Diplomacy is not peripheral to public health—it is how public health gets done

By guest contributor Kathy Bunka

As a career diplomat with an educational background in international public health, I have come to see diplomacy not as an optional skill, but as a foundational one for global or public health practitioners. It can be learned, refined, and practiced—and in today’s world of fraying multilateralism, it is indispensable.

Public health professionals are trained to understand how diseases spread, how interventions work, and how systems can be improved. Yet many of the greatest barriers to better health outcomes are not biological or medical. They are political, institutional, and human.

This is precisely where diplomacy enters the picture.

At its core, diplomacy is the art of managing relationships among actors with different interests. It is about negotiation, persuasion, and advancing shared objectives without unnecessary confrontation. Public health practitioners engage in diplomacy constantly—whether negotiating with ministries of health, coordinating with international organizations, working with NGOs, or communicating evidence to policymakers, media, and the public. They may not always call it diplomacy, but that is precisely what it is.

Historically, diplomacy was a closed, government-to-government exercise conducted behind doors, through formal channels and slow-moving negotiations. Public health, in parallel, was often seen as a technical field driven by science, medicine and technical expertise.

That distinction no longer holds. Both worlds have changed dramatically. The rise of the internet, the 24/7 news cycle, and the democratization of information have transformed diplomacy into a far more open and complex practice. Public health now operates in this same environment, where scientific evidence competes with political narratives, economic and ideological interests, misinformation, and public emotion.

Today, influence no longer rests solely with governments. It flows through a wide ecosystem that includes international organizations, NGOs, donors, scientists, academics, media, cultural figures, social media influencers, and the general public. Public health practitioners must navigate this landscape with agility. The success of a vaccination campaign, a pandemic response, or a global health treaty depends not only on evidence, but on the ability to align these diverse actors toward a shared goal.

Complicating this landscape further, this evolution is unfolding against a far more difficult geopolitical backdrop. We are witnessing a rise in authoritarian and illiberal regimes, a retreat from multilateralism, and a contraction of international aid and cooperation. In many countries—including Canada—the language of values is increasingly giving way to the logic of realpolitik, with governments prioritizing narrow domestic economic and security interests over global solidarity. For public health, this shift is profound: it weakens collective action at precisely the moment it is most needed. The onus is therefore on all of us not to accept this drift as inevitable. The world will not correct itself. If anything, this is the moment to double down on diplomacy—to sustain cooperation, defend shared principles, and ensure that global health does not become another casualty of geopolitical fragmentation.

Consider major global health achievements such as the WHO Framework Convention on Tobacco Control, the global eradication of smallpox, or the Paris Agreement, the Ottawa Treaty, or ongoing negotiations toward concluding a pandemic agreement.  These are not simply technical victories—they are diplomatic ones. They required countries to reconcile competing interests, negotiate compromises, and sustain cooperation over years—often decades—of effort.

Modern diplomacy also demands a broader set of skills than in the past. Today’s practitioners must be able to translate complex scientific ideas into language that resonates with policymakers, communities, and the media. They must build networks, mobilize coalitions, and communicate across cultural and institutional boundaries. In this sense, public health professionals are no longer just data analysts or program designers—they are also communicators, advocates, and negotiators.

A case study from outside the traditional health sphere illustrates these dynamics. The Declaration Against Arbitrary Detention in State-to-State Relations, launched in 2021, was a diplomatic initiative aimed at addressing the growing use of individuals as leverage in international disputes. While rooted in human rights and consular policy, the campaign offers lessons for public health.

The initiative required sustained diplomatic engagement across governments, international organizations, civil society, legal experts, and the media. It involved building a coalition of actors with different priorities and perspectives, framing the issue in ways that resonated globally, and maintaining momentum over time. By 2025, more than 80 nations have endorsed this declaration. Ultimately, it helped elevate arbitrary detention from a bilateral grievance to a broader international concern, increasing the reputational costs for states engaging in such practices.

The lesson for public health is clear: progress often depends on the ability to build alliances that extend far beyond the immediate technical community. Whether addressing vaccine hesitancy, antimicrobial resistance, climate crisis, or pandemic preparedness, practitioners must engage a wide range of stakeholders and align them around a shared objective. This is becoming harder in today’s world of rising authoritarianism and fraying multilateralism—but it is precisely why it matters more.

Communication is central to this effort. In today’s information environment, evidence does not speak for itself. It must be translated, framed, and communicated in ways that are credible and compelling. Public health practitioners must be able to operate in multiple “languages”: the language of science, the language of policy, and the language of public understanding.

This does not mean abandoning rigor or “spinning” the facts. It means exercising judgment—knowing when to use data, when to use narrative, and when to engage quietly or publicly. The way an issue is framed can determine whether it gains traction or meets resistance.

If diplomacy is the enabling force, what does it require in practice?

The good news is that diplomacy can be learned. It is not an innate talent reserved for a select few, but a set of skills and habits that can be developed over time.

First, it requires learning to separate impulse from response. In contentious situations—such as debates over vaccination—an immediate, emotional reaction may be satisfying but counterproductive. A diplomatic response seeks to listen and understand before persuading.

Second, it involves perspective-taking. Effective practitioners ask not only what they want to say, but how their message will be received, what constraints others face, and what outcomes are realistically achievable in practice.

Third, it requires mastery of language. Words matter. The difference between a confrontational statement and a carefully framed message can determine whether dialogue continues or breaks down. It is also why precision in language is a strategic skill, not a stylistic one.

Fourth, it depends on exposure to difference. Diplomacy is strengthened through engagement with people from different backgrounds, cultures, and viewpoints. This exposure builds empathy and reduces the tendency to oversimplify complex issues.

These skills can be practiced in everyday settings—within teams, communities, and professional environments. They are reinforced through reflection, mentorship, and experience. Over time, they become second nature.

For public health practitioners, the implications are profound. Public health is not only about drugs, data, models, and interventions. It is about people, institutions, and power. It is about navigating competing interests, building trust, and enabling collective action.

In that sense, diplomacy is not peripheral to public health—it is how global and public health gets done in the real world.

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