International Institute for Global Health, United Nations University, Kuala Lumpur, Malaysia
Institute for Global Health, University College London, London, UK.
BMJ Glob Health. 2023 Sep;8(9). doi: 10.1136/bmjgh-2023-013067.
The past four decades have seen a steady rise of references to 'security' by health academics, policy-makers and practitioners, particularly in relation to threats posed by infectious disease pandemics. Yet, despite an increasingly dominant health security discourse, the many different ways in which health and security issues and actors intersect have remained largely unassessed and unpacked in current critical global health scholarship. This paper discusses the emerging and growing health-security nexus in the wake of COVID-19 and the international focus on global health security. In recognising the contested and fluid concept of health security, this paper presents two contrasting approaches to health security: neocolonial health security and universal health security. Building from this analysis, we present a novel heuristic that delineates the multiple intersections and entanglements between health and security actors and agendas to broaden our conceptualisation of global health security configurations and practices and to highlight the potential for harmful unintended consequences, the erosion of global health norms and values, and the risk of health actors being co-opted by the security sector.
过去四十年间,健康领域的学者、政策制定者和从业者频繁提及“安全”问题,尤其是在涉及传染病大流行所带来的威胁方面。然而,尽管健康安全话语日益占据主导地位,但在当前的全球健康批判研究中,健康和安全问题以及行为体相互交织的诸多不同方式仍在很大程度上未得到评估和剖析。本文探讨了 COVID-19 疫情之后出现的并日益增强的健康安全关系,以及国际社会对全球卫生安全的关注。本文承认健康安全概念具有争议性和易变性,提出了两种截然不同的健康安全方法:新殖民主义健康安全和普遍健康安全。在此分析的基础上,我们提出了一种新的启发式方法,勾画出健康和安全行为体以及议程之间的多重交叉和纠缠,以拓宽我们对全球健康安全结构和实践的概念化,并强调可能产生有害的意外后果、侵蚀全球健康规范和价值观,以及健康行为体被安全部门拉拢的风险。