Disease and Security

Natural Plagues and Biological Weapons in East Asia

Christian Enemark

• Publisher: Taylor & Francis
• Year: 2007
• eBook ISBN: 9781134101320
• Edition: 1
• Topic: History
• Subtopic: Military & Maritime History
• Index: History

Focusing on East Asia, this book sets out a framework for analyzing infectious disease threats in security terms. It covers the security significance of naturally occurring disease outbreak events such as SARS and avian influenza, the development and use of biological weapons by state and non-state actors, and the security risks associated with laboratory research on pathogenic micro-organisms.

Christian Enemark devises a conceptual framework for securitization that is useful for policy makers by using the overlaps and synergies between different infectious disease threats. The book draws heavily on material from public health and scientific literature to illustrate the cross-disciplinary requirements for addressing infectious diseases challenges in security terms. Fast-moving, naturally occurring disease threats are of increasing concern to governments and individuals, and it is therefore important to recognize their close relationship to the security challenges posed by Biological Weapons and pathogen research.

Disease and Security will be of much interest to students of international security, public health and Asian politics.

1
Infectious diseases as a security challenge

At the beginning of the twenty-first century, the threat of infectious disease outbreaks continues to be a serious health concern. However, some aspects of that threat are presently so serious that they warrant treatment in security terms. Accordingly, this book proposes a framework for ‘securitizing’ a set of infectious disease threats that may arise through natural processes or as a result of human agency, and that have the greatest potential to cause a high degree of damage and disruption in a short space of time. This new, integrated framework is valuable because many security-oriented approaches to infectious disease have hitherto been misguided or inadequate.

To securitize an issue is to lend it a sense of urgency, and to seek some of the overriding political interest and superior financial resources associated with more traditional (military) concepts of security.¹ More than 1,400 species of infectious microbes are known to cause disease in humans, but this book does not propose to securitize them all. Every society tolerates a certain degree of illness such that not all infectious diseases may reasonably be considered a security threat – the mild effects of the common cold, for example, are readily accommodated. Rather, a particular disease may be deemed a security threat when its effects reach the point of imposing an intolerable burden on society. The point at which a disease burden qualifies as intolerable, however, is largely a matter of political judgement. Consequently, the threshold for securitization of a microbial threat may vary from country to country, and from disease to disease. As a general model applicable to any country, this book proposes that the best candidates for securitization are those infectious disease threats that inspire particular human dread, and which therefore generate a level of societal disruption disproportionate to the morbidity and mortality burden they pose.

This approach stands in contrast to the tendency of security scholars and policy-makers hitherto to focus on HIV/AIDS as the highest-profile link between infectious diseases and security. Such attention predates the passage in 2000 of UN Security Council Resolution 1308 which was the first time a health issue had been framed ‘officially’ as a global security concern. The Resolution expressed concern about the potential adverse effects of HIV/AIDS on UN peacekeeping personnel, but it also stressed more generally that this pandemic, ‘if unchecked, may pose a risk to stability and security’.² Government policy documents on the topic of HIV/AIDS typically span a range of issues, from how the disease is undermining military capacity to how it is impoverishing millions and destroying social structures vital to internal state security. HIV/AIDS featured prominently, for example, in an influential US National Intelligence Council report on the implications for the United States of global infectious disease threats published in 2000.³ The following year, however, saw biological attacks in the United States using bacteria that cause anthrax, as well as the publication of a method for genetically engineering a vaccine-resistant poxvirus.⁴ The outbreak in 2003 of severe acute respiratory syndrome (SARS) supported further an emerging argument that the security implications of infectious diseases extend beyond HIV/AIDS.

Nevertheless, it would be a mistake to suppose that HIV-oriented models for thinking about disease in security terms can simply be extended to other pathogenic micro-organisms. In a 2005 article, for example, Jeremy Youde sought to ‘demonstrate how infectious disease control can be integrated into the three major schools of thought in American international relations theory – neo-realism, neo-liberalism, and constructivism.’⁵ In doing so, however, he concentrated on sub-Saharan Africa alone, and on HIV/AIDS alone. Despite this deliberately narrow focus, Youde sought to derive extremely broad lessons: for example, ‘[b]y incorporating health security concerns like AIDS into neo-realism, one can gain a better perspective on how states maintain their survival’;⁶ and ‘AIDS thus impacts many of the concepts that lie at the heart of constructivist theories of international relations, making it invaluable to incorporate disease (and health security in general) into international relations’ (emphasis added).⁷ It is a reality of medical science, however, that there is no disease ‘like’ AIDS. For reasons such as its long incubation period and modes of transmission, and in the absence of a cure, the virus that causes AIDS is one of a kind. In terms of required medical and public health responses, security-oriented approaches to the AIDS threat cannot simply be transposed onto other infectious diseases, much less ‘health security in general’.

The sheer burden of HIV/AIDS, measured in terms of morbidity, mortality and its longer-term social effects, could form the basis for a securitization framework built along different lines. However, this book does not seek to address the security implications of infectious diseases by following a road that is already well-trodden.⁸ Rather, drawing primarily on data from East Asia,⁹ this book sets out to demonstrate the value of a securitization framework that is limited to three categories of infectious disease challenges presently facing the region:

1 fast-moving outbreaks of natural origin;

2 biological weapons (BW); and

3 the risks associated with research on pathogenic micro-organisms.

Conceptually, and for response purposes, there are extensive synergies and overlaps between each category. The rationale for selecting East Asia as the geographic focus for observation and analysis is correspondingly three-fold:

1 the region has been and is likely to remain the cradle of emerging diseases that spread rapidly;

2 it has a history of state and non-state interest in and use of BW; and

3 the amount of pathogen research being conducted in the region is increasing alongside surging interest in biotechnology generally.

