Tracing the terms, traditions and disputes that came to define a field.
Author: Adela Santos · Postdoctoral Visiting Fellow at Global Health Centre, Geneva Graduate Institute (2025–2026)
A systematic review of 2,474 scholarly records, 859 institutional documents and 62 think-tank reports. Searches run 2026-08-20. The graph is 27 concept nodes, 15 landmark definitions, 6 traditions and 3 disputes.
Data · Methods · Contribute to the genealogy →
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World & institutions
BEFORE YOU SCROLL
What this shows
This essay asks how a practice acquired a name and an operational definition, and which conceptual lineages coexist under it. Edges record terminological descent and contestation, not influence.
The practice precedes the name: "health diplomacy" is in print from 2001, six years before the 2007 name.
The 2007 definition became the institutional reference point, in 5 of 9 institutional definitions.
Scholarly definitions remain plural across registers.
Parallel language traditions and a geography of authorship sit alongside the English vocabulary.
BEFORE THE WORD · 1948–1963
Health diplomacy was practised before it was named. In 1948 the WHO Constitution entered into force. In 1958, during the Cold War, the Soviet delegate Viktor Zhdanov proposed to the World Health Assembly that smallpox be eradicated worldwide. A year later came the Cuban Revolution, in 1962 the Missile Crisis, and in May 1963 Cuba sent its first medical brigade abroad, to Algeria.
I · THE FIRST VOICES · 1974
The first voices: Cahill and Bourne
In 1974 an editorial put the two words side by side for the first time we could find: Medicine and diplomacy. Its author, Kevin Cahill, is the earliest voice in this genealogy. No record in the corpus cites it.
1978 · BOURNE
1978 · BOURNE
Four years later Peter Bourne gave the idea a purpose: health as "a means for bettering international relations", a basis for dialogue "bridging diplomatic barriers". It was the year of Alma-Ata and its call for health for all. The field would later treat Bourne as its origin point, mostly at second hand, through Katz and colleagues in 2011.
II · PRACTICE BEFORE THEORY
Practice before theory: Cuba, Thomas and the bridge for peace
Cuba had been sending doctors abroad since 1963. In 1989 Julie Feinsilver began to give that practice a name, and in 1993 a book, Healing the Masses, with a chapter on Cuban medical diplomacy. Later she described it as collaboration that yields health benefits and better relations at once, a source of symbolic and material capital.
1989 · A DISCIPLINE IS ASKED TO LOOK
1989 · A DISCIPLINE IS ASKED TO LOOK
In 1989, the year the Berlin Wall fell, Thomas argued that International Relations had to take health seriously as a subject. The same demand returns in this genealogy in 2022, with Kickbusch and Liu.
HEALTH AS A BRIDGE FOR PEACE
HEALTH AS A BRIDGE FOR PEACE
In Central America, PAHO and WHO used health programmes to open dialogue between warring parties, and called it Health as a Bridge for Peace. Ciro de Quadros and Daniel Epstein evaluated the experience in 2002. Bourne's phrase about bridging diplomatic barriers had anticipated the vocabulary.
SOLIDARITY FROM THE SOUTH
SOLIDARITY FROM THE SOUTH
From the Cuban practice descends another vocabulary: South-South health cooperation. Célia Almeida and colleagues described it in 2010 as horizontal cooperation that builds capacity instead of transferring technology. Paulo Buss and José Roberto Ferreira traced it the same year.
III · HIGH POLITICS · 2000–2005
Health enters high politics
Within five years health reached the rooms where states bargain hardest. The Security Council called HIV/AIDS a possible risk to stability (2000). The WTO Doha Declaration said patent rules should support public health and access to medicines (2001). Then came SARS (2003), the first WHO treaty, on tobacco (2003), and new International Health Regulations (2005).
2001–2007 · A REVOLUTION IN FOREIGN POLICY
2001–2007 · A REVOLUTION IN FOREIGN POLICY
From 2001 David Fidler wrote about health diplomacy, and by 2005 he described what was happening as a revolution: health had become an issue of foreign policy as never before. Between 2001 and 2006 he returned to it again and again. The term health diplomacy was in print six years before the field got its global name.
IV · THE NAME · 2007
The name: Kickbusch, Silberschmidt and Buss
In 2007 seven foreign ministers declared at Oslo that health was a pressing foreign-policy issue. The same year, Ilona Kickbusch, G. Silberschmidt and Paulo Buss gave the field the name it still carries: "global health diplomacy" was to "capture these multi-level and multi-actor negotiation processes that shape and manage the global policy environment for health".
