“Health Security” in the New National Security Paradigm


Dr Nadeem Jan

Burgeoning globalization poses another threat to global health security: a disease from one corner can reach the other in the shortest possible time.

On the 14th of January 2022, the Prime Minister of Pakistan launched the first national security policy.
This comprehensive document covers all aspects of human and national security and has presented policy options, challenges, and statements of intent on all most all matters of national interest.
A cursory look at the policy reveals the level of efforts put in to provide a reasonable shape to this document. The team and all stakeholders engaged in the process deserve applauds for this gigantic work.
It is indeed a big leap forward that it is the first policy document that has put the citizens at the epicentre of national policy development. The documents have aligned both the state and human security in a mosaic fashion that can have major dividends for the state and its citizens; if adequately implemented.
The document contains eight sections.
In the first section, conceptual elements of Pakistan’s national security framework have been mentioned. In section II, six thematic sections of the policy with desired goals and objectives are mentioned. Section III mentions the “National Cohesion,” emphasising the preservation of ideology and culture, thus, making public service responsive to the needs of citizens. Section IV focuses on economic security, specifically trade, energy, education, and emerging technologies. Section V provides policy guidelines for ensuring defence, deterrence, territorial integrity, and space and cyber security.
Section VI focuses on “Internal Security” and examines the challenges of terrorism, violent sub-nationalisms, extremism, and organized crime. Section VII is on “Foreign Policy” that assesses global realignments, Pakistan’s key bilateral and multilateral relationships, and overall approach towards diplomacy. Section VIII is about “Human Security” that examines population and migration, health security, climate and water security, food security, and gender balance.
The Policy provides a framework related to all key national security issues that the government intends to achieve in the next five years.
Of significant importance is the shift that it has brought in policymaking by:
-Moving from geostrategic to geo-economics,
-From state-centric to human-centric,
-From reactiveness to proactiveness,
-From one entity to the whole of government approach
-And from silos to inclusiveness.
This document, nonetheless, is not an exception to the rule that to “err is human” but that is for the next time.
For now, we would zoom on the much-ignored health security domain that the document has briefly referred to.
Health security:
The health of the population is the result of the state’s health, economic, political, environmental, security, food, and communal policies.
Health becomes a national security issue when diseases cross borders and engulf a wider spectrum of society, rendering the system helpless. Therein, it requires the “whole of a national approach” to tackle. This was exactly the Pakistan response when COVID struck: the formation of the National Coordination Committee and NCOC are all major steps taken in the right direction.
The results of this civil-military coherence led to astonishing results, especially when our health systems and strategic capacity in comparison to other developed countries were pretty meagre.
The 21st century can be rightly called a century of the virus-man versus virus-we are in a perpetual battle against the virus in all parts of the world.
From Polio to HIV/AIDS virus to Ebola, Zika, SARS, MARS and now COVID-19, the virus has eroded the whole spectrum of humanity at large; not only health but the economy and national security of the nation-states as well.
The world witnessed how the most developed health systems like those of the US, Italy, and Germany were shaken by the coronavirus epidemic.
It is not the first and neither would be the last onslaught of the virus.
The other key threat to health security is frequent virus mutation, rising drug resistance, and other zoonotic diseases.
Threats of chemical and biological warfare and bioterrorism pose a key risk to world peace. Burgeoning globalization poses another threat to global health security: a disease from one corner can reach the other in the shortest possible time.
The policy paper briefly mentioned health security, focusing on enhancing national capacity for surveillance and health emergency response. Some generic statements on nutrition, Sehat cards, and COVID-19 were referred to.
But it lacked the key national policy guidelines required for the development of a secured health system in Pakistan.
Despite the recent pandemic, not much has been put in for the development of a robust preparedness and response capacity. The kind of global health security apparatus required is unfortunately still a far cry.
In a WHO Joint external evaluation Report on Pakistan health security in 2018, Pakistan scored 48.3 per cent.
The current situation is more provirus than anti-virus and future virus attacks may result in more catastrophe.
Even a dedicated Focal person for Global health security hasn’t been notified, the national action plan for the global health security agenda is staggered, to say the least.
Taking a cue from the national security document, the health ministry should redraft a comprehensive national health security plan and develop a mechanism to ensure its seamless implementation. It’s one of the most cost-effective and efficient interventions that the health industry can have.
In the health emergency domain, there are three vertical EOCs functioning, one for polio, the other for COVID, and the third one for public health emergencies.
In the interest of resources and impact, the investments in all three vertical programs must be integrated into “one centre of excellence” for an overarching “National Health Security,” with various vertical arms.
This is a zero-cost but high returns intervention and merely a matter of political will and leadership.
The division of labour at the Ministry may be redefined to allocate dedicated senior-level leadership and technical resources to Health security, this bifurcation of the ministry would save money and time and enhance our preparedness for better emergency response.
The next steps and the “How factor” of the National Security policy?
Risk analysis and risk mitigation strategy must be developed for the implementation of this policy document.
In a classy development sector paradigm, such policy statements then require the concerned ministries, departments and sectors to develop meticulously strategic road maps, a detailed implementation action plan with timeline, indicators and resources envelope
The development of a monitoring framework initially by the national security division as a whole for the policy framework and then subsequently by the concerned departments and ministries, so the implementation of this national policy can be monitored.
A live dashboard for overseeing the implementation of this national policy be projected at The PM office to monitor the implementation status in real-time.
Jointly monthly reviews by all stakeholders with PM in the chair would provide a political boost, the same mechanism with some modifications may be implemented at the provincial level as well. In the interest of stringent accountability, the development and rolling down of an exclusive accountability framework would help in the smooth implementation of this cherished policy.
This policy has set the course for progressive out-of-the-box strategic thinking and fills in the national spiritual and psychological vacuum; much required for taking this country where it is destined for?