Handbook of Governance and Security
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Handbook of Governance and Security

Edited by James Sperling

The Handbook of Governance and Security examines the conceptual evolution of security governance and the different manifestations of regional security governance. In particular, James Sperling brings together unique contributions from leading scholars to explore the role of institutions that have emerged as critical suppliers of security governance and the ever-widening set of security issues that can be viewed profitably through a governance lens.
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Chapter 20: Health

Sara E. Davies


In the 1990s and for most of the first decade of the twenty-first century, much of the discussion and focus on global governance and diplomacy concerning health made reference to security language, actors and discourse (Aldis 2008; Davies 2008; Elbe 2011). There was a widespread presumption that, for the most part, the marriage of health issues to security would ‘harness political leadership and resources for various international health issues’ (Elbe 2011: 220). The UN General Assembly’s interest in global health as a foreign policy concern has been attributed to these earlier efforts to promote health issues as a security and diplomatic concern (Kickbusch et al. 2007; Feldbaum et al. 2010). In a 2010 article published in International Affairs, I argued that there was a long-standing tension between a ‘statist’ approach which focused on investing in international health initiatives to protect national interests and a globalist approach which called for investment in international health initiatives and emphasized a human right to health care that stood apart from calculations of national benefit (Davies 2010: 1185–6). In this chapter I return to this argument in three parts. First, I explore the origins and evolution of health security. I then discuss how health security, from both an academic and policy perspective, has led to a different emphasis on what and who is to be secured in the area of global health. Finally, I explore these tensions in relation to the issue of global infectious disease control, specifically the revised International Health Regulations (IHR) of 2005.

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