An unconventional prescription for diplomacy

The following is an excerpt from an article by Vanessa Bradford Kerry, Sara Auld, and Paul Farmer. Read the full piece in the September 23, 2010 issue of The New England Journal of Medicine.

At first glance, medicine may seem unrelated to foreign policy, but in reality it is an unappreciated partner of diplomacy. In many parts of the world, poverty, inequity based on ethnicity or sex, shoddy public infrastructure, and environmental degradation have resulted in poor health as well as political and social instability. Poor health, in turn, fuels social vulnerabilities and discord, as illness diminishes productivity and disrupts family and social structures. The United States, a major funder of global health initiatives, has an opportunity to change the way it helps to tackle these challenges by investing in local health systems, equitable economic growth, and sustainable development.

To break the cycle of poverty and disease, we believe that the United States should create the equivalent of a Marshall Plan for health — a program that would train and fund both local providers and U.S. health care professionals to work, teach, learn, and enhance the health care workforce and infrastructure in low-income countries. We envision this program as an International Health Service Corps (IHSC), through which health care workers would engage in medical-service and capacity-building partnerships overseas in exchange for health-related graduate school scholarships and forgiveness of student loans. This effort should be targeted to health care providers in the United States and partner countries who are committed to serving the poor.

Although medicine's immediate aim is to combat illness and alleviate suffering, health care is also a tool for addressing the economic, social, and cultural problems associated with poor health. There is broad consensus that improvements in health can reduce poverty and contribute to long-term economic growth and development. The 2001 Commission on Macroeconomics and Health calculated that a 10% improvement in life expectancy translates into a 0.3% increase in economic growth. Interventions for human immunodeficiency virus infection, tuberculosis, and vaccine-preventable illnesses have all improved the condition of otherwise poor populations and demonstrated that just as disease transcends borders and can adversely affect regional economies, sound investments in health promotion can strengthen economies.

Read the full article online at The New England Journal of Medicine.