Abstract
Discussions of the politics and practicalities of confronting health security challenges—from infectious disease outbreaks to antimicrobial resistance and the silent epidemic of noncommunicable diseases—hinge on the conceptualization of health security. There is no consensus among analysts about the specific parameters of health security. This inhibits comparative evaluation and critique, and affects the consistency of advice for policymakers. This article aims to contribute to debates about the meaning and scope of health security by applying Baldwin’s (1997) framework for conceptualizing security with a view to propose an alternative framing. Asking Baldwin’s concept‐defining questions of the health security literature highlights how implicit and explicit assumptions currently place health security squarely within a narrow traditionalist analytical framework. Such framing of health security is inaccurate and constraining, as demonstrated by practice and empirical observations. Alternative approaches to security propose that security politics can also be multiactor, cooperative, and ethical, while being conscious of postcolonial and feminist critique in search of sustainable solutions to existential threats to individuals and communities. A broader conceptualization of health security can transform the politics of health security, improving health outcomes beyond acute crises and contribute to broader security studies’ debates.
Highlights
This article sought to contribute to debates about conceptualizing health security and understanding health security politics
It set out to challenge the use of traditional security paradigms, which obscure the significance of public health threats to individual and community security and well-being
The current COVID-19 pandemic has brought these issues to the fore with a much sharper focus than previous public health emergencies of international concern
Summary
Discussions of health security periodically climb up the global political agenda, mostly in response to global health-related concerns and challenges—from public health emergencies of international concern and pandemics, e.g., H1N1, Ebola, Zika, and the 2019 COVID-19 pandemic,[1,2,3,4,5,6,7,8] to concerns about antimicrobial resistance, defined by the World Health Organisation (WHO) as a fundamental threat to human health, development and security,[9] and the “silent” noncommunicable disease pandemic.[10,11] Academic interest in and appetite for health security analysis has not abated either, as indicated by recent “Lancet” contributions.[5,12,13,14,15] The response to the global. Fidler (2003) provides detailed analysis of the practical ways in which the linkages between public health and national security have emerged He concludes that the realpolitik perspective on national security is driving the development of the concept of public health security in the United States despite three other possible formulations—common, human and ecological security.[38] Rushton (2011) observes that health security continues to be framed in narrow traditional terms as national security and underpinned by particular concerns of interest to rich industrialized states, which shape a narrow discourse that largely disregards the needs of the Global South.[39] McInnes adds that “health issues are not identified as national security risks by reference to an explicit set of criteria but rather have arisen in an ad hoc manner and been agreed to intersubjectively by key national and international actors.”[19] These observations inadvertently contribute to normalizing dominant political discourses about the paramount nature of the national interest, the centrality of the interests of powerful states and the relevance of only acute health threats to security thinking. The implications of US leadership in shaping the international health security agenda remain understudied, and yet critically relevant to what is included and excluded from that agenda
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