(Re)constructing global health security and universal health coverage: norm contestation and interaction

To effectively tackle public health challenges, policymakers increasingly advocate for aligning global health security (GHS) and universal health coverage (UHC), two influential norms driving international health cooperation. However, despite operating within overlapping spheres of governance, the normative histories linking GHS and UHC remain relatively unexplored in the literature. This article examines how GHS and UHC have been (re)constructed – from distinct policy sectors to synergistic norm regimes – through repeated contestation and interaction. Utilizing the ‘norm life cycle’ framework to trace development across three stages (emergence, tipping point/cascade, internalization), this study discursively analyzes key texts from major crises and international agreements spanning several decades to unpack how both norms, and their underlying discourse and core functions, have influenced each other as they evolved. The findings illustrate that GHS and UHC norms may be better understood as dynamic ‘processes’ rather than static concepts. The article concludes that GHS and UHC norms have shaped each more significantly than previous scholarship suggests, characterizing them as continuously evolving, closely interlinked, and increasingly integrated. This work contributes not only to broader discourse on international norms theory, but also offers pragmatic implications for navigating normative development where multiple norms compete for influence amidst ever-shifting priorities.