Infectious disease has affected state security throughout history, but only recently has this been recognised in policy and strategy. International cooperation over health-security has grown incrementally since initiatives like the International Sanitary Conferences in the nineteenth century attempted to coordinate the collective management of this trans-border issue. Since this time, a consensus has built around the impetus for health-security: global efforts are required to avoid and contain cross-border communicable disease outbreaks with potential for mass casualties. However, the use of the security sector as a viable partner has rarely been employed.
Within the Indo-Pacific region, the risk of infectious disease outbreak is considered to be particularly critical. In 2011, WHO Western Pacific Region asserted that “health security in the Asia Pacific Region is continuously threatened by emerging disease”. The 2003 severe acute respiratory syndrome (SARS) outbreak, for example, stressed regional health systems and highlighted the ease at local outbreaks can swiftly translate into pandemic scale.
For many, the threat of new and emerging diseases to national health and economic stability galvanises the regional health-security project. Health system vulnerabilities, hyper-connectivity and political fractures across the Indo-Pacific are seen as sufficient conditions for widespread communicable disease transmission. Australia undoubtedly has an important role in mobilising and supporting concerted action within the region.
This is reflected in the Australian government’s most recent investment in health-security, the Health Security Initiative for the Indo-Pacific Region. Through substantial financial, diplomatic and technical engagement, the Department of Foreign Affairs and Trade is looking to meaningfully advance Australia’s contribution to regional health-security.
Certainly, a significant part of this will focus on strengthening the traditional pillars of local, national and regional health systems, that in turn support health-security. Investment in technical factors will be complemented by bureaucratic and structural initiatives. This will bolster evidence base planning, early detection and rapid response.
Despite this, there has been an under-exploration of the role of the security sector in infectious disease preparedness and response. Consider, for example, that the UN Security Council’s resolution in 2000 declaring HIV/AIDS a risk to international peace and stability was the first to locate infectious disease within a security lens.
There are strong reasons to search widely when partnering with conventional health-based actors. The regional, national and local agencies whose remit is the promotion and maintenance of public security and safety should be a common feature. Militaries, law enforcement, border control and corrections need to be recognised as a key part of realising health-security.
Some condemn this pattern of ‘health securitisation’, whereby infectious disease is deemed an existential threat to the survival of the nation, arguing that it endangers the efficacy of health-based responses, distorts the global health agenda and undermines human rights. On the other hand, others maintain that framing disease as a security threat can unlock resources and political willpower that would otherwise be lacking
The engagement of security actors in health-security can advance efforts to reduce the risk of serious disease events, as well as the burden and impact of such events as they occur. This can be shown in the 2014 Ebola outbreak where national militaries were mobilised in disease preparedness and response, proving to be constructive players. The US military partnered with health services in West Africa for rapid deployment and logistical capacities, implementing public health directives, and protecting strategic areas and resources.
Building national and regional health-security capacities is a core requirement articulated within the International Health Regulations. In particular, a key recommendation expressed by the WHO’s Joint External Evaluations is the need to “build links between public health and security authorities”. The JEE highlight significant fractures in the communications and alignment of strategy between the health and security sectors. This should be a key policy position of the Australian Government.
While the securitisation of infectious disease is a legitimate concern, a detailed operational and strategic assessment of the security sector as global health actors must be undertaken. This will help determine when resources should be mobilised and how security actors can be engaged in partnership with traditional health system stakeholders. As it stands, the role of many actors across the region, such as law enforcement agencies, is being underutilised or poorly conceptualised.
The nexus between security, infectious disease and geopolitics have never been more clearly illustrated as when rioters recently stormed an Ebola triage centre in the Democratic Republic of the Congo.
DFAT, the Department of Home Affairs and the Australian Federal Police should support multi-sectoral initiatives that build understanding and partnership across the Indo-Pacific. The development of structured regional dialogues, for example, would facilitate high-level engagement about the role of militaries, police and others in disease pandemics, where the gaps are and how can we utilise security sectors. Political and technical challenges to holistic pandemic preparedness can be teased out and pathways for action developed to the benefit of our overall response.
Adopting this approach would allow Australian authorities to support regional allies towards health-security. Indeed, improved health-security in the Indo-Pacific region will benefit Australia in reducing the risk and impact of volatile infectious disease outbreaks within its own borders.
Mason Littlejohn is the Indo-Pacific Fellow for Young Australians in International Affairs.