Health Security Threats

The language of ‘national security’ has been far more evident, with certain health issues being interpreted and presented as potential threats to the UK and its population, and little attendant consideration of the impact upon populations overseas. Two contemporary global health issues have been treated in markedly different ways by the UK government. In the first – HIV/AIDS, in particular in Africa – the UK has demonstrated a different approach from other actors in focusing upon the disease as a poverty issue. In the second – the H5N1 strain of avian influenza – rhetoric in the UK has centred around the protection of national security in the face of perceived ‘threats from abroad’, with development policy playing a more limited supporting role.

HIV/AIDS is a disease which is already present in the UK, albeit with relatively low prevalence rates. Its identification as a ‘security threat’ in the international discourse rests largely on its potentially destabilizing effect upon states in sub-Saharan Africa, with a particular emphasis being put on its impact upon military and security forces. It therefore represents a ‘security threat’ primarily to African states, albeit with the potential to escalate into a regional or even global security issue. The debate over H5N1, by contrast, concerns a disease which (as of the time of writing) is not present in the UK. Its gradual spread across the globe has been seen in much more stark national security terms: as an external threat to the health and the economy of the UK which must be defended against.

It has been argued that ’AIDS is causing socioeconomic crises which in turn threaten political stability’. HIV/AIDS as a potential cause of political, social, and economic instability. This link between HIV and insecurity has been widely reproduced in the international policy discourse. Although a considerable amount of international development spending is targeted at HIV/AIDS, the pandemic has become heavily securitized. Indeed, this understanding of the disease as a security issue has played a significant role in placing it so high on the international agenda.

However, UK international policy on HIV/AIDS has not been heavily securitized; rather it has reflected DfID’s concerns in focusing on the pandemic’s relationship with poverty. DfID has led the way in developing the UK response to the global pandemic, the MoD and the FCO have been happy to see DfID take the lead, perhaps influenced by DfID’s greater resource base in Africa. In the case of H5N1 Avian influenza, the UK has been much more in line with the dominant international discourse which has been couched largely in terms of domestic (health) security, with development considerations remaining subservient to that agenda. This is despite the fact that H5N1 avian influenza seems to be strongly related to poverty and rural livelihood issues, and in particular the contagion threat posed by people living in close proximity with the poultry upon which they depend for food, coupled with the lack of capacity and infrastructure to respond effectively to outbreaks in many developing countries.

Department of Health took the lead in preparing for a possible domestic outbreak, working alongside the Department for Environment, Food and Rural Affairs (Defra). Particular emphasis was placed upon surveillance, reporting and isolation of any identified cases, along with ensuring adequate supplies of antivirals and vaccines.8 Unlike HIV/AIDS, where the focus on poverty put humanitarianism at the forefront, in this case consideration of the domestic threat (to health, to the economy and to the functioning of society) posed by a ‘foreign’ disease was prioritized. Ensuring adequate domestic responses to the threat initially completely overshadowed more strategic ‘upstream’ efforts.

This situation seemed to change significantly once cases of human infection in Asia came to light.
Engagement with affected developing countries began to take on greater importance as it became clearer that a ‘Maginot line’ approach was not a viable policy option. At a meeting of donor countries in Beijing in January 2006 pledges of funding actually exceeded the World Bank’s estimate of the funding required. Of the $1.9 billion pledged at the conference, the UK promised $35.5 million of DfID funding.
In the two cases which have been examined here: security and development concerns have been apparent to differing degrees. Whereas the development community in the UK has generally resisted the securitization of HIV/AIDS, in the case of H5N1 it has (belatedly) sought to provide international assistance, but has done so in line with a national security-based policy logic. Even within development policy it is possible to see the tension between humanitarianism and protecting the national interest. Both the 1997 and 2000 International Development White Papers stress the need for a greater commitment to issues of poverty as a moral duty and for reasons of enlightened self-interest. Both can be seen in the varying responses to the global infectious disease challenge.