The securitization of HIV/AIDS

Some Theoretical Implications

The severe casualties and the worldwide spread of HIV/AIDS pandemic have posed a tremendous challenge for the global security. Since AIDS was first diagnosed in the early 1980s, this epidemic has killed more than 25 million world population and approximately 33 million people living with HIV in 2007 (UNAIDS: 2008 Report on the Global AIDS Pandemic). The growing regional prevalence of HIV/AIDS in Southern Africa, the Russian Federation, China, India, and Southeast Asia since 2000 (Keeling, 2003) has further underlined the gravity and the urgency of the problem.

In response to this predicament, the governments and various international institutions have attempted to address the pandemic not only as a public health and development issue, but also an international security issue (Elbe, 2005: 403; International Crisis Group Report, 2001). It was not until the adoption of the United Nations Security Council (UNSC) Resolution 1308 in 2000, which delivers the HIV/AIDS pandemic in order to maintain international stability and security, that the step to globally securitize the issue of health - HIV/AIDS pandemic in particular - met its historical impetus. What follows this action was the ongoing series of a massive-scale mobilization of resources to fight the global pandemic (Busby, 2009).

This move was largely identified by most scholars (Rushton, 2007; Elbe, 2005; Girshick, 2004; Pereira, 2008) as a securitization of HIV/AIDS pandemic. It exposed the subject to be part of a greater theoretical discourse on security, notably towards the Copenhagen School's conception of securitization. Elbe (2005: 1) mentions that "symbolically this historic shift in the international perception of HIV/AIDS was captured on 10 January 2000 when, in an unprecedented move, the UN Security Council temporarily abandoned its traditional concern with regulating the deployment of armed force in international politics, and considered instead the growing impact of AIDS on peace and security in Africa". However, consecutively, the securitization of HIV/AIDS has also been a subject of theoretical scrutiny and debate to date.

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Taking into account the Copenhagen School's approach, this paper discusses the securitization of the HIV/AIDS issue by pinpointing the theoretical implications of categorizing the pandemic as part of security agenda. It mainly argues that the framing of the HIV/AIDS as a security concern is a contested effort leaving the securitization concept in a weak position which allows other theoretical approaches to gain their momentums within the field. The argument will be developed by elaborating three key theoretical implications from putting HIV/AIDS a security issue: it contributes to the never-ending discourse of the narrow-broad terms of security; it stimulates criticisms towards the unempirical securitization notion in the context of HIV/AIDS; and finally it looks at other approaches which provide significant insights to the discourse. The paper concludes with a discussion for the findings and their relations to the future state of the Copenhagen School's securitization conception.

Securitization

Security is a very much debatable concept by definition. Buzan (1998) chooses to revisit to the traditional military-political understanding of security, which maintains that security is about survival. Since the late 1990s, the attempts to retreat from the traditional notion of security have resulted in 'wide' and 'deepening' version of security. From this point forward, the contest over the narrow and wide conception of security between scholars has been the cause of the absence of the definition of security. However, as Huysmans put it, this absence may not be a problem as long as experts provide "the legitimate forms of security research" to allow implicit consensus for their alternative views on the nature of threats (Huysmans 2006: 19).

The Copenhagen School approach, materialised in the Buzan's 1983 book People, States and Fear, stands out as "the most comprehensive theoretical analysis of the concept of security in international relations literature to date" (Booth 1991 cited by Smith, in Croft and Terrif 2000: 83). The School's main concept, 'securitization', as Chalk argues (in Caballero-Anthony et.al2006: 114), provides "a more relevant framework for understanding developments in the contemporary era". The literature (Buzan, Wæver and De Wilde 1998) asserts that that security threats are socially constructed and securitization animates the process by which an issue emerges as an 'existential threat' to a designated referent object and digested as a matter of policy consideration and action.

Some Theoretical Implications

The above framework for understanding provides an opportunity for the health or disease issue to mark its place in the theoretical debate of security. The HIV/AIDS issue noticeably falls into the broad framework of discussion of security. Nevertheless, instalment of HIV/AIDS as a security issue is not without further theoretical implications which attach to it, as follows.

'HIV/AIDS as a Security Issue' Discourse

Looking beyond the securitization of HIV/AIDS, the question whether HIV/AIDS should be included as a security issue has already been unsettled for many security theorists. Furthermore, the idea is accounted into the narrow-wide security conception debate as discussed above. Most of the proponents of the HIV/AIDS as part of security agenda reflected the international architecture in the late 1990s where many non-traditional security threats emerged and thus should be addressed with to the security tools of states' national capacities.

