Redefining national security using the case of antimicrobial resistance: a literature review
Authors: Eins Koenig
Journal: The Lancet Global Health (2019)

BackgroundMore than two decades after the UN's introduction of the human security concept in 1994, governments, policy makers, and researchers still preference conventional military notions in their policies on national security. Consequently, issues such as global-health security threats receive less attention than they deserve from governments and researchers. The term "human security" is an intellectually loose concept and lacks clear inter-relationships between its components. In this study, I assess some of the leading definitions of security to determine what makes antimicrobial resistance (AMR) a security issue. AMR and health security are presented as starting points for a coherent human security framework and security analysis in general.MethodsI undertook a review of the online and print security literature, searching books, Jstor, and Google between Feb 1 and June 30, 2017, for articles in English, using the search terms human security concept, AMR, security, and securitisation theory. I included cases from WHO and the UN, the USA, the EU, Russia, India, South Africa, and Ethiopia that described securitisation of AMR. The entities and countries were selected based on criteria relevant to the analysis, including resistance rates, militarisation level and commitment to human security, democracy, and state capacity to handle a crisis (ie, development status).FindingsI included data from 13 reports and one group of online sources in the analysis (WHO and UN [4 reports]; USA [1]; EU [4]; Russia [no official report was used, conclusions based on information contained on government websites, WHO documents and in the academic literature]; India [2]; South Africa [1]; and Ethiopia [1]). Reports and information sources were published between 1994 and 2017. Several themes emerged from the included reports: security is about the protection of core values; a security issue has cascading multisectoral consequences; security is not always about emergencies; and to traditional security scholars, security is about war and conflicts, and is external and state-centric. Further, the human security concept places the individual in focus and has seven components: health, economic, political, community, environmental, personal, and food security. AMR has been declared by governments and researchers as a human security issue with multisectoral effects.InterpretationTraditionalists' view of security is parochial and unrealistic. Use of the human security concept shows that security situations can arise internally. However, understandings of the concept are too broad and vague to be of use in directing research or policy making. A prioritisation of the human security components by governments, agencies, and researchers—as suggested previously by Roland Paris—can help overcome the weakness of intellectual incoherence and this prioritisation can begin with the health sector. Since AMR has short and long-term multisectoral ramifications, it should qualify as a national security matter. Health security cases like AMR hold the key to a coherent security framework because clear interrelationships can be drawn to all other security forms.FundingNone.