David P. Fidler
Excerpted from David P. Fidler, Bioterrorism, Public
Health, And International Law, 3 Chicago Journal of International Law
7-25 , 23-25 (Spring 2002)(57 Footnotes Omitted)
Analyzing the relevance of the anthrax attacks to various
international legal areas is important, but such bioterrorism also
generates concerns that touch upon the future of national and global
public health policy. The anthrax attacks have the potential to affect
the direction and content of national and global infectious disease
control, and this potential impact may not be for the better.
In my work on the interface between public health and bioterrorism
prior to the anthrax attacks, I noticed tension in the public health
community about how to deal with the growing focus on bioterrorism.
This tension concerned how bioterrorism preparedness efforts may affect
the overall public health mission. On the one hand, public health
experts perceived that bioterrorism was a concern and sensed that
addressing bioterrorism might bring more attention and resources to a
public health system suffering from political and financial neglect. On
the other hand, public health experts worried that the bioterrorism
bandwagon might misdirect public health priorities and spending and
adversely affect the public health system in the long run. The consensus
attitude before the anthrax attacks was that public health should
support bioterrorism preparedness and build the best public health
system possible to deal with any infectious disease outbreak.
The anthrax attacks will profoundly affect the strategy to craft
synergy between bioterrorism preparedness and public health
capabilities. The acts of bioterrorism demonstrated how the nation's
public health system is important for national security. In the
aftermath of anthrax, the national security
community in Washington, DC may take control of public health by making
bioterrorism the most important public health priority. We may witness a
shift from a weak national commitment to public health to a strong
effort on homeland security, in which public health plays an important
part. The bioterrorism agenda, as determined by national and homeland
security concerns, will dominate and drive the future direction of US
public health. The frenetic activities in Washington, DC in the
aftermath of the anthrax attacks to improve US public health for
purposes of bioterrorism provide powerful evidence to support this
observation.
Whether the linkage between public health and homeland security
produces the synergy public health experts tried to craft before the
anthrax attacks remains to be seen. I suspect that public health
officials recognize the national security importance of public health
and worry that bioterrorism will transform US public health in unwelcome
and unanticipated ways. Creating the synergy in the post-anthrax
environment will require that the national security, homeland security,
and public health communities develop a partnership of equals. This
partnership requires learning and adjustment by all sides, but public
health has more to fear because of its historical weakness and obscurity
compared to the power and resources the federal government possesses for
national security and the money and political capital being poured into
homeland security.
B. Global Public Health and Bioterrorism: Whither the United States?
The global public health debacle of HIV/AIDS and the general global
crisis in infectious diseases led experts in the late 1990s and early
2000s to argue that the United States must become more engaged in global
public health. Sometimes these
arguments connected public health with national security by claiming
that both naturally-occurring infectious diseases and bioterrorism
constituted a national security threat to the United States.
By and large, the arguments that infectious diseases represented a
national security threat made little impact in Washington, DC. The only
arguments that resonated in Washington related to bioterrorism and
biological weapons proliferation, which represented the most traditional
form of national security threats. In
the wake of the anthrax attacks, the White House and Congress solidified
prior spending patterns by preparing to spend billions of dollars for
homeland defense against bioterrorism.
This mounting national and homeland security effort will dominate US
attitudes toward global public health for the foreseeable future. We may
witness a shift in the United States from a weak global perspective on
naturally occurring infectious diseases that largely affect other
countries to a strong national concern about the malevolent use of
pathogenic microbes against Americans. US engagement in global public
health will, thus, not stray far from the objective of protecting the
homeland from bioterrorism, as evidenced by US participation in the
Ottawa Plan, even though millions of people in developing countries will
continue to suffer and die annually from infectious diseases unrelated
to bioterrorism.
As the victim of bioterrorism, the United States understandably needs
to focus on homeland defense and the public health contribution to that
objective. As people experienced with the bioterrorism debate prior to
the anthrax attacks understood, US vulnerability to bioterrorism is
enormous. Federal and state governments have almost endless
intelligence, law enforcement, and public health work to do to protect
Americans from bioterrorism. The combination of the September 11th
violence and the anthrax attacks leaves the US government with no choice
but to focus energetically on a comprehensive homeland defense.
The focus on homeland defense will filter through to US attitudes
toward the role of international law in public health. The United States
will attempt to use international law to fight bioterrorism rather than
to grapple with the global crisis in naturally occurring infectious
diseases. Making sure bioterrorism is criminalized globally will
supercede the need to build a global infectious disease surveillance
system. Given the fusion of public health and national security in the
wake of bioterrorism, the United States will not hesitate to use its
power, influence, and resources to make the fight against bioterrorism
central to its outlook on the role of international cooperation and
international law in global public health.
Infectious disease problems in the developing world will be even less
important to the United States in the post-anthrax world than they were
previously. The lack of US leadership and engagement with global public
health will handicap efforts by other states, international
organizations, and non- governmental organizations to advance
multilateral cooperation on global public health problems. Even if the
2001 anthrax attacks prove to be an isolated phenomenon, the experience
of bioterrorism on US soil will distract US attention from traditional
public health challenges around the world. The slow, frustrating, and
incomplete progress made in raising US awareness about the global crisis
in infectious diseases in the 1990s may now be another victim of
bioterrorism in the United States.
**Professor of Law and Ira C. Batman Faculty Fellow, Indiana
University School of Law--Bloomington.