Sharing a broad approach of security, Chalk (in Caballero-Anthony, et.al 2006: 116) argues that the transnational spread of disease presents a fundamental threat to both the stability of the international system and its component states as well as the quality of life of individuals, making the issue as a security challenge. Meanwhile, regional scholars in Asia (Ramiah and Panggabean in Caballero-Anthony et.al, 2006) assert that the notion of securitization has considerable appeal as a means of initiating efficient response towards curbing the HIV/AIDS. Thereby they probe why the Copenhagen School does not consider the epidemic an area of non-traditional security by not incorporating health as a sector.

In their parts, the arguments held by the opponents of incorporating HIV/AIDS in the security game mostly depart from the anxiety of whether the issue will properly serve the purpose of the security discipline. Discontentment with extending security studies to add in "poverty, AIDS, environmental hazards, drug abuse, and the like" (Walt 1991 cited by Youde 2004: 8) has been assiduously expressed by Walt. He claims that it may destroy the intellectual coherence and integrity of the discipline while averting the focus of the researchers and policymakers to forge workable solutions to such problems. Whereas, Paris (2001: 93) states that for international politics researchers, the task of transforming the idea of human security into a useful and focused analytical tool for scholarly research is problematic "given the hodgepodge of principles and objectives associated with the concept". Most of these authors concern that loosely defined elements of security may underplay the practicality and instrumentality of the concept during the policy-making.

Other authors utter their scepticism of whether the studies on HIV/AIDS and security linkage are capable to meet the standards of scientific method, rather than grounding the analysis merely from a product of social construction of security. Barnett and Prins have questioned the reliability of the evidence presented in some of the studies about HIV/AIDS and security, in which they deem as lacking data collection and simply anchored in "soft opinions that have hardened into fact" (Barnett and Prins 2006 cited by Vieira 2007: 146). In the absence of empirical facts, the studies instead examine the social construction of HIV/AIDS as a security issue which is a result of the interactions between several actors engaged in the labelling process. Bill McSweeney (1999, cited by Girshick 2004) argues against including HIV/AIDS or the environment in security studies. He senses that "the broadening of security threats and responses is anchored in the judgment that they arise from, and relate to, the quality of the relationship between communities, collectivities, states." Accordingly, Vieira (2007: 146) sees that the social construction of reality, i.e. the interaction between the various discursive articulations (or speech-acts) on the HIV/AIDS-security nexus, is what really makes HIV/AIDS a security issue rather than any identifiable objective fact.

The social construction of HIV/AIDS as a security issue is a not only result of the above narrow-broad security discourse within the epistemic community, but also of the interplay between the all related stakeholders competing to integrate their own values through labelling HIV/AIDS as security issue. For the past 25 years, government leaders, agencies and political scientists in the United States have shared their views on the danger of the pandemic both domestically and internationally. To name a few is U.S. Vice President Gore's effort to internationally securitize AIDS through the UNSC session in 2000, the National Intelligence Council's report in 2000 which linked the spread of infectious disease to the U.S.'s national security, and U.S. scientists like Cathy Cohen, Deborah Gould and Patricia Siplon whose works mainly examined the impact of HIV/AIDS in the level of American society (Densham 2006: 642).

The Empirical Shortcoming of the Securitization of HIV/AIDS

Despite the scholarly debate on whether HIV/AIDS should be accounted as a security issue or not, in this sub-section, this paper assumes that the HIV/AIDS is a securitized issue based on the recent development traced back from the early 21st century, in particular the UNSC Resolution 1308 in 2000. Ever since, the leading premise of securitization presented by the Copenhagen School has been thoroughly scrutinized, as well as criticized, by a range of scholars, particularly in the framework of HIV/AIDS.

The main criticism towards the concept has predominantly been the lack of empirical evidence which contributes to the growing pessimism of whether HIV/AIDS is successfully securitized as an international security issue. Caballero-Anthony and Emmers (2006: 5) deem that "scholars of the Copenhagen School have focused on developing a broad theoretical approach to security studies without paying much attention to empiricism". For example, they offer no indicators of securitization and desecuritization as tools to measure a successful securitization. In the same sense, Vieira (2007: 141) addresses that "Buzan and his followers neglect the empirical verification of actual processes whereby issues, after being successfully securitized in the realm of discursive practices (speech-act), become widely embedded in transnational institutions and states' bureaucracies". This empirical problem creates an analytical gap in the appraisal of the global securitization of the HIV/AIDS epidemic.

