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Cover Contemporary Security Studies

26. Health and Security  

Stefan Elbe and Eva Hilberg

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.