Contagion and Chaos Disease, Ecology, and National
Security in the Era of Globalization (Mit Press)
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Contagion and Chaos
Disease, Ecology, and National Security in the Era
of Globalization
Andrew T. Price-Smith
The MIT Press
Cambridge, Massachusetts
London, England
© 2009 Massachusetts Institute of Technology
All rights reserved. No part of this book may be reproduced in any form by any
electronic or mechanical means (including photocopying, recording, or informa-
tion storage and retrieval) without permission in writing from the publisher.
For information on quantity discounts, email [email protected].
Set in Sabon by SNP Best-set Typesetter Ltd., Hong Kong. Printed on recycled
paper and bound in the United States of America.
Library of Congress Cataloging-in-Publication Data
Price-Smith, Andrew T.
Contagion and chaos: disease, ecology, and national security in the era of
globalization / Andrew T. Price-Smith.
p. ; cm.
Sequel to: The health of nations / Andrew T. Price-Smith. c 2002.
Includes bibliographical references and index.
ISBN 978-0-262-16248-7 (hardcover: alk. paper)—ISBN 978-0-262-66203-1
(pbk.: alk. paper)
1. Communicable diseases—History. 2. Communicable diseases—Political
aspects. 3. Communicable diseases—Social aspects. 4. National security.
5. Security, International. 6. Diseases and history. I. Price-Smith, Andrew
T. Health of nations. II. Title.
[DNLM: 1. Communicable Diseases, Emerging-prevention & control.
2. Disease Outbreaks—history. 3. Environmental Health. 4. Health Policy.
5. Security Measures. WA 100 P946c 2009]
RA643.P73 2009
362.196'9—dc22
2008021363
10 9 8 7 6 5 4 3 2 1
to my grandfather Judge Douglas Cameron (D.C.) Thomas and my
stepfather, Professor John Tennyson (Jack) McLeod
Contents
Acknowledgements ix
Introduction 1
1 Theory and Exegesis: On Health and the Body Politic 11
2 Epidemic Disease, History, and the State 33
3 Pandemic Influenza: On Sclerosis in Governance 57
4 HIV/AIDS, State Capacity, and National Security: Lessons from
Zimbabwe 89
5 Mad Cows and Englishmen: BSE and the Politics of Discord 117
6 Epidemic of Fear: SARS and the Political Economy of Contagion in
the Pacific Rim 139
7 War as a “Disease Amplifier” 159
8 On Health, Power, and Security 189
Conclusion 207
Notes 225
Bibliography 253
Index 275
Acknowledgements
I should like to thank my family for their constant support over the years,
particularly my dear wife Janell, who patiently endured my research
trips, formatted charts, and provided consistent encouragement. Thanks
to my stepfather John Tennyson (Jack) McLeod, my mother Cynthia,
my sister Adrienne, and my dear grandparents Douglas Cameron (D.C.)
Thomas and Margaret (Arla) MacKay Thomas (dec.). I also thank the
entire Harvey and Barounes clans for their warmth and support, particu-
larly Maria and Gerry Harvey, and Edna Barounes (dec.). Thanks to
Christina Greenough for her work on the index.
Thanks to my wonderful colleagues at The Colorado College for their
friendship, intellectual camaraderie, and occasional critiques. My grati-
tude to Dr. Heinz Geppert for his assistance in translating several docu-
ments from archaic German. I should also like to thank Steve Tauber,
Johnathan Daly, and Mark Amen of the University of South Florida,
who provided valuable intellectual engagement and friendship during my
early years in Florida.
Further, I owe a great debt to Steve Morse of the Mailman School of
Public Health at Columbia University. Steve was instrumental in bringing
me to Columbia for my post-doctoral work, and in my occasional returns
since those early days. He has been profoundly influential in his support
of the health and security debate, and in fostering global cooperation to
prepare for emerging disease threats. Insight and encouragement was
also provided by Daniel Deudney of the Department of Political Science
at Johns Hopkins University. Dan’s brave intellectual forays into repub-
lican theory provided a significant impetus to my work in recent years.