This critique tends to be self-fulfilling when looking at what the UNSC have hitherto done to properly securitize the issue in generating international policy-making in this field. This has been the case for Rushton's studies (2007, 2009). Moving on from Waever's concern over the failed and partial acts of securitization (Waever 2003 cited by Rushton 2009), he questions the empirics of the HIV case rather than the theory: "not 'is the securitization of HIV/AIDS possible?', but 'has HIV/AIDS really been transformed into an international security issue?'". Within the UNSC, the exceptional responses as a follow-up from a successful securitization have not really been in evidence so far. Since 2001, there has yet to be any further specific resolutions or thematic discussion or "emergency measures" on HIV/AIDS directly under the UNSC fora, but rather, it is addressed within the scope of UN peacekeeping operations agenda or a partnership framework with UNAIDS.

Many blame the epistemic community for the slow progress, if not a failure, of securitizing HIV/AIDS both at national and international basis, by failing to trigger a more productive and applicable discourse. The deficit of empirical basis, Rushton (2009) argues, is closely related to the ground that international relations literature has been so narrowly focused upon the security implications of the disease, such as military, state failure, and regional stability. This isolated security discourse has apparently influenced the UNSC, as the prime mover of securitization of HIV/AIDS, to concentrate only on the language of security within the pandemic, e.g. peacekeeping and peace building. In Asia Pacific, Chalk (in Caballero-Anthony et.al2006: 131) asserts that the securitization of disease has yet to be successful (and holistic) as a result of the failure of the epistemic community to focus on the security-relevant aspect of the microbial challenges in stimulating more innovative thinking and instrumental policy tools.

Other critical issue which relates to the successful securitization in practical reality is the degree of the acceptance of the audience towards the securitized HIV/AIDS. However, in securitization, "accept does not necessarily mean in civilized, dominance-free discussion; it only means that an order always rests on coercion as well as on consent" (Buzan, Waever, and De Wilde 1998: 25). The passing of the U.S.-proposed Resolution 1308 has yet to be the indicator of the successful securitization of HIV/AIDS as an international security issue based on two reasons.

First, even though the resolution was eventually adopted, there had been an initial rejection from the Council's permanent members Russia, China, and France towards the inclusion of the issue. It portrayed these countries' coerced acceptance towards whether HIV/AIDS should fall within the Council's sphere of activity. In January 2000, US-led resolution draft 1308 was initially opposed by Russia and China, as well as France (Rushton 2009: 10). Such opposition seemingly also came from a number of countries who are the biggest contributors of troops to UN operations. The other reason is the focus on the impact of HIV/AIDS and the health of the peacekeeping personnel which may be applicable only to those countries with high prevalence areas, and with a peacekeeping operation's existence, such as Sub-Saharan Africa and South Africa. This very much segmented resolution could only be partially, or even lesser, relevant to other HIV affected areas, such as Russia, China, and India, which may not take HIV/AIDS into the security account, despite the pandemic alarming prevalence. In Russia, although concerns among the Russian population about the spread and impact of HIV/AIDS is significant, the government continues to treat the problem as a low priority, (Mendelson, Sawyer and Wallander 2000:1). The not-quite elevated level of HIV/AIDS issue as a security predicament in India and China most probably because only a small proportion of their vast populations are infected by HIV epidemic, making them less vulnerable than sub-Saharan Africa to shortages in workers and military recruits (Feldbaum, Lee, and Patel 2006).

Reflecting from these two grounds, the level of acceptance from the states to paraphrase the pandemic in the security term continues to be uncertain both in the past and present. This, back again, creates a stumbling block for securitization concept to justify its empiricism in the context of the audience's acceptation which determines the successful securitization for HIV/AIDS issue.

Alternative Approaches towards the Securitization of HIV/AIDS

One may assume from the discussion above that the securitization of HIV/AIDS, if not miscarried, has yet to bring into greater attention the security portion of the discourse that is generally accepted and materialised by the international society. This has led other approaches attempt to address the HIV/AIDS as a security issue from their own distinct spectacles.

