Is Pandemic Flu a Security Threat?

Click to increase image sizeClick to decrease image size Notes World Health Organisation, A Safer Future: Global Public Health Security in the 21st Century, World Health Report 2007 (Geneva: World Health Organisation, 2007), p. 45. Implementation Plan for the National Strategy for Pandemic Influenza (Washington DC: Homeland Security Council, 2006), p. 18. 'The National Security Strategy of the United Kingdom: Security in an Interdependent World', United Kingdom Cabinet Office, 19 March 2008, p. 14, http://interactive.cabinetoffice.gov.uk/documents/security/national_security_strategy.pdf. Australian Department of Health and Ageing, Australian Health Management Plan for Pandemic Influenza (Canberra: Commonwealth of Australia, 2006), p. 19, http://www.health.gov.au/internet/main/publishing.nsf/Content/ohppandemic-ahmppi.htm/$file/AHMPPI. pdf. Ibid., p. 51. 'Mysterious Disease Kills Thousands of Vietnamese Chickens', Sydney Morning Herald, 7 January 2004, http://www.smh.com.au/articles/2004/01/06/1073268033540.html. World Organisation for Animal Health, 'Update on Avian Influenza in Animals (Type H5)', 4 December 2008, http://www.oie.int/downld/AVIANINFLUENZA/A_AI-Asia.htm. World Health Organisation, 'Confirmed Human Cases of Avian Influenza A (H5N1)', 10 September 2008; http://www.who.int/csr/disease/avian_influenza/country/en/. Yang Yang, M. Elizabeth Halloran, Jonathan D. Sugimoto and Ira M. Longini, 'Detecting Human-to-Human Transmission of Avian Influenza A (H5N1)', Emerging Infectious Diseases, vol. 13, no. 9, September 2007, p. 1351. World Health Organisation, WHO Global Influenza Preparedness Plan: The Role of WHO and Recommendations for National Measures Before and During Pandemics (Geneva: World Health Organisation, 2005), p. 2. World Health Organisation, 'Ten Things You Need to Know about Pandemic Influenza', 14 October 2005, http://www.who.int/csr/disease/influenza/pandemic10things/en/. Ibid. Ibid. Christopher J.L. Murray, Alan D. Lopez, Brian Chin, Dennis Feehan and Kenneth H. Hill, 'Estimation of Potential Global Pandemic Influenza Mortality on the Basis of Vital Registry Data from the 1918–20 Pandemic: A Quantitative Analysis', The Lancet, vol. 368, no. 9554, 23 December 2006, pp. 2211–18. Jeffery K. Taubenberger, A.H. Reid, R.M. Lourens, R. Wang, G. Jin and T.G. Fanning, 'Characterization of the 1918 Influenza Virus Polymerase Genes', Nature, vol. 437, no. 7060, 6 October 2005, pp. 889–93. Notwithstanding these findings, it is important to acknowledge that mutation of H5N1 into a pandemic form is not certain to occur. At present, the virus attaches to cells in the lower respiratory tract of humans. It is possible that a feature of this particular virus may prevent it from ever attaching to cells in the upperrespiratory tract and thus transmitting easily to others through coughing and sneezing. See Debby van Riel, Vincent J. Munster, Emmie de Wit, Guus F. Rimmelzwaan, Ron A.M. Fouchier, Ab D.M.E. Osterhaus and Thijs Kuiken, 'H5N1 Virus Attachment to Lower Respiratory Tract', Science, vol. 312, no. 5772, 21 April 2006, p. 399. US Department of Health and Human Services, 'Community Strategy for Pandemic Influenza Mitigation', February 2007, http://www.pandemicflu.gov/plan/community/commitigation.html. World Health Organisation, A Safer Future, p. 16. Klaus Stöhr and Marja Esveld, 'Will Vaccines Be Available for the Next Influenza Pandemic?', Science, vol. 306, no. 5705, 24 December 2004, p. 2195. Jaro Kotalik, 'Preparing for an