The growing presence of China as a forceful proponent in Global Health is beginning to receive proper attention. There can be no doubt that the Belt and Road Initiative(BRI) of China has begun to define the range of realistic future scenarios for individual and concerted action. These scenarios should simultaneously account for both universalizing and particularizing factors that shape a Global Health perspective as relevant for social, scientific, and economic systems. Such a “GloCalizing” approach cannot limit itself to analysis and description of health situations.

The normative and anthropological meanings of health suggest an embedded conceptual and methodological reflection, as integral part of the emerging Global Health agenda. The intimate connection between Human Rights and Global Health requires that we focus on the purpose of the apparent need „to reform global governance structures to better reflect global realities. Beyond Realpolitik, it is important that we identify the systemic blind spots that have allowed or even supported global health injustices to flourish and connect the dots that have been left out of the current governance. They may point us towards ways to refine and transform not only the means to organize health beyond nations and strata, but inspire us on ways  to think about health requirements in terms of global inter-connectivity. This is the task for an innovative turn to responsible citizenship within a specific Global Health portfolio.

The urgency for players under the established regime for Global Health, to come to terms with this challenge, can serve as a wake-up call. However, this should not effect a rush into activism. China deserves credit for assuming responsibility and signaling openness to pragmatic cooperation across political and cultural borders. This requires a pro-active engagement on the part of the old governance players, and a willingness to learn mutually.

The emergence of new players must be seen as an opportunity to disambiguate the concept of Global Health. It is an opportunity to   re- define global health  as an integrated trans-disciplinary methodology, and to reconfirm the semantic and ethical purpose of global health. This will help foster the spirit of Sustainable Development Goals , rather than merely paying lip-service.It also provides an opportunity to organize collaboration of actors from various backgrounds as experts and build human(e) resources for capability development, to turn the SDG’s into an effective global policy instrument. Limiting ourselves to conventional frameworks, such as aid, capacity building, and diplomacy is redundant. It is even self-defeating. The prevailing portfolio of organized approaches to global issues of health, evidently has not been successful in delivering a robust universal best practice framework. Within a multi-cultural global society, this is not solely but significantly a conceptual problem.

Seen as a programmatic methodology for GloCal strategies, Global Health carries a substantial advantage: we do not depend on vested corporate interests, state pragmatism, or time restrictions for the agenda. We acknowledge the teleological openness of approximative system building and remain free to exercise responsibility in consideration of the blind spots and structural weaknesses that inhibit the full development of social economic value for sustainable Global Health. This implies, to add what is missing where it makes sense and align everything under a clearly defined priority scheme.Thus may we embrace a systematic approach that does what is needed and is honest about it, while being humble and precise in language.

Rochford’s point in a previously published BMJ Global Health Blog is acute: „With increasing academic attention on the rituals of global health diplomacy and calls for social lobbying to improve health for all, we, as global health professionals who acknowledge changing economic realities, have a decision to make – where ought we best focus our limited time, energy and resources?“ BRI offers an opportunity, but does not dictate the direction, and the „existing system“ may, alas, be exhausted but it surely bears a host of experience, civil and professional resources to draw from, with potential that can be employed for the benefit of responsible innovative action.

So, it is not about „Do we support the new, or work to strengthen the old?“, but an exercise in learning and evolving something better suited for the purpose. The SDG agenda, with item 3, “Ensure healthy lives and promote wellbeing for all at all ages”, can trigger such an evolution, if organized properly. That is to say, if the items on this agenda benefit from the particular Global Health perspective, by prioritizing those in a way, that supports what national and corporate perspectives cannot.

This blog entry by our co-founder Ole Doering has been first published on BMJ Global Health here.