2010–2011 · OTHERS TAKE IT UP
2010–2011 · OTHERS TAKE IT UP
Others took the name and built on it. Ronald Labonté and Michelle Gagnon sorted the arguments for health in foreign policy into six frames, among them security, trade and human rights (2010). Katz and colleagues divided the practice into core, multistakeholder and informal diplomacy (2011), and narrated global health diplomacy as the successor of Bourne's medical diplomacy.
V · AN OPERATIONAL REFERENCE POINT
One definition becomes the reference point
Scholarly definitions stayed plural; institutions converged on one operational reference point. Of 9 institutional definitions we located, 5 adopt the wording of Kickbusch and colleagues, 2007. The registers follow the normative, necessary and instrumental typology Suerie Moon uses in her teaching on health diplomacy, with a fourth, mixed, for definitions that combine them.
A DEFINITION THAT TRAVELLED
A DEFINITION THAT TRAVELLED
Sometimes the adoption is almost word for word. PAHO defines health diplomacy as "the practice by which governments and non-state actors attempt to coordinate global policy solutions to improve global health". Ruckert, Labonté and colleagues had written nearly the same sentence in 2016, in a critical review that found the field under-theorised.
VI · OTHER LANGUAGES
Many languages, other histories
The English name was never the only one. In Portuguese, Paulo Buss and colleagues at Fiocruz wrote of diplomacia da saude. In Spanish, Sebastián Tobar and others of diplomacia sanitaria. In French, Dominique Kérouedan of diplomatie de la sante mondiale. In German, Hein and Kickbusch of globale Gesundheitspolitik, and in Chinese, Zhang Qingmin of weisheng waijiao.
VII · POWER
Power: who uses health, and for what
Nye's idea of soft power (2004) gave the field a new question: not what health diplomacy is, but who uses it and for what. Katz and colleagues described US global health initiatives as smart power. Middle powers, emerging powers and niche diplomacy followed.
VACCINES AS DIPLOMACY · 2014
VACCINES AS DIPLOMACY · 2014
Peter Hotez defined vaccine diplomacy in 2014, rooting it in Cold War cooperation on vaccine science between adversaries. The context strip holds two earlier events: in 1958 a Soviet delegate proposed eradicating smallpox, and in 1980 the World Health Assembly declared it eradicated. In 2014 the Security Council called Ebola a threat to international peace and security.
VIII · THE CRITICS
The critics, and after COVID-19
The definitions also drew critical responses. In 2016 Ruckert, Labonté and colleagues found the field fragmented and under-theorised. In 2021 Seow Ting Lee criticised the soft-power framing for treating health provision as influence. The corpus also has a geography: 63.7% of resolvable first authors are affiliated in the Global North.
ANSWERS · 2022–2023
ANSWERS · 2022–2023
Kickbusch answered fifteen years after her definition. With Liu she recast global health diplomacy as part of how global health is governed, and as a site of power. In 2023 Didier Wernli and colleagues mapped it as a network of World Health Assembly resolutions running from 1948 to 2022, back to the year this story began.
IX · AFTER COVID-19 · 2020–2025
IX · AFTER COVID-19 · 2020–2025
The pandemic changed the vocabulary fast. Vaccine diplomacy went from 8 records before 2020 to 164 after it; pandemic diplomacy appears only after 2020. New names are still arriving, though thinly: public health diplomacy (5 definitions) and digital health diplomacy (3). In May 2025 the World Health Assembly adopted the WHO Pandemic Agreement.
LIMITS
What remains open
The corpus is mainly indexed literature: 93.5% of Corpus A records with a language value are in English. Gray literature is included as 859 institutional and 62 think-tank documents, screened but not read in full.
This is a history of the scholarly vocabulary, not of treaty negotiation: the tobacco convention (2003), the IHR (2005) and the Pandemic Agreement (2025) appear as context only. Its relation to global health law and governance is left open.
Authors are invited to propose corrections or missing works.
Forty-odd authors, nine institutional definitions, six traditions, one name. The map holds all of them, with every source and limit attached. Zoom in to find your own place in it.
Drag to pan · Ctrl/⌘ + scroll or pinch to zoom · double-click to zoom in
The static figure the interactive map is built from, as vector graphics:
60 nodes and 65 edges. Also available as a
PNG.
How to read the map
Horizontal axis: year of the earliest located anchor source for each node. First use remains undetermined. Vertical position: layout.
Bands group nodes for readability. They are an editorial grouping and encode no variable.
Edges record terminological descent and contestation documented in the coded literature, not influence. Their families are: descent / branching (19); defines / redefines (13); links / overlaps (11); responds to / critiques / contests (10); parallel tradition (6); institutional adoption (6). Each edge carries a rationale and an evidence identifier, shown on hover or tap.
