Public Relations Review 35 (2009) 127–129
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Public Relations Review
Research in brief
Public relations and health diplomacy Kurt Wise Public Relations Department, Quinnipiac University School of Communications, 275 Mount Carmel Avenue, Hamden, CT 06518, United States
a r t i c l e
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Article history: Received 3 June 2008 Received in revised form 2 October 2008 Accepted 6 January 2009 Keywords: Public relations Public diplomacy Health diplomacy Relationship management
a b s t r a c t Authors have noted the convergence of public relations and public diplomacy, yet public relations scholars have ignored an important aspect of public diplomacy–health diplomacy. Health diplomacy involves activities that improve global health while strengthening relationships between the United States and peoples abroad. This article encourages greater public relations involvement in health diplomacy. © 2009 Elsevier Inc. All rights reserved.
1. Introduction It would be difﬁcult to visit a bookstore in the United States without coming across a work concerning anti-Americanism (Katzenstein & Keohane, 2007; Kohut & Stokes, 2006). Although not drawing as much attention as the broader ﬁeld of public diplomacy, health diplomacy is also an important factor to consider when discussing the reputation of America around the globe. There has been little involvement of public relations scholars and practitioners in discussions about health diplomacy. The purpose of this paper is to suggest that public relations scholarship has much to offer the ﬁeld of health diplomacy. Scholars and practitioners have the knowledge and skills to make health diplomacy efforts more successful. By helping make health diplomacy efforts successful, public relations academics and professionals can play a meaningful role in helping to improve the image of the United States in other nations. 2. Public diplomacy As Fitzpatrick (2007) noted, there is no universally-accepted deﬁnition of public diplomacy. Fitzpatrick (2007) examined the state of public diplomacy and concluded that the deﬁning worldview of the ﬁeld “is characterized by asymmetry and self-interest, as reﬂected in the soft power paradigm” (p. 207). Nye (2004) summarized the idea of soft power in foreign affairs: Soft power is the ability to get what you want through attraction rather than coercion or payments. When you can get others to want what you want, you do not have to spend as much on sticks and carrots to move them in your direction (p. 256). Fitzpatrick (2007) concluded that the predominant view in the public diplomacy ﬁeld is that “two-way communication and relationship-building are viewed as a means to advance an institution’s self-interest rather than the dual interests of the sponsoring institution and its foreign publics” (p. 207). Public diplomacy is seen far too often as a means to get the peoples of other nations to behave as those behind the efforts want them to behave rather than establishing true relationships that beneﬁt both parties. Fitzpatrick (2007) recommended 0363-8111/$ – see front matter © 2009 Elsevier Inc. All rights reserved. doi:10.1016/j.pubrev.2009.01.003
K. Wise / Public Relations Review 35 (2009) 127–129
that public diplomacy be developed using a relational paradigm proposed by Ledingham (2003). Under a relational paradigm, Fitzpatrick (2007) argued, “establishing supportive relationships with the range of state and non-state actors that inﬂuence a nation’s ability to carry out its foreign affairs’ objectives would be the central purpose of the public diplomacy function” (p. 209). A key feature of public diplomacy practiced under a relational model would be “heightened attention to the diplomacy of deeds” (p. 209). I agree with Fitzpatrick (2007) that public diplomacy is – at least to a signiﬁcant degree – the diplomacy of deeds. Words, of course, matter. But deeds mean more than words in helping to build mutually beneﬁcial relationships over time. As Ledingham (2003) noted, the building and sustaining of relationships “requires not only communication, but organizational and public behaviors, a concept central to the relationship management perspective” (p. 194). Public relations practitioners and scholars who understand the importance of deeds – and have the requisite skills to manage the relationships necessary to coordinate the diplomacy of deeds – can make a meaningful difference in the health diplomacy arena. 3. Health diplomacy Concurrent with the interest in public diplomacy is a marked increase in scholarly activity in health diplomacy. As is the case with public diplomacy, no universally-accepted deﬁnition of health diplomacy exists. Health diplomacy, as Kickbusch, Novotny, Drager, Silberschmidt, and Alcazar (2007) noted, “is a ﬁeld in the making, with a need for both conceptual development and practical training programs” (p. 972). For the purposes of this discussion Novotny and Adams’ (2007) deﬁnition will be used. The authors deﬁned health diplomacy as “a political change activity that meets the dual goals of improving global health while maintaining and strengthening international relations abroad, particularly in conﬂict areas and resource-poor environments” (p. 1). The diminished reputation of the United States around the world is well documented (World Public Opinion, 2007). Bernard Kouchner, the co-founder of the humanitarian organization Doctors Without Borders, recently said although it was possible to partially restore America’s image overseas, “It will never be as it was before” (Smale, 2007). Although Bernard Kouchner’s opinion may be true, health diplomacy can be a key tool in improving America’s image around the world. Kassalow (2001) argued the U.S. has a unique opportunity when it comes to health: “Public health. . . is a unique site in foreign policy. Here U.S. leadership in international health affairs can provide an unequivocally positive framework for pursuing what is in our interest as well as that of the world” (p. 7). 