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HEALTH AND NATIONAL SECURITY
George C. Fidas
(Originally Published in the book Divided Diplomacy and the Next Administration:
Conservative and Liberal Alternatives, edited by Henry R. Nau and David Shambaugh,
Washington, DC: The Elliott School of International Affairs, The George Washington University,
2004.)
INTRODUCTION
Health is a transnational issue because microbes know no borders. Health is a development
issue because studies increasingly demonstrate that good health can contribute to
economic growth while bad health can constrain it. Health also is a national and global
security issue because it can contribute to insecurity at the personal, communal, national,
and international levels. For the most part, health security also has become a bipartisan
issue as both American liberals and conservatives have come to realize that attenuating
the growing health divide between rich and poor in the world is an important component
of the broader effort to deal with failing states, the roots of terrorism, and other 21st-century
threats.
THE GROWING INFECTIOUS DISEASE THREAT
Despite earlier optimism in the health community, infectious diseases remain a leading
cause of death, accounting for a quarter to a third of worldwide annual deaths and twothirds
of childhood deaths. The renewed threat from diseases owes to environmental degradation
and global warming that are spreading diseases; changes in human demographics
and behavior, such as accelerated urbanization and unsafe sex and drug injection practices;
and high-tech medical procedures that also carry a higher risk of infection. It also
results from changing land and water use patterns that increase contact with disease vectors;
growing international travel and commerce that can spread microbes as fast as the
speed of aircraft; and the inappropriate use of antibiotics that fosters microbial resistance
and makes them increasingly useless.
Although smallpox has been eliminated, 20 other well-known diseases such as tuberculosis
and malaria have re-emerged or spread geographically over the past three decades,
often in more virulent and drug-resistant forms. More ominously, 35 new diseases have
been identified, including HIV, Ebola, hepatitis C, and, most recently, SARS, for which
no cures are yet available.
■ Some 60 million people have been infected with HIV over the past two decades,
and 38 million are living with the virus. The disease has killed more than 20 million
people, and by 2020, at least another 68 million are projected to die of AIDS, 55
million of them in Sub-Saharan Africa.
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