2025/12/11 by Delaram Akhavein, Lea Elora A Conda, Sary Valenzuela +4 · 1 voice
Economics, Econometrics and Finance · Medicine · Social Sciences · #Global Security and Public Health #Healthcare Systems and Reforms #Viral Infections and Outbreaks Research
paper · pdf · doi:10.1093/heapol/czaf110
openalex publication_date 2025/12/11 · openalex created_date 2025/12/12 · openalex updated_date 2026/07/29
As global framings of health continue to expand their reach, the Philippines, like many other countries, must navigate the overlapping pressures of donors, international institutions, and domestic political agendas in setting priorities. One such framing is the framing of health as a security issue. This study examines how health security framing-how it is interpreted and operationalized-influences priority-setting in the Philippines. Drawing on 25 interviews with government (at national and sub-national levels) and non-government actors and using a realist approach, this study sought to identify the outcomes of health security framing (as triggered or reinforced by mechanisms such as uncertainty, self-protection, self-preservation, self-reliance, and norm-setting) and the context in which the outcomes manifest. Findings show that health security framing reshapes priorities by reinforcing centralized, top-down approaches at both international and national levels. These framings influence not only what is prioritized but also which actors make decisions and how those decisions are justified. At the implementation level, it manifests in health workers facing misaligned operational frameworks, vertical programming, and burdensome reporting requirements tied to donor funding. Security norms become institutionalized with the involvement of military and security actors in health. The study demonstrates that health security is not a static concept, but a dynamic phenomenon co-constructed through global discourses, donor agendas, and domestic governance practices, all of which are shaped by power relations and history. While health security mobilizes resources and political attention, it also introduces trade-offs that risk exacerbating inequities and diverting attention from the structural determinants of health.