Global Health Policy in the Second Obama Term: Chapter 1: Global Health Diplomacy

The practice of U.S. health diplomacy is increasingly concentrated in the domain of the secre-tary of state, drawing crucially on a broad range of implementing agencies. Secretary Clinton drove an unusually muscular health diplomacy during the first Obama term, emphasizing ration-alizing the interagency process, elevating gender as a guiding lens, leveraging greater country ownership, committing to multilateral organizations, and focusing on results. Particular attention has been paid to building an AIDS-free generation, eliminating preventable child deaths, and launching innovative public-private partnerships. The administration now faces questions over how—with a new secretary, fiscal challenges, and an expanding agenda—to sustain and consolidate its diplomatic outreach for global health. The strategic rationale for global health must be revised and updated. The emergence of middle-income countries as influential shapers of global health policy creates both opportunities and challenges. It is unclear whether and how the next secretary of state will pick up where Secretary Clinton left off.