Understanding global security - Peter Hough

HEALTH THREATS TO SECURITY
public health in what has been described as a ‘welfare mix’ (Rose and Shiratori 1986).
However, the wholesale dismantling of welfare state provision has not happened in
any country, despite economic and political arguments favouring this, partly because
public opinion considers state health provision a right and partly because public
health practitioners have powerfully resisted this. Similarly, medics and scientists
operating at the global level provide a powerful lobby in favour of maintaining the
WHO’s horizontal strategy. The epistemic community for global public health is an
influential one since its opinions are generally seen as informed and clearly inspired
by the provision of a public good rather than any sectional interest. The standing of
the WHO was evident in 2003 during the SARS outbreak when governments and
the general public interpreted their recommendations not to travel to the affected
cities of Beijing and Toronto as authoritative ‘bans’.
Benatar et al. argue that:
it is both desirable and necessary to develop a global mindset in health ethics,
we also suggest that this change need not be based merely on altruism, but
could be founded on long-term self interest. For example, it has been shown
by mathematical modelling for hepatitis B that resources needed to prevent one
carrier in the United Kingdom could prevent 4,000 carriers in Bangladesh,
of whom, statistically, four might be expected to migrate to the UK. Thus it
would be four times more cost-effective for the UK to sponsor a vaccination programme
against hepatitis B in Bangladesh than to introduce its own universal
vaccination programme.
(Benatar et al. 2003: 133) 3
Appreciation of the WHO from the global general public is increasing on both a
pragmatic level, spurred by personal security fears, and on an empathetic level, due
to greater awareness of the suffering of others. In this way we are beginning to
witness a globalization of Sen’s entitlements thesis and the gradual realization of
Mitrany’s dream of Functionalist world revolution.
Key points
• Increased human movements and societal changes, associated with contemporary
globalization, have heightened the cross-border threat posed by
both transmittable and non-transmittable illnesses.
• Technical solutions to combat diseases were successful from the 1940s to the
1970s, most notably in the eradication of smallpox by the WHO, but increased
resistance to drugs and pesticides has prompted a resurgence of some diseases
like malaria.
• This setback prompted the WHO to advocate a more ‘horizontal’ approach to
global public health in which alleviating the underlying causes of vulnerability
to disease is stressed. At the same time the ‘vertical’ approach of seeking to
eradicate diseases continues to be pursued by the WHO in alliance with private
donors.
• The traditional state security implications of diseases like AIDS has attracted
greater governmental interest in global public health policy.
176