Influenza Pandemic: Ethical Issues', in Michael J. Selgelid, Margaret P. Battin and Charles B. Smith (eds), Ethics and Infectious Disease (Malden: Blackwell, 2006), p. 97. Warwick McKibbin and Alexandra Sidorenko, Global Macroeconomic Consequences of Pandemic Influenza (Sydney: Lowy Institute for International Policy, 2006). UNDP, Human Development Report (New York: United Nations Development Programme, 1994), pp. 27–8. World Health Organisation, A Safer Future, p. 5. Shannon Selin, 'The Security Implications of SARS', CANCAPS Bulletin, no. 37, 2003, p. 10. Recent publications include Susan Wright, 'Terrorists and Biological Weapons: Forging the Linkage in the Clinton Administration', Politics and the Life Sciences, vol. 25, no. 1–2, March–September 2006, pp. 57–115; Reynolds M. Salerno and Lauren T. Hickok, 'Strengthening Bioterrorism Prevention: Global Biological Material Management', Biosecurity and Bioterrorism, vol. 5, no. 2, June 2007, pp. 107–16; Nicholas A. Sims, 'The Future of Biological Disarmament: New Hope after the Sixth Review Conference of the Biological Weapons Convention', Nonproliferation Review, vol. 14, no. 2, July 2007, pp. 351–72. The use of influenza virus for biological-warfare purposes, highly unlikely but not impossible, is beyond the scope of this article. United Nations Security Council, UNSCR 1308, 17 July 2000, http://daccessdds.un.org/doc/UNDOC/GEN/N00/536/02/PDF/N0053602.pdf. See, for example, P.W. Singer, 'AIDS and International Security', Survival, vol. 44, no. 1, Spring 2002, pp. 145–58; Gwyn Prins, 'AIDS and Global Security', International Affairs, vol. 80, no. 5, October 2004, pp. 931–52; Stefan Elbe, Strategic Implications of HIV/AIDS, Adelphi Paper 357 (New York: Oxford University Press for the International Institute for Strategic Studies, 2003); Alan Dupont, East Asia Imperilled: Transnational Challenges to Security (Cambridge: Cambridge University Press, 2001), pp. 212–27; Harley Feldbaum, Kelley Lee and Preeti Patel, 'The National Security Implications of HIV/AIDS', PLoS Medicine, vol. 3, no. 6, June 2006, pp. 0774–78; Colin McInnes, 'HIV/AIDS and Security', International Affairs, vol. 82, no. 2, March 2006, pp. 315–26. National Intelligence Council, 'The Global Infectious Disease Threat and its Implications for the United States', http://www.wilsoncenter.org/topics/pubs/Report6-3.pdf, January 2000. Mely Caballero-Anthony, 'Combating Infectious Diseases in East Asia: Securitization and Global Public Goods for Health', Journal of International Affairs, vol. 59, no. 2, Spring 2006, pp. 105–27; Alexander Kelle, 'Securitization of International Public Health: Implications for Global Health Governance and the Biological Weapons Prohibition Regime', Global Governance, vol. 13, no. 2, April–June 2007, pp. 217–35, Sara E. Davies, 'Securitizing Infectious Disease', International Affairs, vol. 84, no. 2, March 2008, pp. 295–313. Julian Palmore, 'A Clear and Present Danger to International Security: Highly Pathogenic Avian Influenza', Defense and Security Analysis, vol. 22, no. 2, June 2006, pp. 111–21; Christian Enemark, Disease and Security: Natural Plagues and Biological Weapons in East Asia (London: Routledge, 2007), pp. 41–58. Barry Buzan, People, States and Fear: An Agenda for International Security Studies in the Post-Cold War Era, 2nd ed. (London: Harvester Wheatsheaf, 1991), p. 117. Richard Ullman, 'Redefining Security', International Security, vol. 8, no. 1, Summer 1983, p. 133. Ole Waever, 'Securitization and Desecuritization', in Ronnie