Tuesday's announcement by President Barack Obama — that the US would be sending in an army of 3,000 to fight Ebola — came as a relief to the many wondering when the international community would wake up to the daily horror show playing out in West Africa.But the tactics also raised some questions: why was Obama sending soldiers to fight off a virus? And why has he been characterizing this disease spread as a "security threat" and "security priority"?
Why Obama is describing Ebola as a "security threat"
Obama has repeatedly referred to the threat of Ebola in security terms, arguing the virus could cripple the already fragile economies in the African region. He's made the case that this will have consequences for not only the security of countries there, but also for nations around the world — even if the virus doesn't spread beyond Africa.
For examples of this war-like mentality, look no further than the president's address, delivered Tuesday from the Centers for Disease Control headquarters in Atlanta:
"If the outbreak is not stopped now, we could be looking at hundreds of thousands of people infected, with profound political and economic and security implications for all of us. So this is an epidemic that is not just a threat to regional security — it's a potential threat to global security if these countries break down, if their economies break down, if people panic. That has profound effects on all of us, even if we are not directly contracting the disease."
Obama could have called Ebola a "public health threat" or "global health threat." But with this bold declaration that the virus is a "security threat", he is doing two things. First, he's trying to convey that the outbreak in West Africa — even though it's on a distant continent — presents an existential threat to America. This language shifts the focus from "them" to "us." Second, he's signaling that the risk is immediate enough to justify the galvanization of American resources.
This has become an increasingly common way to talk about disease
The World Health Organizations constitution, penned in 1946, says that "health of all peoples is fundamental to the attainment of peace and security." But only in the last 15 years have diseases increasingly been treated as security issues.
Writing in the medical journal the Lancet, international relations specialist Stefan Elbe points out that 2000 marked a fundamental shift toward the "securitization of disease." That January, the UN Security Council made the unprecedented move of convening a meeting to address the out-of-control HIV/AIDS pandemic. This resulted in a massive concentration of resources into HIV/AIDS research, and made the conversation about addressing the disease an international one requiring a global and coordinated effort.
Since then, the Lancet article continues, "The rise of the new health security paradigm has even seen some health issues becoming formally incorporated into national security strategies."
In 2005, President George W. Bush became concerned about mutations of the H5N1 bird flu, and declared the flu strain a security threat. Bush's declaration resulted in the establishment of America's first pandemic preparedness plan, says Laurie Garrett, a Council on Foreign Relations senior fellow for global health. And other nations adopted similar strategies.
Over the years, with globalization and the speed at which infectious diseases spread, health threats are seen as something different. "Everybody has come to agree that the economic impact of a serious virulent pandemic is so severe that it can undermine trade and prosperity in any affected country," Garrett says. And this has changed how countries respond to even the most distant threats.
Is security framing the right approach to Ebola?
On Thursday, the UN Security Council held an emergency meeting on the Ebola epidemic. This is the second disease to warrant such a gathering since HIV/AIDS. The reason Ebola is referred to in security terms is simple, Garrett says: "This epidemic is so dire and our toolkit is so limited."
There are no drugs or vaccines yet on the market for the disease, and the Ebola body count is rising fast. Half of the deaths so far have happened in the past month, meaning the rate of infection is exponentially increasing. Already, the virus has spread beyond the three West African nations most afflicted (Guinea, Liberia, and Sierra Leone) into Senegal and Nigeria. At this rate, it's a numbers game: with more and more infections, it's only a matter of time before another sick person gets on a plane and brings the virus across another border. Then another. And another.
"In the end, we'll either stop this or see it go from epidemic to endemic based on the same toolkit that was used for the first Ebola outbreak in 1976," Garrett says. That's a sorry state of affairs.
For these reasons, Garrett believes calling Ebola a threat to national and global security is the right thing to do and will help muster resources to address a rapidly deteriorating situation. As Garrett points out in Foreign Policy, since Ebola has escaped its usual environs — the bushes and rural communities of Africa — and made its debut in dense, urban centers this year, it has become a potential existential threat in major cities in Africa and beyond in a way no one could have foreseen.
Drawing on the vast resources of the US military to focus on logistics, capacity building, and coordinating supplies makes sense, she added, noting that it was the US forces who turned the post-Katrina disaster in New Orleans around. "It is at least possible that the US military, bringing in medical supplies and marshaling forces in an appropriate and organized manner (in West Africa), that they will be viewed as heroes."
But others don't see it that way. Simon Rushton, who researches the global politics of health at the University of Sheffield, says, "One of the big problems with the Ebola outbreak has been a lack of public trust in not only West Africa's own governments but in the west. Sending a load of US troops is unlikely to build trust, and might have the opposite effect."
We already know that people with the disease have been hiding from public view, afraid of being kept in quarantine, and wary of health workers, Rushton says. "Using military can lead to politics of fear."
A surge response doesn't address the root causes of the epidemic: broken and under-funded health infrastructure, poverty, and misaligned incentive systems for the development of treatments to address diseases of the poor, like Ebola.
"What we're reaping here with Ebola is the consequence of a long-term failure to help countries develop their own health systems," says Rushton. "If stable health systems were in place and functioning properly, Ebola would have been contained."
Military action might be partially effective, it might bring this outbreak to a close. But it might also heighten distrust in the authorities and the international community.
The other danger is that the health resources sent to Africa become disproportionately focused on the Ebola threat. "This surge mentality gives you single-minded focus on one particular disease" at a time when many others are ravaging Africa in numbers far greater than Ebola, Rushton added. But scourges like malaria and diarrhea are not ripe for the imagery and action that "security threats" conjure.