Climate change reveals disease as national security threat

Medill National Security Reporting ProjectJanuary 10, 2011 

WASHINGTON — One of the most worrisome national security threats of climate change is the spread of disease, among both people and animals, 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.

"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 currently was done largely through publicly available medical information and mathematical modeling, but that's hardly enough to spot sudden disease trends quickly.

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

In coming decades, more heat, humidity and rainfall could allow mosquitoes, ticks and other parasites and carriers of tropical and subtropical diseases to spread to areas where they didn't exist previously, infecting populations that haven't built up resistance to them, intelligence and health officials say.

Malaria, cholera and other diseases are now being seen in parts of Asia and Africa where they weren't detected previously, something experts attribute to climate change. Dengue fever returned to the United States in 2009 after a 75-year absence — and might spread to 28 states, according to a Natural Resources Defense Council study.

Plants and animals also have been affected. Bark beetle infestations, for instance, have ravaged forests from Alaska to the Southwest and threaten to decimate commercial forestry, experts warn.

The U.S. government has mobilized its health intelligence community to get ahead of the problem, but many obstacles remain to identifying potential threats and responding to them.

Many countries lack the health infrastructure to detect diseases. Even the U.S. itself has significant holes in its public safety net due to budget cuts and inattention paid to the health risks of climate change.

"There is a gap in our surveillance to even determine whether the vectors are changing, and new diseases are being created and spread," 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 that fall under the supervision of the Office of the Director of National Intelligence, the agency created after the Sept. 11, 2001, terrorist attacks to coordinate intelligence gathering.

"There are key uncertainties," she noted, "including how quickly climate change will occur and the locations where the impacts will be most pronounced.''

Officials at the CIA's Center on Climate Change and National Security, created in September 2009 to gather information on the threat from global warming, say countering the spread of disease is high on their agenda.

The Department of Defense also has devoted significant resources to the problem, said Kent Hughes Butts of the Army War College. One of his top concerns: that the spread of disease in developing countries is helping to create "conditions that terrorists seek to exploit.''

The U.S. Global Change Research Program, which Congress created in 1990 to coordinate the work of 13 government agencies on global warming, released a report in April that identified 11 key health areas at risk from climate change. Among the concerns were diseases spread by food, water and pests such as mosquitoes and ticks; respiratory allergies; asthma and other respiratory diseases; and heat-related deaths and illnesses.

But the effort still hasn't figured out which threats are the most crucial, said Dr. George Luber, the director of the Centers for Disease Control and Prevention's climate change program at the National Center for Environmental Health.

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

The impact of disease on Africa's stability has long been a concern for U.S. intelligence and military officials, and the National Intelligence Council recognized in a National Intelligence Estimate in 2000 that "climatic shifts" were likely to allow diseases such as malaria and yellow fever to spread to new areas.

Eight years later, NIC Chairman Thomas Fingar told Congress that climate change would affect the military's new Djibouti-based Africa Command, which, Fingar said, "is likely to face extensive and novel operational requirements.''

"Sub-Saharan African countries — if they are hard hit by climate impacts — will be more susceptible to worsening disease exposure," Fingar said.

But detecting disease outbreaks remains a challenge, particularly in impoverished areas where medical care and modern communications systems are absent. A serious outbreak could soon overwhelm local governments and spur mass migration of infected victims across international borders.

"There are no international contingency plans for such an occurrence, nor are even the basic information systems in place to link (disease reporting) to potential response mechanisms like the U.N. Security Council or NATO,'' the National Intelligence Council concluded in a report it released two months ago.

Health officials question whether even the United States is prepared to handle the unpredictable impacts of climate change. Many local health systems lack trained health technicians who can diagnose new diseases, and the right epidemiological equipment.

They note that diseases once considered rare in the United States, such as dengue fever and West Nile virus, are no longer uncommon. West Nile virus, which was reintroduced to the United States in 1994, is now present in 44 states, while the mosquitoes that carry dengue fever are found in counties where 173.5 million Americans live.

Howard Frumkin, a former director of the CDC's National Center for Environmental Health who's now the dean of the University of Washington's School of Public Health, called the U.S. ability to cope with climate-related disease "shaky."

"It's the entire range of preparedness work, from problem identification to preparedness action to adaptation actions to testing the programs," he said. "All needs to be strengthened."

That's a message that hasn't been carried to the nation's political leaders, however. In its budget proposal for 2011, for example, the White House budget office zeroed out the CDC's vector-borne disease division. The Senate voted to restore the $26.7 million in funds, but the funding still has not been approved by the House of Representatives.

"There wasn't a real understanding of what kind of impact this would have on American health and people worldwide," said Karen Goraleski, the executive director of the American Society of Tropical Medicine and Hygiene.

What role politics will play in the U.S.'s ability to prepare for a climate-related health catastrophe in the new Republican-led House remains to be seen. In 2007, the administration of President George W. Bush deleted six pages from the prepared congressional testimony of then-CDC director Dr. Julie Gerberding that detailed the human health impacts of climate change.

This year, for the first time, the CDC gave out $5 million grants to 10 states and cities for climate-related health impacts. The National Institutes of Health used some money from the American Recovery and Reinvestment Act stimulus for grants that look at which populations are most vulnerable to climate change in the U.S.

But that hardly satisfies concerns.

"We're making progress, but it's a slower progress than it needs to be," Frumkin said. Climate change "is advancing far faster than has been forecast. We need to be ready not in 20 years or in 30 years, but relatively soon."

Chen is a graduate student in Northwestern University's Medill School of Journalism. This story is part of Medill's National Security Reporting Project, which is overseen by Josh Meyer, a former national security writer for the Los Angeles Times who now teaches in Medill's Washington program, and Ellen Shearer, the director of Medill's Washington program.

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