Anti-Terror Vs. Anti-Pandemic:
Guest-blogging over at Balkinization, Daniel Solove criticizes the government for paying too much attention to anti-terrorism measures and not enough attention to the possibility of a pandemic that could kill millions of people. He writes:
  The most devastating national security issue is, in my opinion, the possibility of a pandemic. But there is little attention to this issue. Sadly, it's because all of the folks crying out to protect our security are so myopically focused on terrorism that they're neglecting to think rationally about where the most likely risks are. . . .
  . . .
  . . . [I]nstead of talking about the usual trade-offs between security and civil liberties, perhaps we should begin talking about the trade-offs when we expend so many resources addressing one security issue while neglecting other security issues. Pandemics are national security issues too, but sadly "national security" appears to be co-opted as a synonym for "terrorism prevention."
  I strongly agree with Solove that the government should be paying more attention to the possibility of a pandemic. But I'm not sure I see the argument that the reason for the relative lack of attention is the government's focus on anti-terrorism measures. Why does government focus on anti-terrorism measures lead to less focus on minimizing the risk of a pandemic? Perhaps the funding for the two might go into some similar pots, but I wonder if this might cut both ways: perhaps more antiterrorism funding could lead to more money being spent on average for pandemic issues, rather than less. This is pure speculation, as I don't know how the two issues are linked either as budgetary or personnel matters, but it's not clear to me that attention to one takes away attention from the other.

  To the extent that Solove is making a point about what topics are receiving lots of public attention rather than government attention — something that does set up more of an either/or relationship — his point seems valid but directed at the wrong target. If there has been too much public attention on the tradeoff between terrorism and civil liberties relative to other threats, then presumably the fault is less the government's (which does not invite such attention, obviously) than the media's. The tradeoff between security and civil liberties has received a tremendous amount of public attention because the media has decided to give it a tremendous amount of attention; the risk if a pandemic has received little public attention at least in part because the press doesn't like to report on it nearly as much. If the amount of the reporting is out of whack with the reality of the threats, then one place to begin is by better matching the former to the latter.
Gregory Tetrault (mail):
Some of the anti-terrorist funding goes towards improved public health programs and improved communications and coordination among federal, state, and local publich health agencies. These improvements make us better prepared for epidemics and pandemics as well as bioterrorism. The Veterans Administration hospitals are part of a federal network of healthcare facilities that act as sentinels for bioterrorism or epidemic events.

I agree that not all bioterrorism-directed spending is worthwhile, but at least some of it has public health relevance unrelated to terrorism.

Note: I am a clinical pathologist on the Infection Control Committee of the Memphis VA Medical Center.
6.29.2005 8:43pm
ajf (mail) (www):
the best way to prevent a pandemic is to have a solid basic public health infrastructure -- better monitoring and reporting, for one. good primary health care is also a must, as is public trust in the government and clear lines of communication from government to the public. unfortunately, i don't think the u.s. has any of those things at the moment, and they're not something you can fix with a band-aid.

note: i'm an MPH.
6.29.2005 9:47pm
Daniel Chapman (mail):
Considering there is an open portal for terrorists to cross our southern border, AND illegal immigration across that border is responsible for countless diseases entering the US (such as TB), it would seem we could kill two birds with one stone...

Any legislators up to the task? anyone? Yes, I see you back there Mr. Sensenbrenner... anyone else?
6.30.2005 10:35am
I think that the argument is silly. Anyone paying attention knows that the same infrastructure and people respond to natural disasters, public health emergencies and attacks. This is not theoretical -- we all saw after the tsunami what a carrier battle group can do in public emergency anywhere in the world.

cathy :-)
6.30.2005 11:42am
Tom Chambers:
As a virologist, I agree with AJF. The government has a National Pandemic Preparedness Plan, which calls for enhancing public health infrastructure and stockpiling oseltamivir. I don't know what progress has been made. CDC is already devoting a lot of attention to the bird flu in SE Asia. Prototype vaccines are in the works. Beyond that it is not clear to me what Daniel Solove expects the government to do.

A bit of history might help explain some governmental reticence about publicly pushing this issue.

First, Solove mentions that pandemics occur at 24-year intervals on average. A quarter-century ago the accepted wisdom was that pandemics occur at 11-year intervals on average and the next one was already due. We're still waiting.

Second, the last time the government stepped in to stop an incipient pandemic was the swine flu scare of 1976. On the advice of the experts, Gerald Ford authorized a mass-vaccination program. Several million people were vaccinated, then the program was terminated because (1) there was no epidemic; (2) there was heightened incidence of Guillane-Barre paralytic syndrome associated with the vaccine.
6.30.2005 1:22pm