By expanding the scope of public health to embrace and propagate the principles of human security, Pakistan and the global community could create sustainable practices through which all people would be healthier and more secure.
Human security is an evolving concept for organizing societal endeavors in the tradition of public health. It places the welfare of people at the core of programs and policies, is community oriented and preventive, and recognizes the mutual vulnerability of all people and the growing global interdependence that mark the current era. Health is a crucial domain of human security, providing a context within which to build partnerships across disciplines, sectors, and agencies. That potential has been demonstrated in field programs in which health-care delivery featuring multi-sectoral co-operation across conflict lines has been used to enhance human security. Such programs can be a model for collaborative action, and can create the sustainable community infrastructure that is essential for human security.[i]
Human health is a precious asset that is constantly being challenged. Pakistan experienced such a challenge recently with the tragic assassination of health workers engaged in a door-to-door campaign of polio immunization. The political dimensions of this act threaten not only the people of Pakistan, but also the global framework of public health. That framework protects everyone, in both the richest and the poorest countries. To illustrate, the World Economic Forum, in its Global Risks 2013 report, highlights the potential for sharp decline in the efficacy of antibiotics. The report discusses the problem of overuse, and the slow development of new antibiotics, saying: “Are we in danger of returning to a pre-antibiotic era in which a scratch could be potentially fatal?” The onset of that return may be difficult to predict, but there is little doubt about the principles that must undergird public-health measures to sustain the efficacy of antibiotics. Measures must be global in scope, near-universal in application, and reliant on cooperation at multiple levels.
The concept of human security has roots more than a century old, but was first defined by the UN Development Program in 1994. It was described as the security of persons in seven domains: economic security (assured basic income); food security (physical and economic access to food); health security (relative freedom from disease and infection); environmental security (access to sanitary water supply, clean air and a non-degraded land system); personal security (security from physical violence and threats); community security (security of cultural identity); and political security (protection of basic human rights and freedoms). Chronic and acute threats to security were recognized. Human security was identified as a universal need, in recognition of the interdependence of people in the modern world, and its preventive aspect was emphasized.
Human security offers an alternative to prevailing ideas about the exercise of power, within and between countries. It acknowledges our interdependence and mutual vulnerability, the importance of global cooperation, and the need for integrated, cross-sector solutions to contemporary problems. Those problems include health threats, climate change and other symptoms of ecological stress, economic instability, poverty, injustice, political violence, and the proliferation of highly destructive weapons.
The field of public health already expresses the basic principles of human security. Thus, members of the public-health community around the world could play important roles in propagating those principles and extending them to other sectors. As that work progressed, it could transform priorities and redirect resources. Consider two examples. First, governments around the world now spend about US$1.7 trillion annually on military activities, with questionable benefits in terms of security. Some of that expenditure could be redirected in ways that would enhance human security both globally and locally. Second, governments now subsidize fossil fuels to the extent of about US$0.4 trillion annually, despite the adverse effects of fossil-fuel burning on Earth’s climate. Those effects are becoming evident through phenomena including increased incidence of droughts, floods, and storms. Pakistan is all too familiar with destruction wrought by droughts and floods. The fossil-fuel subsidies could be redirected to support new systems for renewable supply and efficient use of energy, with significant benefits for human health.
A human-security approach rooted in international consensus could bring added value to existing policies and programs. Thus, the world would benefit from a comprehensive strategy for expanding the scope of public health within a human-security framework. An effective strategy would operate through existing institutions and promote collaboration by: national governments; international agencies; private foundations; academic institutions; professional groups; citizen organizations; and businesses, including pharmaceutical companies. Collaboration of this kind has become increasingly frequent in the modern era, but must be more intensive and must engage additional actors. It is especially important that people and institutions whose focus has been on national defense and security find a common purpose with counterparts who focus on health, social justice, environmental protection, and other aspects of human security.
[i] Paula Gutlove and Gordon Thompson, “Human Security: Expanding the Scope of Public Health”, Medicine, Conflict & Survival, Volume 19, Issue 1, 2003. See: