SINGAPORE — Given the real possibility of a global pandemic, possibly from the possible outbreak of a virulent influenza, it’s time to ask: Should states treat infectious diseases as security threats?

Although the concept of security, particularly in East Asia, has been expanded to include both conventional and nonconventional threats, health security has not been included in the region’s security lexicon. But given the multidimensional threats posed by infectious diseases like HIV/AIDS, SARS (severe acute respiratory syndrome) and, more recently, the H5N1 virus (bird flu), it is time that states “securitize” infectious diseases.

In 2003, SARS put the region’s medical capability to test. The situation was compounded by the fact that there was no known cure and that many victims were health-care workers. The psychological impact was significant. As one doctor in Hong Kong put it, when doctors and nurses become victims, “the whole community panics.”

The impact of SARS was also reflected in the sudden disruption of several Asian economies. The crisis lasted for about five months from the time the health alert was declared. Economic losses were estimated at $50 billion for the region and about $150 billion worldwide.

SARS had the potential to damage a government’s legitimacy. Beijing’s poor handling of SARS in the early stages undermined its credibility, and led to international calls for more transparency and accountability.

Another significant issue was how crisis-management measures, particularly the mandatory quarantine, related to civil liberties. Incidents of people resisting and violating quarantine laws were reported in several countries. The question of how far authorities should go to impose quarantines became an issue as governments tended to revive quarantine laws that in many countries predated World War II.

There are other reasons why the international community should not wait for state failure before considering infectious diseases a national security matter:

With globalization, the scale, speed, and extent of movement of people and goods are without parallel.

The incidence as well as the spread of infectious disease are greatly exacerbated by “artificial” disease force-multipliers, including modern medical practices, accelerating urbanization, climate change from global warming, and new social and behavioral patterns.

The threat from infectious pathogens is greater than ever. Klaus Stohr, head of the World Health Organization’s Global Influenza Program, warned that if a virulent new human-to-human flu pandemic breaks out due to a virus like H5N1, about 2 million people in Asia and 7 million globally will die, and another 1.5 billion will seek medical attention. And while a vaccine can be developed, it may be too little, too late, for many victims.

Moreover, according to WHO, new diseases are emerging at an unprecedented rate of one per year. Examples include Ebola hemorrhagic fever in Africa, the West Nile-hantavirus pulmonary syndrome in the United States, and Nipah encephalitis in Southeast Asia. Older diseases like tuberculosis have re-emerged. New strains of food-borne diseases have appeared such as Creutzfeldt-Jacob (mad cow) disease, first detected in 1996.

The outbreak or resurgence of infec tious diseases can undermine a state’s control of its territory and threaten regional stability. Diseases like SARS have made countries aware of their vulnerability to infectious pathogens, which can easily cross borders in ways that defy traditional military defenses. As SARS has borne out, countries can tighten immigration controls to turn away travelers who might be carriers, but this measure failed to stem the spread of the virus.

How does adding a security label to infectious diseases help address this threat? Plainly, it is important to bring in the health component when addressing comprehensive security. This allows for better awareness and preparedness in addressing threats brought on by infectious diseases, and makes states conscious of the other impacts of these diseases on the well-being of states and societies.

Attempts to “securitize” have been limited. Peter Chalk, a security analyst from RAND Corp., has argued that, while regional states may have begun to recognize the security dimension inherent in the contemporary “microbial era,” most effectively recognize only one facet of the overall disease threat: its use as a weapon for offensive purposes. A number of countries have integrated homeland security structures complete with dedicated bio-response components. Yet, official deliberations in multilateral forums and other efforts have not addressed the broader dimensions and concerns of health and human security.

This limited approach to securitizing infectious diseases can be attributed to the delayed impact of infectious diseases, which diminishes the sense of urgency, plus concerns about internal interference in a country’s domestic affairs. Still, there are reasons to be optimistic. Several regional collaborative frameworks now exist for fighting infectious diseases within the 10-member Association of Southeast Asian Nations plus Japan, China and South Korea. They include the SARS Fund and initiatives to set up a regional center for disease surveillance control. More can be done.

Incorporating health into the region’s notion of comprehensive security allows for an integrated, multilateral approach to fighting infectious diseases. This involves bringing together different actors to work with the medical community to cope with infectious diseases. This requires a change of mind-set in coordinating agencies in, for example, agriculture, environment and defense.

An integrated, multilateral approach also requires building a mechanism for global, regional, and domestic disease surveillance and control, and developing and promoting international regimes to avert health disasters.

Finally, Asia must revisit the issue of poverty and its linkages with infectious diseases. The burden of infectious diseases like HIV/AIDs, malaria and tuberculosis falls overwhelmingly on the poorest regions. According to WHO, in 2002, 75 percent of all deaths due to infectious diseases occurred in Southeast Asia and sub-Sahara Africa. Of that figure, 28 percent came from Southeast Asia.

Adding infectious diseases to the security agenda, as well as considering innovative approaches, both integrated and multilateral, should be part of the rethinking of security in the region.

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