The COVID-19 pandemic has laid bare deep fissures in the current global health architecture and highlighted the need for urgent reform. The US and the UK, both erstwhile leaders in global health and biological preparedness, have renewed commitments to health security as a framework for mitigating the threat of future pandemics. Yet the reflexive tendency to frame health risks in security terms has obscured the assumptions and trade-offs at stake. In a critical examination of the health security paradigm, this report argues that, while the security implications of pandemics are clear, the concept of health security distracts attention from the underlying determinants of health that exacerbate the effects of severe disease outbreaks and disproportionately affect the most vulnerable. The report offers recommendations for developing and sustaining a human-centred approach to global health.

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