Crisis Discourse in Human Resources for Health: A Move Towards Securitization?

Abstract

Since the 1960s, a persistent shortage of health workers has led professionals managing Human Resources for Health (HRH) to frame their field as in “crisis.” Since the HIV/AIDS epidemic, this discourse has coincided with a general securitization of global health. I explore the extent to which crisis discourse in HRH potentially signifies securitization of HRH using a narrative review of 153 articles from the PubMed database and a case study of a global, USAID-funded HRH strengthening partnership (The Capacity Project). Findings show a marked discursive shift after a 2004 collaborative report by the “Joint Learning Initiative,” which led to increased and normalized crisis discourse focusing on the threat of systemic collapse. Programmatically, this shift enabled an emergency-oriented technical approach focusing on high-level solutions that increase efficiency and surveillance and establish a new type of emergency manager: the global HRH crisis expert. I argue that the discourse of crisis may be pushing HRH towards fast-track action scenarios common to securitization, potentially closing the door to community-oriented or upstream approaches. Anthropologists or other social scientists working with local communities should monitor these developments and become active participants in HRH steering groups or political-legal bodies to support upstream and alternative (non-biomedical) solutions, such as community health resources.