The Foreign Service Journal, July-August 2020

34 JULY-AUGUST 2020 | THE FOREIGN SERVICE JOURNAL A career FSO with extensive experience in global health diplomacy discusses the practical problems— all solvable—in bringing the current and future health crises under control. BY J I MMY KOLKER Ambassador (ret.) Jimmy Kolker’s 30-year Foreign Service career included five posts in Africa and three in Europe. He was U.S. ambassador to Burkina Faso (1999-2002) and Uganda (2002-2005). He then served as deputy U.S. global AIDS coordinator and, after retiring from State, as head of the HIV/AIDS Section at UNI- CEF’s New York headquarters (2007-2011) and in the Department of Health and Human Services’ Office of Global Affairs. From 2014 to 2017, he was assistant secretary for global affairs at HHS. C ontrolling the spread of infectious diseases requires multilateral coopera- tion. The objective of the first Interna- tional Sanitary Conference in Paris in 1851 was to reduce to a safe minimum the conflicting and costly maritime quarantine requirements of different nations. Possibly the first binding inter- national convention of the modern era addressed cholera. It came into force in Venice in 1892. At the same time, health systems and health care have always been, and remain, national (and, in many cases, subnational) responsibilities. The novel coronavirus—SARS-CoV-2—has high- lighted this dichotomy. Countries have taken widely different approaches to preventing and treating the spread of the disease it causes, COVID-19, while the U.S. administration publicly blamed the United Nations agency responsible for global health, the World Health Organization, for failing to provide timely and accurate information on COVID-19 and abetting China in cover- ing up key developments. Every pandemic is different, and the new coronavirus crisis is unprecedented in many ways—not least in the speed and inten- sity of the virus’ transmission around the entire world and, as a result, its exposure of weaknesses in leadership and institutional structures at the international and national level everywhere. But lapses notwithstanding, a multilateral approach remains funda- mental in meeting the current challenges. It is essential that the United States engage diplomatically at a senior level in global health governance, decision-making and emergency response. In the following, I discuss some of the problems we face and suggest practical solutions. The WHO We Have Is Not the WHO We Need The World Health Organization was the first technical agency established under the United Nations in the late 1940s. It is an awkward creature of its time, governed by an annual weeklong FOCUS ON PANDEMIC DIPLOMACY G overnance COVID-19 AND Global Health