Contagious Fears; Infectious Disease and National Security

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Infectious Disease and National Security

In an increasingly interdependent world, the United States faces an array of new global challenges that transcend the traditional definition of national security. One important example is the resurgence of infectious disease. In the 1960s and 1970s, powerful antibiotic drugs and vaccines appeared to have banished the major plagues from the industrialized world, leading to a mood of complacency and the neglect of programs for disease surveillance and prevention. Over the past few decades, however, infectious diseases have returned with a vengeance.

Worldwide, 20 well-known maladies, including tuberculosis, malaria, and cholera, have reemerged since 1973 in more virulent or drug-resistant forms or have spread geographically. Over the same period, at least 30 previously unknown diseases have been identified for which no cures exist. Examples include Ebola and other hemorrhagic fevers in Africa, the worldwide AIDS pandemic, Legionnaire's disease, Lyme disease, Hepatitis C, "mad cow disease," Sin Nombre virus, Nipah virus, and new strains of influenza. Although AIDS was not recognized until the 1980s, it now infects some 36 million people worldwide and kills three million annually. Since 1980, the US death rate from infectious diseases has increased by about 4.8 percent per year, compared with an annual decrease of 2.3 percent in the 15 years before 1980. At present, nearly 170,000 US citizens die annually of AIDS and other infections.

Not only do importations of disease threaten US citizens directly, but devastating epidemics such as AIDS are spawning widespread political instability and civil conflict in countries where the United States has significant interests. The Clinton administration sought to address these challenges by placing public health on a "new security agenda" along with other nontraditional threats such as environmental degradation, dwindling supplies of clean water, global warming, mass migrations of refugees, and overpopulation. In response to critics who questioned the relevance of infectious disease to national security, President Clinton's National Security Advisor Sandy Berger wrote recently, "[A] problem that kills huge numbers, crosses borders, and threatens to destabilize whole regions is the very definition of a national security threat.... To dismiss it as a 'soft' issue is to be blind to hard realities."

In January 2000, the National Intelligence Council supported the Clinton administration's policy by publishing an unclassified National Intelligence Estimate (NIE) assessing the implications of the global spread of infectious diseases for US national security. Packed with sobering statistics, the NIE concludes that over the next 20 years, emerging and re-emerging infectious diseases will endanger US citizens at home and abroad, threaten troops deployed overseas, and exacerbate political and social instability in key countries and regions. This instability, in turn, will contribute to humanitarian emergencies and military conflicts to which the United States may have to respond. The report also warns that the threat of biowarfare and bioterrorism will grow as rogue states and terrorist groups exploit the ease of global travel and communication to pursue their deadly objectives.

Multiple factors have facilitated the emergence anti spread of infectious diseases. The overuse of antibiotics to enhance the growth of chickens and cattle has contributed to a dramatic increase in drug-resistant microbes at a time when the discovery of new antibiotics has lagged; the settlement of formerly remote jungle areas has brought humans into increased contact with exotic viruses; the rise of megacities in developing countries with poor health systems has created "hot spots" for the evolution of new infectious agents; climate change has led to a shift in the geographical distribution of pathogens and their insect vectors; and the growing volume of cross-border travel and trade associated with globalization has provided new opportunities for microbial "hitchhikers. …