When Health Becomes Security: Theorizing Infectious Disease Securitization Beyond the Biomedical Frame – A Scoping Review

Sanaa Aslam; Maidah Hanif; Muhammad Omar Niaz; Maryam  Naseem

doi:10.51253/pafmj.v76iSUPPL-1.13722

Authors

Sanaa Aslam Department of Community and Preventive Dentistry, Foundation University College of Dentistry and Hospital, Islamabad Pakistan,
Maidah Hanif Department of Community and Preventive Dentistry, Foundation University College of Dentistry and Hospital, Islamabad Pakistan, https://orcid.org/0000-0002-6771-1128
Muhammad Omar Niaz Department of Community and Preventive Dentistry, Foundation University College of Dentistry and Hospital, Islamabad Pakistan,
Maryam Naseem Department of Community and Preventive Dentistry, Foundation University College of Dentistry and Hospital, Islamabad Pakistan,

DOI:

https://doi.org/10.51253/pafmj.v76iSUPPL-1.13722

Keywords:

Securitization Theory, Security-Public Health Nexus, Emerging Infectious Diseases, Global Health Security, National Security, One Health.

Abstract

Objective: The Securitization Theory by the Copenhagen School frames the unchecked spread of infectious diseases as an existential security threat, broadening traditional militarized security concepts to include public health. This review enhances understanding of the securitization of infectious diseases and its implications for interpreting contemporary “existential” security threats.

Data Sources: Using Prisma guidelines, two independent researchers identified relevant literature using the PubMed, Science Direct, Google Scholar, and Medline databases.

Study Selection: The search strategy focused on articles published in the past 15 years in English. Boolean Operators and key terms used include: “emerging infectious diseases” AND “securitization theory” OR “securitization,” “security–public health nexus,” “infectious diseases” AND “health security,” and “securitization of COVID-19” AND “securitization theory.” Concept papers, peer-reviewed articles, books, and policy analyses (policy briefs) were included. Non-English publications, editorials, or conference abstracts, and any other literature lacking clear relevance to the securitization of infectious diseases were excluded.

Data Extraction and Synthesis: The data collection took four months, resulting in 137 citations from database searches and 31 from supplementary sources. After removing duplicates, 61 citations were included, with three non-English papers excluded.

Conclusions: The in-depth deliberation on the securitization of infectious diseases presented in this article offers a modern pragmatic worldview of utilizing securitization theory as a practical security analysis tool while reconciling with critics of the theory to facilitate policies and public health responses for pre-emptive global health security, governance, and regulation.

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References

1. Romer D, Jamieson KH. Conspiracy theories as barriers to controlling the spread of COVID-19 in the U.S. Soc Sci Med 2020; 263: 113356. https://doi:10.1016/j.socscimed.2020.113356

2. Romer D, Jamieson KH. Conspiratorial thinking, selective exposure to conservative media, and response to COVID-19 in the US. Soc Sci Med. 2021; 291: 114480.

https://doi:10.1016/j.socscimed.2021.114480

3. Topp SM. Power and politics: the case for linking resilience to health system governance. BMJ Glob Health 2020; 5(6): e002891.

https://doi:10.1136/bmjgh-2020-002891

4. Otukoya TA. The securitisation theory. Int J Sci Res Arch 2024; 11(1): 1747–1755. https://doi:10.30574/ijsra.2024.11.1.0225

5. Eroukhmanoff C. Securitization theory: an introduction [Internet]. E-International Relations. 2018 Jan 14 [cited 2023 Dec 30]. Available from:

https://www.e-ir.info/2018/01/14/securitisation-theory-an-introduction/

6. Honigsbaum M. Between securitisation and neglect: managing Ebola at the borders of global health. Med Hist 2017; 61(2): 270–294. https://doi:10.1017/mdh.2017.6

7. Pannu J, Barry M. Global health security as it pertains to Zika, Ebola, and COVID-19. Curr Opin Infect Dis 2021; 34(5): 401-408.

