Prioritizing Infectious Diseases as National Security Agenda
United Nations Department of Economic and Social Affairs (UNDESA) estimated that there were about 1 billion migrants (214 million international and 740 million internal migrants) in 2010 living outside their country or region of origin. This extent of rise in people’s mobility followed by rapid urbanization has led to easy transmission of pathogens and increased global burden of infectious diseases.
Historically, infectious diseases have been the most important contributor to human morbidity and mortality. While migration, on one hand been a ‘blessing‘, with free movement of goods, capital and labor between countries, on the other hand, been a ‘curse‘ in disguise, with increased vulnerabilities to some of the deadliest and life disabling viral diseases. The rapid spread of infectious diseases such as Zika, HIV/AIDS, Ebola, Avian Influenza, SARS and MERS-CoV have been terrorizing the current global population.
There is a global realization of the extent of devastation to human health and well-being these infectious diseases can bring about. Particularly in Low and Middle Income Countries (LMICs), concerns of political legitimacy, economic and social resilience dominate political processes. In this context, there is an urgent need to consider health beyond the realms of ‘soft’ development agenda.
The end of the Cold War in 1990s opened doors for global and national prioritizations to non-military issues such as health and education. The United Nations Development Program (UNDP) report, ‘New Dimensions of Human Security’ published in 1994 paved way for considering health as a security issue with the formalization of the term ‘health security’. Governments gradually became more aware about the threat that infectious disease outbreaks could pose to their citizens’ health and to their countries’ economic and political stability. As a result, responses to these disease threats started appearing in national security strategies.
Going by the securitization theory (as conceptualized by Barry Buzan, Ole Waever and Jaap de Wilde in their seminal work, Security: A New Framework for Analysis in 1998), a specific issue (such as health) is perceived as an urgent, existential threat to a given referent object, such as state, a community, the biosphere or the economic system. It is anticipated that this sort of framing (of diseases) producesthe required policy response geared to national protection.
Securitizing infectious diseases, interestingly can contribute to prioritizing reforms in-country and globally such as the declaration of AIDS as a global threat by the United Nations in 2000. Likewise, in 2014, UN Security Council adopted resolution 2177 stating that the unprecedented extent of the Ebola outbreak in Africa constitutes a ‘threat to international peace and security’ leading to formation of United Nations Mission for Ebola Emergency Response (UNMEER). Other instances include Organization of African Unity (OAU) governments coming together for HIV/AIDS resulting in Abuja Declaration on HIV/AIDS in 2001; Association of South East Asian Nations (ASEAN) countries’ meet in 2003 for SARS and recent declaration by World Health Organization (WHO) in February 2016 declaring Zika as ‘public health emergency of international concern’.
This extent of prioritization of infectious diseases at the global and regional level has a chain-effect upon nation-state governments to follow suit. However, easier said than done, there are multiple complexities associated making such prioritizations difficult. LMICs in the last 3 decades have gone through a lot of political, socio-cultural and economic transformations. This instability has been problematic in terms of mainstreaming the health priorities in the ideal ‘European style’ as the securitization theorists would have desired coming from the Copenhagen School of Security Studies. Furthermore, the global bodies such as WHO to take charge in such circumstances was also not feasible as it would question the country’s ability to safeguard the well-being of their citizens as well as concern of sovereignty to decide the future of its own citizens. The internal tension in the country the ‘intervention’ by global bodies could be even more challenging than the threat posed by the disease, resting upon the securitization theory’s premise of understanding the country’s socio-cultural norms and practices first.
Prioritization of health as a national security agenda alone does not solve problems. Implementation of commitments, plans, policies and programmes is the key. Firstly, adequate earmarked funding ensures proper infrastructural (human resources and logistics) arrangements for disease control and prevention. Technical and managerial capacity of health workers for effective and efficient implementation also should be optimized through training and capacity building initiatives. A Research and Development (R&D) unit need to be established within the Ministry of Health to initiate and promote high quality evidence generation to inform national policy documents on a regular basis. Partnership with non-state actors such as non-profit and private sector can encourage long-term initiatives for regularization of funding and sustainability.
The Ministry of Health in Nepal is currently headed by a popular youth leader. In this already ‘favorable’ context, it would be a missed opportunity if health is not prioritized as national security agenda.
-(Uprety is associated with Health Research and Social Development Forum (HERD) as Research Uptake and Communications Manager.)