UC San Diego

Background: Global health diplomacy (GHD) has the potential to advance foreign policy objectives, but how GHD impacts outcomes remains unclear. Interestingly, Brazil has started to play a larger role in foreign policy via South-South cooperation (SSC), and these activities correspond to the current thinking on GHD modalities. This dissertation will focus on Brazil’s SSC activities to understand the impacts of GHD.

Objective: The primary objectives of this dissertation are: to refine the taxonomy of GHD, and to develop a framework that can be used to measure how GHD can impact trade (e.g. trade balance) and health outcomes (e.g. antiretroviral [ARV] coverage).

Methods: Paper 1: We reviewed GHD, SSC and Brazil health cooperation using peer-reviewed journal articles, government documents, white papers, and non-governmental reports (2001- 2015) to refine the taxonomy of GHD and align GHD and SSC activities. Paper 2: We evaluated the impact of GHD on trade balance by comparing available data from Countries of Africa with Portuguese as their Official Language (PALOPs) and select non-PALOPs using non-parametric methods. Paper 3: We evaluated the impact of GHD on ARV coverage by comparing available data from PALOPs and select non-PALOPs using non-parametric methods, similar to Paper 2.

Results: Paper 1 refines the definition of GHD and determines how Brazil’s SSC represents an expansion of GHD activities. Paper 2 identified that Brazil’s SSC with PALOP countries is associated with higher trade balance than with select non-PALOP countries. Paper 3 found that although Brazil’s SSC had an impact on trade balance, it did not translate into higher ARV coverage in the PALOP countries, compared to select non-PALOP countries.

Conclusion: This dissertation defined how Brazil’s SSC is a form of GHD. These investigations also determined that Brazil’s GHD activities have led to a greater trade balance among PALOP countries but has not led to greater ARV coverage, despite this health metric being a stated goal among PALOP countries. Overall, this dissertation aligns GHD and SSC activities and goals, thus expanding the taxonomy of GHD activities and strengthens the empirical methodology that can be used to evaluate impacts of GHD.