Research programme: Contributions of Global Health Diplomacy to equitable health systems in east and southern Africa January 2012- December 2014

Regional Network for Equity in Health in East and Southern Africa (EQUINET)

How can African policymakers engage in global health diplomacy to achieve more equitable health systems and better population health? What factors have supported effective negotiation of African policy goals on health systems within health diplomacy?

In 2012 EQUINET[1] is initiating a three year policy research programme to address these questions in east and southern Africa (ESA). Through the programme, working with government officials in health and diplomacy, with technical institutions, civil society and other stakeholders in ESA countries, we will examine the role of global health diplomacy (GHD), including south –south diplomacy, in addressing selected key challenges to health and strengthening health systems and will use the evidence and learning to inform African policy actors and stakeholders within processes of health diplomacy.

The lead institutions in EQUINET for the work are Training and Research Support Centre (TARSC), working with Southern and East African Trade information and Negotiations Institute (SEATINI). We will feed into regional processes, including the Strategic Initiative of Global Health Diplomacy co-ordinated by the East Central and Southern Africa Health Community, in which EQUINET implements work on research and strategic information. We are working with the Centre for Trade Policy and Law, the secretariat and information lead for the Global Health Diplomacy Network (GHD-NET). An multidisciplinary advisory group from government, diplomat, academic and civil institutions provides guidance and peer review for the work.  The programme is supported by IDRC (Canada).

The programme has issued an open call, reviewed protocols with an advisory group and provided grants for investigations in three case study areas that were defined as priorities in global health diplomacy (GHD) by senior officials and Ministers in 2011 for the region, to identify the manner in which African interests around equitable health systems are being advanced through GHD, and the lessons learned for effective GHD.

The three case study areas are:

  1. Implementation of the WHO Code on international Recruitment of health personnel: The case study will explore the issues motivating the code in SSA, their negotiation and expression in the global code, and the manner in which processes for implementation are being used to raise and advance SSA interests. How far were the policy interests of African countries carried into the Code in the diplomacy around it and what affected this? How far are  countries in east and southern Africa using the code as an instrument for negotiating foreign policy interests on health workers? How are countries using the monitoring of the Code to engage in the diplomatic environment on African policy interests on health workers?
  2. Collaborating on access to essential drugs through south- south relationships with China, Brazil and India  :  This case study will explore the dimensions of collaboration on drug production, distribution and regulation across countries within the region, and with China, Brazil and India. What are the identified bottlenecks to local medicine production in the region? How have joint activities in trade and production of essential medicines between ESA countries and Brazil, India and China addressed the bottlenecks? What are the implications for national and regional policies and agreements on medicines and for global negotiations, including on research and development?
  3. The involvement of African actors in global health governance on universal access to prevention and treatment for HIV and AIDS: This case study will focus on the participation, issues raised, outcomes and thus influence of African state and non-state actors on the decision making processes in global institutions resourcing universal access to prevention, treatment and care for HIV and AIDS. It will explore the spaces the Global Fund and World Bank provide for African participation in global health decision making on performance based financing, and the extent to which African actors nationally and regionally extend their agency within these participatory spaces. The work will also explore the role that WHO plays in the interface between African actors and the Global Fund and World Bank.   

The case study protocols are supported to broadly include:

  • literature review, document analysis and analysis of meeting and negotiation reports, gather and organize background evidence on the case study area
  • Setting up of a small advisory group of policy and technical advisors for the case study area based on their knowledge, policy roles in the specific area, to guide and review the research, capacity building and dissemination activities in the case study
  • Stakeholder analysis with a database of policymakers, knowledge brokers, diplomats, technical institutions and other stakeholders, identifying the existing relationships, communities of practice,  knowledge to policy links and networks that exist around the specific areas, and from this analysis with the advisory group of the core institutions, individuals and groups with whom to  engage (i) to draw input on the areas of focus for the case study area, (ii) to involve in capacity building/ policy dialogue activities (building on this throughout  the case study processes through peer review and policy dialogue forums)
  • Interview (email or face to face) key informants relevant to the case study from African and global level
  • Peer review from relevant stakeholders,  policy dialogue forums to review findings

We will share the evidence through policy dialogue forums, and draw strategic advice on and peer review of the work. We will use innovative strategies that make timely links between policy, technical and other personnel, to support preparations for negotiations or global discussions underway within the domain of the case study.

Public information will be disseminated through the websites and newsletters of EQUINET, the GHD-Net and partners, and through policy briefs and reports.   As materials are gathered for the work these will be made available through the searchable web based annotated bibliography at

For further information please visit www.equinetafrica or contact EQUINET Secretariat, TARSC Box CY2720, Harare, Zimbabwe  email

[1] EQUINET is a network of professionals, civil society members, policy makers, state officials, parliamentarians and others within 16 countries in east and Southern Africa, who have come together to promote and realise shared values of equity and social justice in health