Over the past 20 years, the United Nations Security Council (UNSC) has sought to securitise health, framing infectious disease as a threat to national security. This trend towards securitisation has continued in the current COVID-19 pandemic.

Since the end of WWII, human rights have been a foundation for global health governance through the UN. These rights have provided a normative framework and political catalyst for the World Health Organization (WHO) responses to common health problems, with health long seen to be outside of the remit of the UNSC. However, as WHO faced new threats that highlighted its institutional limitations, infectious disease governance shifted towards the UNSC.

Evolving Security Council debates to advance global health

Human rights-based approaches seek to realise the “highest attainable standard of health” by assuring determinants of health such as food, housing, and medicine. In contrast, “health security” views health instrumentally, positing global public health as a means of achieving national security, rather than as a human right and end in itself. Global health governance under WHO and the UNSC has highlighted the tension between the human rights and health security framings.

With the end of the Cold War, Global South countries had advanced “human security”— a rights-based framing of economic development — as a new agenda for the international community. States in the Global North soon refashioned the idea into “health security,” shifting focus from the harms of poverty to the threat of bioterror. This positioned health-related human rights as subordinate to national security, neglecting many public health threats in a globalising world.

COVID-19 has dramatically increased international political awareness that global health risks can threaten both security and rights. In May 2020, the 73rd World Health Assembly opened its COVID-19 response discussion by recognising the health and human rights implications of the pandemic, recalling WHO’s Constitutional mandate to uphold the right to health, before issuing a broad call to action that spanned freedom of movement, gender equality, access to medicines, and global research collaboration. The comprehensive sweep of the resolution illustrated the expansiveness of WHO’s human rights framing of the pandemic, a framing that has been increasingly raised in ongoing efforts to realise vaccine equity.

Following months of divergent national efforts to mitigate COVID-19, the UNSC finally held an open debate on pandemics and security in July 2020. Recognising that the virus had exacerbated inequalities, which often lead to instability and conflict, the debate focused on how states could prevent human rights violations in emergency health responses, demonstrating a remarkable shift towards centring human rights concerns in responding to global health crises. This debate resulted in Resolution 2532, acknowledging the disproportionate impact of the pandemic on minority populations, including women, refugees, older people, and people with disabilities. The Security Council further requested that states include the participation of these groups in the development and implementation of responses to the pandemic.

While this resolution lacked any explicit mention of human rights obligations or any guidance to protect human rights in the pandemic response, it served to introduce human rights norms and principles, specifically around nondiscrimination, in the health security response. When the Security Council returned to the pandemic response in February 2021, Resolution 2565 addressed the need for humanitarian action to ensure vaccine equity, especially amid armed conflict. However, this again prioritised securitisation over human rights norms and did little to align efforts across WHO and the Security Council.

Health securitisation as a threat to human rights?

The UNSC acknowledged that in its first ever discussion on global health that framed HIV/AIDS as a security threat, it was “exploring a brand-new definition of world security” and establishing “a precedent for Security Council concern and action on a broader security agenda.” Within this understanding of security, there is some evidence that over time the UNSC is increasingly recognising some aspects of human rights.

However, there are challenges presented by the Security Council’s attempts to incorporate human rights into this broader global health security agenda. Whereas human rights are inalienable and should be embedded continuously into state practice, securitisation is invoked only in times of crisis, limiting the everyday nature of rights. It has become clear that an expansion of militarised responses to COVID-19 has served to displace long term and more sustainable, comprehensive participatory public health approaches, which are grounded in human rights.

Attempts to securitise health have proven effective in increasing resources directed towards public health preparedness, enabling states to expand attention and resources to the pandemic response, and thus realising the right to health in infectious disease control. However, this securitisation of health has also displaced WHO’s leadership in achieving global health solidarity, as resources are increasingly focused on securitised aspects of national health rather than broader health objectives, such as universal health coverage.

The invocation of rights within the UNSC has thus been limited. While WHO and other UN institutions have addressed rights holistically, recognising that rights are interconnected and interrelated in health, Security Council resolutions have, where they have engaged with rights at all, focused narrowly on vulnerable groups and economic protection in conflict settings. Where human rights are inextricably linked to health efforts, there are dangers in not focusing more broadly on social determinants of health or more cross-cutting health services such as primary care.

The COVID-19 pandemic has once again illustrated the importance of human rights, addressing underlying inequities in the global response to infectious diseases. In order to make the Security Council’s pronouncements more effective in responding to future global health challenges, it will be necessary to incorporate a more robust framing of rights in responding to underlying determinants of health, drawing together the work of the Council and WHO in global health governance. While the current composition of the Security Council may make this overt recognition difficult, past practice provides a path to galvanise resources and attention towards human rights obligations as a foundation of global health security.

Sharifah Sekalala is a Professor of Global Health Law at the University of Warwick. She is an interdisciplinary researcher whose work is at the intersection of international law, public policy, and global health. She is particularly focused on the role of human rights frameworks in addressing global health inequalities. Her work has been published in leading legal, international relations and public health journals. Prof Sekalala is currently the PI on a Welcome Trust funded project on digital health apps in Sub Saharan Africa.

Caitlin R. Williams is a PhD student at University of North Carolina at Chapel Hill. Her research interests center on implementation strategies to ensure that evidence-based practices reach under-served and marginalized communities. At UNC, Caitlin supports the work of the WHO Collaborating Center for Research Evidence on Sexual and Reproductive Health, primarily through her involvement with the Family Planning National Training Center for Service Delivery Improvement. She also collaborates with the Institute for Health Policy and Clinical Effectiveness (IECS) in Buenos Aires, Argentina.

Benjamin Mason Meier is a Professor of Global Health Policy at the University of North Carolina at Chapel Hill. Meier’s interdisciplinary research—at the intersection global health, international law, and public policy—examines rights-based approaches to health. Working collaboratively across the University of North Carolina’s Department of Public Policy and Gillings School of Global Public Health, Meier has written over one hundred articles on the development, evolution, and application of human rights in global health.

This is an edited extract of Sekalala, Williams, and Meier’s article in the Australian Journal of International Affairs, titled “Global health governance through the UN Security Council: health security vs. human rights?” It is republished with permission.