https://doi:10.1097/QCO.0000000000000775

8. Messner W. The contingency impact of culture on health security capacities for pandemic preparedness: a moderated Bayesian inference analysis. J Int Manag 2023; 29(5): 101056.

https://doi:10.1016/j.intman.2023.101056

9. Raj A. Stefen Elbe, Security and global health: towards the medicalization of insecurity. Int Sociol 2012; 27(5): 690–692.

https://doi:10.1177/0268580912452378

10. Enemark C. Is pandemic flu a security threat? Survival 2009; 51(1): 191–214. https://doi:10.1080/00396330902749798

11. Stritzel H. Securitization theory and the Copenhagen School. In: Security in translation. New Security Challenges Series. London: Palgrave Macmillan; 2014.

https://doi:10.1057/9781137307576_2

12. Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Syst Rev 2021; 10: 89.

https://doi:doi:10.1186/s13643-021-01626-4

13. Arksey H, O’Malley L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol 2005; 8(1): 19–32. https://doi:10.1080/1364557032000119616

14. Greenwood MT, Wæver O. Copenhagen–Cairo on a roundtrip: a security theory meets the revolution. Secur Dialogue 2013; 44(5–6): 485–506. https://doi:10.1177/0967010613502573

15. McCoy D, Roberts S, Daoudi S, et al. Global health security and the health-security nexus: principles, politics and praxis. BMJ Glob Health 2023; 8: e013067.

https://doi:10.1136/bmjgh-2023-013067

16. United States. National Intelligence Council. National intelligence estimate: the global infectious disease threat and its implications for the United States. Environ Change Secur Proj Rep 2000; (6): 33-65.

17. Iliffe J. The African AIDS epidemic: a history. Athens (OH): Ohio University Press; 2006. ISBN: 9780821416891.

18. Peterson S. Epidemic disease and national security. Secur Stud 2002; 12(2): 43–81.

19. World Health Organization. International Health Regulations (2005). Geneva: World Health Organization; 2005 [cited 2022 Dec 28]. Available from:

https://www.who.int/publications/i/item/9789241580410

20. Spuches G, Sabatini F, Palermo G, Caravello E. Risk narrations and perceptions in the COVID-19 time: a discourse analysis through the Italian press. AIMS Geosci 2020; 6: 504–514.

https://doi:10.3934/geosci.2020028

21. Yuk-ping CL, Thomas N. How is health a security issue? Politics, responses and issues. Health Policy Plan 2010; 25(6): 447–453. https://doi:10.1093/heapol/czq063

22. Bengtsson L, Rhinard M. Securitisation across borders: the case of ‘health security’ cooperation in the European Union. In: Rhinard M, editor. Collective securitisation and security governance in the European Union. 1st ed. London: Routledge; 2020. p. 23–38.

23. Sperling J, Webber M. The European Union, security governance and collective securitization. West Eur Polit 2019; 42: 228–260.

https://doi:10.1080/01402382.2018.1510193

24. Acharya A. The R2P and norm diffusion: towards a framework of norm circulation. Glob Responsib Protect 2013; 5: 466–479.

https://doi:10.1163/1875984X-00504006

25. Jin J, Karackattu JT. Infectious diseases and securitization: WHO's dilemma. Biosecur Bioterror 2011; 9(2): 181–187.

https://doi:10.1089/bsp.2010.0045

26. Eckmanns T, Füller H, Roberts SL. Digital epidemiology and global health security: an interdisciplinary conversation. Life Sci Soc Policy 2019; 15(1): 2. https://doi:10.1186/s40504-019-0091-8

27. Sanford S, Polzer J, McDonough P. Preparedness as a technology of (in)security: pandemic influenza planning and the global biopolitics of emerging infectious diseases. Soc Theory Health 2016; 14: 18–43. https://doi:10.1057/sth.2015.8

28. Long C. Securitising infectious disease outbreaks: the WHO and visualisation of molecular life. Eur J Int Secur 2023; 8(4): 493–512.

https://doi:10.1017/eis.2022.36

29. Wishnick E. Dilemmas of securitization and health risk management in the People’s Republic of China: the cases of SARS and avian influenza. Health Policy Plan 2010; 25(6): 454–66. https://doi:10.1093/heapol/czq065

30. Bingham N, Hinchliffe S. Mapping the multiplicities of biosecurity. In: Lakoff A, Collier SJ, editors. Biosecurity interventions. New York: Columbia University Press; 2008. p.173–193.

