THE FOREIGN SERVICE JOURNAL
Health programs are not just international good deeds;
they can be a powerful instrument in the ambassador’s toolbox.
FOR U.S. DIPLOMACY
Senior Foreign Service Officer Mark C. Storella is deputy
assistant secretary for the Bureau of Population, Refugees
and Migration. Prior to his current assignment, Ambas-
sador Storella served as deputy chief of mission at Embassy
Brussels. From 2010 to 2013, he was U.S. ambassador to Zambia.
From 2009 to 2010 he was senior coordinator for Iraqi Refugees and
Internally Displaced Persons in Baghdad, and has served as deputy
permanent representative at U.S. Mission Geneva. He has also served in
Phnom Penh, Bangkok, Paris, Rome and Washington, D.C.
he job of a chief of mission (COM)
is to advance American interests
wherever he or she is assigned. To
do so, ambassadors try to apply all
the instruments at their disposal.
Health diplomacy can be an invalu-
The United States has a unique
capacity to have a global impact
in health. Our institutions, our people and our investments are
unparalleled. And people take note when our work saves lives,
especially the lives of children. The President’s Emergency Plan
for AIDS Relief, known as PEPFAR, will be seen someday as Pres-
ident George W. Bush described it: a “medical Marshall Plan”
that saved an entire continent. As we all work to prepare for and
ON GLOBAL HEALTH DIPLOMACY
defeat emerging diseases and pandemics, health programs are
not just international good deeds; they are an investment in the
security of the American people. Ambassadors would be wise to
seize the opportunity our health programs present.
Nevertheless, ambassadors are sometimes reluctant to
engage fully on health initiatives. Most ambassadors assigned
to countries with sizable health programs got there by way of
25-year careers that focused on traditional forms of diplomacy,
especially political and economic work. Their hard-wired
priorities are usually governance, security and trade. Most
State Department Foreign Service officers have only a glancing
acquaintance with health programs during an entire career.
Health programs may also seem too technical or scientific to
be easily mastered. At the mention of terms like viral load and
epidemiology, many career FSOs might want to run for the hills.
U.S. government-led health efforts have saved and improved
millions of lives, and changed the very course of the AIDS pan-
demic—yet may not initially appear to fall within the direct pur-
view of a chief of mission. Where is the room for a COM to lead?
And how can health programs advance our broader agenda?
When I arrived in Lusaka as ambassador in 2010, I had many
of the same questions. But I took stock of our goals and the tools
our mission had to achieve them. What jumped out was that our
generous Fiscal Year 2010 bilateral assistance budget of approxi-
mately $350 million consisted almost entirely—or about 85 per-
BY MARK C . STORE L LA