A new innovative method to measure the cost of war: future with fewer conflicts via harm reduction approaches.

BACKGROUND: The destruction of World War I (WWI) and World War II (WWII) changed the world forever. In this analysis, the economic costs of WWI and WWII are considered via a harm reduction approach to highlight the cost of war via the mortality of military personnel. The harm reduction philosophy and homeostasis of a biological cell are utilized as a pragmatic approach and analogy to give a greater context to the findings, despite the omission of civilian casualties and military disabilities. METHODS: Tangible (e.g., loss of wages, productivity, and contributions) and intangible (e.g., quality of life) costs are estimated based on the value of each military personnel derived from secondary data and a mathematical model. This is the first study to estimate the cost of war based on soldier's mortality during the first and second World War. RESULTS: Based on the tangible value, the WWI and WWII cost for the military personnel was US$43.204 billion ($13 billion ≤ α ≤ $97 billion) and US$540.112 billion ($44 billion ≤ α ≤ $1 trillion). When the intangible cost is considered, it is estimated that the WWI cost was beyond US$124 trillion ($43 trillion ≤ ß ≤ $160 trillion), and the WWII cost was above US$328 trillion ($115 trillion ≤ ß ≤ $424 trillion). The sensitivity analyses conducted for WWI and WWII demonstrate different ranges based on tangible and intangible values. CONCLUSIONS: In the current climate of increasing hostilities, inequalities, global warming, and an ever-changing world, economic prosperities are directly linked to peace, stability, and security. Therefore, any future decisions for military conflicts need to increasingly consider harm reduction approaches by considering the cost of life and potential disabilities for each nations' soldiers, sailors, and pilots.

Global Water Challenges in Sub-Saharan Africa and how to strengthen science-policy dialogues on transboundary governance and cooperation.

The United Nations Water Conference 2023 highlighted the need for concrete actions to boost integrated water resources management for achieving the Sustainable Development Goals and called for strategies to enhance cooperation among stakeholders. Technical cooperation between countries and institutions in transboundary systems, e.g., on environmental data collection, is an effective way to promote international diplomacy and prevent disputes between riparian states. Still, establishing collaborations to inform bilateral dialogues on the identification of environmental challenges, their causes, and development priorities may be a difficult task in itself. This is particularly true in the African context because of limited resources and lack of data. In this paper, we analyse the case of nine transboundary river basins in Sub-Saharan Africa to identify which water-management challenges are perceived as most important by the different riparian countries from a policy and scientific perspective. Our insights are based on the most up-to-date scientific papers, open access reports and technical literature, river basin authority's strategy papers, projects' summary reports, and national policy documents. We also complement these sources with the pieces of information we gained through collaborations with regional and local experts, and management bodies (such as river basin authorities). We highlight the current water-related conflicts and the gap between the priorities identified by the scientific community and different riparian countries on how to tackle hydro-climatic change and improve food and energy security, human and environmental health. Based on our experience, we discuss some keys to building trust among stakeholders, strengthening cooperation, and identifying shared water-governance measures in transboundary river basins. They are: (i) connect science and policy to provide sound knowledge for the right questions, (ii) value local knowledge and exploit the complementarity of different perspectives, (iii) consider multiple spatial scales and multi-level stakeholders to leave no one behind, (iv) promote a culture which values trade-offs and handles complexity, and (v) co-create data and knowledge to facilitate stakeholder dialogue from problem definition to intervention identification.

Comparative analysis of healthcare systems in the Horn of Africa and the evaluation of Türkiye's diplomatic health studies conducted in Somalia.

This study examines the effectiveness of the countries' health systems in the Horn of Africa region. It also investigates the perspectives of actors who have played an active role in health affairs in Somalia carried out by Türkiye. Using the Data Envelopment Analysis and Malmquist Total Factor Efficiency Analysis, we investigated the effectiveness of the health systems and improvements made throughout the years. In the countries of interest, efficiency levels and average total factor productivity showed positive and/or negative trends between 2000 and 2020. Kenya showed a marked performance in achieving improved average total factor productivity thanks to the effective use of current technology in health, success in integrating new technologies into the health system, and a high potential to produce more output despite insufficient existing inputs. The remaining countries lagged behind in improving their production factors. Since 2014, Türkiye has provided health services in Somalia through health diplomacy and conducted medical examinations for numerous patients in a well-equipped hospital.

