Health security threats widely expose the Philippines’ health system as highly vulnerable. This vulnerability stems from a combination of structural factors, including a large population concentrated in urban centers, socioeconomic and geographical disparities, and a decentralized health governance system.
Together, these factors strain health infrastructure, hinder service delivery, and weaken the country’s ability to prevent, detect, and respond effectively to public health emergencies.
The COVID-19 pandemic exposed a hard truth: health is no longer a peripheral concern but a central pillar of economic and national security. Health security extends beyond pandemics to emerging and re-emerging diseases, antimicrobial resistance, climate change, and other threats that transcend borders. Yet responses remain largely fragmented and domestic.
Health security is therefore both a national and global imperative.
The state of health security today
With globalization, outbreaks now easily transcend borders and continents. Against this backdrop, health security has emerged as one of the most pressing non-traditional security challenges of our time.
Despite the World Health Organization’s warning of a looming pandemic more than a year before COVID-19 struck, the world remained dangerously unprepared—exposing the gap between recognizing risks and acting on them.
The Philippines’ vulnerabilities are quantifiable. Total health expenditure accounts for only 6.7% of GDP in 2025, while the country continues to face healthcare workforce shortages, inadequate social health insurance coverage, and limited public hospital capacity. The 2021 Global Health Security Index ranked the Philippines at 27.7, below the global average of 28.4, reflecting significant gaps in preventing and responding to public health risks.
The country’s health workforce crisis is compounded by the continuing diaspora of Filipino health professionals. The Philippines is one of the world’s largest exporters of nurses, driven in part by substantially higher salaries abroad. In 2023, only 59.7% of registered doctors and 53.55% of nurses were actively practicing in the country. The Second Congressional Commission on Education (EDCOM II) also reported that there is a shortage of approximately 290,000 healthcare professionals and that there are only 21.2 healthcare workers for every 10,000 people in the country.
The decline in the number of Filipino health professionals raises serious implications for national health security. This “brain drain”, more than an economic problem, weakens the country’s capacity to prevent, detect, and respond to health emergencies.
Disease outbreaks further expose gaps in prevention. Dengue remains a persistent threat, with cases reaching as many as 14,000 in a span of two weeks last October 2025. Measles and rubella cases also surged dramatically in 2025, increasing by 32 percent compared with 2024. Polio, eradicated for nearly two decades, re-emerged in 2019, revealing gaps in routine immunization. Together, these crises point to a health system trapped in perpetual reactive management.
Health disinformation compounds these vulnerabilities by undermining trust in health authorities and professionals. This loss of confidence has had direct public health consequences, creating secondary epidemics where preventable diseases resurge among communities. A 2024 Reuters investigation found that the U.S. ran a covert influence campaign from 2020 to 2021 using over 300 fake social media accounts to undermine confidence in Chinese-made Sinovac COVID-19 vaccines—the first vaccine available in the Philippines. During this time, the country recorded one of the lowest vaccination rates in Southeast Asia, with only 2.1 million of its 114 million citizens fully vaccinated against a target of 70 million.
This is a stark reminder that when health information is deliberately manipulated, it puts lives at risk and undermines public trust. The weaponization of health information must be treated as a serious national security threat.
Regulatory gaps pose another threat. Unregistered or illegal drugs, supplements, and health products are widely sold through online marketplaces, where enforcement remains largely reactive. While the FDA already has an online verification portal, stronger early controls are needed to stop harmful products from entering the Philippine market. Similar gaps also manifest within the formal food supply chain. Chemical adulteration in food represents a significant yet insufficiently addressed threat to health security. The FDA has repeatedly found banned industrial dyes, including the carcinogenic Rhodamine B, in sold food products. These recurring violations point to the need for stronger preventive regulation and monitoring.
The limits of the current framework and a broader perspective
The prevailing health security framework remains shaped by a security-first logic that often privileges the interests of high-income countries and treats low- and middle-income countries primarily as sources of threats. Responses consequently emphasize containment and short-term solutions, relying heavily on states, international institutions, and biomedical technologies while giving insufficient attention to the structural causes of health inequity and vulnerability.
The Ateneo School of Government proposes to rethink health security in the Philippines through its Health Governance Program. Health security must encompass more than surveillance and emergency response. It must also address health literacy and disinformation, cybersecurity, pharmaceutical supply chains, rising healthcare costs, malnutrition and stunting, conflict, climate change, antimicrobial resistance, and unequal access to care.
This initiative supports the realization of Universal Health Care by focusing on four key areas of the health systems strengthening framework: (1) governance and leadership, (2) financing, (3) service delivery, and (4) human resources for health. Through research, education and capacity-building, and partnerships across government, the private sector, and civil society, the program seeks to strengthen the foundations of a resilient health system.
Redefining health security means moving the Philippines from reactive crisis management toward prevention, resilience, and equity. Achieving this requires sustained collaboration among policymakers, health institutions, international organizations, academia, and civil society. Health security is no longer simply a health issue, but a national and international imperative that demands coordinated, multisectoral action.
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The authors are affiliated with the Health Governance Program of the Ateneo Policy Center, the research and public policy unit of the Ateneo School of Government. Kenneth Y. Hartigan-Go serves as Senior Research Fellow, Ray Anne Germia and Nathan Angelo Santos as Research Assistants, and Angel Faye Castillo as Program Manager.
The views expressed herein are those of the authors and do not necessarily reflect the views of Ateneo de Manila University.