The emergence of Ebola as a global health security threat: From ′lessons learned′ to coordinated multilateral containment efforts

Abstract Linking health and security has become a mainstream approach to health policy issues over the past two decades. So much so that the discourse of global health security has become close to synonymous with global health, their meanings being considered almost interchangeable. While the debates surrounding the health–security nexus vary in levels of analysis from the global to the national to the individual, this article argues that the consideration of health as a security issue, and the ensuing path dependencies, have shifted in three ways. First, the concept has been broadened to the extent that a multitude of health issues (and others) are constructed as threats to health security. Second, securitizing health has moved beyond a rhetorical device to include the direct involvement of the security sector. Third, the performance of health security has become a security threat in itself. These considerations, the article argues, alter the remit of the global health security narrative; the global health community needs to recognize this shift and adapt its use of security-focused policies accordingly.

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Recognizing noncommunicable diseases as a global health security threat

Bulletin of the World Health Organization ◽

10.2471/blt.17.205732 ◽

2018 ◽

Vol 96 (11) ◽

pp. 792-793 ◽

Cited By ~ 10

Author(s):

Amrita Saha ◽

George Alleyne

Keyword(s):

Global Health ◽

Noncommunicable Diseases ◽

Global Health Security ◽

Security Threat ◽

Health Security

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The Zika Virus

Feminist Global Health Security ◽

10.1093/oso/9780197556931.003.0003 ◽

2021 ◽

pp. 53-80

Author(s):

Clare Wenham

Keyword(s):

At Risk ◽

Global Health ◽

Zika Virus ◽

Vaccine Development ◽

Levels Of Analysis ◽

Global Health Security ◽

Security Threat ◽

Health Security ◽

Integrated Vector Control

This chapter offers a contextual narrative to the Zika outbreak and justifies a pertinent case study for gender analysis in global health security. It contends that Zika was constructed as a security threat at multiple levels of analysis. This framing perpetuated an exclusion and problematization of women in global health security more broadly. The chapter argues that the key policies developed—integrated vector control, vaccine development and behavioural requests around reproduction, to paraphrase, ‘clean your houses and don’t get pregnant’—were inherently gendered given the activities required are socially prescribed women’s activities. It further argues that although the outbreak revolved around women, gender was not mainstreamed into any of the policies developed, and the securitised policies failed to protect those women most at risk from the disease.

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Zika and In/visibility

Feminist Global Health Security ◽

10.1093/oso/9780197556931.003.0004 ◽

2021 ◽

pp. 81-106

Author(s):

Clare Wenham

Keyword(s):

Global Health ◽

Health Interventions ◽

Northeast Brazil ◽

Global Health Security ◽

Security Threat ◽

Public Health Interventions ◽

Health Security ◽

The Public ◽

Feminist Discourse ◽

Public Audience

This chapter begins with the premise that women are not a homogenous group; and some women are more important than others to global health security, which relays important information about political prioritisation. The chapter then shows how the Zika outbreak provides a pertinent example for a detailed nuanced analysis of in/visibility, which might have wider ramifications for understanding this concept in feminist discourse. Women cradling babies born with CZS were on the front pages of newspapers, policy reports and the collective global psyche. But it was a certain type of woman, performing a particular function of motherhood to legitimise activity within a security narrative, instrumentalised to garner support for extraordinary measures amid the public audience of the security threat. The affected women were conspicuous in the narrative of global health security, and were instrumentalised to facilitate Zika’s securitisation, but that these same Zika infected and affected women were invisible as the target group for public health interventions, particularly when considering intersectionality—these women were poor, black, single, and living in northeast Brazil.

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Lessons Learned in Global Health Security Implementation

Health Security ◽

10.1089/hs.2019.0157 ◽

2020 ◽

Vol 18 (S1) ◽

pp. S-4-S-7

Author(s):

Ronald L. Moolenaar ◽

Cynthia H. Cassell ◽

Nancy W. Knight

Keyword(s):

Global Health ◽

Lessons Learned ◽

Global Health Security ◽

Health Security

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The emergence of zika virus as a global health security threat: A review and a consensus statement of the INDUSEM Joint working Group (JWG)

Journal of Global Infectious Diseases ◽

10.4103/0974-777x.176140 ◽

2016 ◽

Vol 8 (1) ◽

pp. 3 ◽

Cited By ~ 91

Author(s):

StanislawP Stawicki ◽

Veronica Sikka ◽

VijayKumar Chattu ◽

RaajK Popli ◽

SagarC Galwankar ◽

...

Keyword(s):

Global Health ◽

Zika Virus ◽

Working Group ◽

Consensus Statement ◽

Global Health Security ◽

Security Threat ◽

Health Security ◽

Joint Working Group

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Strengthening multisectoral coordination on antimicrobial resistance: a landscape analysis of efforts in 11 countries

Journal of Pharmaceutical Policy and Practice ◽

10.1186/s40545-021-00309-8 ◽

2021 ◽

Vol 14 (1) ◽

Author(s):

Mohan P. Joshi ◽

Tamara Hafner ◽

Gloria Twesigye ◽

Antoine Ndiaye ◽

Reuben Kiggundu ◽

...