4. Public relations and American health diplomacy Public relations scholars would instantly recognize much of the relationship-centered language used by authors writing for public health audiences as well as the nature of challenges facing public health leaders. The number of key actors involved in global health issues has grown, and many public health writers have noted the importance of relationships and collaboration when addressing global health issues. Long gone are the days when diplomats, for example, work with only other diplomats. Diplomats, said Kickbusch, Silberschmidt, and Buss (2007), need to “interact with the private sector, nongovernmental organizations, scientists, activists, and the media, to name a few, since all these actors are part and parcel of the negotiating process” (p. 230). As noted by MacPherson, Gushulak, and Macdonald (2007), meeting health challenges through international cooperation and collaboration has become an important part of foreign policy, especially when dealing with the health implications of issues such as migration and population mobility: “In a globalized and ever more integrated world there remains a need for a collaborative global approach to health and foreign policy that extends beyond traditional interventions” (p. 203). Collaborative efforts are crucial to health diplomacy. I agree with the suggestion that collaboration is a core value of public relations (Grunig, 2000). In addition, the management of relationships has been the topic of numerous scholastic efforts in public relations over the past several years. Public health leaders would gain signiﬁcant insight on the management of the relationships mentioned by Novotny and Adams (2007) if they confronted this new health diplomacy challenge from a relational perspective as recommended by Fitzpatrick (2007). Novotny and Adams (2007) have asked, “How can health create bridges between worlds (industrialized and industrializing, for example) by way of recognition of shared responsibilities for health development, shared disease risks, and similar issues in global health security?” (p. 5). Public health ofﬁcials are probably unaware that considerable progress has been made in the building and maintenance of the “bridges” mentioned by Novotny and Adams (2007). Put simply, we in public relations are bridge builders. We are in a unique position to assist in health diplomacy efforts, and we must seize opportunities to do so. References Fitzpatrick, K. R. (2007). Advancing the new public diplomacy: A public relations perspective. The Hague Journal of Diplomacy, 2, 187–211. Grunig, J. E. (2000). Collectivism, collaboration, and societal corporatism as core professional values in public relations. Journal of Public Relations Research, 12, 23–48. Kassalow, J. S. (2001). Why health is important to U.S. foreign policy. New York: Council on Foreign Relations and Milbank Trust. Katzenstein, P. J., & Keohane, R. O. (Eds.). (2007). Anti-Americanism in world politics. New York: Cornell University Press.
K. Wise / Public Relations Review 35 (2009) 127–129
Kickbusch, I., Novotny, T. E., Drager, N., Silberschmidt, G., & Alcazar, S. (2007). Global health diplomacy: Training across disciplines. Bulletin of the World Health Organization, 85, 971–973. Kickbusch, I., Silberschmidt, G., & Buss, P. (2007). The need for new perspectives, strategic approaches, and skills in global health. Bulletin of the World Health Organization, 85, 230–232. Kohut, A., & Stokes, B. (2006). America against the world: How we are different and why we are disliked. New York: Henry Holt and Company. Ledingham, J. (2003). Explicating a theory of relationship management as a general theory of public relations. Journal of Public Relations Research, 15, 181–198. MacPherson, D. W., Gushulak, B. D., & Macdonald, L. (2007). Health and foreign policy: Inﬂuences of migration and population mobility. Bulletin of the World Health Organization, 85, 200–206. Novotny, T., & Adams, V. (2007). Global health diplomacy: A global health sciences working paper. Available at http://www.globalhealthsciences. ucsf.edu/pdf/GH DiplomacyWorkingPaperFINAL.pdf. Nye, J. S., Jr. (2004). Soft power and American foreign policy. Political Science Quarterly, 119, 255–270. Smale, A. (March 13, 2007). U.S. image overseas will be difﬁcult to ﬁx, a French ally says. The New York Times, p. A9. World Public Opinion. (2007). World view of U.S. role goes from bad to worse. Available at: http://www.worldpublicopinion.org/pipa/articles/home page/306. php?nid=&id=&pnt=306&lb=hmpg1.