Questioning health security: Insecurity and domination in world politics

Abstract

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It has become common to speak of health security, but the meaning of the latter is often taken for granted. Existing engagements with this notion have been constrained by an excessive focus on national security and on the securitising efforts of elites. This has led to an increasingly sceptical outlook on the potentialities of security for making sense of, and helping to tackle, health problems. Inspired by the idea of security as emancipation, this article reconsiders the notion of health security. It takes as its starting point the concrete insecurities experienced by individuals, and engages with them by way of an analytical framework centred on the notion of domination. Domination deepens analysis by connecting individual experiences of insecurity, the social interactions through which these are given meaning, and the structures that make them possible. Domination also broadens the remit of analysis, shedding light on the multifaceted nature of insecurity. The analytical benefits of this framework are demonstrated by two examples: HIV/AIDS; and water and sanitation. The lens of domination is also shown to bring benefits for the political engagement with global health problems.