Redefining security - lessons from public health (original) (raw)
Related papers
Political Studies
How is the rise of global health security transforming contemporary practices of security? To date the literature on global health security has sought to trace how the securitisation of global health is affecting the governance of diseases in the international system; yet no-one has analysed -conversely -how the practices of security also begin subtly to change when they become concerned with a growing number of contemporary health issues. This article identifies three such changes. First, health security debates endow our understandings of security and insecurity in contemporary world politics with an important medical dimension. Second, the rise of global health security enables a range of medical and public health experts to play a greater role in the formulation and analysis of contemporary security policy. Finally, health security debates have also encouraged attempts to secure populations through recourse to a growing array of pharmacological interventions and new medical countermeasures. Drawing upon a rich literature in medical sociology, these three transformations in the contemporary practice of security collectively constitute the 'medicalisation of security'. This novel perspective on the rise of global health security also reveals new limitations inherent in the emerging health-security interface -limitations associated not so much with the processes of 'securitisation' already noted in the global health literature, but rather with wider social processes of 'medicalisation'. Awareness of the additional limitations renders the threat of a future pandemic even more serious than is commonly thought.
A Genealogy of Global Health Security
International Political Sociology, 2012
human security debates about HIV/AIDS also saw the mass delivery of millions of antiretroviral therapies to people living in sub-Saharan Africa and other developing countries. Nor will this tendency disappear anytime soon, as current anxieties about a range of noncommunicable lifestyle "time bombs" are also increasingly managed by resorting to surgeries and pills (obesity) and nicotine replacement therapy (smoking). In the end, then, the medicalization of insecurity demands of us citizens that in order to be secure, we must first become patients. Viewed in this new light, different lines of research on health security begin to open up. How, for example, are medical knowledges and metaphors shaping the practice of military intervention and counterinsurgency practice? What new medicines are being developed to make soldiers less fearful in combat or to tire less quickly? What, moreover, are the legal and political strategies through which citizens are persuaded to ingest medical countermeasures? Why and how are these new political rationalities resisted? What is the role of political economy, and indeed pharmaceutical businesses, in the rise of health security? How does this medicalization of security also fan new anxieties, especially around the emergence of diseases for which there are no drugs, or indeed around diseases that are becoming drug resistant. These are some of the new lines of flight emerging from an international political sociology of global health security.
The politics of prevention: Anti-vaccinationism and public health in nineteenth-century England
Medical History, 1988
The coming of compulsory health legislation in mid-nineteenth-century England was a political innovation that extended the powers of the state effectively for the first time over areas of traditional civil liberties in the name of public health. This development appears most strikingly in two fields of legislation. One instituted compulsory vaccination against smallpox, the other introduced a system of compulsory screening, isolation, and treatment for prostitutes suffering from venereal disease, initially in four garrison towns.' The Vaccination Acts and the Contagious Diseases Acts suspended what we might call the natural liberty of the individual to contract and spread infectious disease, in order to protect the health of the community as a whole.2 Both sets of legislation were viewed as infractions of liberty by substantial bodies of Victorian opinion, which campaigned to repeal them. These opponents expressed fundamental hostility to the principle ofcompulsion and a terror of medical tyranny. The repeal organizations-above all, the Anti-Compulsory Vaccination League and the National Association for the Repeal of the Contagious Diseases Acts-were motivated by different sets of social and scientific values.3 Nevertheless, their activities jointly highlight some of the political conflicts produced by the creation of a public health service in the nineteenth century, issues with resonances for the state provision of health care up to the present day. Compulsory vaccination was established by the Vaccination Act of 1853, following a report compiled by the Epidemiological Society on the state of vaccination since the
Human Security: Expanding the Scope of Public Health (2003)
Human security is an evolving principle for organizing humanitarian endeavours in the tradition of public health. It places the welfare of people at the core of programmes and policies, is community oriented and preventive, and recognizes the mutual vulnerability of all people and the growing global interdependence that mark the current era. Health is a crucial domain of human security, providing a context within which to build partnerships across disciplines, sectors and agencies. These principles have been demonstrated in field programmes in which health-care delivery featuring multi-sectoral co-operation across conflict lines has been used to enhance human security. Such programmes can be a model for collaborative action, and can create the sustainable community infrastructure that is essential for human security.
The problem of how to build peace in post-conflict societies continues to loom large for governments and development agencies worldwide. This article examines the involvement of the UK development community in the creation of the World Health Organization’s ‘Health as a Bridge for Peace’ (HBP) programme. It argues that the new development policy context brought in by the United Kingdom Labour administration in 1997 appeared to provide fertile ground for health-sector initiatives such as these to become an important part of the UK’s peace-building strategy, but that HBP in fact failed to take root. The role of individuals, the changing departmental focus of the Department for International Development (DFID), its relationship with WHO, and the absence of persuasive evidence for the efficacy of HBP are highlighted as being crucial in explaining the policy’s mysterious disappearance.
Medicine, Conflict and Survival, 2017
In this article, I want to show that the securitization of health issues in the name of national interests led to the militarization of health care in the context of the war against terrorism. However, the connection between health and security also gave way to the emergence of the notion of human security, thus, converging with the human right to health approach and the cosmopolitan discourse on global health. These two perspectives on the relation between health and security lead to conflicting imperatives in the current state of counter-terrorism operations. I argue that when the securitization of health concerns in the name of national security conflicts with the provision of health care in the name of universal human rights, the higher moral end must trump the prudential one. Moreover, it is a duty to promote the human right to health when liberal democracies in foreign policies directly violate this moral ideal in the name of national security.
Towards a new definition of health security: A three-part rationale for the twenty-first century
Global Public Health, 2019
In recent years the framings of global health security have shifted while the structures governing global health have largely remained the same. One feature of the emerging reordering is the unresolved allocation of accountability between state and non-state actors. This brings to critical challenges to global health security to the fore. The first is that the consensus on the seeming shift from state to human security framing with regard to the global human right to health (security) risks losing its salience. Second, this conceptual challenge is mirrored on the operational level: if states and non-state actors do not assume responsibility for health security, who or what can guarantee health security? In order to address global health security against the backdrop of these twenty-first Century challenges, this article proceeds in three parts. First, it analyses the shortcomings of the current state-based World Health Organization (WHO) definition of health security. Second, taking into account the rising pressures posed to global health security and the inadequacy both of state-based and of ad hoc non-state responses, it proposes a new framing. Third, the article offers initial insights into the operational application of beyond state responses to (health) security challenges.