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We've just come around to acknowledging — in part due to the efforts of former Secretary of State Hillary Clinton — that climate change is an emerging national security threat that we need to urgently address. Now, members of the National Academy of Medicine are drawing attention to another threat, but it starts out on the microscopic scale: Pandemics. Drawing upon experts from around the world, researchers warn in "The Neglected Dimension of Global Security — A Framework for Countering Infectious-Disease Crises" that epidemics could claim millions of lives and generate billions in economic damage, exactly the conditions that leave gaping national security holes.
Threats to American welfare might be traveling through our airports, but they aren't human. They're the planes generating three percent of our total CO2 emissions annually, and the microorganisms that lie dormant in travelers from around the world, waiting for the perfect circumstances, just like Ebola did in 2014 with a devastating epidemic that ravaged a completely unprepared West Africa. The Ebola epidemic wasn't just devastating for West Africans, though. It also highlighted the fact that the global community as a whole is ill-prepared to deal with a fast-moving epidemic, and that spells trouble.
In the wake of the Ebola outbreak, the World Health Organization urged reforms to public health policy, pushing the global health community to adopt a more proactive strategy to anticipate epidemics rather than react to them. The agency also identified eight pathogens of particular concern, warning that they could explode in human populations with serious ramifications since many lack effective treatments and are highly aggressive. Infectious disease isn't just a matter of public health concerns, though, because a sick population is a politically unstable one vulnerable to outside attack, for a host of reasons, and agencies like the State Department and Pentagon need to be as invested in infectious disease research as the National Institutes of Health and Centers for Disease Control and Prevention — only this time, that biomedical research isn't about studying prospective bioweapons.
17 experts from 12 countries laid out the framework of their concerns in no uncertain terms, pointing to both historic evidence and contemporary issues. One classic example is the Black Death, which had a huge influence on European societies and brought about utter collapse for some European communities. Other pandemics have had similar effects — for example, the so-called Spanish Flu of the 1910s effectively brought parts of the United States as a standstill because so many people were sick, dying, or dead that it was impossible to provide even basic services like trash collection. Some communities ran out of coffins. It was followed by a lesser-known and truly bizarre epidemic: Encephalitis lethargica, in which patients developed fatigue so extreme that some failed to wake altogether, sometimes for years. We still don't understand what caused the condition, let alone how to treat it.
A major disease outbreak could quickly spread across the globe, and the researchers estimate that it could be a bigger threat than wars and economic turmoil. Of particular concern is the fact that epidemics in failing states could be disastrous. Microbes know no borders, and a nation with no public health infrastructure, resources to dedicate to research and development, or cooperative international ties to draw upon for assistance could become an explosive hot zone. Should an aggressive influenza virus develop in Syria, for example — not out of the question — refugees fleeing the nation would likely spread it throughout the Middle East and into Europe, destabilizing countries as they go and creating public panic. This example is particularly appropriate given the already existing xenophobia surrounding immigration policy in Europe, as an issue like this could cause even more regressive social policy and cascading consequences like increased violence against immigrants, added weight for terrorist organizations framing the West as the bogeyman, and refusal on the part of coalition forces to set politics aside and focus on controlling a public health threat.
In fact, coalition forces are in the process of actively eroding public health infrastructure in some regions of the world. While the U.S. may have bombed a Doctors Without Borders (also known as MSF, reflecting its French acronym) hospital in Afghanistan on accident, multiple MSF facilities have been struck since and the international aid group has raised accusations that it is being deliberately targeted. Similarly, the pharmaceutical industry stands accused of denying access to life-saving medicines through pricing and import standards. The Trans Pacific Partnership, namechecked in the State of the Union and the pride and joy of the Obama Administration, could raise the prices of drugs around the world, including in the West, quite significantly. Cuts to public health in regions like the United Kingdom are also a grave concern.
Meanwhile, drug-resistant bacteria are on the rise around the world, and many are seen in cases of co-infection: Tuberculosis and HIV are a particularly lethal combination. Russia is experiencing a huge problem with rapidly-spreading, highly infectious drug-resistant tuberculosis that it is ill-equipped to treat. Polio, a disease many Westerners think is eradicated, remains a problem in Pakistan, and public health workers have trouble reaching at-risk populations. These problems increase the risk of financial and political instability, not the kind of thing we want in hostile nations with formidable arsenals. Both Pakistan and Russia, for example, have the bomb.
The experts warn that while disease has traditionally been the remit of public health agencies, the international security community needs to become involved as well, identifying four axes of particular concern: Epidemic preparedness; improving public health; investing in global and regional supports; and fast-tracking research and development. It would cost around $4.5 billion to implement their comprehensive recommendations, but those moves could result in saving $60 billion, or more, and a pandemic of this scale isn't hypothetical, but inevitable. They also note that measures to address other security issues like banking collapses are far more expensive, justifying investment in global public health.
Their recommended expenditures include sinking funds into R&D, addressing failing public health infrastructure, and creating reserve funds to deploy in the event of a call for rapid response. These are all smart public health moves, and they're also intelligent global security ones, which means they should be on the agenda for the next President of the United States, because we have numerous global public health agencies begging for political intervention, but very slow movement on the governmental end.
National security was a huge theme in the State of the Union, and we can expect it to be big on the campaign trail as well. Many candidates are positioning Daesh and other terrorist organizations as the biggest threat, pointing to flashy and awful events like last year's bombing in Paris as well as sustained violence in Syria and the Middle East. These threats are highly visible and can be used to strike fear into the hearts of voters, but when it comes to long-term security and the potential loss of national identity, human life, economic stability, and cultural progress, they aren't the thing we should be worried about.
We should fear the shifts in global climate that are creating refugees of their own, along with changing the agricultural landscape, devastating communities with hurricanes, droughts, and other weather events, and fundamentally altering societies all over the planet. And we should fear the rapidly-evolving organisms all over the world that we already know are making inroads in human communities, as well as those we don't know about, waiting for their spillover point. For that matter, we should be talking about the interactions between climate change and infectious disease, like the conditions that push humans and animals closer together, or the weather patterns that are facilitating growth of viral and bacterial populations.
As you evaluate who you're voting for, especially if you get an opportunity to question candidates directly, look over their platforms to see what they're proposing for public health and whether they're explicitly connecting global health and national security. If they aren't addressing these issues, find out why.
And if you want some good reads on infectious diseases and public health, here's a roundup to start you off.
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