnerable populations residing in this region.

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This study explores the global health diplomacy phenomenon by focusing on how and why health is integrated into foreign policy. Over the last decade or so, precipitated primarily by a growing concern about the need to strengthen global health security and deliver on the Millennium Development Goals, foreign policymakers have been paying more attention to health as a foreign policy concern and several countries have adopted formal global health policy positions and/or strategies. To elucidate a deeper and clearer understanding of how and why health is integrated into foreign policy, this thesis used a case study research design that incorporated literature and document review and interviews with twenty informants to conduct an in-depth analysis of the United Kingdom’s (UK) Health is Global: A UK Government Strategy 2008-13. Health is Global represents the first example of a formal national global health strategy developed using a multi-stakeholder process. Briefer background case reviews of three nations that are leaders in global health diplomacy - Brazil, Norway and Switzerland, were also conducted to inform the analysis of the in-depth case. Policy analysis included categorizing data into five areas: context (why?), content (what?), actors (who?), process (how?) and impact (so what?). The Multiple Streams Model of Policymaking and Fidler’s health and foreign policy conceptualizations - revolution, remediation and regression - were used to analyze the findings. Based on this analysis, the primary reason that the countries examined have decided to focus more on global health is self-interest - to protect national and international security and their economic interests. Investing in global health was also seen as a way to enhance a state’s international reputation. In terms of self-interest, Brazil was an outlier, however. International solidarity and health as a human right have been the driving forces behind its long-term investment in development cooperation to date. Investing in health for normative reasons was also a prevalent through weaker theme in the UK, Swiss and Norwegian cases. The study highlighted the critical role that policy entrepreneurs who cross the domains of international relations and health play in the global health policymaking process. In regards to advancing a conceptual understanding of global health diplomacy, the findings propose that the whole-of-government global health policymaking process is a form of global health diplomacy. The thesis elucidated factors that underpin this process as well as lessons for other nations, in particular, Canada. While ascertaining the impact of national global health strategies was not the main objective of this thesis, the study provided an initial look at the impact of these policy instruments and processes. Such impacts include better collaboration across government actors leading to enhanced policy coherence and a more strategic focus on global health. Finally, some have argued of late that the global health revolution is over due to the current world economic crisis. Considering the level of interest in whole-of-government global health strategies and the ever growing and sophisticated world-wide global health policy community, based on this thesis, the global health revolution is alive and well.

This study explores the global health diplomacy phenomenon by focusing on how and why health is integrated into foreign policy. Over the last decade or so, precipitated primarily by a growing concern about the need to strengthen global health security and deliver on the Millennium Development Goals, foreign policymakers have been paying more attention to health as a foreign policy concern and several countries have adopted formal global health policy positions and/or strategies. To elucidate a deeper and clearer understanding of how and why health is integrated into foreign policy, this thesis used a case study research design that incorporated literature and document review and interviews with twenty informants to conduct an in-depth analysis of the United Kingdom’s (UK) Health is Global: A UK Government Strategy 2008-13. Health is Global represents the first example of a formal national global health strategy developed using a multi-stakeholder process. Briefer background case reviews of three nations that are leaders in global health diplomacy - Brazil, Norway and Switzerland, were also conducted to inform the analysis of the in-depth case. Policy analysis included categorizing data into five areas: context (why?), content (what?), actors (who?), process (how?) and impact (so what?). The Multiple Streams Model of Policymaking and Fidler’s health and foreign policy conceptualizations - revolution, remediation and regression - were used to analyze the findings. Based on this analysis, the primary reason that the countries examined have decided to focus more on global health is self-interest - to protect national and international security and their economic interests. Investing in global health was also seen as a way to enhance a state’s international reputation. In terms of self-interest, Brazil was an outlier, however. International solidarity and health as a human right have been the driving forces behind its long-term investment in development cooperation to date. Investing in health for normative reasons was also a prevalent through weaker theme in the UK, Swiss and Norwegian cases. The study highlighted the critical role that policy entrepreneurs who cross the domains of international relations and health play in the global health policymaking process. In regards to advancing a conceptual understanding of global health diplomacy, the findings propose that the whole-of-government global health policymaking process is a form of global health diplomacy. The thesis elucidated factors that underpin this process as well as lessons for other nations, in particular, Canada. While ascertaining the impact of national global health strategies was not the main objective of this thesis, the study provided an initial look at the impact of these policy instruments and processes. Such impacts include better collaboration across government actors leading to enhanced policy coherence and a more strategic focus on global health. Finally, some have argued of late that the global health revolution is over due to the current world economic crisis. Considering the level of interest in whole-of-government global health strategies and the ever growing and sophisticated world-wide global health policy community, based on this thesis, the global health revolution is alive and well.

