Giving peace a chance? Global donors miss opportunities offered by health initiatives

With World Health Day being celebrated today (7th April), significant opportunities to help bring lasting peace to countries previously torn by civil war – through re-building and improving their local health systems – are largely being missed by the world’s major aid donors, according to important new research funded by the Economic and Social Research Council (ESRC).

Health is increasingly an international matter, with foreign policy and security implications. But issues are too often portrayed only as threats, says Professor Colin McInnes, of the Centre for Health and International Relations, University of Wales, Aberystwyth, who led a joint study with the London School of Hygiene and Tropical Medicine.

He points to continuing concerns in the UK, for instance, about the country’s vulnerability to threats such as ‘Bird flu’, SARS and bio-terrorism. Professor McInnes said: “The HIV/Aids pandemic, famine and the health effects of wars and natural disasters kill millions and are the targets for significant amounts of international aid and charitable giving.

“Our study looked at whether directing attention to health could instead be a source of potential benefit. We examined whether it is possible to focus on health to contribute to security, rather than just responding to threats.”

The project, which included close examination of post-conflict experiences in Sierra Leone, Croatia, Kosovo and South Africa, argues that health initiatives can help create a stable and lasting peace in different ways as the country moves from immediate relief to longer-term development.

Research colleague, Dr Simon Rushton, said: “From our work it is clear that addressing the healthcare infrastructure in societies recovering from conflict is important in two ways – the benefits for health, which are self evident; and the potential to contribute to creating a stable and lasting peace, which is much more challenging.”

The report says there have been some attempts to work along these lines, such as the World Health Organisation’s ‘Health as a Bridge for Peace’ programme. But the study found that this tends to be ad hoc, under funded and patchy.

In the UK, the Government’s Department for International Development does a lot of work on post-conflict reconstruction in the health sector. However, according to the study, generally it does not link this to any systematic attempt at improving the chances of a lasting peace.

The report points out that at national level, providing services – including health – can help governments increase their popularity, reduce alienation from society, and show that they are acting in the interests of all the people.
Professor McInnes said: “Clearly, what happens in the health sector can have a positive impact upon society more widely.”

At a lower level, during reconstruction in war-torn countries, the report says that it is important to work to reduce tensions within the health sector. For example, services being available to some ethnic groups but not others can often cause increased tensions. Similarly, segregation can be an issue – where some facilities, for example hospitals, are used by just one group.

Dr Rushton added: “Chances to have a positive effect on peace and security are being missed. Governments and other international donors need to understand this better, and create programmes to take more advantage of the links between the health sector and peace”.