In the 1990s and for most of the first decade of the twenty-first century, much of the discussion and focus on global governance and diplomacy concerning health made reference to security language, actors and discourse (Aldis 2008; Davies 2008; Elbe 2011). There was a widespread presumption that, for the most part, the marriage of health issues to security would ‘harness political leadership and resources for various international health issues’ (Elbe 2011: 220). The UN General Assembly’s interest in global health as a foreign policy concern has been attributed to these earlier efforts to promote health issues as a security and diplomatic concern (Kickbusch et al. 2007; Feldbaum et al. 2010). In a 2010 article published in International Affairs, I argued that there was a long-standing tension between a ‘statist’ approach which focused on investing in international health initiatives to protect national interests and a globalist approach which called for investment in international health initiatives and emphasized a human right to health care that stood apart from calculations of national benefit (Davies 2010: 1185–6). In this chapter I return to this argument in three parts. First, I explore the origins and evolution of health security. I then discuss how health security, from both an academic and policy perspective, has led to a different emphasis on what and who is to be secured in the area of global health. Finally, I explore these tensions in relation to the issue of global infectious disease control, specifically the revised International Health Regulations (IHR) of 2005.