This study explores the global health diplomacy phenomenon by focusing on how and why health is integrated into foreign policy. Over the last decade or so, precipitated primarily by a growing concern about the need to strengthen global health security and deliver on the Millennium Development Goals, foreign policymakers have been paying more attention to health as a foreign policy concern and several countries have adopted formal global health policy positions and/or strategies. To elucidate a deeper and clearer understanding of how and why health is integrated into foreign policy, this thesis used a case study research design that incorporated literature and document review and interviews with twenty informants to conduct an in-depth analysis of the United Kingdom’s (UK) Health is Global: A UK Government Strategy 2008-13. Health is Global represents the first example of a formal national global health strategy developed using a multi-stakeholder process. Briefer background case reviews of three nations that are leaders in global health diplomacy - Brazil, Norway and Switzerland, were also conducted to inform the analysis of the in-depth case. Policy analysis included categorizing data into five areas: context (why?), content (what?), actors (who?), process (how?) and impact (so what?). The Multiple Streams Model of Policymaking and Fidler’s health and foreign policy conceptualizations - revolution, remediation and regression - were used to analyze the findings. Based on this analysis, the primary reason that the countries examined have decided to focus more on global health is self-interest - to protect national and international security and their economic interests. Investing in global health was also seen as a way to enhance a state’s international reputation. In terms of self-interest, Brazil was an outlier, however. International solidarity and health as a human right have been the driving forces behind its long-term investment in development cooperation to date. Investing in health for normative reasons was also a prevalent through weaker theme in the UK, Swiss and Norwegian cases. The study highlighted the critical role that policy entrepreneurs who cross the domains of international relations and health play in the global health policymaking process. In regards to advancing a conceptual understanding of global health diplomacy, the findings propose that the whole-of-government global health policymaking process is a form of global health diplomacy. The thesis elucidated factors that underpin this process as well as lessons for other nations, in particular, Canada. While ascertaining the impact of national global health strategies was not the main objective of this thesis, the study provided an initial look at the impact of these policy instruments and processes. Such impacts include better collaboration across government actors leading to enhanced policy coherence and a more strategic focus on global health. Finally, some have argued of late that the global health revolution is over due to the current world economic crisis. Considering the level of interest in whole-of-government global health strategies and the ever growing and sophisticated world-wide global health policy community, based on this thesis, the global health revolution is alive and well.

The World Health Organization's Framework Convention on Tobacco Control (FCTC) is the first international public health treaty to address the global spread of tobacco products. Ethnographic research at the fourth meeting of the FCTC's Conference of the Parties in Uruguay highlights the role of the FCTC in recalibrating the relationship between international trade and investment agreements and those of global public health. Specifically, we chart the origins and development of the Punta del Este Declaration, tabled by Uruguay at the conference, to counter a legal request by Philip Morris International, the world's largest tobacco transnational, for arbitration by the International Centre for the Settlement of Investment Disputes over Uruguay's alleged violations of several international trade and investment treaties. We argue that medical anthropologists should give greater consideration to global health governance and diplomacy as a potential counterweight to the 'politics of resignation' associated with corporate capitalism.

