Disease, death and disruption: Globalization, bioterrorism and the politics of catastrophic infectious disease outbreaks

Naturally occurring emerging and reemerging infectious diseases (EIDs) and biological weaponry are both under-recognized, worsening transnational security threats. Bioterrorism (BT) is foremost a civilian public health problem, distinct from other catastrophic terrorism. This interdisciplinary project examines the failure of governments and international institutions to analyze adequately civilian biodefense against Catastrophic Infectious Disease Outbreaks (CIDOs). It reviews definitional questions, including political, social, psychological, and economic debates, and presents a smallpox bioterrorism case study. Although the primary focus is on the United States, the analytic framework is applicable globally. Analysts should view pathogenic threats through a CIDOs lens because it captures both the physical and important perceptual impacts of current and future epidemics on societies.; I also propose an implicit Catastrophic Infectious Disease Outbreak Social Contract between Western citizens and their governments, inspired by John Ruggie's embedded liberalism theory. Under embedded liberalism, states balance the sometimes-harsh consequences of postwar free-market capitalism and globalization with social welfare safety nets. Nevertheless, embedded liberalism is eroding, and this has jeopardized the CIDO Social Contract, unbeknownst to vulnerable Western populations which have not faced a major catastrophic pathogenic outbreak for generations. Globalization, neglect, misunderstanding, and biological technology advances contribute to rising EID and BT threats. Globalization has generated historically unprecedented wealth and medical breakthroughs worldwide, but three related trends collectively raise the indirect public health goods costs, and challenge the liberal economic order's very functioning.; This study includes historical examples and an overview of disease control politics. Amassed empirical data demonstrate how current health and economic policies have thwarted efforts to increase significantly public health infrastructure funding and coordinate planning. This failure threatens to undermine the CIDO Social Contract and collective security against naturally occurring EIDs and BT threats.; The necessary price for continued private, free-market globalization is more globalization, but preferably via stronger public health oversight regimes, major increases in World Health Organization authority and funding to offset World Trade Organization influence, and improved, integrated domestic and international infrastructure. It is my hope that this work shows the necessary interconnection among health politics, economics and global security.