Global health governance has increasingly become articulated and acted upon in ways that emphasise ‘health security’. This article applies a collective securitisation approach to understand how a particular governance regime has evolved at the European level, one concerned with large-scale ‘threats’ to public health and societies at large. The analysis shows that alongside elite-level securitisation moves, transnational professional networks and bureaucratic actors have also taken part both as securitising agents and audience, with outcomes reflected not only in policy change but also new EU-specific surveillance technologies, institutional structures, and information-sharing platforms. While these developments are partially interlinked with global trends, we show that the EU has gradually institutionalised its own approach to health security. This new status quo is enshrined in a legal framework and set of practices with an all-hazards approach targeting preparedness, early detection and containment of ‘serious cross-border threats to health’ of any origin – beyond infectious disease.

This article critically examines a poorly understood aspect of the European security landscape: early warning systems (EWSs). EWSs are socio-technical systems designed to detect, analyse, and disseminate knowledge on potential security issues in a wide variety of sectors. We first present an empirical overview of more than 80 EWS in the European Union. We then draw on debates in Critical Security Studies to help us make sense of the role of such systems, tapping into conceptual debates on the construction of security issues as either "threat" or "risk" related. Finally, we study one EWS - the Early Warning and Response System for infectious diseases - to understand how it works and how it reconciles risk versus threat-based security logics. Contrary to assumptions of a clear distinction between risk-and threat-based logics of security, we show that EWSs may serve as a "transmission belt" for the movement of issues from risk into threats.

The securitization of health concerns within the European Union has hitherto received scant attention compared to other sectors. Drawing on the conceptual toolbox of actor-network theory, this article examines how a ‘health security assemblage’ rooted in EU governance has emerged, expanded, and stabilized. At the heart of this assemblage lies a particular knowledge regime, known as epidemic intelligence (EI): a vigilance-oriented approach of early detection and containment drawing on web-scanning tools and other informal sources. Despite its differences compared to entrenched traditions in public health, EI has, in only a decade’s time, gained central importance at the EU level. EI is simultaneously constituted by, and performative of, a particular understanding of health security problems. By ‘following the actor’, this article seeks to account for how EI has made the hunt for potential health threats so central that detection and containment, rather than prevention, have become the preferred policy options. This article draws out some of the implications of this shift.