The overall task of this book is to synthesize health and security concerns. The proposed framework for securitizing infectious-disease threats is informed by two disciplines whose language and worldviews are often difficult to reconcile. Disciplinary fences have kept ‘security’ and ‘health’ segregated from each other largely because they have represented opposing sets of interests, ideologies and institutions.¹⁰ On one side, the subject matter of security studies has traditionally been death, destruction and military establishments. On the other side, health studies have been about preventing and treating illness, improving quality of life and building up healthcare systems. The value of this book lies in its blending of these two distinct bodies of knowledge, the starting point for which is the mutual concern in both public health and security circles with the need to respond effectively to crises. Infectious disease outbreaks, whether arising from natural processes or as a result of human agency, can be simultaneously a health crisis and a security crisis.

As an introduction to considering infectious disease threats in security terms, this opening chapter is divided into three sections. The first examines the traditional security studies approach of perceiving the significance of infectious diseases in two dimensions:

1 the intersection of disease with issues of armed conflict; and

2 biological warfare.

Beyond the realm of purely military concerns, the second section borrows and adapts some concepts from the Copenhagen School of international security studies and proposes a framework according to which particular disease-based threats could be securitized in their own right. The final section canvasses alternative approaches, from public health and ‘human security’ perspectives, to the problem of infectious diseases. The chapter concludes with an overview of the concepts and subject matter to be explored in the book.

The traditional view: germs, wars and germ warfare

The background to the securitization framework proposed in this book is that infectious diseases are in many ways already a feature of the traditional security studies landscape. In at least two important areas, thinking about disease in security terms is a far from novel idea. First, it has been and likely will remain the case that infectious diseases are highly relevant to military operations. Second, disease-causing micro-organisms are of obvious military concern when they are spread deliberately as a method of warfare.

Military operations

A good introduction to the way in which infectious diseases impact on security is to examine their relevance to military operations throughout history. Broadly speaking, this can be considered in at least four dimensions. First, there is an abundance of evidence to demonstrate the decisive influence of disease upon battle. For example, the historian Livy described an outbreak of plague in the Carthaginian and Roman armies during the siege of Syracuse in 212 BC. The Carthaginians, less accustomed than the Romans to the city’s moist climate, suffered greater casualties from the disease and were defeated shortly afterwards.¹¹ The sixteenth-century demise of the Aztec empire came about mostly because the Spanish conquistadores brought smallpox and measles with them to the New World. And, during the First World War, an outbreak of typhus in Serbia in 1915 was so severe that the fighting on both sides stopped for six months.¹²

The second dimension is that infectious diseases can be of great significance to troop deployments. From the mid-thirteenth century in China, smallpox (which was relatively common among the southern Han people) formed a natural barrier to invasion from the north by Manchurians. When conducting military operations in Han territory, Manchu commanders would deploy only those soldiers who had previously been infected by smallpox and who therefore had lifelong immunity.¹³ In the course of the Crimean War (1854–1856), the French sent over 309,000 men east. Of these, 200,000 were hospitalized – 50,000 as a result of battle wounds and 150,000 because of diseases such as typhus and cholera.¹⁴ More recently, in April 2003, Canada’s health minister suggested that medical staff from the Canadian forces could help to relieve pressure on Toronto hospital staff treating patients with SARS. The military replied that it was already critically short of physicians to look after its troops, and Canada was at the time preparing for a major deployment to Afghanistan. Had the SARS outbreak in Toronto deteriorated to the point where medical personnel from Canadian military units were required to assist, those units would not have been able to deploy overseas.¹⁵

The potential for troop movements to spread infectious diseases is the third dimension. In the thirteenth century, Mongol invasions helped to spread various epidemics of plague between East Asia and Eastern Europe. The greatest smallpox epidemic in nineteenth-century Europe broke out when troops were demobilized at the end of the Franco-Prussian War in 1871.¹⁶ And, during the Korean War, American troops were exposed to the Seoul Hantaan virus – the virus subsequently travelled via troop supply ships to the United States, where it is now endemic.¹⁷

A fourth dimension of the traditional view of disease and security is the way in which conflict and infection can be mutually reinforcing. For example, the former Director-General of the World Health Organization (WHO), Gro Harlem Brundlandt, has warned of dire consequences if an outbreak of Ebola were to occur in a war-torn part of central Africa. In a conflict situation, it would be too dangerous to send in international health experts to assist in containing the disease, and infected people might start fleeing into cities, neighbouring countries and beyond.¹⁸ Christopher Coker has suggested that the Zimbabwean army, in which many officers have AIDS, was deployed in the Democratic Republic of Congo for the purposes of paying the army’s health bills. Given that the average African officer is not paid enough to afford Western AIDS medicine, ‘[p]illaging a neighbouring state is a way of affording drugs’.¹⁹ And, just as AIDS can be an impetus to war, so too can war cause the disease to proliferate. The most obvious example of this is when soldiers who know they are infected wield HIV as a weapon in the form of rape. In a sense, such soldiers are engaging in a crude, small-scale version of deliberate disease or biological warfare.

Biological weapons

The second major area of traditional security studies in which infectious diseases are of direct military concern is BW. These are pa...

Table of contents

• Contemporary security studies
• Contents
• List of illustrations
• Acknowledgements
• List of abbreviations
• 1 Infectious diseases as a security challenge
• Part I Natural plagues
• Part II Biological weapons
• Part III Pathogen research
• Notes
• Index