HEALTH, RESILIENCE, AND HUMAN SECURITY: MOVING TOWARD HEALTH FOR ALL Marcelo Korc, Susan Hubbard, Tomoko Suzuki, and Masamine Jimba Copyright © 2016 Japan Center for International Exchange and Pan American Health Organization All rights reserved. Printed in the United States. ISBN:978-4-88907-147-4 Copyediting by Kimberly Gould Ashizawa. Cover design and typesetting by Patrick Ishiyama. Cover photographs by kovgabor / Shutterstock.com, Franco Volpato / Shutterstock.com, and Nguyen Anh Tuan / Shutterstock.com. Publication is available on the JCIE/USA website (www.jcie.org) and the PAHO website (www.paho.org). Requests for permission to reproduce or translate this publication should be addressed to JCIE/USA, 135 West 29th Street, Suite 303, New York, NY 10001 USA, or to the Communication Department (CMU), Pan American Health Organization, Washington, DC, USA (www.paho.org/publications/copyright-forms). 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HEALTH, RESILIENCE, AND HUMAN SECURITY: MOVING TOWARD HEALTH FOR ALL Table of Contents Acknowledgements ...........................................................................................................................5 Overview .............................................................................................................................................7 The Evolving World of Human Security ........................................................................................ 9 The Evolving World of Health ........................................................................................................ 13 Health and Human Security ........................................................................................................... 15 Added Value of Human Security in the Health Field ..................................................................19 Applying Human Security in Health .............................................................................................23 Key Findings: Take-Away Messages .............................................................................................. 26 Case Studies: Examples of Human Security Approaches in the Health Field .......................... 29 Appendix: UN Resolution on Human Security ............................................................................58 Notes ..................................................................................................................................................59 About JCIE and PAHO ................................................................................................................... 62 Health, Resilience, and Human Security • 5 Acknowledgements The authors would like to thank the many part- Tokyo, Japan, in 2013. We would like to thank ners who helped make this study possible. First all of them for their input and their dedication and foremost, we would like to thank the re- to improving understanding of what a human searchers for their heroic efforts to compile the security approach looks like and what it can ac- case studies contained in this report. Martha complish. The Nippon Foundation was gener- Cecilia Hijar Medina conducted research on ous enough to host the Tokyo workshop as well many of the case studies in the Americas. The as to sponsor one participant’s travel, and JICA cases in Africa are based on research con- also contributed by assisting with the Senegal ducted by Lola Dare and her colleagues at the workshop and sponsoring several participants’ Centre for Health Sciences Training, Research travel costs for the Lima workshop. The Centre and Development (CHESTRAD). Bruno F. Africain d’Etudes Supérieures en Gestion also Sunguya, Akiko Kitamura, Mayumi Shimizu, helped organize the Senegal workshop. Kumiko Takanashi, Syed Emdadul Haque, and At the Japan Center for International Ariful Alam all contributed to the cases from Exchange (JCIE), we would like to thank Kana Asia. Without their contributions, this report Yoshioka and Maya Wedemeyer for their as- would not have been possible. sistance in drafting case studies and organizing In addition to those who developed the case project events. Kim Gould Ashizawa edited the studies, we have great respect and apprecia- report with help from Serina Bellamy, and Pat tion for the people who are in the trenches ev- Ishiyama designed and laid out the report. ery day and who were kind enough to take the At the Pan American Health Organization time to share their stories and experience with (PAHO), we would like to thank Carlos the researchers. Santos-Burgoa—now at George Washington Keizo Takemi and Yukio Takasu provided University—for initiating the partnership be- overall guidance and feedback throughout the tween JCIE and PAHO on human security, Luis entire research and writing process, and we Augusto Galvao for his guidance and support, thank them for their dedication and encour- Kirsten Brownstein for her help in organizing agement. Mehrnaz Mostafavi also took part meetings and starting the research process, in many of the project activities and provided and Francisca Flores for her technical review feedback on several drafts of the report. We of the Spanish translation of the document. We would also like to thank the members of the would also like to thank the many other staff project steering committee in Japan for lending in PAHO’s Washington DC and Lima, Peru, their expertise, including Masaki Inaba, Sumie offices who worked hard to organize the work- Ishii, Yasushi Katsuma, Hideo Kimura, Taro shop in Lima in September 2012. Yamamoto, and Motoyuki Yuasa. Gratitude Finally, the original inspiration for this proj- also goes to Junko Sazaki, Miriam Were, ect came from Tadashi Yamamoto, founding Ritu Sadana, and colleagues at the Ministry president of JCIE and one of the first major of Foreign Affairs, the Japan International proponents in Japan of human security. He was Cooperation Agency (JICA), and the National instrumental in designing the project and took Center for Global Health and Medicine, who part in the first project conference in Senegal in provided valuable input and feedback as well. May 2011. Tadashi passed away in April 2012, Many global health experts shared their in- but his spirit lives on in all of us who had the sights through workshops organized in Dakar, opportunity to work with him over the years. Senegal, in 2011; Lima, Peru, in 2012; and Marcelo Korc Susan Hubbard PAHO JCIE/USA Tomoko Suzuki Masamine Jimba JCIE University of Tokyo Health, Resilience, and Human Security • 7 Overview The year 2015 was an important milestone in the The purpose of this document is to explain world of international development and global to experts in the health and development fields health. It marked the deadline for the Millennium what a human security approach is and show Development Goals (MDGs) and the launch of how it can be applied in an attempt to put in- the 2030 Agenda for Sustainable Development. dividuals and communities on a path toward From a global health perspective, the MDGs achieving a virtuous cycle of good health, represented an important turning point, as three wellbeing, and resilience. In particular, the of the eight goals focused explicitly on health. By document focuses on how the human security focusing on three very specific and widespread approach addresses the linkages among differ- challenges—child health, maternal health, and ent sources of health threats and ensures that communicable diseases—these goals drew atten- interventions are integrated so as to build and tion and resources to these issues, leading to vast sustain health resilience at the individual, com- improvements in the health of millions of people munity, and institutional levels as a path toward around the world. However, the MDGs have health for all through universal health coverage been criticized for failing to address in-country (UHC).2 It also focuses on how human security disparities in progress toward the targets and for can help translate health gains into improve- not taking into account the ways in which the ments in wellbeing on