Introduction
In recent decades, diplomacy has expanded beyond its traditional focus on interstate relations, political negotiations, war and peace, and government-to-government interactions. Contemporary diplomacy increasingly encompasses economic, cultural, scientific, technological, humanitarian, and health-related issues. Among these emerging dimensions, health diplomacy has gained particular importance as a result of globalization, the emergence and spread of infectious diseases, pandemics, humanitarian crises, population displacement, climate change, and the growing interdependence of national health systems. These developments have transformed health from a predominantly domestic concern into an important component of foreign policy, national security, sustainable development, and international cooperation.
Health diplomacy can be conceptualized as the intersection of public health objectives and foreign policy interests. Through health-related cooperation, states can simultaneously pursue humanitarian, scientific, economic, political, security, and diplomatic objectives. The provision of medical assistance, deployment of health professionals, education and training of foreign medical students, transfer of medical knowledge and technology, pharmaceutical and biotechnology cooperation, medical tourism, and participation in international and regional health organizations constitute important instruments of health diplomacy. Accordingly, health diplomacy has increasingly emerged as a dimension of contemporary public diplomacy and an instrument of soft power through which states can enhance their international image, strengthen bilateral and multilateral relations, and advance their foreign policy interests.
This study comparatively examines health diplomacy in the Islamic Republic of Iran and the Republic of Cuba. The selection of these countries is based on several important similarities, including their status as developing countries, significant investments in health and medical education, relatively advanced scientific and medical capabilities, and long-term experience of international sanctions and geopolitical pressure. Despite these similarities, Iran and Cuba have adopted different approaches to organizing and utilizing their health capacities as instruments of foreign policy. The central research question is therefore: What are the major similarities and differences between the health diplomacy of Iran and Cuba, and how do the two countries employ their health-related capacities to advance their foreign policy objectives?
Methodology
This research employs a qualitative comparative methodology and follows a deductive analytical approach. The study is theoretically grounded in the concept of soft power, while health diplomacy constitutes its principal conceptual framework. The comparative analysis focuses on the formation and development of health diplomacy in Iran and Cuba, the domestic health-system capacities underlying their international activities, and the ways in which these capacities have been translated into diplomatic resources.
Data were collected through library research, documentary analysis, and field observation. The documentary sources included academic books and articles, official documents, reports issued by international and regional organizations, institutional publications, statements by relevant officials, research reports, and media sources. In addition to documentary evidence, the researcher utilized direct field observations of the health systems of Iran and Cuba. This combination enabled the study to examine both the formal dimensions of health diplomacy and the domestic institutional, scientific, and professional capacities that support its implementation.
The analysis encompasses several major dimensions of health diplomacy, including the historical development of national health diplomacy, health-system capacities, international medical missions, medical education and training, pharmaceutical and biotechnology capabilities, scientific diplomacy, humanitarian medical assistance, cooperation with international and regional organizations, medical tourism, and the effects of international sanctions and geopolitical constraints.
Results
The findings demonstrate that both Iran and Cuba possess substantial health-related capacities that can function as instruments of soft power and foreign policy. However, significant differences exist in the degree of institutionalization, strategic coordination, and international utilization of these capacities.
Cuba has developed a relatively coherent and long-term model of health diplomacy in which its domestic health system has been systematically linked to foreign policy objectives. The country's emphasis on universal health coverage, primary health care, preventive medicine, and extensive medical education has created a large and highly trained health workforce. The international deployment of doctors, nurses, and other health professionals represents the most distinctive instrument of Cuban health diplomacy. Cuban medical teams have provided health services in numerous countries, particularly in Latin America, Africa, and other developing regions. These missions have served humanitarian purposes while simultaneously strengthening Cuba's international visibility, diplomatic relations, and soft power.
Iran's experience in disease control and health-system development has created opportunities for international cooperation. Medical universities and institutions contribute to the education of foreign students, while pharmaceutical and biotechnology capabilities provide opportunities for scientific and technological exchanges. Humanitarian medical assistance and health services during regional crises represent additional instruments of health diplomacy. Medical tourism also provides an economic and diplomatic dimension by connecting Iran's specialized medical capacities with patients and institutions from neighboring and regional countries.
However, compared with Cuba, Iran's health diplomacy appears to be less systematically integrated into a comprehensive and long-term foreign policy strategy. Although Iran has diverse and significant health capabilities, their conversion into sustained diplomatic influence has not always been institutionally coordinated. International sanctions, restrictions on financial transactions and technology transfer, and broader geopolitical tensions constitute further obstacles to the expansion of Iran's international health activities.
Discussion
The comparative findings reveal important similarities and differences between the two countries. The most significant similarity is that both Iran and Cuba possess substantial domestic health capabilities that can be transformed into international diplomatic resources. Both have invested significantly in medical education, professional training, scientific research, pharmaceutical and clinical capacities despite prolonged external pressures. Moreover, both countries have used health-related cooperation to strengthen relations with developing countries and to project an image of scientific competence and humanitarian engagement.
The principal difference lies in the degree of strategic institutionalization. Cuba has incorporated health diplomacy more explicitly and consistently into its foreign policy. The systematic deployment of medical professionals, international medical education, and the integration of health cooperation with diplomatic objectives constitute a relatively coherent model. Cuban medical internationalism has therefore functioned not only as humanitarian assistance but also as a mechanism for creating long-term interpersonal, institutional, and political relationships.
Iran, in contrast, possesses a broader and more diversified range of health-related capabilities, particularly in pharmaceutical production, biotechnology, advanced medical services, higher medical education, and medical tourism. However, these resources have not always been integrated within a unified health-diplomacy framework. Iran consequently has considerable unrealized potential to transform its domestic health achievements into a more systematic source of soft power.
Conclusion
The study concludes that health diplomacy has become an important dimension of contemporary diplomacy and a potentially significant instrument of soft power, particularly for countries possessing considerable health and scientific capabilities while facing economic and geopolitical constraints. The experiences of Iran and Cuba demonstrate that investment in health infrastructure, medical education, scientific research, pharmaceutical production, biotechnology, and humanitarian assistance can generate diplomatic value and contribute to the advancement of foreign policy objectives.
Cuba represents a relatively coherent and institutionalized model in which medical internationalism, the deployment of health professionals, medical education, biotechnology, and humanitarian assistance have been closely connected to foreign policy. Its experience demonstrates how a country can systematically convert domestic health capabilities into international diplomatic resources. Iran, meanwhile, possesses a diverse and potentially powerful portfolio of health-diplomacy resources, including medical education, pharmaceutical and biotechnology capabilities, advanced clinical services, humanitarian assistance, scientific cooperation, and medical tourism. Its principal challenge is therefore not a lack of health-related capacity but the need to integrate these resources within a clear, coordinated, and long-term national health-diplomacy strategy.