Mobilising against the pandemic threat

Avian influenza (H5N1), once airborne, will travel from host to host as a virus. This means it can pass through common surgical masks. It will take up to 10 days for the onset of symptoms, during which time the person is highly contagious. This leaves plenty of time for the virus to spread undetected.

The different virus characteristics must be noted because the responses need to be disease-specific to be effective. National boundaries are irrelevant to an EID, but not to the practical solutions needed to combat them. These must be trans-national in scope and the capacity for containment is key.

The long-term effects of “creeping” diseases such as HIV-AIDS are being felt in Russia and sub-Saharan Africa, where infection is beginning to impinge on the strength, productivity and stability of the nation state. Disease will mingle with existing tensions and deprivations to rock stability in the region, perhaps even to the point of total collapse in some areas.

Although these cases are at the worst end of the spectrum, they are useful in trying to understand how an extreme manifestation of even a slow-moving, non-airborne disease has the potential to affect national security.

With airborne diseases, the implications emerge almost immediately. SARS cost the Asia-Pacific region an estimated $40 billion - an epidemic that lasted six months. The economic impact of the disease was exacerbated by fear and confusion. With H5N1, the epidemic could last up to three years and would be infinitely more costly, and more deadly.

The effects of EIDs in all countries - and even within countries - will not be the same. Infection as a security challenge will likely depend on the particular disease, as its characteristics will determine how far and how fast it spreads, who its victims are, and the ratio of infection to mortality.

While prosperous nations have an arsenal of better medicine, stronger government, better health systems, education and communication with which to smite an EID, vulnerabilities may stem from these very advantages. There is more travel, trade and tourism, for example, all of which increase the chance of cross-infection.

Then there is demography. Susan Peterson has argued that countries such as China and India have large populations that could more easily cushion a huge death toll from an EID. Conversely, the same proportion of deaths per thousand occurring in Europe, where birth rates are already below replacement level, could be devastating.

Wealthier societies are psychologically less prepared for large-scale deaths from disease within their population: it follows that the trauma and economic shock could possibly then be greater. Panic and suspicion would grow as every citizen became a potential biological bomb. Confidence in the government’s custodial function would erode and could provoke a crisis of legitimacy for the power structure. People would retreat into a survivalist mindset and could begin to see the government as the visible manifestation of an invisible enemy.

Good information may do little to mitigate the situation. A study conducted in Canada during the SARS outbreak found that just exposing people to large amounts of information about the disease was not enough to strengthen their knowledge, nor to convince them to change their behaviour.

The particular properties of EIDs make them a hot candidate for securitisation. Policies for government co-operation on non-military threats remain underdeveloped and this needs to change. The government needs to be able, in a disease emergency, to marshal the resources of the state - public and private - towards fighting the viral enemy. It may be required to impose unpopular decisions on its people, including quarantine, travel restrictions, shortages of goods, a ban on large public gatherings, compulsory vaccinations and the like.

Death tolls could be massive from H5N1. A global “bird flu” pandemic would put almost every country in a protracted state of siege. Surviving this state requires detailed planning - including stockpiling of vaccines, medicine, fuel, even food - and deep co-operation with the private sector.