La salud global es un asunto de seguridad

Global Health is a Security Issue

27.2.2018
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Should Global Health be Considered a Security Issue?

Is the gradual securitization of most health issues a positive or a negative development for effective global health governance? The outstanding words in this question are “securitization” and “effective”. Thus, the question in simpler English is: will the labelling of health as a security issue be a good thing? The answer to this question is both “No” and “Yes”, according to various scholars.

A consequence of declaring an issue to be a threat to security is the fact that it creates a feeling of insecurity

No, in the sense that since the interest is on the outcome of the process, securitization itself is found to have negative consequences. For instance, according to Didier Bigo, a consequence of declaring an issue to be a threat to security is the fact that it creates a feeling of insecurity. In his writings on migration, he argues that securitization creates unease and uncertainty among migrants – that is, securitizing migration gives politicians power to restrict freedom of movement. Migrants are perceived as religious fanatics in France, revolutionaries and deviants in Germany, and as rioters with no respect for decent social behaviour in the United Kingdom. He further argues that this results into a migrant not only becoming public enemy for breaking the law, but also a private enemy for mocking the politician’s will. 

On the other hand, once an issue is securitized, “it takes on increased significance and importance; we will be more inclined to devote part of our limited resources to our own protection against this perceived threat. As a result, actions, albeit only declaratory, will often be taken”. This is the case in Asia since the severe acute respiratory syndrome (SARS) epidemic in 2003. It can be seen in Table below that, aside from Cambodia and Malaysia, government spending on health increased in Asia between 2003 and 2006.

Table: Health care spending in Asia in 2003 and 2006

 

 

Country

2003

2006

GNI (PPP $)

Government health expenditure as % of total spending

Per capita Government spending on health (PPP $)

GNI (PPP $)

Government health expenditure as % of total spending

Per capita Government spending on health (PPP $)

Cambodia

1080

14.8

49

1550

10.7

43

China

3200

1

92

4660

9.8

144

Indonesia

2700

4.8

31

3310

5.3

44

Japan

27 790

17.1

1812

32 840

17.7

2067

Malaysia

9620

8.6

250

12 160

7

226

Philippines

2800

5.4

70

3430

6.4

88

Republic of Korea

18 590

9.1

535

22 990

11.9

819

Singapore

34 140

6.8

383

43 300

5.4

413

Thailand

5970

13.5

205

7440

11.3

223

Vietnam

1750

5.5

51

2310

6.8

86

Source: Based on data from the World Health Organization.

Notes: GNI = Gross National Income, PPP = Purchasing Power Parity.

Prior to the SARS crisis, the Chinese government spent relatively little on public health; just 1% of all government spending was directed to the sector in 2003, the lowest percentage for any Asian state, which is no wonder China was overwhelmed by the SARS epidemic.

Furthermore, it is true that some health issues can be addressed within national borders but some infectious diseases can overwhelm state capacity like the Ebola outbreak in West Africa in 2014 and the SARS epidemic in Asia in 2003. In some cases, the way that states address the public health issue creates panic among the citizens. For instance, in Liberia, during the Ebola outbreak, the state-imposed interventions included cremation of bodies and the enforcement of quarantine measures for asymptomatic individuals. While this was done to contain the outbreak, it actually elicited unintended stigma and fear because military forces were used to enforce quarantine and the call for cremation was not adequately managed by the state such that those who could afford it paid for their dead ones to be buried “while the poor were forced either to keep the body at home or to wait for the Burial Team and send the body to the Crematorium”.

Some health problems, in particular infectious disease outbreaks, are a threat to human security because they can result in too many deaths and/or inflict too much damage worldwide

Acknowledging the fact that securitization of some issues may pose negative consequences like the case of migrants, I would rather see health issues get the needed attention they deserve. Hence, in conclusion, in light of the above, I think the gradual securitization of health issues is a positive development for effective global health governance. Some health problems, in particular infectious disease outbreaks, are a threat to human security because they can result in too many deaths and/or inflict too much damage worldwide. Hence, such issues need to be securitized to give them the needed attention, especially since health is not only a human right, but a scarce resource that needs to be protected and is worth fighting for.


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