Why health diplomacy should be understood as a deterrence instrument: evidence from Sweden's health system.

Sweden’s health system is increasingly exposed to strategic vulnerabilities arising from globalised pharmaceutical supply chains, medicine shortages, antimicrobial resistance, and hybrid geopolitical threats. In a period of heightened international tension, safeguarding health security has become an urgent policy concern. While the securitisation of health diplomacy raises ethical and political challenges, this article argues that health diplomacy should be understood not only as a cooperative instrument but also as a form of deterrence that operates through governance integration, transparency, and strategic interdependence, strengthening national resilience. In this context, deterrence refers to reducing the incentives and opportunities for adversarial actors to exploit health-system vulnerabilities, such as pharmaceutical shortages or supply-chain disruptions, to generate societal disruption, undermine public trust, or exert political pressure. Focusing on Sweden, the article shows how deeper Nordic and European Union coordination enhances anticipatory capacity, stabilises access to critical medicines, particularly antibiotics, and reinforces crisis communication and public trust. Positioning health diplomacy within broader security architectures can support continuity of care during systemic stress while remaining anchored in civilian governance and global health norms.