In the post-colonial era, the concept of country ownership and local ownership of infectious disease or other global health programs has increased in prominence and importance. While in many settings this is related to the transfer of funding and resourcing to local actors in order to reduce dependence on aid, from the barefoot diplomacy perspective it is also critical that local ownership engenders a sense of community investment—of pride in the program. This, in turn, relates to questions of sustainability and transferability of health responsibilities to local actors—all of which need to be managed with the principles of diplomacy and international relations in mind. The techniques by which this can be achieved—ranging from the development of local community advisory boards, to the certification of local ownership of programs, to the solicitation of other sources of local advice and expertise on what program will function best in each setting—are explored here.