By time (in Explore): the horizontal axis runs from 1948 to 2025 and places each node at the year of its first located anchor. Three lanes separate world and institutional events, scholarly terms and definitions, and institutional definitions. Nodes from the same year are stacked in a fixed order; vertical position within a lane is layout only. Edges appear when a node is selected; the 20 edges whose target was first located before their source are dashed, because a later work defines, takes up or contests an earlier term. A dashed ring marks the 4 institutional definitions whose year is not recorded in the institutional table.
How to cite
Santos, Adela. (2026). The Genealogy of Global Health Diplomacy: Terminological Descent, Conceptual Branching, and Contestation (Version V1.0) [Data set]. Zenodo. https://doi.org/10.5281/zenodo.22127805
Searches run 2026-08-20. The essay draws on the corpus as of that run.
Where the corpus is written from
First-author affiliation country for Corpus A, as recorded in data/documents.csv.
1,430 of 2,474 records have a resolvable country; 1,044 (42.2%) do not, because the
affiliation country is absent from the index metadata. Among resolvable records, 911 (63.7%) are Global North and
519 (36.3%) Global South (UN M49 developed-regions rule), across 106 countries.
Affiliation shows where knowledge is produced, not from which perspective.
First-author records per country, 1,430 resolvable records (Equal Earth projection). Colour classes are log-spaced; the North/South split is shown in the bar below, not in colour. Every value is also in the table at the end of this section.
12–45–910–2425–4950–99100+no record
Not drawn at this map scale (4 countries, 15 records, counted in every figure above): Hong Kong (7, no 1:110m geometry); Singapore (6, no 1:110m geometry); Niue (1, no 1:110m geometry); Réunion (1, no 1:110m geometry).
Global North 63.7%Global South 36.3%
All 106 countries, with counts and shares
Country
Region (UN M49)
First authors
Share of resolvable
US
Global North
367
25.7%
GB
Global North
129
9.0%
CA
Global North
100
7.0%
ID
Global South
81
5.7%
BR
Global South
65
4.5%
IN
Global South
54
3.8%
CH
Global North
52
3.6%
AU
Global North
45
3.1%
CN
Global South
41
2.9%
DE
Global North
28
2.0%
TR
Global South
25
1.7%
IR
Global South
24
1.7%
ZA
Global South
23
1.6%
RU
Global North
21
1.5%
PK
Global South
18
1.3%
JP
Global North
14
1.0%
NL
Global North
14
1.0%
PL
Global North
13
0.9%
BE
Global North
11
0.8%
IT
Global North
11
0.8%
AE
Global South
10
0.7%
NG
Global South
10
0.7%
SE
Global North
10
0.7%
MY
Global South
9
0.6%
TW
Global South
9
0.6%
ES
Global North
8
0.6%
FR
Global North
8
0.6%
KE
Global South
8
0.6%
VN
Global South
8
0.6%
AR
Global South
7
0.5%
CZ
Global North
7
0.5%
EG
Global South
7
0.5%
HK
Global South
7
0.5%
IE
Global North
7
0.5%
MX
Global South
7
0.5%
NO
Global North
7
0.5%
AT
Global North
6
0.4%
KR
Global South
6
0.4%
PT
Global North
6
0.4%
RS
Global North
6
0.4%
SG
Global South
6
0.4%
UA
Global North
6
0.4%
CL
Global South
5
0.3%
CM
Global South
5
0.3%
GH
Global South
5
0.3%
TT
Global South
5
0.3%
HU
Global North
4
0.3%
IL
Global North
4
0.3%
PH
Global South
4
0.3%
TZ
Global South
4
0.3%
AZ
Global South
3
0.2%
BD
Global South
3
0.2%
CU
Global South
3
0.2%
DK
Global North
3
0.2%
ET
Global South
3
0.2%
IS
Global North
3
0.2%
KZ
Global South
3
0.2%
LK
Global South
3
0.2%
QA
Global South
3
0.2%
TH
Global South
3
0.2%
UZ
Global South
3
0.2%
ZW
Global South
3
0.2%
BY
Global North
2
0.1%
CO
Global South
2
0.1%
EE
Global North
2
0.1%
FI
Global North
2
0.1%
GR
Global North
2
0.1%
HR
Global North
2
0.1%
LY
Global South
2
0.1%
MK
Global North
2
0.1%
NP
Global South
2
0.1%
NZ
Global North
2
0.1%
PA
Global South
2
0.1%
PY
Global South
2
0.1%
SA
Global South
2
0.1%
AL
Global North
1
0.1%
BA
Global North
1
0.1%
BF
Global South
1
0.1%
BG
Global North
1
0.1%
BN
Global South
1
0.1%
BW
Global South
1
0.1%
CG
Global South
1
0.1%
CR
Global South
1
0.1%
DO
Global South
1
0.1%
GA
Global South
1
0.1%
GE
Global South
1
0.1%
JO
Global South
1
0.1%
KH
Global South
1
0.1%
LU
Global North
1
0.1%
MA
Global South
1
0.1%
ME
Global North
1
0.1%
MM
Global South
1
0.1%
MZ
Global South
1
0.1%
NE
Global South
1
0.1%
NI
Global South
1
0.1%
NU
Global South
1
0.1%
OM
Global South
1
0.1%
PE
Global South
1
0.1%
PS
Global South
1
0.1%
RE
Global South
1
0.1%
RO
Global North
1
0.1%
RW
Global South
1
0.1%
SK
Global North
1
0.1%
SL
Global South
1
0.1%
UG
Global South
1
0.1%
VE
Global South
1
0.1%
Definitions in the field
Recurrence uses citation linkage. The denominator is 2,066 Corpus A records with a usable DOI that cite each definitional work. The
408 records without a DOI are excluded from this calculation. Corpus B and Corpus C remain separate.
