An overwhelming number of clinics, antiretroviral drugs, and education campaigns have flooded countries hard-hit with HIV/AIDS. South Africa is one of those countries. However, even after years of funding efforts and program developments to stop the spread of the disease, South Africa held the title of “world’s rape capital” as late as year 2012. Once again, health policies have failed to address a key component of global health initiatives—security. And rampant gender violence is just the beginning.
On April 5, 2013, CSIS hosted an event titled “U.S. Policy Priorities for Global Health Diplomacy and Multilateral Engagement in the Second Obama Term.” The three speakers included Dr. Nils Daulaire, Assistant Secretary for Global Affairs in HHS, Leslie Rowe, Ambassador in the Office of Global Health Diplomacy for the State Department, and Todd Summers, a senior advisor for the CSIS Global Health Policy Center. The talk overall had a very optimistic ambiance, highlighting the many positive programs that the government developed in tackling global health issues.
However, listening to this talk with a security perspective, I could not help but notice an elephant in the room. The efforts for multinational collaboration on disease detection and prevention is wonderful, and the work being done to have more accountable finances by having the implementing countries show the donor countries exactly how the funds are being used is worthy of applause. Nonetheless, security needs must also be met in order to make global health solutions effective and enduring. It is hard to fight HIV in countries like South Africa where gender violence is so rampant that a woman has a better chance of being raped than graduating from high school. It is hard to fight infectious diseases in countries that have overcrowded refugee camps, with great exposure to vectors that transmit disease and environmental hazards, due to rampant, organized, violent crime in their home. Humanitarian assistance in the form of vaccines, one-purpose clinics, or money in areas facing war and violence is like passing food through a window to a person being threatened at gunpoint by a man inside.
It is only after years of violent intentions and distrust amongst ethnic groups, communities, and even nations are overcome that the many mutual benefits of improved global health can be appreciated and great strides can be taken towards achieving them. Marginalized groups facing daily conflict and living in fear are often those very groups that face the greatest biosecurity threats. Their security needs cannot be overlooked if public health is to become a truly “global” enterprise.