D. Lipschutz (ed.), On Security (New York: Columbia University Press, 1995), p. 52. Implementation Plan for the National Strategy for Pandemic Influenza, p. 2. Ibid., p. 1. Paul Slovic, Baruch Fischhoff and Sarah Lichtenstein, 'Facts and Fears: Understanding Perceived Risk', in Richard C. Schwing and Walter A. Albers (eds), Societal Risk Assessment: How Safe is Safe Enough? (New York: Plenum, 1980), p. 209. Ibid., p. 211. World Health Organisation, World Health Report 2002: Reducing Risks, Promoting Healthy Life (Geneva: World Health Organisation, 2002), p. 32. Jessica Stern, 'Dreaded Risks and the Control of Biological Weapons', International Security, vol. 27, no. 3, Winter 2002–03, p. 102. Erik Eckholm, 'SARS is the Spark for a Riot in China', New York Times, 29 April 2003, p. A1. Peter Chalk, 'Disease and the Complex Processes of Securitization in the Asia- Pacific', in Mely Caballero-Anthony, Ralf Emmers and Amitav Acharya (eds), Non-Traditional Security in Asia: Dilemmas in Securitization (Aldershot: Ashgate, 2006), p. 127. Stewart Tendler, 'Flu Doctors to be Given Police Guards', Times Online, 2 November 2005, http://www.timesonline.co.uk/article/0,,25149-1853843,00.html. Department of Defense, Department of Defense Implementation Plan for Pandemic Influenza (Washington DC: Office of the Assistant Secretary of Defense for Homeland Defense, 2006), p. 16. 'Implementation Plan for the National Strategy for Pandemic Influenza', p. 153. Susan Peterson, 'Epidemic Disease and National Security', Security Studies, vol. 12, no. 2, December 2002, p. 51. Rebecca Katz and Daniel A. Singer, 'Health and Security in Foreign Policy', Bulletin of the World Health Organization, vol. 85, no. 3, March 2007, p. 233. Colin McInnes and Kelley Lee, 'Health, Security and Foreign Policy', Review of International Studies, vol. 32, no. 1, January 2006, p. 11. Stefan Elbe, 'Should HIV/AIDS Be Securitized? The Ethical Dilemmas of Linking HIV/AIDS and Security', International Studies Quarterly, vol. 50, no. 1, March 2006, pp. 119–44. Ibid., p. 120. Nellie Bristol, 'US Senate Passes New PEPFAR Bill', The Lancet, vol. 372, no. 9635, 26 July 2008, p. 277. Elbe, 'Should HIV/AIDS Be Securitized?', p. 128. Katz and Singer, 'Health and Security in Foreign Policy', p. 234. 'Siracusa Principles on the Limitation and Derogation Provisions in the International Covenant on Civil and Political Rights', Human Rights Quarterly, vol. 7, no. 1, 1985, p. 6. Rajnarayan Chandavarkar, 'Plague Panic and Epidemic Politics in India, 1896–1914', in Terence Ranger and Paul Slack (eds), Epidemics and Ideas: Essays on the Historical Perception of Pestilence (New York: Cambridge University Press, 1992), pp. 8–10, 204. Elbe, 'Should HIV/AIDS Be Securitized?', p. 128. Ibid. US Department of Health and Human Services, 'Community Strategy for Pandemic Influenza Mitigation'. K. Lee and D. Fidler, 'Avian and Pandemic Influenza: Progress and Problems with Global Health Governance', Global Public Health, vol. 2, no. 3, July 2007, p. 226. Elizabeth M. Prescott, 'SARS: A Warning', Survival, vol. 45, no. 3, Autumn 2003, p. 218; World Health Report 2003: Shaping the Future (Geneva: World Health Organisation, 2003), p. 77. Jacques deLisle, 'SARS, Greater China, and the Pathologies of Globalisation and Transition', Orbis, vol. 47, no. 4, Fall 2003, p. 598. Ann Mongoven, 'The War on Disease and the War on Terror: A Dangerous Metaphorical Nexus?', Cambridge Quarterly of Healthcare Ethics, vol. 15, no. 4, October 2006, p. 412. World Health Organisation Writing Group, 'Nonpharmaceutical Interventions for Pandemic Influenza, International Measures', Emerging Infectious Diseases, vol. 12, no. 1, January 2006, p. 83. Ibid., p. 88. See, for example, Athol Yates, 'Close Airports or Pandemic Influenza Will Fly In', Australian Homeland Security Research Centre, August 2007, http://www.homelandsecurity.org.au/files/airport_closure_flu.pdf. WHO Writing Group, 'Nonpharmaceutical Interventions for Pandemic Influenza, International Measures', p. 86. 