oa South African Medical Journal - Public health security – caring for the health of populations? - from the editor

Volume 110 Number 1
  • ISSN : 0256-9574
  • E-ISSN: 2078-5135



In September 2000, the United Nations Millennium Declaration was signed and the Millennium Development Goals (MDGs) were derived from this declaration. At the same time as the Sustainable Development Goals and MDGs were being developed, there was a growing awareness of the potential role of infectious diseases – and specifically epidemics and pandemics – in national security. In 2000, the National Intelligence Council produced a report entitled The Global Infectious Disease Threat and Its Implications for the United States. This was USA-specific and focused on the extent to which the ‘growing global infectious disease threat’ would affect the USA, both within the continent and also its activities and influence elsewhere in the world. Infectious diseases are then seen through a ‘national security lens’, e.g. tropical disease research conducted by the US Department of Defense’s Institutes is motivated by the ‘security interest’ to understand infectious diseases that threaten military personnel abroad. This was at a time when even the World Health Organization (WHO) in its 1999 World Health Report said that it ‘does not make economic sense to try to provide comprehensive medical services for everyone’. The overarching philosophy was that the provision of healthcare must be ‘cost-effective’ and that ‘effective treatment is too expensive to be considered “realistic” in resource-poor settings’ – leading to acceptance of a lower standard of care – setting resource-poor countries up for health-related problems, poor response to emergencies, etc.[1] Which has of course been seen with the increasing numbers of outbreaks and emergencies and consequent population movements and increasing poverty – and then there is climate change as well.

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