HIV/AIDS and national security: A history of benefits and hazards

Background: While global health leaders have embraced links between HIV/AIDS and national security to gain support for HIV/AIDS efforts, academic studies have warned of hazards associated with this nexus. Methods: Semi-structured interviews with 27 key policymakers and extensive document review were used to create a history of events that linked HIV/AIDS and national security and evaluate the impact of this nexus. Results: The potentially negative repercussions of the HIV/AIDS – national security nexus have not materialized in countries that have viewed the disease as a national security issue. In Thailand and Uganda, framing HIV/AIDS as a threat to national security was critical to creating political support to address the disease. The security implications of the pandemic elevated HIV/AIDS to the United Nations Security Council and contributed to massive scaling up of US funding to fight the pandemic. The overall policy response to the HIV/AIDS – national security nexus has been to enhance broad-based public health action against the pandemic, with some increased focus on militaries and peacekeepers. Conclusions: To date the HIV/AIDS – national security nexus has created political and financial benefits for the fight against the pandemic. However, many of the potentially negative repercussions of this nexus have not materialized because HIV/AIDS has not yet directly threatened the security interests of powerful states. If evidence demonstrated direct links between the pandemic and national security interests, the classification and politization of public health data, and shifting of funding towards militaries and strategically important states would become more likely.