The spread of infectious disease can be deadlier than world wars — the Spanish flu, for instance, killed millions more people than World War I, one of the deadliest conflicts in human history. Yet present threats to public health, though less overt, could be considered more insidious than a deadly pandemic. In this Perspective, the authors review the current scope and operation of global health security, identify emerging threats, and assess how adequately current visions of global health security account for these threats. The authors identify two main threats to global health security: slow-burn problems — whose long-term effects are underestimated, potentially causing them to receive insufficient attention until it is too late to reverse the damage — and emerging technologies that have beneficial uses but that also can be used as weapons. The authors propose that a broader definition of global health security should be considered — one that would extend well beyond the threats of pandemics and bioweapons of mass destruction. They also maintain that global health security requires greater systematic focus on the complex interlinkages among human physical and mental health, animal health, and the environment.
Policymakers will face the challenge of balancing agility and rapid decisionmaking during times of crisis with a holistic scope that encompasses both imminent and future threats. The authors recommend that infectious disease remain a priority of global health security and that efforts to increase collaboration and trust among international leaders be fostered. In addition, the authors argue that global health security must not come at the expense of efforts to advance global public health, well-being, and human rights.