The NIC’s Miller and other U.S. intelligence and health officials say much of the problem lies overseas. Response mechanisms for a large-scale outbreak, they say, are not in place.
That’s a problem because a disease outbreak is often an early warning sign of fundamental instability in a country or region that has broader security implications for the U.S., according to Chad Briggs, the Minerva chair of energy and environmental security for the Air Force.
If a major outbreak were to occur, it could overwhelm local governments and spur mass migration of infected victims across international borders, provoking conflicts and “placing a burden to respond on civilian institutions and militaries around the world,” according to the Pentagon’s 2010 Quadrennial Defense Review.
“There are no international contingency plans for such an occurrence, nor are even the basic information systems in place to link [disease reporting] to potential response mechanisms like the UN Security Council or NATO,’’ the National Intelligence Council concluded in a report it released two months ago in conjunction with the European Union’s Institute for Security Studies. (pdf)
Gaps at home as well
Today, globalization has enabled any disease to move from one part of the world to another within a 24-hour period—including the United States.
And though the U.S. has better monitoring, diagnostic and response capabilities than most countries, some health officials question its ability to handle the unpredictable impacts of climate change domestically.
“It’s been a problem in the U.S. … Health and other sectors have just been given a lower priority,” said Dr. Kristie Ebi, who wrote the human health and climate change chapter in the 2008 Fourth Assessment report by the UN Intergovernmental Panel on Climate Change.
West Nile virus was reintroduced into the U.S. in 1994, allegedly by stowaway mosquitoes on a plane to New York. The disease spread across the country, and by the end of 2002, there were more than 4,000 reported cases in 44 states.
Dengue fever, which can be life-threatening if left untreated, also has been spreading in the U.S. due to the geographic expansion of mosquitoes, some experts say.
An estimated 173.5 million Americans live in counties with one or both of the dengue-carrying mosquito species, according to the Natural Resources Defense Council report.
In addition, officials say many local health systems lack trained health technicians who can diagnose new diseases, and the right epidemiological equipment.
“With a foundation that shaky, we don’t have the national capability that we need,” said Howard Frumkin, former director of the CDC’s National Center for Environmental Health and now dean of the University of Washington’s School of Public Health. “It’s the entire range of preparedness work – from problem identification to preparedness action to adaptation actions to testing the programs – all needs to be strengthened.”
Even after the Florida outbreak, the White House budget office zeroed out the CDC’s vector-borne disease division for fiscal 2011, which would have jeopardized studies that look at dengue fever along the U.S.-Mexico border and the CDC’s dengue branch in Puerto Rico.
“There wasn’t a real understanding of what kind of impact this would have on American health and people worldwide,” said Karen Goraleski, executive director of the American Society of Tropical Disease and Hygiene.
Though the Senate voted to restore the $26.7 million in funds, the budget still needs House approval. Goraleski’s group is one of several petitioning Congress to restore the money. (pdf)
Politics has also played a role in the U.S. health response to climate change.
In 2007, the White House deleted six pages of congressional testimony given by then-CDC director Dr. Julie Gerberding. Six pages detailing the human health impacts of climate change, including vector-borne, food-borne and allergy impacts, were redacted from Gerberding’s testimony.
With a preparedness gap that stems from the weak local health surveillance and extends to inattentive policymaking, some federal agencies are trying to get ahead of the problem, but “it’s a question of competing priorities,” said Dr. John Balbus, the senior public health adviser at the NIH’s National Institute of Environmental Health Sciences and co-chair of Global Change Research Program’s human health group.
This year, the CDC gave out—for the first time—$5 million grants to 10 states and cities for climate-related health impacts.
This past year, the NIH used some American Recovery Act funds for grants that look at which populations are most vulnerable to climate change in the U.S.
“We’re making progress, but it’s a slower progress than it needs to be,” Frumkin said. Climate change “is advancing far faster than has been forecast. We need to be ready not in 20 years or in 30 years, but relatively soon.”
This story also appeared in McClatchy newspapers: Climate change reveals disease as national security threat.