First, despite the vagueness of its definition and scope, human security promises a human approach to deliver the health security issues, in particular 'injury' and 'disease'. Health security is one of the seven components of threats to human security, which was coined in the 1994 UNDP Human Development Report (HDR). States' acceptance towards the concept is evidently embodied in the formation on the Human Security Network (HSN) in 1999 consisting of 13 'like-minded' countries[1] that until today had intensively held a number of ministerial meetings raising specific issues such as human rights, conflict prevention and HIV/AIDS and health security at high level. The consent for HIV/AIDS as a security issue emanates predominantly from the adherents of the 'human security'. Thomas (in Tadjbakhsh and Chenoy 2007: 46), perceives human security as an integrative concept allowing for bridging and interconnection of sector specific threats to people in the international system, rather than states.

The alternative conceptions of security such as human security, indeed, have a more widespread policy impact in the framework of global health governance (Rushton 2009), for instance the target to combat HIV/AIDS and other diseases within Millennium Development Goals. Thus, Rushton (2009) proposes the need to securitize the issue of health in the context of alternative discourses of global health within the international relations discourse and literature, apart from securitizing only the security impact of the pandemic.

Second, the recent attempts to internationally securitize HIV/AIDS have an important biopolitical dimension that ought to give rise to some concern. Inspecting the pandemic from a 'wider' term of security, author such as Elbe holds that such importance 'not just because it represents a novel way of conceptualizing the AIDS pandemic, but also because it turns international security into a site for the global dissemination of a biopolitical economy of power around the government of 'life'' (Elbe 2005: 404), or at the level of population - including levels of 'disease'.

Within the biopolitical framework, the securitization of HIV/AIDS is significant because it constitutes a revealing example of the gradual geographical extension and globalization of the West's biopolitical strategies to the non-Western world (Elbe 2004), giving rise to novel normative dangers such as the stigmatization for people living with AIDS. The biopolitical introduction within the HIV/AIDS-security nexus brought a novel and alternative spectrum that potentially enriches the securitization literature. Yet such approach may not be holistic to answer the pandemic as a security problem and limited only to the individual or human level.

Finally, as discussed earlier, constructivist scholars has criticised the Copenhagen School's lack of conceptual tools to understand the impact of externally induced securitization processes on pre-existing regional and domestic systems. These scholars (Balzacq 2005; Stritzel 2005 cited by Vieira 2007: 141) are not satisfied by Buzan, Waever and De Wilde's elaboration on the social power and facilitating conditions (1998: 31-33) for successful securitization, which do not discuss "the interplay between the autonomous linguistic practices of securitization and the structured social and power contexts in which these practices take place". In his claim, Vieira (2007) offers better conceptual tools, namely the HIV/AIDS Securitization Norms (HASN), which is aimed at analytically embracing the myriad of implicit and explicit principles, rules and ideas underlying international action towards HIV/AIDS. The elaboration of the securitization norms emphasizes the process of how the securitization takes place and the impact of such securitizing move towards the domestic and regional system. Nonetheless, whether this perspective will provide better conceptual drive for the policy making in the security field is another question to address.

Conclusion

The inclusion of HIV/AIDS as one of many in the 'list of security threats' offers a unique way to better understand the plentiful security discourse within the epistemic community. The application of the Copenhagen School's leading premise securitization to the HIV/AIDS issue have hitherto resulted in several theoretical implications.

First, HIV/AIDS, along with several other contemporary issues, contributes to the ongoing debate of whether the issue is appropriate to be accounted as a security concern. The heart of the debate lies within the concern from a number of authors over the potentiality of such issues to distract security scholars from conducting empirical research in this area.

Along these lines, the second implication revolves around the empirical limitation for the successful securitization of HIV/AIDS, in particular within the UNSC as a primary international security agent. Some scholars have questioned the factual effects and the instrumentality of the discourse for the policy making, while others have expressed uneasiness towards the inappropriate direction of the security discourse within the epistemic community.

Lastly, HIV/AIDS securitization has stimulated many alternative approaches, especially to modify the limitations of the securitization concept, thereby offering various angles to the problem. At least three approaches - human security, biopolitic perspective, and constructivism - are identified during the research of this paper. Still, one may argue that these approaches underline a less holistic solution to the problem by highlighting only certain dimension of the securitization.