I should also like to note the persistent intellectual influence of my doc-
toral advisor David A. Welch, and also that of Louis Pauly, Franklyn
Griffiths, Salim Mansur, and Mark Zacher.
x Acknowledgements
The research for this volume was supported by various grants and
awards over the years. Generous patrons of this work include the Social
Science Executive Committee, the Dean’s Office at The Colorado College,
the Christian-Johnson Foundation, the Benezet Award, the Mrachek
Award, Asian Studies, and all of The Colorado College. Additional
support was provided by the Center for Globalization of the University
of South Florida, the US Department of Homeland Security, the US
Department of Defense, and the World Affairs Councils of the United
States. Finally I should like to thank my research assistants, Carmen
Huckel, Rachel Shaffer, and Carlie Armstrong. I am grateful for the kind
assistance I received from the library staff at the Statsbiobliothek Berlin,
and at the Osterreichische Nationalbibliothek in Vienna. Finally, I should
like to express my appreciation for the patience and diligence of my
editors, Clay Morgan and Paul Bethge, and to the entire staff of the
MIT Press.
Contagion and Chaos
Introduction
Great catastrophes may not necessarily give birth to genuine revolutions, but
they infallibly herald them and make it necessary to think, or rather to think
afresh, about the universe.
—Fernand Braudel (1980)
Health is the fulcrum of material power, and therefore it is central to
the interests of the modern sovereign state. In the present day, novel
trans-national threats to the security of states have arisen in the form of
multinational terrorism, the proliferation of weapons of mass destruc-
tion, and global environmental change. From the mid 1990s on, scholars
of international politics have speculated that emerging and re-emerging
infectious diseases may also constitute a threat to international security,
through their negative effects on sovereign states. Population health
contributes directly to the endogenous prosperity and stability of a par-
ticular polity, to the consolidation and projection of sovereign power,
and ultimately to the security of the state. The health of the body politic
thus contributes directly to the functionality of the apparatus of
governance.
Liberating the people from the shackles of disease and hunger con-
tributes directly to the development and consolidation of endogenous
human capital, which consequently augments economic productivity
and the production of both social and technical ingenuity. The resulting
prosperity permits the extraction of fiscal resources from the people via
mechanisms of taxation to fill the coffers of the state. In view of the
fungibility of economic power, such revenues may be transformed into
public goods delivered to the people, or channeled into the apparatus of
coercion (the military and police) so as to maintain order and project
power abroad.
2 Introduction
The antithesis of health, epidemic disease, then, presents a direct
threat to the power of the state, as it erodes prosperity, destabilizing
the relations between state and society, renders institutions sclerotic,
foments intra-state violence, and ultimately diminishes the power and
cohesion of the state. As such, epidemic infectious disease is profoundly
disruptive to an affected polity, undermining its security. Yet contagion
also contains the seeds of catalytic socio-economic and political
transformation.
The principle of creative destruction lies at the core of all natural
processes of change.1 Geologists speak of catastrophic disruptions pro-
duced by phenomena such as volcanism, earthquakes, and impact events,
yet out of such chaotic periods a new order emerges. Fire sweeps through
an ecosystem, devastating the local flora and fauna, and in the aftermath
a new ecological equilibrium coalesces. In these natural processes one
sees a pattern: an original period of stasis and equilibrium, then a period
of chaotic destabilization (turbulence), and then the establishment of a
second equilibrium that may differ radically from the one that preceded
the destruction. Thus, natural systems exhibit periods of stasis followed
by abrupt change—a model of punctuated equilibrium, if you will.2 The
human species (and the institutions it has fashioned) emerged in the
context of such catalytic (and non-linear) processes, and despite our
anthropocentric hubris we remain deeply embedded within the global
ecology, subject to droughts, hurricanes, earthquakes, and epidemic
diseases.
