Emerging Practices in Global Health Cooperation

On December 6th the CSIS Global Health Policy Center hosted a half-day conference on “Emerging Practices in Global Health Cooperation: Brazil, China, India, Russia and South Africa”. It featured panelists with expertise on the engagement of emerging economies, such as the BRICS, with international organizations, and through trilateral, regional and South-South cooperation schemes.

Over the past year, CSIS has worked with locally-based research centers in each of the BRICS to support shared research, facilitate discussion, and disseminate policy analysis to encourage greater understanding of the ways in which approaches to global health policy and cooperation are changing. Building on the outcomes of workshops held in Beijing, Moscow, Rio de Janeiro, and Johannesburg, the December 6 seminar will feature expert panelists whose presentations will highlight how each nation conceptualizes its current and future health outreach; identify new and evolving trends with respect to regional, South-South, and trilateral health cooperation; and articulate an agenda for future discussion and research.


Part 1: The Engagement of the BRICS with International Organizations 

During the first panel, Peter Fourie (AIDS Foundation of South Africa) focused on the role of South Africa within the BRICS community. South Africa officially joined the BRICS in March of 2011. While questioning the appropriateness of South Africa’s membership in the BRICS community, noting that in many ways it is an economic, geographic and demographic outlier, Fourie discussed the relevance of South African participation in setting an agenda for global health cooperation within the BRICS context. He emphasized the ideological similarities among the BRICS, and the valuable use of health as a means to project soft power in the multilateral arena.

Yanzhong Huang (Council on Foreign Relations and Seton Hall University) elaborated on the involvement of the BRICS in global health activities. He suggested that some of the BRICS, such as China, engage in global health policy and programmatic efforts to demonstrate that they are responsible international stakeholders, able and willing to respect international rules and adopt a normative multilateral approach to global health governance.

Julia Kulik (University of Toronto) examined the history of health challenges in Russia, with a focus on the country’s growing burden of non-communicable diseases. She highlighted the opportunity Russia has to display international leadership on NCDs as host of the 2012 APEC Summit, the 2013 G20 Summit, and the 2014 G8 and BRICS Summits.

Listen to audio from Part 1.

Download Peter Fourie's presentation.

  Download Julia Kulik's presentation.

Part 2: Regional Interactions and Trilateral/Regional/South-South Cooperation 

In the second panel, Priya Balasubramaniam (Public Health Foundation of India) emphasized the potential for health investments in India to serve as a driver for economic development. She described India’s move toward universal health coverage as a means of reducing poverty while increasing global leadership. She suggested that as India’s health system evolves, it has the opportunity to become a global leader in the movement toward worldwide universal health coverage, particularly given its similarities to other countries of the South in terms of disease dynamics, living conditions, health systems and its social, political, economic and geographic environment.

Jonathan Hale (Bureau of European and Eurasian Affairs, USAID) discussed U.S. and Russian collaboration on the eradication of polio in Central Asia through trilateral capacity-building exercises, technical cooperation, human resource training, and disaster preparedness planning.

Marian Jacobs (University of Cape Town) questioned the relevance of the BRICS, focusing instead on the shared democratic credentials, emerging economy status, potential for world engagement and rights framework of IBSA, which involves India, Brazil and South Africa in trilateral cooperation. She further emphasized the need for South-South cooperation for economic development.

Felix Rosenberg (Fiocruz) finished by highlighting the nexus between health and foreign policy, citing cooperation in global health as a diplomatic tool for driving national security strategies, and shaping geopolitics. He discussed some of Brazil’s the global health priorities that include: building strong national health systems and structures, creating horizontal partnerships between governments or government-linked civil society organizations to allow for joint learning and cooperation based on mutual trust and shared interests, strengthening ties between ‘affinity nations’ to improve the bilateral, and North-South-South trilateral, relationships within the larger multilateral governance space.

When the health ministers from the BRICS met for the first time in Beijing in July of 2011 they agreed to collaborate on advancing global health goals, but as the conference presentations suggest, the countries have diverse agendas and interests when it comes to global health cooperation. How will the BRICS work together to fulfill health-related promises? Are they poised to step up with more funds and commitment in light of the financial crises in Europe and U.S.? What are the opportunities for triangular cooperation in the future? The influence of the BRICS on global health will be determined by the response of each of the countries to these important challenges and questions.

Listen to audio from Part 2.

Download Priya Balasubramaniam's presentation.

Download Marian Jacob's presentation.


Part 3: Conclusions and Next Steps


J. Stephen Morrison, CSIS Global Health Policy Center
Katherine Bliss, CSIS Global Health Policy Center

Listen to audio from Part 3.

Related Publications

This report represents the first step in an 18-month CSIS initiative focused on how the BRIC (Brazil, Russia, India, and China) countries and South Africa are influencing activities, practices, and strategies in the area of global health diplomacy. Whether and how the BRICs and South Africa use the November 2010 G-20 Summit in Seoul, or future G-20 meetings, to engage on global health through the new G-20 Working Group on Development remains to be seen. It is clear that each country is stepping up its work on global health through its official development assistance—as a bilateral donor, through its work in multilateral institutions, and by supporting overseas health-related research and innovations. Yet it also seems unlikely that the non-G-8 countries within the G-20 will want to let the major industrial powers in the G-8 off the hook when it comes to their existing commitments on health in the developing world. In the end, how the BRICs and South Africa choose to move forward on global health will depend in large part on their own histories of international interaction on health, on their continued financial growth, and on the extent to which engaging in foreign activities does not conflict with their domestic health and development priorities.


This volume is a compilation of papers that were written for the Conference on China’s Emerging Global Health and Foreign Aid Engagement, sponsored by the Center for Strategic and International Studies (CSIS) and the China Institute of International Studies (CIIS), in Beijing on May 24, 2011, as part of a larger CSIS initiative to examine the global health engagement of the BRIC countries (Brazil, Russia, India, and China). Focusing specifically on China’s health and foreign aid engagement in Africa, the volume includes contributions by U.S. and Chinese experts.



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