Cette étude examine l'efficacité des systèmes de santé des pays de la région de la Corne de l'Afrique. Il étudie également les perspectives des acteurs qui ont joué un rôle actif dans les affaires de santé en Somalie menées par Türkiye. En utilisant l'analyse de l'enveloppe des données et l'analyses d'efficacité des facteurs totales de Malmquist, nous avons étudié l'efficience des systèmes de santé et les améliorations apportées au cours des années. Dans les pays intéressés, les niveaux d'efficacité et la productivité totale moyenne du facteur ont montré des tendances positives et/ou négatives entre 2000 et 2020. Le Kenya a fait preuve d'une performance marquée dans l'amélioration de la productivité totale moyenne du facteur grâce à l'utilisation efficace de la technologie actuelle dans le domaine de la santé, au succès de l'intégration de nouvelles technologies dans le système de santé et au potentiel élevé de produire plus de produits malgré l'insuffisance des produits existants. Les autres pays sont en retard dans l'amélioration de leurs facteurs de production. Depuis 2014, Türkiye a fourni des services de santé en Somalie par le biais de la diplomatie de santé et a effectué des examens médicaux pour de nombreux patients dans un hôpital bien équipé.

Enhancing global health diplomacy for non-communicable diseases: application of the global health network framework.

BACKGROUND AND AIM: Understanding the characteristics of global policy actors and the political context in which they address diplomatic issues in the field of NCDs can play an important role in advancing NCD-related goals. The purpose of this study was to identify and analyze the network of global health actors in the field of NCDs in Iran. METHODS: This study was conducted in 2020 using a qualitative methodology and framework analysis. In-depth semi-structured interviews were conducted with subject-matter experts from all levels of diplomacy, including global, regional, and national, who had managerial, administrative, and academic experience. FINDINGS: A total of 21 interviews were conducted with individuals who met the inclusion criteria. Following the framework of the World Health Network, the findings were divided into three general areas: the features of the network and the actors; the policy environment; and the characteristics of the issue. CONCLUSION: A successful and sustainable program to combat NCDs requires the participation of multiple actors from governments, the private sector, and civil society at international, national, and local levels. The Global Network for Prevention and Control of NCDs should enhance the effectiveness of NCDs policies by highlighting the need to simultaneously improve the internal factors of the network, including relationships among the actors; external factors, including the policy environment; and the complex nature of NCDs.

Engaging Early-Career Scientists in Global Policy-Making.

Pressing global challenges, such as climate change, the COVID-19 pandemic, or antibiotic resistance, require coordinated international responses guided by evidence-informed decisions. For this purpose, it is critical that scientists engage in providing insights during the decision-making process. However, the mechanisms for the engagement of scientists in policy-making are complex and vary internationally, which often poses significant challenges to their involvement. Herein, we address some of the mechanisms and barriers for scientists to engage in policy-making with a global perspective by early-career scientists. We highlight the importance of scientific academies, societies, universities, and early-career networks as stakeholders and how they can adapt their structures to actively contribute to shaping global policies, with representative examples from chemistry-related disciplines. We showcase the importance of raising awareness, providing resources and training, and leading discussions about connecting emerging scientists with global decision-makers to address societal challenges through policies.

Science diplomacy on display: mobile atomic exhibitions in the cold war: Introduction to Special Issue.

Despite the increasing interest in science exhibitions, there has been hardly any work on mobile science exhibitions and their role within science diplomacy - a gap this thematic issue is meant to fill. Atomic mobile exhibitions are seen here not only as cultural sites but as multifaceted strategic processes of transnational nuclear history. We move beyond the bipolar Cold War history that portrays propagandist science exhibitions as instances of a one-way communication employed to promote the virtues of the two major and conflicting political powers. Instead, Science Diplomacy on Display follows mobile atomic exhibitions as they move across national borders and around the world, functioning as spaces for diplomatic encounters. Exhibitions play a vital role not only in the production of knowledge and the formation of political worldviews but also as assets in diplomatic negotiations and as promoters of a new worldview in which nuclear stands at the centre. They are powerful iconic diplomatic devices, that is systems of representations that capture the diplomatic processes in action and make the nitty-gritty details of international relations visible. This issue seeks to trace the multiple and often contradictory meanings that mobile exhibitions took on for various actors.

COVID-19 and Global Distributive Justice: 'Health Diplomacy' of India and South Africa for the TRIPS waiver.

