Week 8 - Health Security Flashcards
Health Security Definition
Health security is “a sense of certainty for human beings to obtain medical help for themselves and their relatives when they know of such need”
- WHO defines HS as “the activites required, both proactive and reactive to minimize the danger and impact of acute public health events that endanger people’s health across geographical regions and international boundaries”
- Lots of literature highlighting the lack of clarity on what health security is, some oppose the use of security in the health realm
Dimensions of Health Security
Security of people - lack of health access/well-being, non-comunicable diseases and mental health, rare diseases with low incidences
Security of community - pandemics/emerging infections, antimicrobial resistance (AMR), food and water safety, natural disasters and weather related threats
Security of states - CBRN threats, armed conflicts
IHR
International Health Regulations - legally binding, helps countries with disease prepardness
GHS Index
Ranks a country’s readiness to headle a disease
Aspects of Healthcare System improvements
- Services (effecitve, safe and quality, minimum waste)
- Workforce
- Leadership and governance - strategic policy framework
- financing - adequate funds
- commodities and technologies - well-functioning health system ensures equity
Recurrent Themes in current understandings of Health Security
- Protection against threats
- Emergence of new global conditions for when existing approaches are inadequate (medical aid for failed states)
- Problematic engagement of new actors (military establishments) - gov’t should create a special body for when militaries are involved with health issues
- Linkage to FP interests - no concensus of the limitations of public health and security
Feldbaum (2006)
Treating global health issues as national security threats may focus attention on countries/diseases which post threats to wealth nations - the global health community should carefully scrutinize areas where global health and national security overlap
Concerns of Developing Countries
developing countries are increasingly suspicious of global health iniatives
RLE - Indonesia’s refusal to share isolates from human cases of H5N1 on the grounds that they were unlikely to recieve benefits like vaccines or technoogy transfers - showcases the security dilemma and an intersection between health and security
- any attempts to revise IHR terms and implement “health security” were not accepted by developing countries
Harms of a Breakdown in Health Security understanding
- breakdown of cooperation and development
- distortion of global public health - reassignment of resources without a clear definition of security is harmful - developing countries are unlikely to accept ‘global health security’ as a justification for international agreements
Long Term Consequences of CW use (Halabja and Syria)
1988 - Suddam Hussein military forces bombed the city of Halabja in Iraqi Kurdistan with CWs
- Severe environmental impacts that damaged the local agarian economy
- burden of responsibility, dermatological, ophthalmic and neurological problems
- In Syria - look at the psychological impacts - lack of capacity of healthcare services to deal with chemical attacks and lack of protective equipment
Framework for Impacts of CW use
1) individual health
2) community health
3) environmental impacts
Effective healthcare system must take the following considerations
- appropriate system of triage
- proper individual protection
- monitering service to identify threats + long term assessment and exposure
- epidmiological approaches to identify public health impacts
- clinical guidance on dealing with chemical agents
- appropriate system of documentation/information
Impacts of COVID
- global supply chain breakdown, disruptions to production, export controls, vaccine and pharmaceutical development
- individuals saw public health measures enroaching on public liberties
- enornous economic disruption, proof that health needs should be a security concern
Clash of the nexus between health and security
Some argue - health is security and public health should sit within FP doctrines and national security strategies
- others argue that health should remain as aspect of public policy/development
- critics of the health-security nexus are concerned that it stretches security too far, dangerous approach for addressing global health
1st affect of diseases and national security
Threatens a state’s military effectiveness
- disease native to a war zone (infecting soldiers in the vicinity, hampering performance and incurring costs)
RLE - HIV/AIds prevalence among African militaries and peacekeeping missions - military organizations devoted resources to disease survallience and biomedical research (first success in securitising disease since HIV threatened state stability and militaries/peacekeeping) Barnett and Prins (2006) - does not seem to be a direct relationship ebtwene HIV and state instability
2nd affect of diseases and national security
Affect state’s ability to function effectively - weaking critical infrastructure, energy distribution, communication, health and education provision, economic impacts
- loss of active workforce
reductions in domestic consumption/international ecports - economic ontraction
- weakening gov’t institutions
- food scarcity
poorer populations bear a disproportionate share of costs relative to income (entrenching inequalities)
Price-Smith (2002) - suggest that disease is the greatest threat to a state’s existence, inequalities/tensions between groups, political destabilization
3rd affect of diseases and national security
Direct threat to the citizens which the state aims to protect
- high mobility betwen borders, economic interdependence means that infectious diseases can spread rapidly
Biosecurity - biological weapons
- weaponized diseases
- states usualy claim they’re defensive programs to understand biological weapons and uncover ways to defend against them
- the biosecurity dilemma - states cannot be certain that another state’s biosecurity programs are purely defensive
Biosecurity - bioterrorism
- deployed by non-state actors with catastrophic results
- Anthrax attacks in the US 2001 - 2008 report “the US should be less concerned that terrorists will become biologists and far more concerned that biologists will become terrorists” - questions about how the government should secure biological research
Accidental/Inadvertent Release
- wider question about biological research
- justification on how to improve research on viruses - malicious actors might replicate published research
Biosecurity - dual-use dilemma
- research aimed to improve medical treatments or improving agricultural productivity, can be used for malicious purposes like bioweapons
Park 2012 - critics argue that the possibility of accidents.misuse means tha thte risks outweigh the benefits
RLE - the US National Science Advisory Board - recommends that research methods should be censored to avoid replication by bioterrorists, however, some critics argued that they were restricting vital work
Arguements for Human Security as one fundamental maxim
- Health’s focus on achieving security
- better health security = improved income security = better econoic positions = higher living standards
- diseases/illnesses disrupt individual employment, add to costs fo treatment and damage to family - Health and human rights
- “right to health” in an institutional framework
by claiming health issues as security issues - raises the pollitical profile of health concerns (eg. HIV/AIDs recieved attention and funding to improve assistance for victims and improve organizations
RLE - COVAX and ‘vaccine nationalism’
- COVAX plan - high income countries would pay to ensure vaccines, giving funding for low income countries to get vaccines
- failed to recieve funding (countries like India imposed export controls to keep vaccines in borders), creates massive inequalities between vaccinated countries and not
- guided by national security - prioritizng protection of one’s own state
Is the security framework the best way to deal with health issues?
- brings: heightened attention, urgency, resources, but also: politics and practices associtated with national security
- justifies invasive gov’t technqiues
- also focus tends to be on the short term rather than looking at long term preperation and mitigation