'Comments from the Center for Biosecurity of UPMC on the National Strategy for Pandemic Influenza: Implementation Plan', Biosecurity and Bioterrorism, vol. 4, no. 3, 2006, p. 322. Peter Caley, Niels G. Becker and David J. Philp, 'The Waiting Time for Inter-Country Spread of Pandemic Influenza', PLoS ONE, vol. 2, no. 1, art. e143, January 2007. 'International Health Regulations: the Challenges ahead', The Lancet, vol. 369, no. 9575, 26 May 2007, p. 1763. Daniel Deudney, 'The Case against Linking Environmental Degradation and National Security', Millennium, vol. 19, no. 3, December 1990, pp. 462–65. Ibid., p. 475. Peterson, 'Epidemic Disease and National Security', p. 46. Harley Feldbaum, Preeti Patel, Egbert Sondorp and Kelley Lee, 'Global Health and National Security: The Need for Critical Engagement', Medicine, Conflict and Survival, vol. 22, no. 3, July–September 2006, p. 196. World Health Organisation, A Safer Future, p. 66. World Health Organisation, 'Constitution', 1946, http://www.who.int/entity/governance/eb/who_constitution_en.pdf. World Health Organisation, '58th World Health Assembly, International Health Regulations (2005)', 2005, http://www.who.int/csr/ihr/WHA58-en.pdf. Yanzhong Huang, 'Mortal Peril: Public Health in China and its Security Implications', Health and Security Series (Washington DC: Chemical and Biological Arms Control Institute, 2003), p. 69. World Health Organisation, 'Summary of Probable SARS Cases with Onset of Illness from 1 November 2002 to 31 July 2003', 26 September 2003, http://www.who.int/csr/sars/country/table2003_09_23/en/. Dennis Normile, 'Indonesia to Share Flu Samples Under New Terms', Science, vol. 316, no. 5821, 6 April 2007, p. 37. John Aglionby and Andrew Jack, 'Indonesia Blames WHO for Bird Flu Deal', Business Day Online, 8 February 2007, http://businessdayonline.com/?c=125&a=11127. 'Indonesia Edges Closer to Sharing Bird-Flu Samples', Nature, vol. 450, no. 7170, 26 November 2007, p. 599. US Department of State, 'US Government Support to Combat Avian and Pandemic Influenza', 4 June 2007, http://www.state.gov/r/pa/scp/86190.htm. Margaret Harris Cheng, 'Cash Boost for Avian Influenza Exceeds Expectations', The Lancet, vol. 367, no. 9507, 28 January 2006, p. 289. 'Chair's Summary', New Delhi International Ministerial Conference on Avian and Pandemic Influenza, December 2007, available at http://www.delmincon.com/. World Health Organisation, 'World Health Assembly Closes', 23 May 2007, http://www.who.int/mediacentre/news/releases/2007/wha02/en/index.html. Implementing the WHO plan to increase the global supply of vaccine is estimated to cost $3–10bn: World Health Organisation, Global Pandemic Influenza Action Plan to Increase Vaccine Supply (Geneva: World Health Organisation, 2006). Additional informationNotes on contributorsChristian EnemarkChristian Enemark is Lecturer at the Centre for International Security Studies, University of Sydney, and a Visiting Fellow at the John Curtin School of Medical Research, Australian National University.