Disease: A top U.S. security threat

Mosquitoes that transmit malaria and dengue fever are sensitive to temperature changes. These types of diseases are destabilizing regions of the world that will affect U.S. national security. (Stock.XCHNG)

By Jessica Q. Chen
Medill National Security Reporting Project

WASHINGTON – One of the most worrisome national security threats of climate change is the increased spread of disease, with potentially millions of people at risk of serious illness or death and vast numbers of animals and crops also in danger of being wiped out, U.S. intelligence and health officials say.

But more than a decade after such concerns were first raised by U.S. intelligence agencies, significant gaps remain in the health surveillance and response network—not just in developing nations, but in the United States as well, according to those officials and a review of federal documents and reports.

And those gaps, they say, undermine the ability of the U.S. and world health officials to respond to disease outbreaks before they become national security threats.

Identifying health threats

The Human Health and Working Group report details 11 disease and health consequences of climate change.

“We’re way behind the ball on this,” said Josh Michaud, who has worked at the Defense Department’s National Center for Medical Intelligence and its Global Emerging Infections Surveillance and Response System.  “It’s a collective action problem.’’

Michaud said monitoring is done largely through the gathering of open-source medical information and mathematical modeling, but that gaps remain.

U.S. intelligence officials said the spread of disease is one of their top four climate change-related security concerns, along with food and water scarcity and the impact of extreme weather on domestic infrastructure. Outbreaks can destabilize foreign countries, especially developing nations, overtax the U.S. military and undermine social cohesion and the economy at home.

In the coming decades, more heat, humidity and rainfall will allow mosquitoes, ticks, parasites and other tropical and subtropical disease vectors to spread into new areas where people have not built up any resistance to them, the intelligence and health officials said.  Other environmental changes can spawn new infectious diseases that may be undetectable, causing new concerns, they said.

Regions in Africa and Asia already have witnessed expansions of malaria, cholera and other diseases that experts attribute to climate change. Pakistan, Zimbabwe and Cameroon have experienced cholera outbreaks in the last couple of years.  In the U.S., dengue fever returned in 2009 after a 75-year absence. A Natural Resources Defense Council study said dengue fever could spread to 28 states. (pdf) Such concerns prompted federal health officials to declare it a nationally reportable disease last January.

The United States has begun to see the potentially devastating impact on plants and animals as well. Bark beetle infestations, for instance, have ravaged forests from Alaska to the Southwest and threaten to decimate the commercial foresting industry, experts warn.

Gaps in the global system

In response, Washington has mobilized its health intelligence community to get ahead of the problem.  But the officials say obstacles remain in identifying potential threats and responding to them.

Many countries that are flashpoints for outbreaks lack the health infrastructure to detect diseases. There are also major gaps in the global health network to coordinate response efforts. And the U.S. itself has significant holes in its public safety net, in part due to budget cuts and inattention paid to the health risks of climate change.

Those are the conclusions top U.S. intelligence and health officials have made, based on interviews, reports and testimonies. And one of their biggest concerns, they say, is not knowing the true magnitude of the threat.

“There is a gap in disease surveillance to even determine the totality of the pathogens … and whether the vectors that may spread these diseases are moving into new habitats,” said Dr. Joy M. Miller, the senior global health security adviser for the National Intelligence Council, the center of strategic thinking for the CIA and other agencies within the Office of the Director of National Intelligence. “There are key uncertainties, including how quickly climate change will occur and the locations where the impacts will be most pronounced.’’

The U.S. intelligence community is working with the Centers for Disease Control and Prevention and with its counterparts overseas, according to Miller, but there is still more to do.

“We need to improve disease monitoring, and share information and expertise,’’ particularly in developing nations, Miller said. “Without this information, new diseases can emerge and spread globally before we have time to develop vaccines or other countermeasures.”

In September 2009, the CIA created a Center on Climate Change and National Security, whose officials say countering the spread of disease is high on their agenda.

The Department of Defense also has devoted significant resources to the problem, both at the Pentagon and in the field, said Kent Hughes Butts of the Army War College, who works closely with U.S. military commanders and intelligence officials to explore links between climate change and security. One of his top concerns: that the spread of disease in developing countries is helping create “conditions that terrorists seek to exploit.’’

In December 2009, the U.S. Global Change Research Program created an interagency working group on climate change and human health. It released a report in April that identified 11 key health areas at risk from climate change.  They included diseases spread by food, water and vectors such as mosquitoes and ticks; respiratory allergies; asthma and other airway diseases; and heat-related deaths and illnesses.

As a participant in that effort, Dr. George Luber, the director of the CDC’s climate change program in the National Center for Environmental Health, said that the report didn’t prioritize the threats because it was only a starting point for federal researchers and policymakers to better understand climate’s impact on human health.

“We really haven’t gotten to the point where we can start putting even qualitative estimates on future burdens,’’ Luber said.

A decade of concerns

For generations, U.S. intelligence and military officials have kept a close eye on Africa and other hotspots where the emergence of infectious diseases could impact national security.

In 2000, the National Intelligence Council issued a formal report on global infectious diseases, and concluded that “climatic shifts’’ were likely to enable diseases like malaria, yellow fever, dengue fever and cholera to spread to new areas, “and could add several million more cases in developing country regions over the next two decades.’’ (pdf)

“The persistent infections disease burden is likely to aggravate and, in some cases, may even provoke economic decay, social fragmentation, and political destabilization in the hardest hit countries in the developing and former communist worlds,’’ the National Intelligence Estimate concluded.

Eight years later, NIC Chairman Thomas Fingar told Congress that climate change could force the U.S. military to dramatically expand its humanitarian operations.

The new Africa Command “is likely to face extensive and novel operational requirements,’’ Fingar said.  “Sub-Saharan African countries—if they are hard hit by climate impacts—will be more susceptible to worsening disease exposure.”

Last year, the University College London Institute for Global Health and the respected British medical journal Lancet concluded that “climate change is the biggest global health threat of the 21st century, ” and one where a coordinated public health response is “needed urgently.” (pdf)

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