1. HUMAN SECURITY AND HUMAN HEALTH
Lincoln C. Chen, MD
April 2, 2004

2. “Human Security Now” People-centered, not just states
Security, rights, and development
Threats broadened – conflict/poverty
Actors expanded – govt, business, civil
Strategy
Empowerment – bottom up
Protection – top down

3. Security Health Linkages
“Intrinsic”
Human survival, human health core of “security”
Human life is the heart of security
“Instrumental”
Good health enables functioning
Health permits choice, freedom
Health in military history
Which health problems? Criteria
Scale
Urgency
Intensity
Externalities

4. Linkages

5. Health Recommendations
Peace and equitable development
Knowledge-base
Access to information, knowledge
Intellectual property for human security
Socially-driven
Public health systems for priority diseases
Primary health community-based
Global health security

6. Questions? A. The case of health in human security? Focused vs broad?
Urgent vs long-term?
B. Health and the politics of “securitization”
State vs stakeholder?
Constituency resonance
C. Track recommendations?
1. Health and state security
2. Security from epidemics – e.g. “SARS”
3. Health security among poor

7. Scope and Time

8. Leading Causes Death

9. Violence-related Deaths

10. Health Crises in Selected Countries
Source: World Health Report 2003, Human Development Report 1994.

11. HIV/AIDS: Next Wave?

12. B. Politics of “Securitization”
Prioritization
Public resource allocations
“Sustainable development”
Broad, long-term, beyond specific fields
Principle, value-base
Constituency resonance
Democratic practice in security?
International cooperation?

13. Government Budgets (% GDP 1995)
COUNTRY
HEALTH
DEFENSE
D/H
Brunei
2.2
5.5
2.5
Cambodia
0.7
5.9
8.4
Indonesia
0.6
1.3
Malaysia
1.5
2.7
1.8
Philippines
1.4
1.1
Singapore
4.7
3.6
Thailand
1.6
Vietnam
7.2
6.5

14. C1. Health and State Security
History of war and disease
Health, colonialism, WWII
Multiple interactions
Conflict casualties – direct/indirect; now/future
State failure and health failure
HIV and crisis of governance
Germs as weapons – anthrax
Dual use
Health protection as security protection

15. C2. Epidemics SARS SARS (and Avian Flu)
Viruses - ecologic and evolutionary threat
Epidemic – lethality
“Contagion” – fears, panic, disruption
Economic costs – SARS $60 b
Political instability – China, Thailand
Protection – public health infrastucture
Parallel to military defense

16. C3. Health Security Among Poor
Poor people sickness and death
Development or security challenge?
Exclude
Humanitarian, but not “security” threat
Include
Interdependence of human security
Pathways of externalities, e.g. terrorism
Poverty – “greatest human security threat”