Generals Can’t Fight the Last Pandemic

By Danyale C. Kellogg

iStock illustration

The early 2020 episode of the USS Theodore Roosevelt aircraft carrier clearly demonstrated the thin, permeable line between public health and national security.

COVID-19 was detected on the ship while she was at sea, forcing her to make a months-long emergency port call in Guam as upwards of 1,150 crew members tested positive for the virus, calling into question how prepared the military was for a major disease outbreak.

While this number pales in comparison to the more than 46 million cases and 750,000 deaths the United States has suffered in total thus far, it should serve as a warning of what may come next if the nation isn’t prepared.

In the 21st century, which has been marked by increasingly frequent major epidemics and pandemics, the old playbook doesn’t cut it anymore.

Health threats, especially pandemics, are national security threats, and they must be treated as such. This sentiment, long up for debate in academic circles, has started to gain more traction in policy circles, including with Max Rose, former senior advisor to the secretary of defense on COVID-19.

While there are challenges inherent to this approach, the United States can better ensure success by adequately sharing the burden of pandemic planning across the government, investing more in medical countermeasures and vaccines, and ensuring the industrial base is adequately prepared for future pandemics.

The most pressing issue is effectively securitizing health by balancing this with general improvements in public health and not putting all the burden on the Defense Department’s shoulders, as Dr. Gregory Koblentz and Dr. Michael Hunzeker of George Mason University’s biodefense program warn.

Scholars in public health have argued that health securitization — accepting a health threat as an existential security threat — undermines public health by detracting resources and creating an “us versus them” mindset that hurts health outcomes overall. Pathogens do not care about national borders and pandemics are not zero-sum games. As such, effectively treating pandemic planning like a national security priority demands burden sharing and compromise with public health agencies.

This type of planning and preparedness building also demands interdisciplinary and cross-sectoral collaboration. As the U.S government works to better facilitate this, more health care organizations will likely find themselves overtly at the center of national security efforts.

This blurring of health care and national security will require these companies to have strong cybersecurity postures, particularly as health care is increasingly digitized and personalized, while making sure they can deliver critical products and services when the next health crisis comes.

The United States must also continue to invest in vaccine and medical countermeasure research and improved healthcare and community health.

Thus far, the government has spent an estimated $39.5 billion to support the development of COVID-19 vaccines, including the initial $4.95 billion for 300 million doses provided to Moderna to help offset market risks.

This all came after decades of research on mRNA vaccines, a platform technology which was made possible by government funding, including from the Defense Department. Companies need these types of government incentives to offset market risk for a variety of countermeasures, particularly as the threats of antimicrobial resistance and novel pathogens rise, making this a priority for national security spending.

Government and private organizations also cannot allow their pandemic plans to become too COVID-19 or respiratory illness-specific in the aftermath of this pandemic. It isn’t known what the next pandemic will be, but, in addition to influenza, the World Health Organization warns that diseases like Nipah, Ebola, Chikungunya, Crimean-Congo Hemorrhagic Fever, or the next “Disease X” represent the greatest pandemic threats.

Whatever comes next, the world could soon be facing a much deadlier pandemic caused by a pathogen that does not spread at all like COVID-19. Planning must be generalized and adaptable so that it can be tweaked to fit the next pandemic, helping ensure workforce stability and continuity and the ability to produce vaccines and therapeutics rapidly.

These initial steps represent major shifts in how health threats are viewed and where they fit in the context of U.S. national security in the modern world. The 21st century has thus far seen the 2009 H1N1 pandemic, COVID-19 pandemic, and multiple major epidemics, including Ebola in West Africa from 2013 to 2016 and SARS in 2002.

Increased global travel and trade, population growth encroaching on wildlife habitats, and other changes increase the risk of pandemic disease.

This demands adaptation of how we view health threats and the kind of priority they are afforded in defense policy and industrial capacity.

Whatever the next pandemic is, the nation cannot afford to be caught off guard again.

The Defense Department and the rest of the national security community are uniquely well-suited to lead and invest in efforts that use a whole-of-society approach to make sure we are better prepared for the inevitable next pandemic. It is vital that we harness that power now.

The next crisis could be much deadlier.

Danyale C. Kellogg is an NDIA junior policy fellow.

Topics: Defense Department

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