US Global Health Diplomacy Under The Perspective Of Hegemonic Cycle

The United States has been committed to tackling the global HIV/AIDS crisis since1980 s,and US global health diplomacy(GHD)has been relatively mature and sound as a vital pillar of US foreign policy.In 2003,President Bush launched the President’s Emergency Plan For AIDS Relief(PEPFAR),which is the largest initiative for single disease in history,marking the summit of global health diplomacy in the United States.From the perspective of hegemonic cycle,the thesis studies the practical operation effects of PEPFAR based on data analysis,so as to evaluate the development of US global health hegemony.The thesis first reviews the history of US GHD that it was in germination stage before the emergence of HIV/AIDS with the major purpose of protecting the national economy and security,or achieving strategic objectives through foreign health assistance.The outbreak of HIV/AIDS epidemic was a turning point for US GHD to enter into a period of rapid development,and the global health security became an important part of US national security.After the 9/11 Attack,the US GHD matured and established the hegemonic power in the field of global health.Besides that,the thesis further discusses the role of PEPFAR in US GHD,concluding that the large-scale investment and sound system make it the most concentrated embodiment of US GHD.Subsequently,the thesis concentrates on the development and operation mechanism of PEPFAR.It illustrates that PEPFAR has experienced three stages from emergency response to global HIV/AIDS epidemic,to partnerships for sustainable development of HIV/AIDS control,and further to accelerate the elimination of the global HIV/AIDS epidemic.With PEPFAR as core,US GHD has formed a “whole-of-government”approach characterized by “Bilateral and Multisectoral Partnerships,Disaggregated Data-Driven System,and Result-Oriented Target-Setting Pattern”,which provides a solid foundation for the operation of US global health hegemony.The third part,based on data analysis,explores the actual effects of PEPFAR at the health level and social level,and particularly pays attention to key populations in the community of HIV/AIDS patients.The study indicates that taking 2008 as the watershed,the impacts of PEPFAR has undergone a process from expansion to recession.Currently,nearly half of the countries have shown a stagnant even upward trend in HIV/AIDS control,which specifically reflects in regional,gender and group discrepancies,among which the situation of key populations and children is especially severe.Finally,the thesis analyzes the roots of PEPFAR’s failure from both within and without,and deems that the future of PEPFAR is not optimistic.To sum up,even though PEPFAR has made some achievements,it is found that PEPFAR has been in the process of declining due to the defects of the mechanism in itself and the influences of the external environment.No matter from the health or social development level,the effects of current HIV/AIDS prevention and control is unsatisfactory.As the core of US GHD,PEPFAR’s performance demonstrates that US hegemony in the global health has been on the wane,which will hinder the process of ending the global HIV/AIDS epidemic in 2030.Confronting with global health crisis like HIV/AIDS,the hegemonic leadership has been proved unavailing to deal with the issues.On the contrary,countries should cooperate proactively with the bridge of international mechanisms and mobilize the strength of various actors in international community in order to promote human health and well-being.