Ruckert et al. 2016 - critical review; IR levels-of-analysis taxonomy
2016
71
39
2066
1.89%
Kickbusch & Liu 2022 - reconstructing power and governance
2022
124
38
2066
1.84%
Feinsilver 2010 - fifty years of Cuba's medical diplomacy
2010
99
18
2066
0.87%
Chattu et al. 2021 - COVID-19 vaccine, TRIPS and GHD (India)
2021
64
18
2066
0.87%
Feinsilver 1989 - Cuba as a 'world medical power'
1989
80
4
2066
0.19%
Wernli et al. 2023 - WHA resolutions as a normative network
2023
7
1
2066
0.05%
Four limits apply. Citation of a definition understates adoption because uncited paraphrase is invisible here. OpenAlex citation coverage is incomplete. Recency suppresses the most recent entries mechanically. Wernli et al. has one citing work because it is a 2023 paper. A citation may concern a work's evidence instead of its definition.
How the corpus was built
This section reports the search stages and their counts. The full narrative, including every access failure, is in
methodology/STAGE2_CONCEPTS_METHODS.md.
Stage
n
Detail
Records retrieved from bibliographic indexes
11,387
50 search strings across OpenAlex 8,731, Europe PMC 1,472, Crossref 1,174, arXiv 10
After within-index deduplication
7,151
4,236 removed as the same record hit by several strings
After cross-index deduplication
5,700
1,451 removed by DOI, PMID or fingerprint match
Screening frame
5,366
65 empty titles and 269 title-year version duplicates removed
Included at title and abstract screening
2,478
2,888 excluded; hand-check of 120 gives 90.8% agreement
Corpus A, scholarly literature
2,474
core GHD 2,316, adjacent governance 158
Corpus B, institutional and policy
859
WHO IRIS 701, UN Digital Library 158, searched separately and never pooled with A
Corpus C, think-tank reports
62
CSIS 58, indexed think-tank publishers 4
PRISMA-style flow. Web of Science, Scopus, JSTOR, ProQuest, PAIS International, HeinOnline and
Google Scholar were requested and never searched, all being licence-gated and unreachable from the analysis
environment. That absence bounds every coverage claim on this page.
The static figure the interactive map is built from closes the essay:
see the whole genealogy.
Visual Argument
Visual Argument is an author-led, evolving practice for communicating complex research through interactive visual forms. It brings an argument's evidence and limits into view for readers beyond its usual specialist audience.
This project draws on data-led explanatory visual storytelling, including work such as The Pudding, and explores how that approach may inform conceptual and empirical research in the social sciences. It is an exploratory effort. Documented suggestions and contributions are welcome.
Data, code & contributions
The Zenodo record (Version 1.0; DOI: 10.5281/zenodo.22127805) contains the coded literature and structured outputs used to reconstruct this genealogy. It supports inspection and reuse of the coding and reconstruction.
Research & Metadata
Author
Adela Santos
Affiliation
Postdoctoral Visiting Fellow, Global Health Centre, Geneva Graduate Institute (IHEID) 2025–2026
Canonical dataset citation:
Santos, Adela. (2026). The Genealogy of Global Health Diplomacy: Terminological Descent, Conceptual Branching, and Contestation (Version V1.0) [Data set]. Zenodo. https://doi.org/10.5281/zenodo.22127805
Contributions & Policy
Corrections, extensions, and documented additions to the literature are welcome. Proposed additions should preserve source traceability and distinguish newly located evidence from records included in Version V1.0.
