Global health diplomacy and India: Global health today finds itself at an inflection point. Once seen as a shared global good, health is increasingly entangled in nationalist politics, funding cuts, and widening disparities. International forums that once facilitated consensus now expose deep divisions. Amid this, the very idea of collaboration in global health—once synonymous with solidarity—has come under stress.
For professionals from the Global South, immigrants, Indigenous groups, and marginalised communities, even participation in global health events can be fraught with exclusion or even danger. Yet, in this fragmented terrain, the role of global health diplomacy—the intersection of public health and foreign policy—has never been more vital. It promises not just better health outcomes but a more equitable global order.
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The architecture of collaboration
Collaboration in global health is not a feel-good slogan but a functional necessity. Health challenges—whether pandemics, antimicrobial resistance, or climate-linked diseases—do not recognise borders. Effective responses require cooperation among governments, international bodies, academia, NGOs, and the private sector. Such partnerships, however, are not born equal.
As Faerron Guzmán has argued, collaboration requires synergy, equity, and shared governance. It demands power-sharing across disciplines and borders. Theories like complexity science underscore this point: small interventions in health systems can lead to large, often unpredictable effects. The planetary health and One Health frameworks further highlight the ecological interdependence of human, animal, and environmental health. These are not abstract concepts but blueprints for how institutions must think and act.
Learning from experience
Evidence from cross-sector partnerships offers sobering insights. In the UK, for instance, collaborations between community health providers and social services have shown limited results unless underpinned by integrated care models. Similarly, in India, public-private partnerships in primary healthcare have delivered patchy outcomes, largely because governance remains weak and local realities are often ignored.
Frameworks like the Bergen Model of Collaborative Functioning offer some clarity. They help analyse mission alignment, leadership dynamics, and trust among partners. But even these models cannot address entrenched inequalities. The asymmetries between North and South, funder and recipient, expert and beneficiary persist. A recent Global Health study (Rosenbaum et al., 2025) observed that the global health “community of practice” remains young, aspirational, but fragmented—lacking institutional cohesion and leadership depth.
Global health diplomacy — the missing lever
This is where global health diplomacy enters. GHD involves using diplomatic tools to prioritise health in global agendas—by negotiating agreements, coordinating crisis responses, and aligning health goals with development, trade, and security policies. In an increasingly multipolar world, it is both a strategic necessity and an ethical imperative.
Consider the ongoing negotiations on the Pandemic Treaty at the World Health Organisation (WHO). These aim to codify global rules for preparedness, vaccine sharing, and surveillance. Or take the US-led President’s Emergency Plan for AIDS Relief (PEPFAR), which has long been a foreign policy tool to foster goodwill through healthcare. China’s medical diplomacy in Africa—via hospitals, training programmes, and equipment donations—has similar motivations.
Measuring what matters
Assessing the effectiveness of global health collaboration and diplomacy requires more than inputs and outputs. It needs to examine power dynamics, network cohesion, and policy influence. Equity-informed critical interpretive synthesis and collaborative governance frameworks, like Emerson’s model, are among the new tools being used. Network analysis, too, is being deployed to map actors and identify who really drives change—and who is left out.
These tools reveal uncomfortable truths. Despite the rhetoric of inclusion, health diplomacy is still dominated by elite actors. Southern institutions are often partners in implementation but not in agenda-setting. Meanwhile, much of the data, funding, and expertise continue to flow from North to South, seldom the reverse.
Results are real—but so are gaps
Despite these flaws, the gains from global health collaboration and diplomacy are undeniable. According to WHO data, 431 million more people now have access to essential health services without catastrophic financial costs. Around 637 million benefit from better health emergency preparedness. Tobacco control, air quality improvements, and sanitation have improved the lives of 1.4 billion people globally.
Initiatives like Gavi, the Vaccine Alliance, and the Global Fund have bridged critical gaps between rich and poor countries. But funding shortfalls, donor fatigue, and governance dysfunction threaten to undo these gains. Collaboration works best when backed by clear rules, shared goals, and mutual respect—not just goodwill or media-friendly summits.
Participation of Global South
One of the most under-discussed aspects of global health diplomacy is its colonial hangover. Despite calls for decolonising global health, the architecture of international collaboration remains largely unchanged. North-South partnerships often operate under an implicit hierarchy, where Southern actors are expected to implement, not design or lead.
As Kickbusch and Ilona have outlined, GHD has seven core dimensions—from promoting health over other national interests to contributing to peace and managing stakeholder relations. Yet their model underplays the extent of marginalisation in global forums. It also fails to account for innovations emerging from the Global South—solutions forged from scarcity, community engagement, and local wisdom.
What needs fixing
There is no shortage of recommendations. Strengthen South-South cooperation. Create genuine co-leadership models in multilateral institutions. Elevate Indigenous and community-based voices. Shift funding models to prioritise equity over efficiency. And build ethical frameworks for collaborative research that move beyond consent toward co-creation.
Global health diplomacy also needs to be embedded within the broader Global Health Security Agenda. Health must be viewed not only as a humanitarian goal but as integral to national resilience and international stability. The COVID-19 pandemic made this painfully obvious.
The promise of global health diplomacy lies in its ability to turn dialogue into action, and action into justice. But for that promise to be realised, we must dismantle the hierarchies that currently shape collaboration. We need not just more diplomacy—but better diplomacy, rooted in mutual respect, shared power, and an unwavering commitment to equity.
In a world where borders are tightening and multilateralism is faltering, global health diplomacy may be one of the last remaining tools to build bridges. The question is whether the global health community will have the courage to wield it wisely.