Introduction preoccupations. Aid and Health has become ever



Increasingly health has become an ever more
securitised issue; put simply, current access to health is commonly framed as
crucial to the military, environmental and economic security by government and private
international organisations. The securitization of health seeks to lend a sense
of urgency to a non-traditional military issue, to attract an overriding
political interest and the superior financial resources associated with more
traditional (military) concepts of security. In recent decades’ global health
issues such as HIV/Aids, Polio and Ebola are commonly high on the agenda of
foreign policies of developed nations. Addressing global health challenges has
evolved into a type of global health diplomacy (GHD). The international challenges
that health faces have been coloured by conflicting national political
priorities and influenced profoundly by international donor preoccupations. Aid
and Health has become ever more politicized and militarized issue particularly in
areas of conflict and humanitarian crisis. Consequently, the basic ethical principles
of humanitarian aid: neutrality and impartiality are threatened. The
effectiveness of international aid, of which health is an essential component
has been diluted by the global skewing of aid to a handful of Fragile nations alongside
UK and US military interventions and public health interventions, to reflect
donor national security interests, economic impact and trade policies. Therefore,
there has been a colossal failure to consider the wider impact of the
securitisation of health and the ethical and moral implications that arise. In
response, this essay will analyse the complexity of securitisation, its
pitfalls and promises, and offer potential solutions to the issue.

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How did health come to receive the Security
Tag now?


Health has always been politicised issue
and has played a role in foreign policy. 
During the early cold-war years, the United States Provided $17 billion
under the Truman Doctrine and Marshall Plan to post war European countries in
the hope of rolling back communism. European states were entitled to buy everything
from ” medicine to mules” from American companies; consequently, Stalin
forbade the Cominform countries to apply for Marshall Aid. The difference
in the securitisation of aid is that it is used as an instrument to achieve
military objectives. The transition of the securitisation of health did not
happen by chance, it was actively cultivated by the US and then followed by
others. Following the 9/11 attacks, the advent of the war on terror sparked a reshaping
and refocusing of US foreign policy and the distribution of aid to countries deemed
as Fragile. The retired US General Stanley Crystal states “Modern warfare is
not fought around people, but among them, the key objective is the people. That
makes development a tactic of war.” The U.K and US governments unapologetically
view the instrumentlisation of health for to achieve military objectives.  In a bid to win the population’s Hearts and
minds, military intervention has been conducted in the form of developmental
aid.  National security and foreign aid
policy are seen to be strategically and intrinsically linked.


United states seeks to integrate the resources of military and foreign aid to
enable them to use soft power- rather than military invasion.  The demilitarization of foreign policy to
include aid for achieving national security is evident that the capability and strength
and to invade and control countries in the post-World war II era had deteriorated.
 Evidence of this is seen in previous
conflicts in Vietnam, Somalia and Sierra Leone. In 2011, US Secretary of state
Hilairy Clinton announcement the demilitarization of foreign policy to include
Aid. She expressed her ambition to expand our cabaility to deploy military and
civilian teams together to support stabilisation efforts and built capacity in
other states. “Development is a strategic, economic and moral imperative — as
central to advancing American interests and solving global problems as
diplomacy and defence.” It is “time to elevate development as a central pillar
of all that we do in foreign policy”. U.S. counterinsurgency (COIN) strategy
explicitly calls for the harmonization of economic and military expertise and
co-operation.  Half of US aid is given to the development of security
forces to militarise the state. The common theme is the building up of the
state through an excessively  equiped and
 supersized police and military forces-
most with rocket propelled grenades.  It
can be argued that in this context aid is not a humanitarian intervention but a
military and strageic one.


The Benefits of Securitisation


The securitization of Health optimizes proactivity
which is at the core of effectively combating infectious diseases through
strengthened health systems and preparedness.  Western nations and the World Health Organization
(WHO)—have portrayed infectious disease as an imminent security menace that
requires an innovative and novel leadership approach to address its containment. 
WHO was praised for the management of the containment of SARS in 1997. Infectious
disease epidemics pose not only a local health but threaten international
health security.


