Global Health Security and Diplomacy in 2024: Lead, Leverage, and Elevate

Global Health Security and Diplomacy in 2024: Lead, Leverage, and Elevate

Last year was challenging in several ways, and it can be easy to feel pessimistic about the prospects of countries working together to overcome the seismic conflicts, the record temperatures, and other threats to global peace and prosperity.  

Yet, entering 2024, we also see reasons for optimism. At the intersection of health security and diplomacy where we work, a focused effort is beginning to yield tangible benefits on intertwined issues. If we can build on that progress, it could help improve lives and livelihoods in communities all around the world in the years to come.   

Our optimism was epitomized at a November symposium cohosted by the new U.S. State Department Bureau of Global Health Security and Diplomacy (GHSD) and the Council and Foreign Relations. A few weeks later, it was evidenced once more by the first health-focused day at a United Nations Climate Change Conference (COP) and its outputs: a political declaration endorsed by 144 countries and $1 billion in aggregated public, private, and philanthropic commitments to climate and health programs. 

U.S. Special Presidential Envoy for Climate John Kerry speaking at the COP28 Health Day Opening Session in Dubai, United Arab Emirates, on December 3, 2023.
Youtube/COP28UAE

To drive progress to improve human and environmental health in 2024 and beyond, three words—lead, leverage, and elevate—must be transformed from buzzwords to action.  

Lead With Partnership 

Secretary of State Antony Blinken launched the new GHSD Bureau last August to lead United States’ diplomatic efforts to strengthen global health security. GHSD Bureau staff are coordinating, collaborating, and communicating with U.S. government agencies, foreign governments, and partners across sectors and regions to prevent outbreaks and address future health threats.   

At the symposium, Chikwe Ihekweazu, for the Division of Health Emergency Intelligence and Surveillance Systems in the Emergencies at the World Health Organization, said that early in the COVID-19 pandemic, world leaders “literally in real time struggle[d] to make decisions, in part because public health systems were just not prepared, developed, designed, or implemented in a way with the agility, flexibility to give these leaders the information that they needed to make the decisions with the agility and speed they demanded.” The need for real-time information sharing and communication was constant at foreign ministries throughout the pandemic, solidifying a long-term need for foreign ministry communication, cooperation, and coordination on global health security actions. 

The climate crisis and the health crisis are one and the same . . . totally connected and totally converging at this moment in time


John Kerry

Leadership must also come from all facets of society and in every community. As UNAIDS’ Executive Director Winnie Byanyima reminded participants at the symposium, the success of global health diplomatic efforts will be predicated on how much we can enable community leadership. As former Director of the U.S. National Institute of Allergy and Infectious Diseases Anthony Fauci said, the imperative of genuine community input, two-way learning, and engagement is the paramount lesson from the HIV/AIDS pandemic that must be applied to the global health security challenges of the future.  

Discussions will intensify in 2024 to strengthen the global health security architecture, including on securing adequate financing such as the Pandemic Fund, addressing specific disease threats such as ending HIV/AIDS as a public health threat by 2030, and promoting international cooperation on pandemic prevention, preparedness, and response through potential International Health Regulations amendments and a potential pandemic agreement.   

Civil society engagement and partnerships have been essential in the HIV/AIDS response, and we must deepen collaborations as a cornerstone of strengthened global health security.  

John Nkengasong and Anthony Fauci speak at the Global Health Security and Diplomacy in the Twenty-First Century Symposium,  in Washington, DC, U.S., on November 13, 2023.
Council on Foreign Relations

Leverage Investments for Global Health Security 

We frequently see results of local leadership in stopping epidemics before they start—from halting Ebola virus disease in Democratic Republic of Congo, to Nipah virus in India, to dengue in Indonesia—efforts that save lives by halting the spread of disease. 

These actions are enabled when foreign assistance is effectively leveraged to strengthen health systems around the world—from laboratories to supply chains to countermeasures. For example, investments made by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) to deliver essential HIV/AIDS services have been vital in ongoing responses to other infectious diseases, such as cholera, COVID-19, Ebola, and tuberculosis.  

At the World Health Assembly, regional summits, and other forums in 2024, leveraging health assistance to enhance pandemic preparedness will be crucial. The United States, for its part, is committed by 2025 to directly supporting at least 50 countries to strengthen and achieve regional, national, and local capacity in infectious disease prevention, detection, and response to infectious disease threats. 

Multisectoral experts gather for Global Health Security and Diplomacy in the Twenty-First Century, in Washington, DC, U.S., on November 13, 2023.
Council on Foreign Relations

Elevate Health Security as a Foreign Policy Priority 

Going forward, the pace of change in our world demands that health security be elevated now as a top priority of governments around the world, and not just during the acute phases of pandemics. As Maj. Gen. (ret) Paul Friedrichs, director of the newly established White House Office of Pandemic Preparedness and Response Policy, stated at our symposium: 

If you look at the confluence of artificial intelligence, biotechnology, nanotechnology, is not far-fetched to say that the practice of medicine is changing at a pace that we literally have not seen since the antibiotic era began, if not faster. And that creates the tremendous potential for good things to happen in the next five to ten years, and also the tremendous peril for those people in the world who want to misuse that technology to do so in a way that undermines the health security of countries around the world. 

U.S. Ambassador to the United Nations Linda Thomas-Greenfield best summarized the challenge ahead of us at our symposium when she said strengthening global health security and diplomacy is not an “abstract policy debate” but one in which decisions “have real impacts on people around the world, and especially the most vulnerable among us.”  

If cooperation, coordination, collaboration, and communication are the cornerstones of efforts to strengthen global health security in 2024 and beyond, diplomacy can harness humanity’s collective potential to meet the health security challenges of the days and years ahead.  

Ambassador Linda Thomas-Greenfield speaks at the Global Health Security and Diplomacy in the Twenty-First Century Symposium in Washington DC, U.S., on November 13, 2023.
Council on Foreign Relations

Hillary H. Carter, PhD, serves as the acting principal deputy coordinator for global health security and diplomacy for the U.S. Department of State Bureau of Global Health Security and Diplomacy, where she leads the outbreak response, health security, and health diplomacy functions. 

Thomas J. Bollyky is director of the global health program and senior fellow for global health, economics, and development at the Council on Foreign Relations.

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