Le choléra est une épreuve qui interroge l’instrument naval français et ses actions au-delà des seules problématiques de l’hygiène navale ou de la contribution des navigations à la diffusion de l’épidémie. Il est à la fois une épreuve de terrain, locale, collective comme individuelle, et un enjeu de relations internationales. Il requiert un engagement constant et en profondeur de la part du service de santé des armées en général, de la Marine en particulier. Il contribue à la fragilisation d’un espace méditerranéen en pleine recomposition alors que la France de l’après 1815 cherche à y saisir des opportunités pour peser à nouveau dans le concert des nations à travers une plus grande implication dans les crises qui secouent sa façade méridionale. Cette politique offensive, faite de diplomatie conventionnelle et d’interventions militaires, de défense des intérêts commerciaux et de relance d’une politique expansionniste sinon impérialiste, repose en partie sur la sollicitation de forces navales en cours de relèvement. En proposant une étude sur la confrontation entre la puissance navale française en Méditerranée et la circulation du choléra entre 1831 et 1856, il s’agit de comprendre, essentiellement à travers un regard naval, comment, au-delà du péril majeur que ces épidémies successives constituent pour la santé publique en France et en Méditerranée, elles en viennent à représenter une formidable opportunité offerte à la France de s’affirmer comme une puissance sanitaire de premier plan, alors que se préparent deux premières conférences sanitaires internationales de Paris (1851 et 1859) . / Cholera: “a crucial and revealing challenge, helpful to measure the bravery and intellectual value of the Navy’s physicians”. According to Jacques Leonard’s word, cholera defied the French Navy as a whole. It questioned the French naval instrument and actions beyond the mere issues of sea hygiene or the spreading of the epidemic through sailing. It was both a field issue, as well at a local level as at the individual and collective ones, and a meaningful issue in international relations. It required a constant and deep commitment from the military health service in general, and from the Navy health service in particular. It contributed to weakening the Mediterranean area in a period of reconstruction as post-1815 France intended to seize opportunities to become again a prominent member in the community of Nations through a stronger commitment in the crises that were then striking its southern part. This pro-active policy, combining military intervention and conventional diplomacy, the preservation of trading interests and the renewal of an expansionist and even imperialist policy, partly relied on the appeal to restructuring naval forces. By studying the confrontation between French naval power in the Mediterranean and the spreading of cholera from 1831 to 1856, the purpose, here, will be to understand, mainly through a naval perspective, how those successive epidemics evolved from the status of threats to public health to that of becoming an unexpected opportunity to stand a sanitary power, as two international conferences on health were to take place in Paris (1851 and 1859).

The way we understand the term health is being changed significantly under continuous globalisation. Even though in the past, health issues were a concern of a particular country, today, as a result of intensive trade and travelling, these issues reach beyond the boarders of national states and influence millions of people around the world consequently. Thus, the issue of health is moving from the national to the international level and a new concept of Global health emerges. Global health is a notion, which has evoked a lot of interest among politicians, academics, theoreticians, and within the whole international community, too. The international community is aware of its responsibility for global improvements to health through collective action. Thus, this thesis is aimed at the analysis of the development and practice of diplomacy in the sphere of health, as well as identifying the reasons of international co-operation of states in this field. The thesis concludes that the co-operation in global health is based on moral values, which are included in human right to health. Lastly, thesis scrutinizes human right to the enjoyment of the highest attainable standard of health.

