The Foreign Service Journal, December 2004

12 F O R E I G N S E R V I C E J O U R N A L / D E C E M B E R 2 0 0 4 RAND Surveys FS on Health and Foreign Policy The RAND Center for Domestic and International Health ( www.rand. org/health/healthsecurity ) an d the Nuffield Trust ( www.nuffieldtrust. org/uk/index.html ) ar e conducting a survey among Foreign Service officers to determine their views of the role that health issues play, or should play, as explicit components of U.S. foreign policy. The survey, the results of which had not been released as of press time, is part of a broader effort to connect the scientific and diplomatic communities by conveying to the latter a sense of the importance and global nature of health issues. As this issue of the Foreign Service Journal underscores (see p. 20), health has become a central, albeit often overlooked, factor in U.S. foreign pol- icy and security. This reflects a funda- mental change in international rela- tions — in an age of increasing inter- dependence, the line between domes- tic and foreign policies is increasingly blurred. Health crises may originate within one country’s borders, but their effects are distinctly global. The Global Threat of New and Reemerging Infectious Diseases ( www.rand.org/publications/MR/ MR1602 ), a 2 003 RAND report, is a comprehensive analysis of the secu- rity implications posed by infectious diseases, whether they occur natu- rally or as a result of terrorism. As the report notes: “Today, the United States and most of the world face lit- tle danger from direct military assault from an opposing state. This threat has been supplanted with con- cerns about ‘gray area’ challenges that face the global community.” Among these “gray area” concerns are several global health crises, fore- most among them the spread of infec- tious diseases and the pervasive threat of bioterrorism. The RAND Center for Domestic and International Health runs a variety of projects to address these problems. Along with the afore- mentioned survey and a series of stud- ies, the center’s programs include strengthening California’s public health infrastructure, improving dis- ease surveillance in the D.C. area, preparing for the psychological effects of a terrorist attack, and developing a research agenda for the Global Health Policy Research Network, an affilia- tion of experts in international public health. The RAND Center has also partic- ipated in several trilateral conferences with health experts from Canada and the United Kingdom. In April 2003, representatives from each country met in Washington, D.C., to discuss how to bring health and security into the “for- eign policy mainstream.” Topics included: improving global health governance, developing a common research program to integrate health and foreign policy, and building multi- lateral partnerships for action. — David Coddon, Editorial Intern Medical Tourism: India Joins the Pack Forget the Taj Mahal. “Bolliwood?” Not a chance. For many, India’s hospi- tals have become a prime tourist attraction; in New Delhi, hospitals are a hot new “outsourcing” money-spin- ner. Consulting firm McKinsey & Co. says medical tourism could become a $2-billion-a-year business in India alone by 2012. With “Third World prices and First World care,” India’s hospitals are hard to resist. Nor is distance an obstacle. The Washington Post reported Oct. 21 that last year alone, 150,000 foreigners visited India for medical reasons. Among them was Howard Staab, who traveled 7,500 miles from his home in Durham, N.C., for a heart operation that would have cost $200,000 at home. The total cost in India: $10,000, including travel expenses. Speaking of travel expenses, Indian hospitals are now offering complete packages — after your operation, you can relax in a luxury hotel and enjoy top-rate entertainment. The Houston-trained chairman of India’s Apollo Hospitals, Dr. Prathap C. Reddy, has offered to subcontract work from the British National Health Service, carrying out surgery — hip C YBERNOTES W e did not have anywhere near enough people in place with the right language skills or the right sensitivities to respond [to negative images of Americans shown on Arabic television]. — Edward P. Djerejian, asked by Colin Powell to investigate rising anti-Americanism in the Arab world, www.nytimes.com , Oc t. 12.