Public Health is the Future of Global Security
Whether it’s incremental climate change, famine, drug and food management, noncommunicable disease, emerging infectious diseases, or unstable environmental conditions, global security is closely tied to global health threats. About a decade ago, I was asked what I thought might cause the “end of the world.” Would it be nuclear war? An alien invasion? Perhaps a meteor? I said none of those — it would be infectious disease. Not long after, COVID-19 emerged on the horizon and proved just how vulnerable the world can be.
The aftermath revealed millions dead, a decimated economy, disrupted supply chains, diminished military readiness, and massive unemployment. While COVID-19 did not end the world, its impact was felt like no other and reflected a world-ending apocalyptic environment of isolation and quarantine. It was the optimal setup for anarchy, disorganization, and weakened nation states. Today, the uncertainties and dynamics of the public health environment is still constant, and the global health threats are increasing. However, in the current political climate, the government has proposed significant cuts to many public health programs and agencies. This is not a time to reduce public health support, on the contrary, public health must be considered a top priority by our lawmakers, health experts, and military leaders.
What is Public Health?
When I asked people what public health was before COVID-19, I was often met with blank stares and a range of assumptions — a reminder of how little many understood the field at the time. As defined by the American Public Health Association, public health protects and promotes the health of people and their communities. When I say ‘people’ this also includes the U.S military and government employees.
Public health was a historically significant element in allowing military forces to organize, gain the advantage, and become coherent fighting forces, much of it through inoculation. This protection largely includes communicable and noncommunicable disease and the more relevant intersection to the military — Weapons of Mass Destruction (WMD). Public health is a collaborative effort that includes several threat vectors that require a diverse group of practitioners from the U.S military and government. It is an effort that has historically and persistently benefited our military and nation while building relationships through humanitarian assistance and post-war reconstruction efforts. Its value and benefits remain as relevant today as ever.
As a related recommendation: If you want a fun scientific based read that touches infectious disease, check out a book called The Real Science Behind the X-Files: Microbes, Meteorites, and Mutants. I also suggest an open-source website to follow current public health/disease issues and outbreaks: Global Incident Map
Who are the Primary Actors in the U.S Public Health System?
From the federal level there are some well know agencies that are devoted to this area.
The U.S Department of Health and Human Services (HHS) consists of the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), and the National Institute of Health (NIH). These agencies are the most prominent and focus a lot of their efforts on research, prevention, policy, preparedness, and investigation. I would highly encourage readers to research an intriguing unit under the CDC called the Epidemic Intelligence Unit.
Some lesser known but vital parts of this mission are the U.S Public Health Service (which is comprised of multiple federal health agencies), the National Center for Medical Intelligence (NCMI) under the Defense Intelligence Agency (DIA), and the Defense Health Agency (DHA). After these agencies you have a few smaller branch components as well. These agencies are critical because the U.S government and specifically the U.S military is entrusted with defending the United States and protecting its citizens, including its own members for military readiness.
The U.S Military had not Anticipated a Crisis of this Scale
During the COVID-19 outbreak, the U.S military had a limited plan in place for novel viruses of this scale. Disease surveillance and response were inadequate for a problem set of this magnitude, even when the US knew it was not a matter of if, but when. In addition, the close quarters of troops made the infection and incidence rate proliferate. Furthermore, this pandemic seriously disrupted supply chains. Military historians recognize that logistics are fundamental; without effective logistical support, an army cannot function. This affected everything from troop training to real-world operations. Moreover, medical equipment and Personal Protective Equipment (PPE) was especially difficult to obtain and resupply. As a result, the U.S military was forced to deal with a) an overall vulnerable and frail military force and U.S population, b) augmentation of forces for civilian support, c) increased mental health issues for troops, d) limited operational capacity, e) insufficient remote work capability, and f) growing domestic and international tensions.
Framing the Problem
National Security includes numerous unpredictable problems and dimensions that policymakers and warfighters must face as a nation. Understandably, the most pressing threats and a war for over two decades changed the threat perspective for our warfighters. The U.S aperture focused in on these issues and put aside the idea of a massive pandemic. The U.S military and overall, the U.S government faced recency bias and looked at the predictable, direct, and experienced threats more often than the black swan event.
As previously mentioned, though resilient, the U.S military — as with every other military — was unprepared for a pandemic of this level which should not have been the case. Research reflects that not only does the world experience global pandemics somewhat reliably but more frequently, roughly every 20 years or less, and they are becoming increasingly severe as well. As a strategic imperative, public health must be fully integrated into Department of Defense planning and policy. Failure to consider other risks is like the guy who trains daily in jujitsu or firearms for close quarters battle but ends up getting fatally injured because he didn’t wear his seatbelt—a preventable outcome.
Pushing Forward
After COVID-19 the U.S military took corrective action to improve its public health readiness and response, but under the current environment, I am concerned about the unwarranted attacks on public health, its agencies, and personnel. This is happening at a time when global health threats are on the rise due to globalization. Public health is not only national security but global security — now is not the time for the U.S to regress into anti-science rhetoric and relegate public health to a nonessential. Even in the face of unprecedented events like COVID-19, collective memory can be short. For this reason, public health must be continuously sustained and given greater emphasis within the National Defense Strategy.
Public health is not only national security but global security — now is not the time for the U.S to regress into anti-science rhetoric and relegate public health to a nonessential.
Conclusion
When leaders observe threats from the state perspective and overlook the human security variable, problems proliferate. Failure to intervene early is not only an issue in diplomacy and geopolitical warfare but a public health problem as well. Not intervening in a small geopolitical conflict can be a catalyst to increasing conflicts, similar as to failing to treat one disease that leads to comorbidities. This became evident over the past decade as the military began to seriously recognize the long-term implications of obesity on readiness — a concern now paralleled by the growing threat of communicable diseases.
A failure to implement upstream methods of intervention can be catastrophic to the US military and the people they protect.
A failure to implement upstream methods of intervention can be catastrophic to the US military and the people they protect. Without a ready response force, success in war is unattainable. Addressing these issues cannot be achieved through quick or overnight policy fixes once they emerge. The U.S military prides itself on analyzing the history and patterns of war, yet our leaders’ scholarship must also embrace a wider view of threats covering both those far-off, unforeseen dangers and the more familiar risks that may quietly escalate.
