Health diplomacy has in recent years migrated from the periphery of external relations to the epicentre of strategic positioning. The devastating human and economic repercussions of COVID-19 demonstrated that epidemics, supply-chain fragilities and vaccine inequities could derail entire diplomatic agendas. Consequently, states have started to invest political capital in public-health partnerships that confer both moral authority and pragmatic leverage. Two cases that illustrate this re-prioritisation are Morocco’s intensified multilateral engagement, notably championed by Dr Imane Kendili, and Italy’s newly announced partnership with Côte d’Ivoire, anchored in Abobo, Abidjan.
Health Diplomacy after the Pandemic: Conceptual Underpinnings
The concept of health diplomacy blends technical cooperation with diplomatic negotiation, allowing states to project influence while advancing global public goods. The Foreign Policy Global Health Forum underscored in late 2024 that pandemic preparedness, women’s mental health, and equitable access to medicines are now treated as matters of strategic relevance rather than solely humanitarian concern. Although the term is elastic, it invariably entails cross-ministerial coordination, engagement with non-state actors and an ability to translate clinical priorities into shared security arguments.
Morocco’s Domestic Reforms and External Health Engagement
Moroccan health-diplomacy narratives are no longer confined to traditional aid recipients but frame the Kingdom as a provider of technical know-how. Domestically, Rabat’s 2021 Generalisation of Social Protection project seeks to extend health coverage to twenty-two million citizens by the end of 2025, supported by direct cash transfers to vulnerable households. These internal reforms have enhanced the credibility of Morocco’s outward offers of partnership, enabling figures such as Dr Kendili to advocate for an African Global Health agenda premised on mutual accountability rather than dependency.
The visit of WHO Eastern Mediterranean Regional Director Dr Hanan Balkhy to Rabat from 5 to 7 May 2025 symbolically validated Morocco’s trajectory. Her consultations with Health Minister Amine Tehraoui linked national rollout of universal coverage to broader WHO objectives on essential-service resilience, demonstrating how national reforms can be leveraged diplomatically. The timing coincided with GITEX Africa, where Moroccan officials highlighted digital health solutions as exportable assets, signalling an aspiration to move from recipient to provider status in the global health-technology marketplace.
Italy–Côte d’Ivoire: A Case Study in Triangular Cooperation
On 10 May 2025 the Italian news agency ANSA reported Rome’s pledge to upgrade the Félix Houphouët-Boigny Regional Hospital Centre in Abobo and to rehabilitate ancillary urban health facilities. Implemented through the Mattei Plan and involving the Universities of Padua and the Cattolica del Sacro Cuore alongside Doctors with Africa CUAMM, the initiative employs a triangular-cooperation model: financing and expertise flow from a European donor, governance aligns with Ivorian national strategies, and technical execution is supported by a transnational civil-society network.
Days earlier, CUAMM outlined in Abidjan the operational contours of the maternal-and-child projects, emphasising capacity-building of local staff, refurbishment of infrastructure and integration of faith-based providers into the national system. That local-level orientation converges with the Ivorian government’s pursuit of universal health coverage, thereby satisfying both Rome’s strategic interest in stabilising migration corridors through development programmes and Abidjan’s imperative to close glaring urban health gaps.
Multilateral Negotiations and the Global Governance of Health Security
While bilateral and triangular schemes multiply, diplomatic attention remains riveted to Geneva, where the WHO’s Intergovernmental Negotiating Body is endeavouring to finalise a pandemic treaty by May 2025. Director-General Tedros Adhanom Ghebreyesus has expressed confidence that consensus can be reached, notwithstanding political headwinds. The treaty debate is instructive: it reflects an emerging norm that preparedness and response constitute shared responsibilities necessitating legal codification. Both Morocco and Italy have signalled support, recognising that their respective regional ambitions will be undermined if collective mechanisms to prevent pathogen spill-over falter.
Regional Synergies and the African Continental Agenda
The African Union’s Agenda 2063 and its health-specific frameworks, including the Africa CDC Strategic Plan 2022-2026, locate health firmly within the continent’s security and development matrix. Morocco’s reintegration into the AU in 2017 and its recent overtures towards the African Medicines Agency position Rabat to act as a knowledge broker between Maghreb states and Sub-Saharan partners. Similarly, Italy’s “Piano Mattei” reframes Mediterranean relations by emphasising co-development, with health projects such as the Abobo plan serving as prototypes for wider engagement.
There are important complementarities: Morocco offers linguistic and cultural proximity to Francophone West Africa, combined with growing pharmaceutical manufacturing capacity; Italy brings longstanding hospital-management expertise and EU budgetary resources. Côte d’Ivoire, for its part, leverages its economic dynamism to pilot innovations amenable to replication across the Economic Community of West African States.
Transactional Risks and the Ethics of Health Instrumentalisation
Notwithstanding the positive optics, health diplomacy carries the risk of instrumentalising health for extra-medical ends. Sovereignty sensitivities may be triggered if cooperation is perceived as veiled conditionality. Financing modalities that rely heavily on concessional loans can exacerbate debt vulnerabilities, while dependence on foreign technological platforms may generate cybersecurity liabilities. Furthermore, the co-existence of multiple normative frameworks—WHO regulations, AU treaties, EU development compacts—creates potential for jurisdictional friction. Diplomats must therefore calibrate initiatives so that medical priorities remain primary rather than subordinate to commercial or security imperatives.
Strategic Options for Diplomatic and Political Leaders
First, align national health-security strategies with WHO treaty deliberations to ensure coherence between global commitments and bilateral projects. Second, invest in regional manufacturing of essential medicines and vaccines to mitigate supply disruptions; Morocco’s evolving pharmaceutical sector offers a foundation for Maghreb-West Africa value chains. Third, incorporate capacity-building clauses that privilege skills transfer over hardware donations, as exemplified by the CUAMM-Universities component in Abobo. Fourth, deploy digital-health tools in ways that respect data sovereignty, drawing lessons from WHO’s newly launched AIM Toolkit, which couples artificial-intelligence efficiencies with strict confidentiality protocols. Fifth, embed evaluation metrics on equity and sustainability to prevent health-diplomacy projects from deepening intra-state disparities.
The Moroccan and Italy–Côte d’Ivoire cases analysed here reveal an inflexion point in the practice of health diplomacy. By intertwining domestic reform trajectories with outward cooperation, Rabat is projecting a model of “shared resilience”, while Rome’s engagement in Abobo illustrates how European actors can recalibrate partnerships towards mutual benefit. Whether these initiatives solidify into durable norms will depend on their alignment with multilateral treaty outcomes and their sensitivity to local socioeconomic textures. For diplomats and political leaders navigating an era in which pathogens disregard borders, the lesson is unequivocal: strategic influence now rests as firmly on the robustness of health systems as on traditional military or economic metrics.