The second wave of the COVID-19 pandemic had left heart-wrenching impacts on all facets of life in general and the availability, accessibility, and affordability of medicines and vaccines in particular. Rather, the world has been divided into two groups regarding access to medicine and vaccines as haves and have-nots. The rich countries had pre-ordered the vaccines of COVID-19 along with the holding of the same. The pandemic situation was further worsened, given the Trade-Related Intellectual Property Rights (TRIPS) in practice and restrictions on sharing technology of vaccines, medicines, and life-saving equipment. In this context, India and South Africa have proposed the joint proposal and garnered support for waiving off TRIPS to ensure equity, accessibility, and affordability of vaccines and the same as public goods. In this review, we emphasize that global justice is one of the important elements of normative international theories, which focus on all the moral obligations from the world's rich to the world's poor. The paper also questions and argues that if the rich countries fail to go by the principles of global justice, can the Indian and South African (SA) patent diplomacy play a catalyst role in global justice? The review concludes with an emphasis on global solidarity, and the acceptance of joint India-South Africa's "patent diplomacy" for TRIPS waiver would result in mass production and fair distribution, making the COVID-19 medicines and technologies available to everyone regardless of their poor-rich status.

[The modern role of the resort medicine in medical diplomacy and national humanitarian policy]. / Sovremennaya rol' kurortnoi meditsiny v meditsinskoi diplomatii i natsional'noi gumanitarnoi politike.

Health care in general and medicine in particular play an important role in the geopolitical landscape and the political positioning of the state in the modern world. The health of the citizens of the country is the most important resource of national security. This article, based on a SWOT-analysis, highlights the strengths and weaknesses of the foreign and national resort industry as a part of medical diplomacy, with decomposition to its individual participants. The undoubted advantage of our country in terms of humanitarian policy, on the world stage is shown, specifically in the context of national key success factors, including the technological capabilities of domestic medical science and practice, regarding the availability of trained staff, specialized variable climatic sanatorium and resort institutions network with unique technologies and natural healing resources, coupled with international experience in humanitarian cooperation, developed healthcare system and sanitary and epidemiological supervision of the country. Medical diplomacy and national resort medicine as an active participant of the branch, are strategically important areas in public diplomacy, having the ability to play an important role in achieving national goals in geopolitics.

Competing Responses to Global Inequalities in Access to COVID Vaccines: Vaccine Diplomacy and Vaccine Charity Versus Vaccine Liberty.

Global access to coronavirus vaccines has been extraordinarily unequal and remains an ongoing source of global health insecurities from the evolution of viral variants in the bodies of the unvaccinated. There have nevertheless been at least 3 significant alternatives developed to this disastrous bioethical failure. These alternatives are reviewed in this article in the terms of "vaccine diplomacy," "vaccine charity," and "vaccine liberty." Vaccine diplomacy includes the diverse bilateral deliveries of vaccines organized by the geopolitical considerations of countries strategically seeking various kinds of global and regional advantages in international relations. Vaccine charity centrally involves the humanitarian work of the global health agencies and donor governments that have organized the COVAX program as an antidote to unequal access. Despite their many promises, however, both vaccine diplomacy and vaccine charity have failed to deliver the doses needed to overcome the global vaccination gap. Instead, they have unfortunately served to immunize the global vaccine supply system from more radical demands for a "people's vaccine," technological transfer, and compulsory licensing of vaccine intellectual property (IP). These more radical demands represent the third alternative to vaccine access inequalities. As a mix of nongovernmental organization-led and politician-led social justice demands, they are diverse and multifaceted, but together they have been articulated as calls for vaccine liberty. After first describing the realities of vaccine access inequalities, this article compares and contrasts the effectiveness thus far of the 3 alternatives. In doing so, it also provides a critical bioethical framework for reflecting on how the alternatives have come to compete with one another in the context of the vaccine property norms and market structures entrenched in global IP law. The uneven and limited successes of vaccine diplomacy and vaccine charity in delivering vaccines in underserved countries can be reconsidered in this way as compromised successes that not only compete with one another, but that have also worked together to undermine the promise of universal access through vaccine liberty.

A case-based approach to teaching epidemic and pandemic-related global health diplomacy and security in African countries.

