Understanding global security - Peter Hough

HEALTH THREATS TO SECURITY
This is a war, it has killed more people than has been the case in all previous wars.
Former President of South Africa, Nelson Mandela, on the AIDS epidemic
in South Africa in 2002 (The Economist 2002a: 69)
The globalization of ill health
Disease has long been the biggest threat of all to mankind and, despite the unrelenting
advances of medical science, looks set to continue to be for the foreseeable
future. The Black Death of the fourteenth century claimed more lives in five years
than any military conflict before or since, while the great influenza epidemic
of 1918–20 killed far more than the Great War that it closely followed. The ‘Plague of
Justinian’, which started in sixth century Constantinople and then spread throughout
the Mediterranean, was a classic ‘national security’ issue since it precipitated the
fall of the Byzantine Roman Empire (McNeill 1989: 101–106). In addition, the threats
posed by diseases, like some environmental problems, tend to be transnational
and as such represent a security challenge not easily countered by a human race
artificially sub-divided into independent, though not impervious, units. Today,
AIDS (Acquired Immune Deficiency Syndrome) represents a far greater threat to life
than armed conflict for most sub-Saharan Africans and for many millions more in all
of the inhabited continents of the world.
As with famines and hunger, however, major epidemics and pandemics of
diseases represent only dramatic periodic escalations of an underlying and persistent
threat. Tables 7.1 and 7.2 give an indication of the scale of this threat, the greatest
challenge of all to human security. By the end of the 1970s there was optimism that
humanity’s war against disease was being won. Disease is an enemy of humanity
which can probably never be entirely defeated, but in the decades which followed the
Second World War a growing belief emerged that scientific and medical advances
could eliminate many diseases and at least contain the others. The attack was led by
the use of synthetic (organic) insecticides, following the 1939 discovery of dichloro-
Table 7.1 The ten deadliest disease epidemics and pandemics of all time
Epidemic/pandemic Location Date Death toll
1 Black Death World 1347–51 75 million
2 AIDS World 1981– 23 million
3 InfluenzaWorld 1918–20 21.64 million
4 Plague India 1896–1948 12 million
5 Typhus Eastern Europe 1914–15 3 million
6 ‘Plague of Justinian’ Eastern Mediterranean 541–90 ‘millions’
=7 CholeraWorld 1846–60 ‘millions’
=7 CholeraEurope 1826–37 ‘millions’
=7 CholeraWorld 1893–94 ‘millions’
10 Smallpox Mexico 1530–45 up to 1 million
Sources: Ash (2001: 31), UNAIDS (2002).
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