A new force seems to be at work in public health law and practice. Consider, for example, the proliferation of references to ‘preparedness’; specifically, ‘public health emergency preparedness’ and its more specialised variants such as ‘public health emergency legal preparedness’ and ‘international legal preparedness’. There is also increasing use of related phrases such as ‘global public health security’ and ‘international health security’. Of course, a proliferation of terms is not enough to prove that a new force is in play: language shifts all the time in all sorts of areas, and although such changes may reflect and contribute to deep social transformation, they can also be nothing more than passing fashions with little or no impact. But public health emergency preparedness does not feel like a superficial, short-lived trend: in fact, it seems almost the exact opposite. Indeed, as David Fidler and Laurence Gostin emphasise in their recent book, Biosecurity in the Global Age, a ‘policy revolution’ seems to have taken place – a revolution brought about by a ‘collision’ of public health and security.1 The collision of security and public health is our focus in this article. But before explaining why, we need to define ‘public health emergency preparedness’, in particular its impressive–sounding correlate, ‘global public health security’, and its less readily comprehensible subset, ‘public health emergency legal preparedness’. In the World Health Report 2007, Dr Margaret Chan, Director-General of the World Health Organization (WHO), described ‘global public health security’ as ‘the reduced vulnerability of populations to acute threats to health’.2 Later in the same report, more detailed definitions were provided: Public health security is … the activities required, both proactive and reactive, to minimize vulnerability to acute public health events that endanger the collective health of national populations. Global public health security widens this definition to include acute public health events that endanger the collective health of populations living across geographical regions and international boundaries … .[G]lobal health security, or lack of it, may also have an impact on economic or political stability, trade, tourism, access to goods and services and, if they occur repeatedly, on demographic stability.3 The other term that requires some explanation is ‘public health emergency legal preparedness’. Stated shortly, this is all about having the right laws in place and then using them in the right way in a time of public health emergency.4 In other words, it is about both legal preparedness for, and response to, public health emergencies – it is both proactive and reactive. More generally, it can be said to be an essential part of both public and global public health security, and a subset of public health emergency preparedness.
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Open Access
Jan 1, 2013
Jennifer A Bernstein 
