Instruments of Peace: The Use of Health for National Security

Article excerpt

As the hunt For Osama bin Laden began to focus on the now infamous compound in Abbottabad, Pakistan, the CIA desperately sought confirmation that he was there. The agency came up with an idea: hire a local doctor to conduct a fake vaccination campaign, which it hoped could lead to obtaining blood samples from bin Laden's grandchildren that could be analyzed for a DNA match to bin Laden. One could dismiss the campaign as just another imaginative tactic used by the CIA in the search; the fact that it involved a population health ruse could be of no more significance than had the CIA hired agents to sell lottery tickets door to door in the neighborhood. But the selection of a vaccination campaign may not have been mere happenstance, just another case example of the increasing use of a health intervention to advance a specific national security objective.

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A clue to such thinking emerged after the United Kingdom's Guardian revealed the ruse. After at first refusing to comment, a senior administration official told United Press International that it had been intended as "an actual vaccination campaign conducted by real medical professionals." The statement was only half true. Medical workers were recruited to organize and conduct a vaccination initiative to provide real vaccines for hepatitis B, but the campaign nevertheless was fraudulent from the start as it failed to follow standard immunization procedure, which requires a follow up vaccine that was never administered.

Health and Diplomacy

The relationship among health, national security, and foreign policy has recently gained attention from scholars as well as diplomats. The most obvious use of diplomacy in the health context has been to prevent cross-border infectious disease transmission, and to protect economic interests of domestic corporations in connection with health products. Since the SARS epidemic, diplomatic efforts have strengthened international and regional cooperation to limit transmission of infectious diseases through the World Health Organization's international health regulations (WHO). The negotiations addressed traditional areas of state concern, especially whether outbreak reporting would continue to be constrained by state sovereignty or rather would yield to a more global approach to information dissemination. This past year, further agreements were reached at the World Health Assembly to address sticky issues about sample sharing and access of poor countries to vaccines. Other contentious subjects of international health negotiations include the marketing of tobacco, and the effort to reconcile patent rights of manufacturers of drugs for HIV/AIDS and other diseases predominant in poor countries with the legitimate demand for affordable life-saving drugs.

In other circumstances, diplomacy has been invoked not to resolve disputes pitting economic interests against health, but simply to advance health, both for its own sake and to promote the emergence of well-governed states that can serve the needs of their populations. In 2009, the National Intelligence Council issued a report on Global Health as a Security Issue, arguing that chronic, non-communicable diseases, neglected tropical diseases, maternal and child mortality, malnutrition, sanitation and access to clean water, and availability of basic healthcare were significant to US national security. In Nigeria, for example, diplomatic tools were invoked to overcome politically-inspired resistance to a polio vaccination program. An effective health system contributes to long-term economic growth and, arguably, political stability.

In all these cases, health is seen as an independent good, and diplomacy is used to promote it or reconcile it against other interests. But there is another variation on health diplomacy where health benefits are not the primary focus. Health interventions are used as a means of accomplishing other national objectives. …