Keyword(s):

Antimicrobial Resistance ◽

Global Health ◽

Lessons Learned ◽

World Health ◽

Infection Prevention And Control ◽

Situational Analysis ◽

Global Health Security ◽

Evaluation Tool ◽

Health Security ◽

Global Health Security Agenda

Abstract Background Increasingly, there has been recognition that siloed approaches focusing mainly on human health are ineffective for global antimicrobial resistance (AMR) containment efforts. The inherent complexities of AMR containment warrant a coordinated multisectoral approach. However, how to institutionalize a country’s multisectoral coordination across sectors and between departments used to working in silos is an ongoing challenge. This paper describes the technical approach used by a donor-funded program to strengthen multisectoral coordination on AMR in 11 countries as part of their efforts to advance the objectives of the Global Health Security Agenda and discusses some of the challenges and lessons learned. Methods The program conducted a rapid situational analysis of the Global Health Security Agenda and AMR landscape in each country and worked with the governments to identify the gaps, priorities, and potential activities in multisectoral coordination on AMR. Using the World Health Organization (WHO) Joint External Evaluation tool and the WHO Benchmarks for International Health Regulations (2005) Capacities as principal guidance, we worked with countries to achieve key milestones in enhancing effective multisectoral coordination on AMR. Results The program’s interventions led to the achievement of key benchmarks recommended actions, including the finalization of national action plans on AMR and tools to guide their implementation; strengthening the leadership, governance, and oversight capabilities of multisectoral governance structures; establishing and improving the functions of technical working groups on infection prevention and control and antimicrobial stewardship; and coordinating AMR activities within and across sectors. Conclusion A lot of learning still needs to be done to identify best practices for building mutual trust and adequately balancing the priorities of individual ministries with cross-cutting issues. Nevertheless, this paper provides some practical ideas for countries and implementing partners seeking to improve multisectoral coordination on AMR. It also demonstrates that the WHO benchmark actions, although not intended as an exhaustive list of recommendations, provide adequate guidance for increasing countries’ capacity for effective multisectoral coordination on AMR in a standardized manner.

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The Chronicle of a Disease Foretold: Pandemic H1N1 and the Construction of a Global Health Security Threat

Political Studies ◽

10.1111/j.1467-9248.2011.00925.x ◽

2011 ◽

Vol 59 (4) ◽

pp. 797-812 ◽

Cited By ~ 16

Author(s):

Thomas Abraham

Keyword(s):

United States ◽

Global Health ◽

Infectious Diseases ◽

Pandemic Influenza ◽

Influenza Pandemic ◽

The United States ◽

Global Health Security ◽

Security Threat ◽

Health Security ◽

The Impact

The period beginning in 2004 saw an extraordinary spurt in attention paid to avian and pandemic influenza in the United States and at the global level. A disease that for decades had languished in the ‘dull but worthy’ category of infectious diseases was elevated to a risk to global health security. The securitisation of influenza was not unproblematic. The influenza pandemic of 2009 turned out to be far milder than anticipated, and much of the scientific basis on which planning had proceeded and resources had been mobilised turned out to be wrong. Developing countries with other disease priorities were urged to pour resources into pandemic planning exercises and change poultry-raising practices. The article argues that for an issue to be securitised as a global health threat, it is essential that the United States takes the lead role (or at the very least supports efforts by other leading powers). It uses the Copenhagen School's analysis to examine how avian and pandemic influenza was securitised in the United States, and then uses the concept of framing to examine why this disease was securitised by looking at the prior existence of an issue culture or discourse around emerging infectious diseases, which gained salience after the 2011 anthrax attacks. It finally looks at the impact of securitisation on countries with different priorities.

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Securitizing Zika: The case of Brazil

Security Dialogue ◽

10.1177/0967010619856458 ◽

2019 ◽

Vol 50 (5) ◽

pp. 398-415 ◽

Cited By ~ 9

Author(s):

Clare Wenham ◽

Deborah BL Farias

Keyword(s):

Latin America ◽

Global Health ◽

Zika Virus ◽

Political Crisis ◽

Global Health Security ◽

Security Threat ◽

Health Security ◽

Disease Characteristics ◽

Congenital Zika Syndrome ◽

High Level

Brazil’s Zika virus crisis (2015–17), following hot on the heels of the Ebola outbreak (2014–15), dominated newsfeeds and high-level discussions amid governments, the UN system and beyond, with emerging fears relating to Congenital Zika Syndrome (CZS), embodied by microcephaly. However, beyond the ensuing panic in Latin America facing a generation of Zika babies, the outbreak demonstrates key developments in our understanding of the interaction between health and security, based on the Copenhagen School’s securitization approach. It suggests that unlike previous diseases that were securitized, it was not the virus that was the cause of the security threat, nor how many people were affected, but a combined concern over where (in Brazil at a time of domestic political crisis), when (immediately post-Ebola), who (foetuses and babies), how (unknown disease characteristics) and what was the existential threat (the vectorized unknown). This article shows these developments for global health security through empirical analysis of the multiple securitization processes that occurred within Brazil for the Zika virus, at the subnational and federal levels.

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