Monday, March 07, 2005

Biodefense Versus Public Health

Effect Measure has a terrific post today on how the public-health system is being sacrificed to the biodefense juggernaut. It offers a special rebuke to those who believe that increased bioterror spending will result in some sort of Golden Age for public health.

In reality, these people have it exactly backwards. If you build the best public-health system you can, in order to deal with everyday problems, most of the work of preparing for bioterror gets done automatically. Agent detection is an interesting but comparatively minor field; it doesn't work well, but even if it did, mere data aren't all that useful unless you have a staffed and funded and organized public-system system. Bioterror is primarily an intelligence and law-enforcement issue; the greatest threat (and it really is miniscule in comparison to everyday public-health threats) comes not from international jihadists, but from homegrown racists, lunatics, and apocalyptic religious cults (from Bush's base, in other words). Forcing the public-health system to concentrate on biodefense is like designing a car that has a parachute - in case a bridge you're driving on collapses - but doesn't have seat belts.

But BushCo is ignoring all of this in order to siphon more money into the defense industry's all too capacious pockets; a new bioweapons race - requiring a decade or two of fantastically expensive, taxpayer-funded research into some omnipotent high-tech "bioshield" - would suit them just fine. And as Revere notes, this is likely to have grave consequences for public health and science:

Some of the research will inevitably be secret or classified. No public health research that is classified can serve a public health purpose or even a legitimate scientific agenda. If the results of our research is not to be made available to the global public health community of scientists and public health workers, we are not serving public health, a global enterprise of shared knowledge and endeavor. Instead, we corrupt that enterprise, just as physics was corrrupted by the Cold War.
Meanwhile, new vulnerability testing will be conducted in New York City:
At some point within the next two weeks, Madison Square Garden will play host to a swarm of observers scrutinizing the behavior of an unseen agent.

As early as Wednesday morning, depending on the weather, the carefully orchestrated release of a colorless, harmless gas in Manhattan should help researchers get a better handle on how hazardous contaminants - whether from natural sources or malicious attacks - disperse in an urban setting.
Sounds innocuous enough, perhaps, but it isn't. I believe that under Bush, a return to earlier levels of intensive open-air testing is all but inevitable (if it hasn't happened already). The temptation to use live bacteria, or potentially allergenic aerosols or particulates, is not one I can see BushCo resisting. Whether such vulnerability testing ends up harming people or not, it's expensive, unethical, and indistinguishable from the testing of offensive bioweapons.


Cervantes said...
This comment has been removed by a blog administrator.
Cervantes said...

Whoops, wrong excerpt! Here's the right one:

With regard to "terrorism preparedness," our evidence that current funding is an "empty promise" is given in our commentary. We cited reports that state and local funding cuts and unfunded federal mandates like the smallpox campaign have undercut or outweighed increases in federal spending,1,2 and others have expressed concern about this.3 Centralized data have not been collected, but local reports are consistent. For example, a Virginia health district director reported that 2 new positions were created with federal funds but the mandated activities required the effort of at least 4 full-time employees, so that resources had to be diverted from school health, communicable disease, and environmental health programs (S. Allan, MD, JD, MPH, oral communication, October 18, 2004). A study of California public health programs reported "substantial evidence that reassignments of staff to accomplish preparedness functions, as well as cuts to public health budgets at a county level that have resulted from the current fiscal pressures are compromising other public health functions. Multiple examples of retrenchments in essential programs (such as sexually transmitted disease and tuberculosis contact tracing or teen pregnancy prevention programs) were provided during key informant interviews."4(p7)

Furthermore, some bioterrorism preparedness programs may do more harm than good. The proliferation of laboratories studying bioterrorism agents such as anthrax increases the risk of accidental releases5 as well as deliberate releases, such as the 2001 dissemination of militarized anthrax spores linked to US military research.6

Bioterrorism preparedness programs have turned public health priorities upside down. Huge resources were expended to produce and distribute smallpox vaccine and conduct the failed campaign to inoculate 500 000 health workers without evidence of imminent risk of exposure to a disease eradicated from the ecosphere more than 20 years ago.7 Contrast this with the most recent shortage of influenza vaccine. The government was oblivious to warnings of the impending crisis8 despite serious problems in 3 of the previous 4 flu seasons.9 The lack of attention to and resources for public education about flu and for manufacturing and distribution of the vaccine represented public health negligence in the face of an estimated 36 000 flu-related deaths in the United States every year.

Phila said...

Great stuff, Cervantes! Thanks a million!

Cervantes said...

Man, you have definitely got to get Haloscan commenting, you could get old trying to get access to Blogger commenting.

Anyhow, believe it or not, by a bizarre chain of semi-sleazy circumstances, I'm going to somehow be involved in our state's "Bioterrorism Preparedness" drills. One of those technofascist consulting companies called us up last summer about a proposal that was due the next day, needing a Minority Business Enterprise subcontractor so they could get extra points. We said what the heck, anything for a buck. They got the contract but we still don't know what we're going to do or what this is all about. I'll find out in a couple of weeks, maybe we'll have some fun news to know and tell.

Phila said...

Yeah, I don't know what's up with Blogger lately. It's been incredibly slow.

Unfortunately, I hate Haloscan, too! I'll give it a week or so, but if it keeps up like this, you're right, I'll have to switch. Or maybe people can comment on postcards, instead. Or via a message in a bottle.

Your job sounds interesting...I used to do a similar kind of work, back when Clinton was tossing a lot of money around for EMTs and FFs to be trained in terrorism response. Anyway, keep me posted, by all means!