Kevany Sebastian, Jaf Payman, Workneh Nibretie Gobezie, Abu Dalod Mohammad, Tabena Mohammed, Rashid Sara, Al Hilfi Thamer Kadum Yousif
Med Confl Surviv. 2014 Apr-Jun;30(2):91-109. doi: 10.1080/13623699.2014.890827.
International development programmes, including global health interventions, have the capacity to make important implicit and explicit benefits to diplomatic and international relations outcomes. Conversely, in the absence of awareness of these implications, such programmes may generate associated threats. Due to heightened international tensions in conflict and post-conflict settings, greater attention to diplomatic outcomes may therefore be necessary. We examine related 'collateral' effects of Global Fund-supported tuberculosis programmes in Iraq.
During site visits to Iraq conducted during 2012 and 2013 on behalf of the Global Fund to Fight AIDS, Tuberculosis and Malaria, on-site service delivery evaluations, unstructured interviews with clinical and operational staff, and programme documentary review of Global Fund-supported tuberculosis treatment and care programmes were conducted. During this process, a range of possible external or collateral international relations and diplomatic effects of global health programmes were assessed according to predetermined criteria.
A range of positive diplomatic and international relations effects of Global Fund-supported programmes were observed in the Iraq setting. These included (1) geo-strategic accessibility and coverage; (2) provisions for programme sustainability and alignment; (3) contributions to nation-building and peace-keeping initiatives; (4) consistent observation of social, cultural and religious norms in intervention selection; and (5) selection of the most effective and cost-effective tuberculosis treatment and care interventions.
Investments in global health programmes have valuable diplomatic, as well as health-related, outcomes, associated with their potential to prevent, mitigate or reverse international tension and hostility in conflict and post-conflict settings, provided that they adhere to appropriate criteria. The associated international presence in such regions may also contribute to peace-keeping efforts. Global health programmes may frequently produce a wider range of 'collateral benefits' that conventional monitoring and evaluation systems should be expanded to assess, in keeping with contemporary efforts to leverage development programmes from a 'global health diplomacy' perspective.
包括全球卫生干预措施在内的国际发展项目，有能力为外交和国际关系成果带来重要的隐性和显性利益。相反，若未意识到这些影响，此类项目可能会产生相关威胁。鉴于冲突和冲突后环境中国际紧张局势加剧，因此可能需要更加关注外交成果。我们研究了全球基金支持的伊拉克结核病项目的相关“附带”影响。
2012年和2013年，代表全球抗击艾滋病、结核病和疟疾基金对伊拉克进行实地考察期间，开展了现场服务提供评估、对临床和运营人员的非结构化访谈，以及对全球基金支持的结核病治疗和护理项目的项目文件审查。在此过程中，根据预定标准评估了全球卫生项目一系列可能的外部或附带国际关系及外交影响。
在伊拉克，观察到全球基金支持的项目产生了一系列积极的外交和国际关系影响。这些影响包括：（1）地缘战略可达性和覆盖范围；（2）项目可持续性和一致性的保障；（3）对国家建设和维和倡议的贡献；（4）在干预措施选择中对社会、文化和宗教规范的持续遵守；（5）选择最有效和最具成本效益的结核病治疗和护理干预措施。
对全球卫生项目的投资具有宝贵的外交成果以及与健康相关的成果，因为它们有可能在冲突和冲突后环境中预防、缓解或扭转国际紧张局势和敌意，前提是它们符合适当的标准。在这些地区的相关国际存在也可能有助于维和努力。全球卫生项目可能经常产生更广泛的“附带利益”，传统的监测和评估系统应予以扩展以进行评估，这与从“全球卫生外交”角度利用发展项目的当代努力相一致。
