Securitization of international public health: implications for global health governance and the biological weapons prohibition regime.

Author:Kelle, Alexander
 
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This article analyzes the extent to which international public health has become securitized and what effects this has on global health governance and the biological weapons control regime. Attempts to securitize public health are traced in the two multilateral discursive spaces of greatest relevance to biological weapons arms control and international public health; the community of state parties to the Biological Weapons Convention, and the World Health Organization. The conclusion is that with respect to public health, the identified securitization moves have led to a strengthening of the state as actor in the provision of international public health. For biological weapons arms control, the impact of the identified securitization moves depends largely on the overall development of the biological weapons control regime. KEYWORDS: securitization, international public health, health security, biological security, biological weapons.

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Public health and biological weapons arms control would appear to be two distinct policy arenas with little, if any, overlap in terms of actors involved, problems to address, and solutions to be proposed to better the human condition. Traditionally, security from biological weapons and security from disease were pursued by different actors on both the domestic and the international level. For the former, biodefense and biological weapons (BW) arms control policies were formulated by the military and diplomatic communities, while responsibility for disease prevention and mitigation fell to the public health sectors of states, or to international organizations such as the World Health Organization (WHO). This strict separation has become increasingly blurred.

Starting in the mid-1990s, the possibility of terrorism with biological and chemical weapons has evolved into the number one security threat for military planners and decisionmakers in many countries, most notably the United States. This dramatic shift in threat perception, which was fueled first and foremost by the Aum Shinrikyo 1995 sarin gas attack in the Tokyo subway system and the 2001 anthrax letters sent through the US postal service, had two effects that so far have not been thoroughly analyzed. First, it shifted the balance between biodefense and BW arms control in the fight against biological warfare toward biodefense. The process of readjusting this equilibrium in favor of biodefense has brought with it the second effect: the drafting of public health to fight bioterrorism. (1) While biodefense activities had in the past been geared toward hostile states employing BW, and thus had focused on troop protection in the field by the military forces themselves, this approach was no longer deemed valid in the age of global bioterrorist threats. Those who are "at risk from biological warfare" are no longer a subsection of the population--the armed forces--but are now the population as a whole. Consequently, protective measures had to extend to whole populations as well: enter the public health infrastructure. To better capture and analyze the processes related to this "drafting" of the public health sector, or parts thereof, the concept of "securitization" will be applied. As I have argued elsewhere, such securitization moves have been successfully employed in the United States over the past decade. (2)

The term securitization was introduced into the security studies discourse during the 1990s by a group of scholars, including Ole Waever and Barry Buzan. (3) The development of the concept has to be seen in the context of a more general trend to move beyond a focus on the nation-state and on the provision or analysis of military security issues only. (4) To overcome the shortcomings of some competing approaches to broadening the concept of security, Waever and his colleagues proposed to concentrate on the specificity of security studies and reformulate the concept of security on that basis. Two operations are crucial in this context: speech acts (uttering security) and modalities (threat-defense sequences). (5) The process of securitization is initiated through a

speech act where a securitizing actor designates a threat to a specified referent object and declares an existential threat implying a right to use extraordinary means to fence it off. The issue is securitized--becomes a security issue, a part of what is security--if the relevant audience accepts this claim and thus grants the actor a right to violate rules that otherwise would bind. (6) If a securitizing speech act is performed successfully--and, as I show in this article, this is by no means always the case--the threat-defense sequence, which has characterized traditional thinking about security, has been successfully put into action for a new issue, one that was previously separate from the security discourse.

There are thus three elements to the securitization process: a securitizing actor, a referent object to be securitized, and an audience that accepts (or rejects) the securitizing move. Thus, by looking at speech acts, the securitization concept allows an observer to analyze and link discursive interventions and policy measures beyond those that would normally be considered appropriate. Usually, such new policy measures would manifest themselves in shifting budgetary priorities.

In applying this framework, I analyze the extent to which threats to public health through the deliberate spread of disease have become securitized. As mentioned above, the emergence of the bioterrorist threat in the mid- to late 1990s has in the United States coincided with a reduced reliance on BW arms control in addressing the specter of biological warfare. Instead, biodefense measures, with the concomitant securitization of public health, have been placed center stage in the effort to counter the newly identified existential threat of bioterrorism.

In order to trace securitization moves and map the resulting changes in international public health discourse and the implications this has for both the globalization of public health and the international regime to prohibit BW, I provide in the next section an overview of the deliberate spread of disease in the form of biological warfare. In the following two sections I briefly describe the tools to fight both deliberate and natural disease; BW arms control; and international public health prior to the emergence of bioterrorism as a new existential security threat. My focus in the subsequent section is on the emergence of bioterrorism as security threat and the securitization moves in relation to public health on the international level, with emphasis on the two discursive spaces of the WHO and the community of Biological and Toxin Weapons Convention (BWC) member states. I conclude with a discussion of the implications for the global governance of public health and BW arms control that result from the identified public health securitization moves.

Biological Warfare as "Deliberate Disease"

The use of disease-causing biological agents, or pathogens, in warfare goes back at least several hundred years. (7) Biological warfare agents are usually grouped into five categories: (1) bacteria, such as Bacillus anthracis, the causative agent of anthrax; (2) viruses, such as the ones that cause smallpox, or Ebola; (3) rickettsiae, such as the organism that causes Q-fever; (4) fungi, such as the Aspergillus fungi; and (5) toxins--nonliving products from microorganisms, plants, or animals--such as botulinum toxin, or ricin. Some of these BW agents are mostly incapacitating, while others have a high lethality. Also, some BW agents will be localized in their effects, while others--due to their contagiousness--may cause widespread epidemics. Following from this diversity, biological warfare agents can be employed in a number of attack scenarios. (8)

To make efforts to implement the prohibitory norm against biological warfare even more challenging, the material, technologies, and know-how needed for offensive military BW programs or the pursuit of terrorist BW attacks are of a so-called dual-use character. Not only can they be used for offensive military purposes, but many of the "ingredients" of a BW program have perfectly legitimate civilian applications. Thus, it cannot be deduced from the mere presence of a seed culture of a particular pathogen or a specific type of equipment that a state pursues an offensive BW program.

Furthermore, the nature and scope of biological warfare has changed dramatically as a result of the revolution in the life sciences. As Malcolm Dando has shown for the "three generations of offensive biological warfare programs" of the twentieth century, all the military programs were "developing on the back of growth in scientific knowledge." (9) This pattern seems to continue. As a panel of life sciences experts concluded in a recent assessment of the threat of advanced BW based on biotechnological methods and processes that was conducted for the CIA,

Classes of unconventional pathogens that may arise in the next decade and beyond include binary BW agents that only become effective when two components are combined ...; "designer" BW agents created to be antibiotic resistant or to evade an immune response; weaponized gene therapy vectors that effect permanent change in the victim's genetic make up; or a "stealth" virus, which could lie dormant inside the victim for an extended period before being triggered. (10) Thus, problems in fighting the naturally occurring disease agents of today might be dwarfed by the genetically modified agents of the future, putting an ever increasing burden on biodefense and public health systems.

Fighting Deliberate Disease Through Biological Weapons Arms Control

The Structure of the BW Prohibition Regime

The BW prohibition regime rests largely on the 1972 Biological and Toxin Weapons Convention. It is based on the recognition that the use of BW agents constitutes an...

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