In the contemporary landscape of global health, the concept of health security has rapidly ascended as a pivotal framework that transcends traditional public health paradigms. While public health has long served as the foundation for managing disease prevention, health promotion, and population well-being, recent global challenges have exposed its limitations in addressing emergent, multifaceted threats. The work of Akhavein, Sheel, and Abimbola (2025) in Global Health Research and Policy incisively unpacks the nuanced distinctions between health security and public health, arguing that the former is indispensable for ensuring resilience against a complex array of modern health risks.
At the heart of this dialogue is a realization that public health, with its historical focus on endemic disease control and population-level interventions, is insufficient when confronting contemporary threats such as pandemics, bioterrorism, antimicrobial resistance, and health impacts of geopolitical instability. Health security, in contrast, broadens the scope by encompassing proactive preparedness, rapid response capacities, and robust health system resilience to prevent catastrophic failures. This expanded framework integrates interdisciplinary approaches ranging from epidemiology and environmental science to security policy and economics, reflecting the intricate web of factors influencing health outcomes in an interconnected world.
Through an incisive technical lens, the article highlights that health security reframes the relationship between states and health systems. Public health traditionally operates within a domestic welfare model, emphasizing access, equity, and social determinants. However, health security situates health as a matter of national and international security, necessitating governance mechanisms that prioritize stability, continuity, and threat mitigation on a global scale. This shift demands cooperation across ministries of health, defense, foreign affairs, and intelligence, as well as international bodies, to detect and blunt the effects of emerging threats swiftly and effectively.
One of the critical technical considerations brought forward in the article is the role of surveillance and data integration in health security. Whereas public health surveillance tends to focus on population health metrics and disease burden, health security requires real-time, interoperable data systems capable of detecting anomalous patterns indicative of biological threats or system vulnerabilities. Advances in genomics, artificial intelligence, and digital epidemiology underpin this evolution, generating new opportunities for preemptive intervention that surpass traditional outbreak response mechanisms.
The authors also dissect the socio-political dimensions of health security, pointing out that the securitization of health can simultaneously empower public health infrastructures and provoke ethical debates around civil liberties, equity, and stigma. For example, the deployment of emergency powers or travel restrictions during health crises can mitigate spread but also risk marginalizing vulnerable populations and undermining trust. This balance between protection and rights forms a delicate axis on which health security policies must be calibrated, requiring transparent governance and community engagement.
Furthermore, the paper articulates how global health governance must adapt to the demands of health security. Existing international health regulations and frameworks, while foundational, are ill-equipped for rapid mobilization in the face of novel threats such as synthetic biology pathogens or climate change-induced health emergencies. Strengthening the International Health Regulations (IHR) and expanding collaborative mechanisms like the Global Health Security Agenda (GHSA) are underscored as critical priorities for elevating health security capabilities worldwide.
The economic implications of embracing health security over traditional public health are carefully unpacked. Health security investments—such as biosurveillance infrastructure, stockpiling medical countermeasures, and strengthening rapid response teams—require substantial upfront expenditures. However, these are portrayed not simply as costs but as essential long-term investments that prevent far greater societal disruption and economic losses caused by uncontrolled outbreaks or biological crises. The article presents compelling modeling analyses that demonstrate the cost-effectiveness of preparedness, reinforcing the rationale for integrating health security into national and global budgeting priorities.
In addressing the human resources component, the authors emphasize that health security demands a workforce not only proficient in epidemiology and clinical care but also trained in crisis management, risk communication, and intersectoral coordination. Recruitment and retention strategies must therefore be reimagined to foster expertise and flexibility, empowering personnel to operate effectively during rapidly evolving emergencies. This multidisciplinary capacity building marks a departure from the traditionally siloed training paradigms predominant in public health education.
Technological innovation occupies a central role in the transformation from public health to health security. Cutting-edge developments in pathogen detection using CRISPR-based assays, portable genomic sequencing devices, and real-time mobility tracking enhance early warning and containment efforts. Simultaneously, the ethical integration of such technologies demands rigorous privacy safeguards and equitable access to prevent deepening health disparities. This intersection of technology, ethics, and policy is painted as a defining challenge and opportunity for health security architects.
The authors also interrogate the critical interplay between environmental health and health security. Climate change, urbanization, and biodiversity loss are powerful drivers of emergent diseases and health system stresses. Unlike traditional public health, which often addresses environmental determinants in isolation, health security frameworks necessitate anticipatory modeling and cross-sector mitigation strategies that recognize the systemic feedback loops between ecological disruption and disease emergence. This holistic approach enhances resilience in ways that conventional public health does not fully capture.
Akhavein, Sheel, and Abimbola devote attention to global disparities in health security capacities, highlighting how resource-constrained countries face formidable challenges in meeting international standards due to infrastructure gaps, political instability, and funding shortfalls. Addressing this requires innovative partnership models that combine multilateral funding, capacity building, and technology transfer to create sustainable, context-sensitive solutions. This equity-centric lens is critical to ensuring that health security advances do not exacerbate existing global inequalities.
The article further debates the politicization risks inherent in framing health as a security issue. While securitization can galvanize political will and resources, it may also militarize responses or justify restrictive policies that erode civil society participation. The authors caution against conflating health security with national security to the degree that public health principles and community trust are compromised. Instead, they advocate for a balanced conceptualization that fortifies health systems while preserving democratic accountability and public trust.
Importantly, the paper argues for integrating health security metrics into broader health system performance evaluations. Traditional indicators focus on service delivery and health outcomes but may miss critical capacities such as emergency response speed, flexibility, and interagency coordination. Developing standardized, validated measurement frameworks for health security readiness and resilience is identified as a priority for researchers and policymakers alike, enabling continuous improvement and accountability.
Finally, the article envisions the future trajectory of global health wherein health security and public health coexist as complementary pillars rather than competing paradigms. The synergy between the two can catalyze innovations in policy, technology, and governance that protect populations from both everyday health challenges and rare, catastrophic events. This integrative vision calls for sustained interdisciplinary collaboration, investments in scientific discovery, and inclusive governance structures that reflect the diverse realities of health threats in the 21st century.
The compelling discourse presented by Akhavein, Sheel, and Abimbola ultimately repositions health security as an essential evolution beyond traditional public health. Their rigorous, multifaceted exploration provides critical insights for governments, researchers, and global health actors seeking to navigate an era marked by increasingly complex and unpredictable health challenges. Embracing health security not only safeguards populations but also fortifies the social and economic fabric on which global prosperity depends.
Subject of Research: The conceptual differentiation between health security and traditional public health frameworks, and the necessity of adopting health security to address modern complex health threats.
Article Title: Health security—Why is ‘public health’ not enough?
Article References:
Akhavein, D., Sheel, M. & Abimbola, S. Health security—Why is ‘public health’ not enough?. glob health res policy 10, 1 (2025). https://doi.org/10.1186/s41256-024-00394-7
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