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中國自1963年向阿爾及利亞派遣第一支醫療隊以來，穩定對非洲發展衛生外交，近年來漸吸引中國及外國學者注意，然基於中國對外援的保密性，以及衛生外交未成顯學，對於中國在非洲衛生外交的狀況因此缺乏資料，本文以現有研究結果為基礎，蒐集和整理中國官方資料，描繪出中國在非洲衛生外交發展、規模及樣態。中國藉由衛生外交在非洲取得可觀利益，包括政治方面，如非洲國家支持中國取代台灣在聯合國席位、為中國人權議題護航以及在兩岸議題上支持中國立場；經濟方面，如以衛生外交打進非洲市場，引入中國製藥品以及以醫療物資換取非洲國家資源；軟實力方面：提升中國形象，促進中非在其他方面的合作。然中國在非洲衛生外交也面臨不少挑戰，包括中國國內醫生不足、語言文化隔閡、中國人大量進入非洲為非洲帶來的威脅感，以及非洲國家效率不佳等問題。 　　本文選用莫三比克為討論個案，主要基於中國對莫國衛生援助穩定，以及莫國非能源出口國，因此正可用以檢視中國官方媒體對中國在非洲衛生外交的「神話」般報導以及有些中國學者對於中國衛生外交不為能源而是傳播道義思想的論述是否真確。研究發現僅管莫國現不具能源，中國藉由提供衛生援助在莫國取得其他重要利益，如政治層面，外科醫生江永生使莫國堅定且明確支持兩岸統一；經濟層面，如熟悉中國藥品的莫國向中國製藥公司購買抗瘧疾藥品，軟實力層面，莫國大部分民眾對中國抱持好感，政府官員也甚讚中莫醫療合作。莫國同時也是第一個曾經拒絕中國醫療隊派遣的國家，也正可藉此檢視中國衛生外交面臨的困境。除語言文化隔閡外，中國醫生不願至莫國偏鄉服務加上其他外國醫生在莫國的競爭使莫國有意降低對中國醫療資源的依賴，是莫國不願續約的主因。中國若不能妥善處理上述問題，莫國可能不會是唯一一個拒絕接受中國醫療資源的國家。 / Since its very first medical team to Algeria in 1963, China has been steadily developing its health diplomacy in Africa. This stably growing flow of medical resources from China to Africa has caught attention from both Chinese and foreign scholars. However, owing to the confidentiality of Chinese foreign aid and the fact that health diplomacy is a term that is relatively new in the academia, there is no clear picture about China’s health diplomacy in Africa. Based on the existing literature, this thesis complies facts and figures principally from Chinese official sources in a bid to draw a clear picture of the development, scale, and pattern of China’s health aid to Africa. Via health diplomacy, China gains considerable benefits. In the political front, African countries that have received medical assistance from China support China’s bid to replace Taiwan in the United Nations, shield China from human right censoring, and stand with China in cross-strait issue. In the economic front, with health diplomacy, China introduces home-manufactured medicine to Africa or simply trades its medical service with Africa’s natural resources, tapping into a continent that is stricken with disease. More than political and economic benefits, health diplomacy most importantly burnishes China’s image in Africa, enhancing its soft power. However, China’s health diplomacy doesn’t go without any obstacles. The lack of volunteer doctors, the barriers of language and culture, a sense of threat conjured by the heavy presence of Chinese in Africa, the inefficiency of African countries and so forth, all present themselves as impediments to China’s health diplomacy in Africa. This thesis chooses Mozambique as the target for further research because China’s medical aid to Mozambique has been very stable. Also, Mozambique is not a major exporter of natural resource; hence it could be used to examine the often mythologized reports from China’s official media on the Chinese doctors serving in Africa, and the claims by some Chinese scholars about how China’s health assistance is not for natural resources but for solidarity. What my research finds however is that despite the lack of energy currently, Mozambique offers some other benefits to China. For political benefits, the Chinese surgeon, Jiang, Yong-Sheng ensures that Mozambique firmly endorses the unification of Taiwan and China. For economic benefits, Mozambique, who is well acquainted with Chinese medicine, purchases anti-malaria medicine from a Chinese medical company. As for soft power, a majority of Mozambicans have favorable opinion toward China. The Mozambican officials for numerous times praise the medical cooperation between China and Mozambique. However, at the same time, Mozambique was the first country that refused to accept a new team of Chinese doctors to come to Mozambique, and thus it is also a good case to analyze the challenges that are facing China now. Apart from language and cultural barriers, Chinese government’s refusal to deploy their doctors in rural areas in Mozambique, and the medical personnel from other countries, make Mozambique tries to gradually reduce its dependence on China’s medical assistance. Being aware of its overdose reliance on China was the main reason why Mozambique didn’t want to renew the contract. If Beijing fails to solve the aforementioned problems, Mozambique might not be the only African country that says no to China’s doctors.