The Role of Medical Diplomacy in Stabilizing Afghanistan (Defense Horizons, Number 63, May 2008)

Abstract : Comprehensive stabilization and reconstruction of Afghanistan are not possible given the current fragmentation of responsibilities, narrow lines of authorities, and archaic funding mechanisms. Afghans are supportive of U.S. and international efforts, and there are occasional signs of progress, but the insurgent threat grows as U.S. military and civilian agencies and the international community struggle to bring stability to this volatile region. Integrated security, stabilization, and reconstruction activities must be implemented quickly and efficiently if failure is to be averted. Much more than a course correction is needed to provide tangible benefits to the population, develop effective leadership capacity in the government, and invest wisely in reconstruction that leads to sustainable economic growth. A proactive, comprehensive reconstruction and stabilization plan for Afghanistan is crucial to counter the regional terrorist insurgency. This paper examines the health sector as a microcosm of the larger problems facing the United States and its allies in efforts to stabilize Afghanistan. A detailed RAND Corporation study cites the absence of an overarching, nationally driven plan, poor coordination, and the lack of a lead actor as major barriers to successful health sector reconstruction and stabilization. Three obstacles identified in the RAND study are at the root of failing U.S. efforts in Afghanistan: poor planning and coordination within and between U.S. Government military, and civilian agencies; lack of an overall health sector reconstruction game plan and the resources required for implementation; and misunderstanding of and failure to adjust for the complex counterinsurgency challenges of security, stabilization, and reconstruction. Focusing on health provides opportunities to overcome Taliban influence, strengthen the young Afghan government, and set the conditions for long-term economic growth.