Conflicting goals
Safeguarding both humanitarian traditions and the interests of the domestic pharmaceutical industry creates tension in the Swiss health-related foreign policy, says Ursula Jasper.
Switzerland has been one of the first countries in the world to have a health-related foreign policy. In 2012, the Federal Council adopted the strategy and incorporated it institutionally. While health policy used to be primarily regarded as a domestic issue and was predominantly dealt with on the cantonal level in Switzerland, the maxim is now that all aspects of health-related topics should also be considered when it comes to foreign policy. This paradigm shift was introduced thanks to the view that many health issues must be considered in their global context, and that given the background of global mobility and interconnectedness, new infectious diseases could quickly become pandemics – like SARS in 2002/03 – and thereby also threaten Switzerland.
The 20 goals to be pursued as part of this interdepartmental foreign health policy strategy are extremely heterogeneous and diverse. They encompass the control of infectious diseases and the improvement of national health systems in developing countries; the strengthening of the World Health Organisation (WHO); drug policy and digitalisation in the healthcare sector; and the expansion of the Swiss research landscape, the promotion of economic interests and the protection of intellectual property. Swiss pharmaceutical companies, aiming to implement patent protection for their drugs worldwide, are particularly interested in this last.
Almost unresolvable tensions
In the coming months, the Federal Council will examine the existing strategy. Its evaluation will show whether such a broad range of goals is sensible or if a tighter focus and prioritisation would be more advisable in the future.
“It would be better if Switzerland advocated for questions of health protection and access to medicines to be given greater weight in trade and investment agreements.”Ursula Jasper
It is already clear that Switzerland’s foreign health policy is marked by almost unresolvable tensions between varied, occasionally even contradictory interests. For example, the humanitarian goal of enabling the largest possible number of people in developing countries to access lifesaving medication is hard to combine with the current form – demanded by the pharmaceutical industry – of patent protection for drugs.
We also need to scrutinise to what extent the explicit commitment to a liberal global economic system and to free trade can be reconciled with the humanitarian vision of the human right to health. For example, various authors have argued that it is unregulated free trade and the privatisation and marketisation of healthcare in a global economic system dominated by industrialised countries that cements structures of inequality and jeopardises the health of large population groups. Accordingly, it would be better if Switzerland advocated for questions of health protection and access to medicines to be given greater weight in trade and investment agreements in future.
Switzerland shows its international political will
The fact that Switzerland established an interdepartmental foreign health policy strategy in recent years was an important step from both a national and a global perspective. This is not only because Switzerland has thereby committed itself to humanitarian principles, such as making access to medication easier or developing local healthcare systems; it also demonstrates the international political will to establish the country in the changing global healthcare architecture, which today consists of a large number of state and non-state actors and initiatives in addition to WHO. This kind of position offers the opportunity to play a key role in reforming and reshaping the international health system and strengthening WHO, which would also benefit Geneva as a centre for international health diplomacy.