The securitization of aid when viewed in
relation to response to a humanitarian crisis can be vital. The logics and
resources of the US army are unprecedented and exceed those of any NGO or
charity. For example, in 2010 the republic of Haiti, an archipelago in the Caribbean
Sea of the was devastated by an earthquake. Essential lifesaving and heavy machinery
for removing debris was deployed by governments for search and rescue
operations. Initially only military planes were permitted access from
delivering aid. NGO’S were able to co-operate with Military govemrnets in the
co-ordination of the delivery of aid. It could be argued in areas such as the
hati earthquake that the military played a larger role in the early stages by
proving earthquake moving equipment. The civilian agengies were much slower at delvery
goods due to being hampered on the ground. In relation to humanitarian criris
the integration and closer co-operation between government and NGOs may be


  Since the invasion of
Afghainstan there has been tremendous advances in education and maternal
health. Over the past decade materal services in Afghanistan has vastly
improved, the number of midwives has increased from 467 midwives in the to more
than 4,600 midwives work in Afghanistan.” Currently  over £750m from the UK  aid budget has been allocated to Afghanistan
between 2017 and 2020 to help create a more stable country and improve people’s
lives – particularly for women and girls. A report co-authored by UNFPA, Afghanistan’s
health ministry, and other partners  estimated that around 1,600 women die from complications
related to pregnancy or childbirth for every 100,000 live births. This mortality
rates have now dropped below 50% of this figure. Gradually there has been a
transition of change for women in terms of rights. There is a women’s rights institute
and  women are able to sit on government boards.



The Wolf in Sheep’s Clothing


The War on terror has paved the way for the
global skewing of aid by donor countires to areas that favour their national
interest is detrimental to the world’s poverty stricken areas. Less attention
is given to the countries who are deemed lesss pf a security issue or  This pursuit is detrimental to those who are
most at risk, i.e those who are most at need . 
Instead the focus is on a handful of 
“fragile countries”: Iraq, Afghanistan and Pakistan alongside Uk
Military operations who have seen increases to their budgets skyrocket to
unprecented levels . The Government department department of international development
DFID , a government department budget that development resources have been
allocated towards other states perceived to be allies in the ‘war on terror’. the
subordination of needs-based aid decisions to national security objectives
means that “strategic” countries – and “strategic” areas
within countries – get disproportionate amounts of aid to the neglect of other
equally poor, and equally “conflict-affected”, neighbours. In 2008,  collation forces  began to scale down operations in Iraq and withdraw,
consequently there was a sharp decline in the amount of  aid donation received as Donor’s securitiy’s
interest are focused to new areas. Countries who remain in similar
circumstances such as Kenya or Democratic Republic of Congo receive
disproportionately  smaller aid donations
in relation to their country’s needs  and
their insecurity and citizen impoverishment is seen as less of a priority.


The view taken by US Military is the maximum
unity of effort” along all “logical lines of operations,” including
reconstruction and economic development. Improving economic conditions is seen
as crucial. It is believed that insurgents will “exploit a lack of employment
or job opportunities to gain active and passive support for their cause.” The
‘politics of fear’ and ‘securitisation of health’ have fuelled, and ensured
funding for, conservative ideas and practices globally, in opposition to more
cooperative structural approaches to strengthen health systems as a health
determinant. Goverments argue that extreme poverty is the incubator for radicalisation,
human misery, disease and the driver of mass migration. However there is
little to no clear causal link between poverty and extremism for example Many
of the 9/11 bombers, and the Christmas Day bomber, came from wealthy families.