A challenging concept to teach, few combined courses on epidemic-related global health diplomacy and security exist, and no known courses are currently available that have been exclusively designed for African nationals. In response, the University of California, San Francisco's Center for Global Health Delivery, Diplomacy and Economics (CGHDDE) developed and delivered a workshop for LMIC learners to better understand how politics, policy, finance, governance and security coalesce to influence global health goals and outcomes.

COVAX, vaccine donations and the politics of global vaccine inequity.

BACKGROUND: In 2021, donor countries, the pharmaceutical industry, and the COVAX initiative promoted vaccine donation or "dose-sharing" as a main solution to the inequitable global distribution of Covid-19 vaccines. COVAX positioned itself as a global vaccine-sharing hub that promised to share doses "equitably, effectively and transparently," according to rational criteria overseen by independent scientists. This article provides a critical analysis of the principles and practice of "dose-sharing," showing how it reveals the politics at play within COVAX. RESULTS: Donated doses were an important source of COVAX's vaccine supply in 2021, accounting for 60% of the doses the initiative delivered (543 million out of 910 million). However, donations could not compensate fully for COVAX's persistent procurement struggles: it delivered less than half of the two billion doses it originally projected for 2021, a fraction of the 9.25 billion doses that were administered globally in 2021. Donor countries and vaccine manufacturers systematically broke COVAX's principles for maximizing the impact of dose-sharing, delivering doses late, in smaller quantities than promised, and in ad hoc ways that made roll-out in recipient countries difficult. Some donors even earmarked doses for specific recipients, complicating and potentially undermining COVAX's equitable allocation mechanism. CONCLUSIONS: COVAX's pivot from global vaccine procurement mechanism to dose-sharing hub can be seen as a "win-win-win" solution for COVAX itself (who could claim success by having access to more doses), for donor countries (who could rebrand themselves as charitable donors rather than "vaccine hoarders"), and for the pharmaceutical industry (maintaining the status quo on intellectual property rights and protecting their commercial interests). Although dose-sharing helped COVAX's vaccine delivery, its impact was undermined by donors' and industry's pursuit of national security, diplomatic and commercial interests, which COVAX largely accommodated. The lack of transparency and accountability mechanisms within COVAX's overly complex governance structure as a global public-private partnership enabled these practices.

Global health diplomacy: Provision of specialist medical services in the Republic of Botswana.

Global Health Diplomacy (GHD) can be defined as the convergence between public health and international affairs. The following case report demonstrates the impact of "brain drain" on provision of specialist medical services in Botswana, a middle-income country in Southern Africa and how GHD is being used to address the challenge. Botswana's priorities include the attainment of Sustainable Development Goals (SDGs) by 2030 which are embedded within the Ministry of Health and Wellness (MOHW) strategy. MOHW strategies include access to health services, reduction in the cost of referral of specialist services, and strengthening primary health care (PHC), which is the vehicle for attaining Universal Health Coverage (UHC). Botswana has, in the past tried to bridge this gap through strategic partnerships with private institutions and bilateral treaties with other states such as the Republic of Cuba and the People's Republic of China. In the private sector, the Ministry has partnered with Indus Medical Group, and a range of private medical institutions both in-country and outside the country. However, challenges experienced with previous partnerships were that the objectives were more service-driven than capacity building, which proved to be unsustainable. The case report outlines the negotiation process between the Government of Botswana represented by MOHW, and St. Paul Medical Missions, a religion-based NGO from Egypt. It demonstrated the importance of all actors and countries being clear on their health priorities at the start of negotiations. GHD is a relatively new concept that can be explored by countries in forming durable partnerships.

Reconceptualising international academic mobility in the global knowledge system: towards a new research agenda.

The cross-border movement of people in higher education has been attracting scholarly attention for decades, but the definition of 'international academic mobility' bears ambiguities. This article reviews the literature on international academic mobility published in the journal Higher Education and beyond. By bridging the literature on international academic mobility from higher education studies and other disciplines, this article proposes to redefine international academic mobility, which highlights the integration of both international student mobility and international faculty mobility. Furthermore, this article outlines a new conceptual framework and research agenda, on the role of international academic mobility in the national, regional, and global knowledge systems. The framework highlights the relationship between international academic mobility and worldwide knowledge acquisition, production, transfer, circulation, networks, and the geopolitics of science. The article also proposes further methodologies for future research on international academic mobility.

The Avengers and the PLA Wolf Warrior: Popular Narratives and Major Power Competition.