31. Cooper AF. Innovation in global health governance: critical cases. 1st ed. London: Routledge; 2009. [eBook published 2016 May 23]. https://doi:10.4324/9781315588629

32. Koch E. Disease as security threat: critical reflections on the global TB emergency. In: Global health and security in question 2008. https://doi:10.7312/lako14606-005

33. Simonsen L, Gog JR, Olson D, Viboud C. Infectious disease surveillance in the big data era: towards faster and locally relevant systems. J Infect Dis 2016; 214(Suppl 4): S380–S385.

https://doi:10.1093/infdis/jiw376

34. Vuori JA. Illocutionary logic and strands of securitization: applying the theory of securitization to the study of non-democratic political orders. Eur J Int Relat 2008; 14(1): 65–99.

https://doi:10.1177/1354066107087767

35. Akter H. COVID-19 in Bangladeshi Daily Newspapers: A Thematic Analysis of Media Coverage. Journal of Global Communication. https://doi:10.5958/0976-2442.2021.00010.0

36. Vearey J, de Gruchy T, Maple N. Global health (security), immigration governance and COVID-19 in South(ern) Africa: an evolving research agenda. J Migr Health 2021; 3: 100040.

https://doi:10.1016/j.jmh.2021.100040

37. Lal A, Erondu NA, Heymann DL, Gitahi G, Yates R. Fragmented health systems in COVID-19: rectifying the misalignment between global health security and universal health coverage. Lancet 2021; 397(10268): 61–67.

https://doi.org/10.1016/s0140-6736(20)32228-5

38. Lal A, Abdalla SM, Chattu VK, Erondu NA, Lee TL, Singh S, et al. Pandemic preparedness and response: exploring the role of universal health coverage within the global health security architecture. Lancet Glob Health 2022; 10(11): e1675–1683.

https://doi:10.1016/S2214-109X(22)00341-2

39. O’Manique C. The securitisation of HIV/AIDS in sub-Saharan Africa: a critical feminist lens. Policy Soc 2005; 24(1): 24–47.

https://doi:10.1016/S1449-4035(05)70048-5

40. Ray-Bennett NS, Collins A, Bhuiya A, Edgeworth R, Nahar P, Alamgir F et al. Exploring the meaning of health security for disaster resilience through people's perspectives in Bangladesh. Health Place 2010; 16(3): 581–589.

https://doi:10.1016/j.healthplace.2010.01.003

41. Baysal B. 20 years of securitization: strengths, limitations and a new dual framework. Uluslararası İlişkiler / Int Relations 2020; 17(67): 3–20. https://www.jstor.org/stable/26928568

42. Chen LC, Leaning J, Narasimhan V. Global health challenges for human security. Cambridge, MA: Global Equity Initiative; Asia Center, Harvard University; distributed by Harvard University Press; 2003.

43. Akhavein D, Sheel M, Abimbola S. How health securitisation shapes health system priorities: a realist synthesis. PLOS Glob Public Health 2025; 5(5): e0004677.

https://doi:10.1371/journal.pgph.0004677

44. Sithivong N, Izumiya H, Munnalath K, Phouthavane T, Chomlasak K, Sisavath L, et al. Cholera outbreak, Laos, 2007. Emerg Infect Dis 2010; 16(4): 745-746.

https://doi:10.3201/eid1604.091493

45. Adeola GL, Ogunnoiki AO. The securitisation of communicable viral diseases in the 21st century: a growing human security danger in a globalized world. Ideal J Arts Humanit 2016; 2(2): 71–82.

46. Brantly ND. Biopolitics at the Nexus of Chronic and Infectious Diseases. J Bioeth Inq 2025; 22(3): 689-705.

https://doi:10.1007/s11673-024-10405-4