implementation of Provisional reconstruction teams who  consist of military and civilian personnel
working in Afghanistan’s provinces to provide security for aid works and help
humanitarian assistance have been criticized as it portrays the subordination of
aid to military stragey rather than addressing issues of poverty. NGOs such as Charity
Christian Aid, who have expressed deep concern” that the “blurring of
the lines between military action and aid delivery” could jeopardise the safety
and impartiality of aid workers. The “politicisation” of aid in
conflict zones, highlights the human cost of blurring security and development
policies and projects. During 2016, 58 major attacks against aid operations
occurred, this resulted in the deaths of 101 aid workers, 98 wounded and 89
kidnapped. The nature in which humanitarian organisations operate and the space
distinushing them from the military effort  is shrinking. One aid worker encapsulates the leadership
and vision of many international charity aid organisations: “While my heart
beats, I have to do what I think I can do – that is, help those who are less
fortunate;”-Mr. Sean Devereux, aged 28, United Nations Children’s Fund Aid
worker assassinated in Kismayo, Somalia,


The use of a military airforce in the deliverance
of humanitarian aid is limited, ineffective and expensive.  It is argued that during relif effrts in
Hati. `the Spanish army spent millions on short term projects which were
designed to have a heavy presence but little effect. Oxfam argued that a
similar water relief effort was achived by the organisation for a fraction of
the Spanish army cost.


The development of schools and hospitals in
Warzones in a bid to win the population’s Hearts and minds is a controversial
and vexed issue. The Military Has Limited Value in developmental Response. Military
development objectives  focus on the
construction of new schools but however fail to implement a traning program for
teachers. They focus on the Hardware i.e the physical presence of resources but
not the software i.e having a sustainsble and long term teacher training
program. Critics argue that money could be better spent in areas that are away
from the active conflict zones.  The
ability to achieve greater value for money in areas where conflict is less of
an issue. Is it an oxymoron to deliver developmental aid in a war zone? Critics
Argue that you need to have security in place before you can even contemplate
other development projects. It is logical to have sequential events of peace
talks and then the development of reconstruction.


International aid plays a vital role in delivering
aid to poverty stricken areas, and investing in long-term and sustainable community
projects to ensure organic growth and development. The securitization of aid
seeks to undermine these objectives. The CIA operation in Abbottabad is  perhaps the most infamous and notorious case of
fraudulent health purpose. It consisted of a controversial sting operation disguised
as a vaccination program  in a bid to
collect information on the location of Osama Bin Laden in a compound in
Abhottabad, Pakistan. A local doctor  was
hired to conduct a fake vaccination campaign, which it hoped could lead to
obtaining blood samples from bin Laden’s grandchildren that could be analysed
for a DNA match to Osama bin Laden. Actions such as these are detrimental to
the reputation of NGOs and ultimately were blamed for the delay  and uptake of Pakistan’s Polio eradication
programs. Utimately The victims of such acts are the children who do not receive
the vaccination due to the Mistrust and suspicion amongst the population. Global
health Strategies should be intended to improve population health and vaccinate
children rather than to be a diplomatic tool for countries to exert their “soft
power” and to score a tactical advantages over terrorist organisations.



“Security” is a fundamental
quality of  that all people deserve to
have. When implementing programs designed to improve security of an area they
should take into consideration the concerns of the population of local areas. For
example security to one area may mean addressing dangerous traffic, or ending
violent attacks and rape.  Therefore security
should be proportionate to the area.


The delegation of aid to poor communities
should not be carried out by the military but instead by NGO’s. In areas of conflict
the dilemma for NGOs is that their ability to operate independently without
military assistance severely limits the scope of their objectives. Therefore Militaries
should respect the operations of NGOs and maintain the humanitarian space
between. Furthermore, NGOs should review there sources of funding to ensure that
they able to act with impartiality and neutrality.



In summary the securitization of Health is
a complicated and controversial issue. In certain scenarios the  securitisation of health can be  seen as logic and beneficial especially in
terms of short-term disaster relief to areas hit by natural disasters. However The
humanitarian and sustainable development efforts developed by NGOs are at risk
of being jeopardised by the securitisation of health as it shifts the view of
aid towards the goal of securing a nationals political goal. Particularly the
use of health interventions for short-term national security objectives is a
dangerous error. It is fundamental that goverment and military powers respect
the humanitarian space of NGOS  and
ensure that humanitarian aid workers can be distinguished as soliders of peace and
not soilders of war.