Bioterrorism, Public Health and the Law 
Law 801: Health Care Law Seminar
Professor Vernellia R. Randall

Will Bioterrorism Reshape Global Public Health?


Lesson Schedule
00: Intro to the Course
01: Intro to the Problem
02: Public Health System
03: Real Threat?
04: Public Health Law
05: Disease-Reporting
06: Quarantine
07: Model Act
08: Military Presence
09: Health Law Revisited


 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.

Related Pages:
Home ] Up ] Bioterroism and Public Health ] Biological Agents ] Dual Use or Poor Excuse? ] CDC Bioterrorism Preparedness and Response ] [ Will Bioterrorism Reshape Global Public Health? ] Bioterrorism - A Renewed Public Health Threat ] A Clear and Present Danger? ] Deaths and Illness--A Comparative Analysis ] The Requirements to Produce Biological Agents by Non-State Groups ] Potential of Use of Biological Weapons in the United States ] WHO Recommendations for Dealing with Bioterrorism ] Emerging Infectious Disease and Public Health (pdf) ] Facts about Biological Agents ]
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Home ] Syllabus ] Introduction to the Course ] Introduction to the Problem ] Public Health System ] Is Bioterrorism a Real Threat? ] Public Health Law and Bioterrorism ] Disease Reporting and Police Powers ] Quarantine and Police Powers ] Model State Public Health Law ] Military Presence and Public Health ] Public Health Law - Revisited ]
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