Health Policy and Systems Responses to Forced Migration by Kayvan Bozorgmehr & Bayard Roberts & Oliver Razum & Louise Biddle

Author:Kayvan Bozorgmehr & Bayard Roberts & Oliver Razum & Louise Biddle
Language: eng
Format: epub
ISBN: 9783030338121
Publisher: Springer International Publishing

The Evolution of “Global Health Security”

The term “health security” is now widely used by both health-related security actors and the public health community. It has been introduced quite recently, but in order to fully grasp its history and the different meanings that have been attributed to it, we have to take into account the history of transborder security of infectious disease control.

In 1851, triggered by widespread cholera epidemics in Europe, the first international sanitary conference was the starting point for international health cooperation (Brown et al. 2006) and eventually led to the formation of the WHO. Since then, legally binding agreements in the form of “international health regulations” (IHR) (previously “international sanitary regulations”) have been in place to combat the spread of a few infectious diseases.

The landmark document for the establishment of the term “health security” was the 1994 Human Development Report (United Nations Development Program (UNDP) 1994). It was themed around “human security” and identified seven dimensions of human security, health security being one. Overall, the report called for a transition from national security, with the nation state at its core, to a people-centred concept of protecting individuals. Based on the premise that security and peace are tied to development and human rights, the report describes health security as comprising two aspects: firstly, collective health security to reduce the vulnerability of societies to threats from cross-border health issues and secondly individual health security to promote access to safe and effective health services and medicines. This duality of addressing both individual and collective health aspects strongly characterises the comprehensive understanding advocated by UNDP. It explicitly includes anything relevant to individual health, both communicable and non-communicable disease, and links disease to poverty and vulnerability. However, the concept described in the report differs from the implementation of health security policies.

The understanding of health security has since been taken forward and changed by many actors, one of the most noteworthy being the World Health Organization (WHO). In 2001, the World Health Assembly (WHA) adopted a resolution on “Global Health Security: Epidemics Alert and Response” (WHA 2001). This was later described as the first step towards understanding global health security as compliance with the IHR (Aldis 2008) and called for a complete revision of the IHR. Subsequently, a comprehensive reform was undertaken in 2005, and one of the major changes was the abandonment of specifying diseases under the IHR (formerly yellow fever, cholera, and plague). While the revision broadened the scope using an all-risk approach, it neglected health inequalities and the social determinants of health. The IHR’s scope now is to prevent, detect, and respond to the international spread of diseases that impose a risk to public health (see Fig. 7.1). Countries are compelled to notify the WHO in the case of infectious disease outbreaks with either serious public health impact, risk of international spread, or the possibility of travel and trade restrictions. The WHO can then proclaim a public health emergency of international concern (“PHEIC”) and quickly initiate a coordinated global response in

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