Global institutions should adopt a rights-based paradigm that focuses on strengthening health systems and access to healthcare rather than securitised containment
The World Health Organisation (WHO) defines global health security as “the activities required, both proactive and reactive, to minimise the danger and impact of acute public health events that endangers people’s health across geographical regions and international boundaries”. The securitisation of health has been driven by a narrow Westphalian approach of protecting nation-states from external threats. While the idea of global health security has been widely invoked; however, its definition continues to lack universal consensus as the concept remains centric on national security and defence rather than people and overall community health.
The securitisation of health has been driven by a narrow Westphalian approach of protecting nation-states from external threats.
The UNDP report emphasised the necessity to promote health security for human development, and the UNSC’s resolution acknowledged the necessity of categorising infectious diseases on the global security agenda—this marked a turning point in global health politics. The Copenhagen school of thought provided the theoretical framework within which the powerful actors securitised a specific issue through the ‘speech acts’. In the years that followed, the importance of health has grown in global political forums, and the concept of ‘health security’ has become a critical part of development discourse, global governance, and foreign policies.
The United Nations Development Programme (UNDP) introduced the idea of human security in its Human Development Report and outlined health security as a key crosscutting element of other indicators of human development.
The substitution of WHO’s disease-oriented policy with a security-oriented policy obfuscates health response vis-à-vis access to medicines and overshadows critical discussions on social, economic, political, and other non-medical determinants of health. For example, the IHR legally requires member states to maintain certain monitoring and surveillance capabilities to report on infectious outbreaks. However, the WHO does not provide additional financial support for the same purpose. With limited funding, the states in the Global South, in many cases, prioritise international compliance and underperform in strengthening their public health systems. Whereas the Global North continues to benefit from the health monitoring and surveillance data received from the Global South. The medicines, drugs, and vaccines developed using data from the Global South are patented in the Global North by the pharmaceuticals of the Global North and marketed at high prices across the world.
Even a few months before the COVID-19 pandemic outbreak, the WHO proposed the Health Systems for Health Security framework to boost the IHR and promote health security by complementing existing international monitoring and surveillance measures.
The UNSC views global health through a security lens, and its resolutions have more negative than positive impacts on global public health outcomes. While UNSC’s engagement in health emergencies has drawn global political attention to the need for cooperation and funding, it has been largely counterproductive, increased discord, compromised solidarity, and unified response. The COVID-19 pandemic is the third infectious disease that has received UNSC’s attention. However, in the face of the global pandemic, the inherent geopolitical rivalries and long-standing tensions between the P5 of the UNSC rendered it powerless. Despite securitisation framing, the UNSC fell short of presenting a befitting response to the pandemic. For example, the UNSC called for solidarity and global cooperation on COVID-19 vaccines. However, most developed nations, including the P5, adopted the nationalistic approach to COVID-19 vaccines and opposed a meaningful TRIPS waiver.
A closer study of these resolutions indicates that the Council has deliberated on health beyond the scope of epidemics and pandemics and established itself as an alternative forum to debate and negotiate global health issues.
The securitised framing of the COVID-19 pandemic generated global political and public attention; however, the global response to COVID-19 was fragmented and ineffective. Failure of WHO’s COVAX initiative, adoption of watered-down TRIPS waiver, discriminatory measures like COVID-19 vaccine passport etc. contributed to a poor response to the COVID-19 pandemic. The COVID-19 pandemic has accelerated the securitisation of health, with developed countries arguing for a wider acknowledgement, acceptance, and adherence to the health security approach in global health governance. For example, the European Union (EU) in the proposed pandemic treaty is suggesting to include provisions on early detection, digital technology for data collection and sharing, pathogen and genomic data-sharing, and stronger health system and reporting mechanisms but persistent issues around data-benefit sharing, access to vaccines, medicines and technology remain underemphasised. The COVID-19 pandemic has highlighted that surveillance, monitoring and data-sharing systems are not enough if developing countries continue to struggle to access vaccines, medicines and technology to address health issues. Therefore, global governance institutions and actors should adopt a rights-based paradigm that focuses on strengthening health systems and infrastructure for delivery and access to healthcare rather than securitised containment alone.
Failure of WHO’s COVAX initiative, adoption of watered-down TRIPS waiver, discriminatory measures like COVID-19 vaccine passport etc. contributed to a poor response to the COVID-19 pandemic.
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Nishant Sirohi is an advocate and a legal researcher. His research focuses on the relationship between constitutional law human rights and development - particularly issues ...Read More +