Governing health through security in the Philippines

A realist analysis

Datos Bibliográficos

ID11490287
AutoresDelaram Akhavein (0009-0008-6610-4677, The University of Sydney), Lea Elora A Conda (0000-0001-7227-5570, Ateneo de Manila University), Sary Valenzuela (Ateneo de Manila University), Percival Ethan Lao (Ateneo de Manila University), Meru Sheel (0000-0001-5453-070X, The University of Sydney), Seye Abimbola (0000-0003-1294-3850, The University of Sydney), Geminn Louis C Apostol (0000-0001-8589-1129, Ateneo de Manila University)
Año2026
Volumen41
Número2
Páginas262-274
Fecha de publicación2026-02-15
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaHealth Policy and Planning (JOURNAL)
Identificadores de la revistaISSN: 0268-1080 • E-ISSN: 1460-2237
EditorialOxford University Press (PUBLISHER • GB)
DOI10.1093/heapol/czaf110
PMID41383105
OpenAlexW4417297802
IdiomaEN
Citas recibidas1
Referencias citadas54

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

Corporate governance · Critical security studies · Framing (construction) · Global health · Human security · International security · National security · Politics · Global Security and Public Health · Healthcare Systems and Reforms · Viral Infections and Outbreaks Research