Telemedicine as a tool for improving human security - Environmental and Human Security in the Arctic - page 157

change on a national and international scale. Other relevant actors, such as
non-governmental organizations (NGOs), are not recognized for their capac-
ity to mobilize national and international forces (never mind what they might
be doing at sub-state/society and individual levels). Human security is thus
framed within a state-centric logic, almost aligning itself with a traditional-
ist's view on security or, at best, the widened approach of Buzan et al . (1998),
despite the rhetorical acceptance of other actors playing a significant role.
Although, as the CHS report (CHS Outline 2003) states, 'Human security
complements state security, furthers human development and enhances
human rights', their remains a need to recognize how non-state actors (who
are acknowledged as having a role) indeed contribute to human security.
Linking human security and health security:
telemedicine as a tool for facilitating cooperation
In exploring whether telemedicine could or should be placed within a human
security framework, I will first explore the assumption that 'health security
today is closely linked to the state'. When I use the term 'the state' I use it
synonymously with 'government'. I view state action to be a result of govern-
ment will. To do so, I will begin where traditional security leaves off - with
the defence of the state.
One could argue that if the state succeeds in making its inhabitants secure
from health threats, then this may increase its legitimacy. If it fails, this may
have a direct impact on the ruler's legitimacy. This is in line with what the
UN report states as a historical fact: 'Health security and military security are
directly related. Indeed from a historical perspective, the legitimacy of rulers
has depended on their capacity to protect the health of the public, through
military and other means' (CHS 2003:97).
In the military sector, states are 'required' to be able to protect their terri-
tory from external aggression. This has led to the existence of armies requiring
personnel, and without access to sufficient manpower, the state cannot protect
itself. Likewise in the health sector, if the state wants to protect its inhabit-
ants from health security threats, there is also a need for manpower. Without
doctors and nurses there would not be any healthcare. Thus, both in the mili-
tary and the health sectors there is a need to secure national self-sufficiency
using manpower. In the military sector, states can increase security through
alliances. In healthcare this may be possible too. This raises the question of
whether states should organize their hospital services across borders. This is
possible and may even be cost effective. The main constraints may be legal
and financial.
If the government wants to achieve legitimacy through health politics and
health security (ensuring the provision of healthcare and mitigating against
health threats), this has to be done through political strategies and measures.
I will divide health politics into three parts: