ABSTRACT
For much of the past 50 years the relationship between health and security has been limited and unidirectional: conflict has caused health problems. These problems have been both a direct result of conflict (largely in the form of combat casualties) and indirect (e.g. the destruction of infrastructure affecting the ability of hospitals to keep working, increased prevalence of water-borne diseases as a result of disruption to the water supply, refugee flows leading to the spread of infectious disease or the overburdening of public health systems). But this was not always the case. In the nineteenth century, as trade between Europe and the rest of the world increased, so did the risk of infectious disease being brought into Europe from elsewhere. Disease was viewed as an exogenous threat which had to be dealt with by means of international cooperation and the introduction of internationally agreed health regulations. Thus the origins of international cooperation on public health lie in the security concerns of Europe in the nineteenth century. After the Second World War however, this relationship disappeared for two main reasons. First, health was presented not as a security issue but as a human right. This move was seen in the constitution establishing the World Health Organization (WHO) in 1948 and reached its high point in the 1970s with the WHO’s ‘Health for All’ initiative. Second, during this period the perception grew that infectious diseases were being conquered, especially through the use of antibiotics. The number of deaths in the West from infectious diseases fell dramatically in the early decades following the Second World War, while in the late 1960s for the first time in history a major infectious disease, smallpox, was effectively eradicated. These successes prompted the US Surgeon General in the late 1960s to declare (perhaps apocryphally) that communicable disease had been conquered, at least for the West. What was patently clear was that this was not the case elsewhere, where living conditions and levels of poverty were much worse. Therefore global health became for the West less of a security concern than one of development.
