For too long, the worlds of global health and international security have existed in isolation. We have traditionally treated health as a medical endeavour and ‘security’ as a political or military one. But ‘security’ is broad. A calm life free of unnecessary illness is a secure one, not just a life free of violence. Conversely, when a health system fails, the consequences ripple far beyond the clinic, disrupting families, affecting social cohesion, economic productivity, and, yes, even political stability. Health emergencies in fragile settings rarely stay contained; instead, the breakdown of healthcare acts as a multiplier of insecurity, capable of amplifying existing tensions. 

Local actors are the backbone of any crisis response 

We saw this connection vividly in 2025 during the Ebola resurgence in the Kasaï Province of the Democratic Republic of the Congo (DRC). In an environment marked by poor infrastructure, limited access, and structural fragility, a localized outbreak threatened to escalate rapidly. The decisive line of defense was not a remote headquarters, but the "human infrastructure" of the DRC Red Cross - local volunteers who were trusted by their neighbours. These frontline workers carried out door-to-door awareness, promoted early reporting of symptoms, supported safe burials, and provided the psychosocial support necessary to prevent a local health emergency from spiralling into a wider crisis. This response underscored a strategic lesson: community-based actors are the backbone of any effective response in insecure environments. 

The role of local actors is even more critical in fractured environments like Yemen. After years of violence and displacement, the country’s institutions have been dismantled. In this context, providing primary care and hygiene campaigns is more than humanitarian relief; it is a stabilizing force in a landscape of fractured public trust. When the Yemen Red Crescent operates where others cannot, they provide the most basic support and predictability that people need to survive. A functioning clinic is a lifeline and piece of peace – calm in a chaotic context.  

Preparedness cannot be pulled off a shelf only when the sirens wail 

The COVID-19 pandemic taught us this on a global scale. It wasn't just a "health event"; it fractured supply chains, closed borders, and eroded the trust that holds societies together. It proved that preparedness cannot be episodic or something pulled off a shelf only when the sirens wail. To be effective, health security must be embedded in the primary healthcare systems and trusted local networks that people rely on every day. Even well-resourced systems revealed structural weaknesses, proving that no nation is immune to the cascading effects of a health collapse. 

Today, the risks are compounding at an alarming rate. Over 120 million people are currently displaced by violence, persecution, and climate shocks. Overcrowded camps with poor sanitation are the perfect breeding ground for cholera, measles, and respiratory infections. Climate disasters follow a similar, deadly pattern: floods contaminate water, droughts undermine nutrition, and heatwaves exacerbate cardiovascular illness. These environmental shocks trigger secondary crises that slow recovery, deepen poverty, and intensify competition over scarce resources. Environmental shocks, health vulnerability, and insecurity are now part of the same intertwined cycle. 

A network of local responders to build trust 

Addressing these risks requires a revolution in how we think about aid. Sustainable stability depends on resilient, informed, and equipped communities. At the International Federation of Red Cross and Red Crescent Societies, our network of 191 National Societies is "local, everywhere". Our volunteers understand the local languages, customs, and power dynamics that outsiders miss; this trust is our most valuable currency. When we train communities in first aid or disease surveillance, we are doing more than transferring technical skills; we are building social cohesion. Trained communities respond faster, are less vulnerable to the panic and misinformation that so often lead to local instability, and recover more quickly from shocks. 

When healthcare is attacked, the "immune system" of a community is dismantled 

However, you cannot have health security if the healthcare workers who are the backbone of the system are not themselves safe. Since the start of 2024, the IFRC network has lost more than 70 staff and volunteers while on duty, including doctors, paramedics, and ambulance drivers. This is an unacceptable toll. We see this most tragically in places like Sudan and Gaza, where the deliberate targeting of aid workers and the destruction of hospitals are direct, catastrophic strikes against the health of an entire population. When doctors are killed and clinics are bombed, the "immune system" of a community is dismantled. The resulting vacuum is filled by disease, displacement, and even deeper instability. 

Investing in community health is not just a moral choice; it is a strategic one. Ignoring this integrated view of health and security carries significant risks, as underinvested primary healthcare leaves countries exposed to future pandemics and prolonged crises. Strong local health systems, trusted volunteers, and sustained engagement are among the most effective tools we have to prevent crises before they escalate. We must empower the people on the front lines to lead the way, ensuring that community resilience is the foundation upon which we build a world that is truly secure. If we fail to secure the foundation of the pyramid, all our other efforts will be in vain.

The views expressed in this commentary are those of the author and do not necessarily reflect the views of the World Health Summit (WHS). This commentary is part of the WHS Perspectives series on health security.