In recent years, some scholars of international politics have argued for the need to integrate the use of visual media into our understanding of global politics. In this respect, film (or movies) represents an effective media of communicating powerful ideas and political worldviews through a smorgasbord of sound and sensory experiences. This essay seeks to draw on the theoretical insights of scholars of visual international politics to analyze the ongoing geopolitical conflict between the United States and China. It will do so by examining two box-office hits in the West and China, namely, the Avengers and Wolf Warrior. Through a study of some of the key storylines in these films, this essay seeks to flesh out the differences in Sino-Western conceptions of patriotism, good and evil, and salvation. It argues that these differences are not just a matter of aesthetic preferences, but reflect more fundamental ideas and political worldviews salient in the thinking of China and the West.

China's "Weaponized" Vaccine: Intertwining Between International and Domestic Politics.

Ever since China has formally joined the WHO-backed global COVID-19 vaccine initiative known as COVAX, there is a presumed notion that China's vaccine diplomacy will make a significant contribution to the international public good and thus uplift Beijing's role as the rule-maker of international order. To scrutinize this, the paper asks if China succeeded in proliferating its weaponized vaccine policy to obtain maximum diplomatic gains and soft power projection to intensify its international image, geopolitical power, and domestic politico legitimacy. The authors argue that despite its vaccine diplomacy demonstrated the robust governance capacity and responsibility to be a great power. Yet, Beijing's geopolitical influence and international image are significantly overrated and not enough to play a more prominent role in the global power fulcrum/equilibrium. On the contrary, China enjoys a leading position on the domestic political front. Its successful portrayal of China's vaccine provision in the global market and remarkable configuration to leverage a deep-rooted nationalism has fundamentally provided China with a powerful rationale to divert its public's attention from Beijing's earlier inadequate handling of the outbreak. The evaluation of the paper reveals that China's vaccine diplomacy's influence in promoting international image and geopolitics is limited but has successfully stabilized its domestic political environment and enhanced its domestic legitimacy.

ASEAN's Diplomatic Tasks During the Pandemic.

What are the implications of COVID-19 for the diplomacy of the Association of Southeast Asian Nations (ASEAN)? What kinds of diplomatic tasks has the pandemic imposed on ASEAN, and in what way has the Southeast Asian association handled them? ASEAN's most fundamental diplomatic task has of course been to continue building ASEAN communities, but the ability of the association of minor powers in Southeast Asia is limited. Hence, it can be said that ASEAN's most important diplomatic task has been to maintain favorable relations with external powers, in particular, with China and the United States. The present study argues that ASEAN has managed to maintain favorable relations with and receive support from both of these external powers by conducting "equidistant diplomacy" with them. In concrete terms, it has fostered favorable relations with China. Yet, without relying excessively on Beijing, it made sure to foster such relations with the United States as well, thereby striking a reasonable balance between these two external powers.

Perks and Perils of Strategic Choice: South Korea's Iran Policy Under Moon Jae-in.

After some two decades of growing partnership between Seoul and Tehran, South Korea's bilateral relationship with Iran reached a bottom of absolute gloom under the leadership of Moon Jae-in. Most of his presidency coincided with the administration of Donald Trump who followed a relatively contrasting approach toward the North Korean and Iranian nuclear issues. Washington's Pyongyang and Tehran policies were naturally bound to create opportunities as well as troubles for the Moon-led Korean government's dealing with North Korea and Iran. Arguing from a perspective of strategic choice, this study asserts that Moon almost forfeited the ROK's commercial interests in Iran for the sake of advancing his North Korean agenda. As a corollary, the South Korean-Iranian ties sank to an all-time low, culminating in unprecedented diplomatic tensions between the two countries over the issue of Iran's oil incomes frozen in Seoul. The Mideast country's subsequent resort to gunboat diplomacy by seizing a Korean oil tanker in the Persian Gulf did also little to break the gridlock over the dilemma of blocked assets because any satisfactory and lasting solution regarding this intractable trouble largely hinged on resolving the fate of Iran's nuclear deal between Tehran and Washington.

The Double Legacy of Bernalism in Science Diplomacy.

Recent debates in the history of science aimed at reconstructing the history of scientific diplomacy have privileged the analysis of forms of diplomacy coming from above. Instead, the objective of this paper is to raise awareness of these debates by looking at attempts at scientific diplomacy from below. Such a shift in perspective might allow us to observe the impact of marginalized social agents on the construction of international diplomatic choices. This article particularly focuses attention on how the legacy of Bernalism has fostered the emergence of two different types of science diplomacy. On the one hand, Bernalism has influenced the goals of organizations such as UNESCO and the World Peace Council, which are forms of science diplomacy I would term from above. On the other hand, Bernalism has also been at the origin of radical scientific movements that I propose to interpret as forms of scientific diplomacy from below. These have, in fact, played a cardinal role not only in raising public awareness of the social and political roles of science, but also in the more direct participation of scientists in defining the political objectives of their research activity. From this point of view, I analyze how an association like the World Federation of Scientific Workers proposed (at least in the beginning) greater democratic participation than the top-down structures of other forms of scientific internationalism.

Global health diplomacy in Mexico: insights from key actors in the field.

BACKGROUND: Global health diplomacy (GHD) focuses on the actions taken by diverse stakeholders from different nations -governments, multilateral agents, and civil society- to phenomena that can affect population health and its determinants beyond national borders. Although the literature on conceptual advancements of GHD exists, empirical studies about how health becomes an issue of relevance for foreign policy are scarce. We present an analysis of the entry processes of health into the foreign policy and diplomatic domains in Mexico from the perspective of key informants of three different sectors. METHODS: A purposive sample of high-rank representatives of three sectors involved in GHD was designed: Two from Health Sector (HS), four from Foreign Affairs Sector (FAS), and three from Non-governmental organizations (NGOs). Nine semi-structured interviews were conducted exploring the topics of: (1) Health concerns entering diplomatic and foreign policy; (2) Processes that allow actors to influence foreign policy and negotiation and; (3) Impact of multilateral negotiations on decision-making at the national level. RESULTS: Our analysis suggests that GHD in Mexico is hierarchically driven by the FAS and health concerns only enter foreign policy when they are relevant to national priorities (such as trade or security). HS possesses a lesser degree of influence in GHD, serving as an instance of consultation for the FAS when deciding on health-related issues at global meetings (i.e., World Health Assembly). NGOs resort to lobbying, advocacy, networking, and coalition-working practices with other sectors (academy, think-tanks) to prevent harmful impacts on local health from multilateral decisions and as a mean to compensate its power asymmetry for influencing GHD processes in relation to the government. CONCLUSIONS: GHD in Mexico occurs in a context of asymmetric power relationships where government actors have the strongest influence. However, NGOs' experience in raising awareness of health risks needs to be weighted by government decision-makers. This situation calls for capacity building on intersectoral communication and coordination to create formal mechanisms of GHD practices, including the professionalization and training on GHD among government agencies.

Opportunities and challenges of global health diplomacy for prevention and control of noncommunicable diseases: a systematic review.

BACKGROUND AND AIM: The growing globalization has changed the goals and methods of diplomacy. Due to the challenges and complexities of dealing with noncommunicable diseases (NCDs) at the national and international levels, policy makers require global health diplomacy (GHD) to achieve the goals of prevention and control of NCDs. The purpose of this systematic review was to identify the challenges and opportunities in GHD for NCDs. METHODS: A systematic review of articles was conducted by searching MEDLINE via PubMed, Web of Science, Scopus, and Embase and by using Google and Google Scholar search engines. Additional articles were identified by reviewing reference lists and a number of special journals. The inclusion criteria include literature published in English from 2007 to 2020, and the exclusion criteria are literature published in any language other than English, absence of full text, dissertations, and duplicates. Overall, 32 articles met the requirements for inclusion in this review and were analyzed using content analysis in MAXQDA 10. FINDINGS: There are 32 published articles on GHD for NCDs. Identified challenges were classified into three levels: global (global health governance), national (Governance at the state level, health sector, and civil society), and industry. The progress on global health issues has created opportunities for the development of GHD for the prevention and control of NCDs. These opportunities were divided into three levels: international, national, and individual level. CONCLUSION: Various challenges at the global level, national level, and industry led to less engagement of policymakers in GHD for prevention and control of NCDs and, as a consequence, a less coordinated approach to address prevention and control of NCDs worldwide. So, there is a need for more efforts of collective action and negotiation for tackling NCDs. Policymakers and managers of the health system should increase the advocacy, building a coalition with civil society, use negotiation and diplomacy to engage with other sectors and organizations, manage industry conflicts, and leverage foreign policy to promote health and welfare.