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Beyond the 2004 Tsunami: Health Diplomacy as a Response

On 26 December 2004, an earthquake off the coast of Sumatra, Indonesia, led to tsunamis that killed more than 220,000 people and caused widespread damage around the Indian Ocean. This marks one of the first times in human history that so many countries were involved in a natural disaster, necessitating a global response. Since the tsunami, people around the world have been watching pictures of the total devastation. While there was immediate concern for survivors and an effort to rescue and track down the missing, government officials from around the world started to focus their attention on mounting the massive relief effort everyone knew would be required. The international effort in helping those affected became ‘‘an interesting new kind of diplomacy,’’ according to the U.S. State Department. ‘‘It was an intensive and immediate effort, multilateral coordination and disaster relief, at a senior level, that in some ways was virtual diplomacy.’’ The new diplomatic ground took advantage of communication technologies such as teleconferencing and e-mail. In the twenty-first century, communication technology has become a central part in mobilizing humanitarian relief and health personnel. Yet the goal of early warning systems traditionally have been used just to avoid or minimize violence, deprivation, or humanitarian crises that threaten the sustainability of human development. Now as the relief and reconstruction operation is underway, we should not lose sight of an opportunity to advance a new kind of health diplomacy and rebuild a less vulnerable region where people and states are organized to respond to future threats. An opportunity has been created to view future warning systems, not just to prepare for short-term containment and relief strategies, but also to design, build support for, and implement longer-term proactive strategies and development programs that can reduce the likelihood of future disasters. Such systems also can build capacity and integrate information targeted to national government officials, representatives of conflicting parties, and local nongovernmental organizations (NGOs) while legitimizing the role of health in civil society. In the post-9-11-01 world, however, more health and humanitarian resources have been centered on security. For example, in 2003 the United States spent $4.3 billion for bioterrorism preparedness, with the world’s largest public health agency, the U.S. Centers for Disease Control and Prevention, spending more than $2 billion on bioterrorism, including more than $500 million for smallpox vaccine, a disease