Historians have argued that contagion wrought profound changes in
the socio-economic, legal, and political orders of afflicted societies.3 Yet
the complex interplay between non-linear natural systems and human
societies is often ignored within the social sciences, particularly in the
domain of political science.4 The political scientist Daniel Deudney has
deplored the lack of inclusion of material-contextual factors in present-
day political science, which acts as if societies evolved and matured ex
nihilo: “[A] major distorting filter in contemporary thinking, particularly
about international relations . . . is a gross underappreciation or misap-
preciation of the importance of material-contextual factors, of nature,
geography, ecology, and technology. We think and act as if technologies
are just our handy tools and as if nature has somehow just been left
behind.”5
Historians have continued to investigate how such material-contextual
variables (including contagion) affect state-society relations. Fernand
Introduction 3
Braudel, one of the foremost historians of the twentieth century, noted
that manifestations of epidemic disease induced profound disruptions
of existing institutions such as markets, economies, and socio-
political systems, and that such disruptions could be protracted.6 In a
Schumpeterian sense, epidemics have the capacity to induce profound
turmoil but often function as catalysts of change, generating transforma-
tion in the belief structures of survivors, in the micro- and macro-level
social and economic structures of affected polities, in the relations
between the state and society, and ultimately between countries. The
profoundly destabilizing effects of contagion result from various mani-
festations of illness, including high levels of mortality and/or morbidity,
the destruction of human capital, economic disruption, negative psycho-
logical effects, the consequent acrimony between affected social factions,
and the deteriorating relations between the people and an often draco-
nian state.
The reader will, doubtless, note the double-entendre in the title of this
book. The historical record suggests that contagion may induce degrees
of chaos within affected societies, the level being dependent on many
subtle contextual variables regarding the pathogen, the affected society,
and the resilience (or capacity) of the state. In addition, the emergence
of novel pathogenic microbial agents results from the complex interplay
of chaotic systems in the natural realm, and from their intersection with
the human ecology. Natural systems exhibit non-linearities (such as epi-
demic growth curves) and emergent properties, govern the emergence of
novel zoonoses, and determine the course of their manifestation as epi-
demic and/or pandemic disease. Such non-linear dynamics are often
observed during periods of war. To the extent that war destroys the
infrastructure of medicine, public health, and sanitation, impedes the
production and distribution of food and medical supplies, prevents sur-
veillance and treatment, and generates poverty, it is a driver of patho-
genic emergence and virulence. To that end, the social and structural
chaos induced by war may act as a powerful amplifier of disease.7
Hypotheses
The first hypothesis advanced in this volume is that epidemic disease may
function as a stressor variable to compromise the prosperity, the legiti-
macy, the structural cohesion, and in certain cases the security of sover-
eign states. Further, disease may exacerbate pre-existing domestic conflicts
4 Introduction
between ethnicities, and/or classes and may generate intra-societal and
intra-state violence, and the resulting societal discord may generate puni-
tive and draconian responses by the state against the people as it seeks
to maintain order. Thus, disease often functions to destabilize the coher-
ence, the power, and (perhaps) the security of the state.
The second hypothesis is that epidemic and pandemic manifestations
of novel pathogens may promote economic and political discord between
countries, although contagion is not likely to generate significant armed
conflict between sovereign states.
The third hypothesis is that only some of the documented infectious
pathogens threaten national security, and that criteria based on lethality,
transmissibility, fear, and economic damage will illuminate which patho-
gens are security threats and which are not.
The fourth hypothesis is that the practices of warfare (both intra-state
and inter-state) will generate “war pestilences,” contributing to the pro-
liferation of infectious disease within the ranks of the combatants and
subsequently to proximate civilian populations. Thus, conflict amplifies
the burden of disease.
The fifth hypothesis is that the paradigm of “health security” is philo-
sophically grounded in the political tradition of republican theory, a
theoretical antecedent to both Realism and Liberalism; that the associa-
tion between the health of the population and perceptions of national
security is ancient but largely forgotten; and that a republican revision
of systems-level international relations theory (with elements of political
psychology) provides an optimal theoretical framework for pursuing
such inquiries.
The biologist E. O. Wilson bemoaned the “fragmentation of knowl-
edge” and argued that the solutions to the complex collective action
problems of the modern age lay in interdisciplinary knowledge and its
practical application. This volume is explicitly a consilient,8 or interdis-
ciplinary, exploration of the relationship among infectious disease, gov-
ernance, and prosperity within affected polities, and between countries.
The material presented herein is admittedly an eclectic synthesis of politi-
cal science, history, biology, demography, economics, psychology, soci-
ology, ecology, physics, and public health. The hope is that such a
work may appeal to a broad audience and encourage new avenues of
thought and investigation across the disciplines, bridging the epistemic
schisms that have deepened over the decades as a result of disciplinary
specialization.
