December 2001/
January 2002

Views expressed are those of the authors, not necessarily of the AFSC.

Public Health is a National Security Issue

Naomi Klein is the author of No Logo: Taking Aim at the Brand Bullies (St. Martin's Press, 2000). Reprinted from The Globe and Mail (Toronto), October 24, 2001.

The real battle lines. What is making the US most vulnerable to terrorist attacks, especially bioterrorism, is not a depleted weapons arsenal but a crumbling public sector.

Only hours after the terrorist attacks on the World Trade Center and the Pentagon, Republican Representative Curt Weldon went on CNN and announced that he didn't want to hear anyone talking about funding for schools or hospitals. From here on, it was all about spies, bombs, and other manly things.

"The first priority of the US government is not education, it is not health care, it is the defense and protection of US citizens," he said, adding, later: "I'm a teacher married to a nurse--none of that matters today."

But now it turns out that those frivolous social services matter a great deal. What is making the US most vulnerable to terrorist networks is not a depleted weapons arsenal but its starved, devalued and crumbling public sector. The new battlefields are not just the Pentagon, but also the post office; not just military intelligence, but also training for doctors and nurses; not a sexy new missile defense shield, but the boring old Food and Drug Administration.

It has become fashionable to wryly observe that the terrorists use the West's technologies as weapons against itself: planes, Email, cellphones. But as fears of bioterrorism mount, it could well turn out that their best weapons are the rips and holes in the United States' public infrastructure.

Is this because there was no time to prepare for the attacks? Hardly. The US has openly recognized the threat of biological attacks since the Persian Gulf war, and Bill Clinton renewed calls to protect the nation from bioterror after the 1998 embassy bombings in East Africa. And yet shockingly little has been done.

The reason is simple: Preparing for biological warfare would have required a cease-fire in America's older, less dramatic war--the one against the public sphere. It didn't happen. Here are some snapshots from the front lines.

The Health System

Half the states in the US don't have federal experts trained in bioterrorism. The Centers for Disease Control and Prevention are buckling under the strain of anthrax fears, their underfunded labs scrambling to keep up with the demand for tests. Little research has been done on how to treat children who have contracted anthrax, since Cipro--the most popular antibiotic--is not recommended.

Many doctors in the US public health-care system have not been trained to identify symptoms of anthrax, botulism or plague. A recent US Senate panel heard that hospitals and health departments lack basic diagnostic tools, and information sharing is difficult since some departments don't have Email access. Many health departments are closed on weekends, with no staff on call.

If treatment is a mess, federal inoculation programs are in worse shape. The only laboratory in the US licensed to produce the anthrax vaccine has left the country unprepared for its current crisis. Why? It's a typical privatization debacle. The lab, in Lansing, Michigan, used to be owned and operated by the state. In 1998, it was sold to BioPort, which promised greater efficiency. The new lab has failed several FDA inspections and, so far, has been unable to supply a single dose of the vaccine to the US military, let alone to the general population.

As for smallpox, there are not nearly enough vaccines to cover the population, leading the US National Institute of Allergy and Infectious Diseases to experiment with diluting the existing vaccines at a ratio of 1 to 5 or even 1 to 10.

The Water System

Internal documents show that the US Environmental Protection Agency is years behind schedule in safeguarding the water supply against bioterrorist attacks. According to an audit released on October 4, the EPA was supposed to have identified security vulnerabilities in municipal water supplies by 1999, but it hasn't yet completed even this first stage.

The Food Supply

The FDA has proved unable to introduce measures that would better protect the food supply from "agroterrorism"--deadly bacteria introduced to the food supply. With agriculture increasingly centralized and globalized, the sector is vulnerable to the spread of disease, both inside the US and outside (as the hoof-and-mouth epidemic demonstrated most recently). But the FDA, which inspected only 1 per cent of food imports under its jurisdiction last year, says it is in "desperate need of more inspectors."

Tom Hammonds, CEO of the Food Marketing Institute, an industry group representing food sellers, says, "Should a crisis arise--real or manufactured as a hoax--the deficiencies of the current system would become glaringly obvious."

After September 11, George W. Bush created the position of "homeland security," designed to evoke a nation steeled and prepared for any attack. And yet it turns out that what "homeland security" really means is a mad rush to reassemble basic public infrastructure and resurrect heath and safety standards that have been drastically eroded. The troops at the front lines of America's new war are embattled, indeed: the very bureaucracies that have been cut back, privatized and vilified for two decades, not just in the US but in virtually every country in the world. "Public health is a national security issue," US Secretary of Health Tommy Thompson observed earlier this month. No kidding. For years, critics have argued that there are human costs to all the cost-cutting, deregulating and privatizing--train crashes in Britain, E. coli outbreaks in Walkerton [Canada], food poisoning, and substandard health care. And yet until September 11, "security" was still narrowly confined to the machinery of war and policing, a fortress built atop a crumbling foundation.

If there is a lesson to be learned, it is that real security cannot be cordoned off. It is woven into our most basic social fabric, from the post office to the emergency room, from the subway to the water reservoir, from schools to food inspection. Infrastructure--the boring stuff that binds us all together--is not irrelevant to the serious business of fighting terrorism. It is the foundation of our future security.

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