Should global health be considered a security issue?
Before addressing this question, I must begin by briefly trying to define what is meant by health securitization and by global health governance (GHG). Health securitization involves declaring and accepting a particular health challenge as an existential security threat and, thereby, reallocating resources to combat this threat. Meanwhile, GHG broadly entails the cooperation of international governments and global health actors towards promoting shared health-related goals in a global context. With these frameworks in mind, the question becomes whether delineating health issues as security threats aids in aligning international actors and effectively achieving desired global health outcomes.
Securitization encourages conceptualizing health crises as external threats that need to be neutralized rather than mutual problems that need to be solved
I posit that securitization undermines such efforts. First, the traditional theory of securitization creates an us versus them paradigm, while effective GHG from a global community perspective necessitates simply an us. Securitization only promotes cooperation insofar as maintaining the security and stability of powerful states without regard to whether such actions promote the health and well being of the individuals in afflicted states. In other words, securitization encourages conceptualizing health crises as external threats that need to be neutralized rather than mutual problems that need to be solved.
By CDC Global (CDC Director exits Ebola treatment unit), via Wikimedia Commons
There is not a clear consensus on the definition of an existential health threat
Securitization presents a second obstacle for effective GHG because there is not a clear consensus on the definition of an existential health threat or a mechanism to enforce the securitization of a threat on an international scale. The powerful players that set the securitization agenda naturally highlight infectious diseases, which are likely to cross borders, regardless of whether this reflects the global burden of disease. However, securitization still depends on the compliance of affected states, which might be reluctant to fall in line if it negatively impacts other sectors such as the authority of the government or the economy. Thus, it similarly allows for the desecuritization of pressing health challenges, which could be equally detrimental to the pursuit of global health.
Perhaps most troubling, securitization, by definition, involves reacting to crises rather than a creating a state of preparedness. In the case of many global health challenges, prevention through capacity building and systems strengthening is key to finding sustainable and scalable solutions to protect the world’s vulnerable populations. Therefore, adopting a strategy of reaction limits the ability of GHG to promote and protect health effectively on a global scale.
WHO Yellow fever vaccination campaign in Kinshasa, Democratic Republic of the Congo (DRC)
Securitization represents a compelling strategy to grab the attention
However, securitization represents a compelling strategy to grab the attention and, thus, the money of wealthier states in order to divert more resources towards tackling urgent global health challenges. As such, proponents of securitization could contend that this point outweighs any disadvantages if an alternative does not exist to mobilize these necessary resources and political will. But is this argument really justifiable if these resources are devoted so as to keep the wealthy safe at the expense of ignoring, and sometimes exacerbating, the underlying determinants that drive disease among the poor? I do not believe it is. Instead, I contend that an International Health Systems Fund offers a potential alternative that could better achieve communal progress in health by creating an infrastructure to serve the enduring needs of vulnerable populations and meet the demands of the global community during health crises.