Stockholm+50: Securitisation of pandemics

The World Health Organization defines global public health security (health security, in everyday parlance) as the activities required, both proactive and reactive, to minimise the danger and impact of acute public health events that endanger people’s health across geographical regions and international boundaries.

Health security is inextricably linked to the use of biological agents as a weapon. Infectious diseases grew as a non-traditional security threat in the last two decades, increasingly getting precedence over traditional security threats.

Significantly, the World Economic Forum 2015 in the backdrop of rising incidence of Ebola, influenza and antibiotic-resistant pathogens flagged “rapid and massive spread of infectious diseases” to be the second-highest risk in terms of global impact, just behind water crises and ahead of weapons of mass destruction.

Pandemics have, thus, begun to be understood and managed through the health security lens and WHO is critiqued to have used securitisation to reclaim its declining authority in the backdrop of the emergence of several international organisations, international non-governmental organisations and public-private partnerships in the post-cold war era.

A likely pandemic

The Johns Hopkins Center for Health Security in collaboration with the World Economic Forum and the Bill and Melinda Gates Foundation hosted Event 201, a high-level pandemic table-top exercise, on October 18, 2019, in New York.

Event 201 simulated an outbreak of a novel zoonotic coronavirus transmitted from bats to pigs to people that eventually became efficiently transmissible from person to person, leading to a severe pandemic.

The scenario stabilised by 18 months, with 65 million deaths. Eventually, with an effective vaccine, it was expected to end up as an endemic childhood disease.

If all these seem uncannily familiar now, what did the 15 “players” representing global business, government, and public health prescribe as policy responses? The key recommendations included:

• Governments, international organisations and businesses to plan for how essential corporate capabilities will be utilised during a pandemic, with public sector efforts likely to become overwhelmed.
• Industry, national governments and international organisations collaborate to enhance stockpiles of medical countermeasures to enable rapid, equitable distribution.
• Countries, international organisations, global transportation companies maintain travel and trade during severe pandemics.
• Governments to provide more resources and support for the development and surge manufacturing of vaccines, therapeutics and diagnostics.
• Global business should recognise the economic burden of pandemics and enhance their preparedness. Global business leaders to play a far more dynamic role, with a stake in pandemic preparedness.
• International organisations should prioritise reducing economic impacts of epidemics and pandemics.
• Governments and the private sector accord greater priority to developing methods to combat mis- and disinformation.

The global and national response were reasonably along these lines.

For example, Operation Warp Speed was a public–private partnership initiated by the US government to facilitate and accelerate the development, manufacturing and distribution of vaccines, therapeutics and diagnostics.

The Rapid Response Regulatory Framework for vaccine development was a similar initiative by the Department of Biotechnology in India.

India uniquely invoked, for the first time, the National Disaster Management Act 2005 (that continues to remain in force) to respond to any disease/epidemic, in conjunction with the colonial-era Epidemic Diseases Act 1897.

This was an extreme case of securitisation of COVID-19 response, that has a foreboding of the future of public health governance in the backdrop of this experience.

‘One health’ helps

‘One Health’ is best understood as collaborative efforts of multiple disciplines working locally, nationally and globally to attain optimal health for people, animals, plants and the environment.

Seemingly a contemporary rage, its roots are traced to the late 19th and 20th centuries with physician leaders in medicine such as Rudolf Virchow and William Osler proposing that human and animal health were inextricably linked.

Emerging and highly fatal zoonotic diseases such as HIV/AIDS, severe acute respiratory syndrome (SARS) and West Nile virus have been the recent challenges.

‘One Health’ thus calls for integrative thinking on human and animal health, and advocates for dismantling disciplinary and professional silos among various disciplines dealing with human, animal and environmental health.

The Supreme Court of India, in its judgement on the Animal Welfare Board of India vs A Nagaraja case, emphasised on the principle of eco-centrism and urgency of a nature-centric approach.

The securitisation response to COVID-19 is a manifestation of the lack of an integrated approach for human, animal and environmental health in India and globally. The symbiotic relationship between human, animal and environment are essential for the evolution and sustenance of this planet.

The international pandemic treaty currently under consideration is centrally rooted in the premise that an equity-oriented “One Health” approach is necessary for pandemic prevention and preparedness. The guidance document of the prospective pandemic treaty lays the roadmap:

• Incentivise the establishment of “One Health” infrastructure, including integrated surveillance systems that, in partnership with international organisations and countries, connect and share data on infectious pathogens in wildlife, companion animals, livestock, humans, and the environment (soil and water) and risk factors for disease emergence;
• Build One Health capacity and pandemic preparedness monitoring, assessment into global governance architecture; and
• Help establish a permanent global “One Health” structure that can oversee and provide technical and scientific support during treaty implementation, review and resolve evolving policy issues while contributing to current and forthcoming pandemic protocol.

What is often not reckoned is the fact that the most important barriers to multi-sectoral action in “One Heath” are political, not technical. COVID-19 has underscored a new spirit and substance in collaborations that need transcend existing networks and disciplines.

Rajib Dasgupta is chairperson of the Centre of Social Medicine & Community Health, Jawaharlal Nehru University, New Delhi and Co-Investigator of the UKRI-GCRF One Health Poultry Hub

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