Improve Alignment Between Domestic and Foreign Policy says U of T Researcher
by Françoise Makanda, Communications Officer at DLSPH
Domestic policy at the expense of foreign policy is an antiquated global health view, say U of T researchers.
DLSPH researchers like Associate Prof. Erica Di Ruggiero are calling on all levels of government to adopt an integrated strategy that recognizes public health as a truly global phenomenon.
“We could do better as a country at those bilateral and multilateral tables by bringing our values about social determinants, equity and health and its place in multiple diplomacy efforts much more strongly and in a more cohesive way through a strategy,” says Di Ruggiero who is also the Director of DLSPH’s Centre for Global Health.
Canada’s international influence has been on the decline, but opportunities are plentiful, say researchers. While much of it can be tied to influence, Di Ruggiero does not believe the status of middle power puts Canada in a weak position – as long as policymakers fight complacency.
“We must be able to co-lead with other countries and build coalitions of the willing in areas where we have not just moral authority, but technical knowledge and an established track record. We have done that in the past, and we can reclaim a bit of that role going forward.”
At the latest Centre for Global Health webinar, distinguished researcher Ilona Kickbusch outlined steps that Canada can take in global health to increase its foreign policy influence and contribute to greater equity. The feminist foreign policy could be an excellent step given Canada’s record in supporting sexual and reproductive health and rights, said Kickbusch. Researchers in attendance agreed that an all-encompassing strategy to connect domestic and international interests must be innovative and could be Canadian-led.
The returns are significant, says Di Ruggiero. As Canada pushes forward key global health issues like climate change, pandemics and equity, it elevates its positioning and its ability to address bigger issues. Canada’s foreign policy agenda hasn’t been recently updated to reflect the current issues of our time, she adds.
Canada should consider bolstering its presence on climate change, Di Ruggiero argues. The federal government has announced its plans to slash greenhouse emissions by 40 to 45 percent by the end of the decade. Although the announcement was well-received, she argues there is more to be done.
“We are disproportionately adding to our carbon footprint as a high-income country, and we can’t be saying that other countries need to be doing better when we’re not. Global health starts at home.”
Dual strategies have their share of inconveniences. A few months ago, Canada pulled some vaccines out of the COVAX agreement, a tricky situation that hurt its global standings and brand – illustrating the balancing act Canada must navigate, says Di Ruggiero.
“On the one hand, you need to meet the needs of your citizens to whom you’re accountable because they are, the ones who elected you and yet, act as a responsible country globally.”
A strategy is not a replacement for stakeholder relationships. Di Ruggiero stresses that the plan itself is to be monitored and managed with key performance indicators. More importantly, it needs to be properly resourced. Plans often fail to monitor, evaluate, and adapt.
“You’re no further ahead five or six years from now with them. You shouldn’t be changing it every day,” says Di Ruggiero. “It also needs to be more driven by the central government, not just one ministry. While you can have lead departments for different things for it to really work, it has to come from a centralized place.”
There’s research capacity within universities and research funders who can partner with countries on how to address some of the strategic plan’s programs, she adds. Key research funders in the Canadian landscape like CIHR and IDRC have just recently launched their multi-year strategic plans, where there is a strong focus on global health and social determinants of equity
“We need to continue to collaborate with colleagues and low-and middle-income countries and other institutions on these topics.”