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Rebecca Katz, Erin Sorrell, and Claire Standley

The last 30 years have seen the global consequences of newly emerging and re-emerging infectious diseases, starting with the international spread of HIV/AIDS, the emergence of Ebola and other hemorrhagic fevers, SARS, MERS, novel influenza viruses, and most recently, the global spread of Zika. The impact of tuberculosis, malaria, and neglected tropical diseases on society are now better understood, including how these diseases influence the social, economic, and political environment in a nation. Despite international treaties and norms, the specter of intentional use of infectious disease remains present, particularly as technological barriers to access are reduced. The reality is that infectious diseases not only impact population health, but also have clear consequences for international security and foreign policy. Foreign policy has been used to coordinate response to infectious disease events and to advance population health around the world. Conversely, collaboration on infectious disease prevention, preparedness, and response has been used strategically by nations to advance diplomacy and improve foreign relations. Both approaches have become integral to foreign policy, and this chapter provides examples to elucidate how health and foreign policy have become intertwined and used with different levels of effectiveness by governments around the world. As the scope of this topic is extensive, this article primarily draws from U.S. examples for brevity’s sake, while acknowledging the truly global nature of the dynamic between infectious diseases and foreign policy, and noting that the interplay between them will vary between countries and regions. In 2014, U.S. President Barak Obama called upon global partners to, “change our mindsets and start thinking about biological threats as the security threats that they are—in addition to being humanitarian threats and economic threats. We have to bring the same level of commitment and focus to these challenges as we do when meeting around more traditional security issues”. With world leaders increasingly identifying disease as threats to security and economic stability, we are observing infectious diseases—like no other time in history—becoming an integral component of foreign policy.


Erik Baekkeskov, Olivier Rubin, Louise Munkholm, and Wesal Zaman

Antimicrobial resistance (AMR) is a global health crisis estimated to be responsible for 700,000 yearly deaths worldwide. Since the World Health Assembly adopted a Global Action Plan on AMR in 2015, national governments in more than 120 countries have developed national action plans. Notwithstanding this progress, AMR still has limited political commitment, and existing global efforts may be too slow to counter its rise. The article presents five characteristics of the global AMR health crisis that complicate the translation from global attention to effective global initiatives. AMR is (a) a transboundary crisis that suffers from collective action problems, (b) a super wicked and creeping crisis, (c) the product of trying to solve other global threats, (d) suffering from lack of advocacy, and (e) producing distributional and ethical dilemmas. Applying these five different crisis lenses, the article reviews central global initiatives, including the Global Action Plan on AMR and the recommendations of the Interagency Coordination Group on AMR. It argues that the five crisis lenses offer useful entry points for social science analyses that further nuance the existing global governance debate of AMR as a global health crisis.