That the Copenhagen School's securitization now appears to be a weak formula for setting HIV/AIDS as a security issue can be accounted to these three theoretical implications. Apart from that, the School still provide an influential theoretical mechanism for many scholars observing the new international security threats. It may be seen that from many security literatures, including in HIV/AIDS, depart their analysis from the School's concept of securitization, as in the case of the alternative approaches discussed above. The problem of a successful securitization is also raised in the discourse and up to now no powerful conceptual tools to measure it could replace the dominance of the Copenhagen School's conception yet. For the case of HIV/AIDS, the securitization itself is still an ongoing process and more and more research may address its future development.

Bibliography

• Busby, Joshua W. (2009) 'Global AIDS Policy in the Age of Obama', Journal of HIV/AIDS and Social Services [online], 8/2: 120-126. Available at: http://dx.doi.org/10.1080/15381500903025639 [Accessed 28 October 2009].
• Buzan, Barry (1991) People, States and Fear, 2nd Ed. New York: Harvester Wheatsheaf.
• Buzan, Barry, Waever, Ole and Wilde, Jaap de (1998) Security: A New Framework for Analysis. Boulder, London: Lynne Rienner.
• Caballero-Anthony, Mely, Emmers, Rafl, Acharya, Amitav (eds.) Non-Traditional Security in Asia: Dilemmas in Securitisation. Hampshire: Ashgate.
• Densham, Andrea (2006) 'Introduction: Politics as a Cause and Consequence of the AIDS Pandemic', American Political Science Association [online], 4/4: 641-646. Available at: http://www.apsanet.org/imgtest/POPDec06Densham.pdf [Accessed 28 October 2009].
• Elbe, Stefan (2005) 'AIDS, Security, Biopolitics', International Relations [online], 19/4: 403-419. Available at: http://www.stefanelbe.com/resources/04-Elbe-1.pdf [Accessed 31 October 2009].
• Elbe, Stefan (2006) 'HIV/AIDS and Security', in Alan Collins (ed.)Contemporary Security Studies [online]. Oxford: Oxford University Press. Available at: http://www.stefanelbe.com/7.html [Accessed 31 October 2009].
• Feldbaum, H., Lee, K., and Patel, P. (2006) 'The National Security Implications of HIV/AIDS', PLoS Med [online], 3/6/e171: 0774-0778. Available at: http://10.1371/journal.pmed.0030171 [Accessed 28 October 2009].
• Garrett, Laurie (2005) A Council on Foreign Relations Report: HIV and National Security: Where are the Links? [online]. New York: Council on Foreign Relations. Available at: www.cfr.org/content/publications/.../HIV_National_Security.pdf [Accessed on 28 October 2009].
• Girshick, Rachel (2004) 'Adopting Institutional Changes: HIV/AIDS and the Changing Institution of Security'; paper presented at the 44th International Studies Association Annual Conference, Montreal (17-20 March) [online]. Available at: http ://cyber.law.harvard.edu/blogs/gems/politicshiv/girshick.pdf [Accessed 28 October 2009].
• Huysmans, Jef (2006) The Politics of Insecurity: Fear, Migration and Asylum in the EU. London: Routledge.
• ICG (2001) International Crisis Group Report: HIV/AIDS as a Security Issue (19 June) [online]. Washington/Brussel: International Crisis Group. Available at: http://www.crisisgroup.org/library/documents/report_archive/A400321_19062001.pdf [Accessed 28 October 2009].
• Keeling, Richard P. (2003) 'Briefing Summary: The Global Challenge of HIV/AIDS, January 2003 [online]'. Available at: http://www.ebookpars.com/ebooks/HIVBriefing.pdf [Accessed 1 November 2009]
• Krause, Keith (2007) Towards a Practical Human Security Agenda. Geneva: Geneva Centre for the Democratic Control of Armed Forces (DCAF), (Policy Paper No.26).
• Mendelson, Sarah E., Sawyer, Julie, and Wallander, Celeste A. (2002) The Security Implication of HIV/AIDS in Russia [online]. Ponars Policy Memo No.245. Available at: http://csis.org/files/media/csis/pubs/pm_0245.pdf [Accessed 9 November 2009].
• Paris, Rolland (2001) 'Human Security: Paradigm Shift of Hot Air?' International Security [online], 26/2: 87-102. Available at: http://muse.jhu.edu/journals/international_security/v026/26.2paris.pdf [Accessed 9 November 2009].
