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This chapter describes the increasingly prominent representation of health as a security issue. It begins by presenting the ‘origin’ story of health security that has led to the contemporary practices we see today in the WHO and UN Security Council. The chapter then looks at the different approaches to health security—namely, human security and national security—and considers why security is mobilized to respond to health issues. The focus here is on public health events and their location (regions and borders). The chapter also examines who the ‘peoples’ to be protected from the dangers of health security are. The COVID-19 pandemic reveals that despite a rapidly emerging global public health threat endangering everyone, with some more exposed to harm than others, the response was not equitable and reinforced existing hierarchies.

What threat can diseases pose to security? The sheer breadth of possible answers to this question has become increasingly evident during the recent COVID-19 pandemic, which was caused by the SARS-CoV-2 virus. This chapter explores three such links between health and security. First, some diseases are identified as threats to human security. The human security framework draws particular attention to diseases—such as HIV/AIDS, malaria, and tuberculosis—that remain endemic in many low-income countries, that continue to cause millions of deaths annually, and that also pose substantial challenges to the survival and well-being of individuals and communities. Second, some emerging infectious diseases—such as SARS, pandemic flu, Ebola, and COVID-19—are identified as threats to national security because their rapid spread can cause high death tolls and trigger significant economic disruption. Finally, some diseases are also identified as narrower threats to bio-security within the context of international efforts to combat terrorism. Here concerns have focused on the spectre of a terrorist attack using a disease-causing biological agent such as anthrax, smallpox, or plague. The chapter concludes by contrasting two different ways of understanding this health–security nexus: as an instance of securitization or medicalization.

This chapter considers a range of issues that have often been neglected in national security agendas or perceived to be outside the purview of strategy. During the cold war, national security agendas were dominated by high politics, whereas low politics were rarely seen as a threat to national security. In the aftermath of the cold war, however, low politics started to garner more attention than high politics. This chapter proposes a conceptual framework based on a utilitarian assessment of environmental, resource, and population issues to determine whether there is a new agenda for security and strategy. It also examines how divergent demographic trends will shape strategy and strategic thinking, and goes on to discuss commons problems, the direct environmental damage caused by military action, the spread of infectious diseases such as measles and Covid-19, and how countries are beginning to exhibit sensitivities and vulnerabilities to issues of low politics.