• Pereira, Ricardo (2008) 'Processes of Securitization of Infectious Diseases and Western Hegemonic Power: A Historical-Political Analysis', Global Health Governance [online], VII/1, Spring. Available at: http://ghgj.org/Pereira_%20processes%20of%20securitization.pdf [Accessed 31 October 2009].
• Prescott, Elizabeth M. (2007) 'The Politics of Disease: Governance and Emerging Infections', Global Health Governance [online],I(1). Available at: http://diplomacy.shu.edu/academics/global_health/journal/PDF/Prescott-article.pdf [Accessed 28 October 2009].
• Price-Smith, Andrew T. (2007) 'Vicious Circle-HIV/AIDS, State Capacity, and National Security: Lessons from Zimbabwe, 1990-2005', Global Health Governance [online], I/1. Available at: http://ghgj.org/Price-smith%20article.pdf [Accessed 28 October 2009].
• Rushton, Simon (2007) 'The development of the HIV/AIDS and security discourse: the role of CSOs'; paper presented at the Peter Wall Institute's London Workshop on Civil Society Organisations and Global Health Governance, London (6-7 October) [online]. Available at: http://www.wsir.pwias.ubc.ca/2007/docs/Rushton%20S,%20The%20Development%20of%20the%20HIV-AIDS%20and%20Security%20Discourse.pdf [Accessed 31 October 2009].
• Rushton, Simon B. (2009) 'HIV/AIDS and Security in the UN System: Dominant Discourse or Passing Fad?'; paper presented at the annual meeting of the International Studies Association's 50th Annual Convention, New York, (15-18 February) [online]. Available at:http://www.allacademic.com/meta/p313007_index.html [Accessed 28 October 2009].
• Smith, Steve (2000) 'The Increasing Insecurity of Security Studies: Conceptualizing Security in the Last Twenty Years', in Stuart Croft and Terry Terrif (eds.). Critical Reflection on Security and Change. London: FRANK CASS. PP. 72-101.
• Tadjbakhsh, Shahrbanou and Chenoy, Anuradha M. (2007) Human Security: Concepts and Implications. London: Routledge.
• UNAIDS (2003) UNAIDS Fact Sheet: HIV/AIDS and Security (August 2003) [online]. Copenhagen: UNAIDS. Available at: http://data.unaids.org/Topics/Security/fs_security_en.pdf [Accessed on 28 October 2009]
• UNAIDS (2008) 2008 Report on the Global AIDS Epidemic [online]. Geneva: UNAIDS. Available at: http://www.unaids.org/en/KnowledgeCentre/HIVData/GlobalReport/2008/2008_Global_report.asp [Accessed 1 November 2009].
• United Nations Security Council. Resolution 1308: on the Responsibility of the Security Council in the Maintenance of International Peace and Security: HIV/AIDS and International Peace-keeping Operations. 17 July 2000.
• Vieira, M. A.(2007)'The Securitization of the HIV/AIDS Epidemic as a Norm: A Contribution to the Constructivist Scholarship on the Emergence and Diffusion of International Norms',Brazilian Political Science Review [online], 1/2: 137-181. Available at: http://socialsciences.scielo.org/pdf/s_bpsr/v2nse/a05v2nse.pdf [Accessed 28 October 2009].
• Wæver, Ole (2007) 'Securitization and Desecuritization', in Barry Buzan and Lene Hansen (eds.) International Security Volume III: Widening Security. London: SAGE Publications. PP. 66-98.
• Williams, Owain and Rushton, Simon (2009) 'Global Health Governance as a Contested Space: Competing Discourses, Interests and Actors'; paper presented at the annual meeting of the International Studies Association's 50th Annual Convention, New York, (5-18 February) [online]. Available at: http://www.allacademic.com/meta/p311363_index.html [Accessed 28 October 2009].
• World Health Organization. Constitution. 22 July 1946.
• Youde, Jeremy (2004) 'Enter the Fourth Horseman: Health Security and International Relations Theory'; paper presented at the 44th International Studies Association Annual Conference, Montreal (17-20 March) [online]. Available at: http://www.allacademic.com/meta/p74099_index.html [Accessed 28 October 2009].

1. Austria, Canada, Chile, Costa Rica, Greece, Ireland, Jordan, Mali, the Netherlands, Norway, Switzerland, Slovenia, and Thailand, as well as South Africa as an observer.