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INHERENCY
INHERENCY- DOD LABS NEED FUNDING AND LABS ...................................................................... 26
INHERENCY- DOD FRAGMENTED .......................................................................................................... 27
INHERENCY- INTEGRATION..................................................................................................................... 28
INHERENCY- STAFF ..................................................................................................................................... 29
INHERENCY- SURVEILLANCE NEEDED ............................................................................................... 30
INHERENCY- LABS NEEDED ..................................................................................................................... 31
INHERENCY- LABS NEEDED ..................................................................................................................... 32
INHERENCY- LABS NEEDED ..................................................................................................................... 33
INHERENCY- LABS NEEDED ..................................................................................................................... 34
INHERENCY- FUNDING NEEDED ............................................................................................................. 35
INHERENCY- FUNDING ............................................................................................................................... 35
INHERENCY- NOT A PRIORITY................................................................................................................ 37
INHERENCY- PERSONNEL, SUPPORT.................................................................................................... 38
INHERENCY- RESOURCES ......................................................................................................................... 38
INHERENCY- RESOURCES ......................................................................................................................... 40

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DISEASES
DISEASES- DISEASE RESISTANCE GROWING .................................................................................... 44
DISEASES- NEW DISEASES EMERGING ................................................................................................ 45
DISEASES- EMERGING NOW ..................................................................................................................... 46
DISEASES- MUTATIONS, EMERGING DISEASES ............................................................................... 47
DISEASES- GLOBAL WARMING ............................................................................................................... 48
DISEASES- CLIMATE/GLOBAL WARMING .......................................................................................... 49
DISEASES: CLIMATE ................................................................................................................................... 50
DISEASES- CLIMATE .................................................................................................................................... 51
DISEASES- HUMAN FACTORS ................................................................................................................... 52
DISEASE- MONOCULTURE ........................................................................................................................ 53
DISEASES- ZOONOTIC ................................................................................................................................. 54
DISEASES- POPULATION GROWTH ....................................................................................................... 55
DISEASES- GLOBAL WARMING/CLIMATE .......................................................................................... 56
DISEASES- EMERGING IN AFRICA ......................................................................................................... 57
DISEASES: INFLUENZA- RAMPANT....................................................................................................... 58
DISEASES: INFLUENZA- ECON ................................................................................................................. 59
DISEASES: INFLUENZA IMPACT- DEATH TOLL............................................................................... 60
DISEASES: BIRD FLU- DEATH TOLL ...................................................................................................... 61
DISEASES: BIRD FLU IMPACT- ECON.................................................................................................... 62
DISEASES- RIVER BLINDNESS .................................................................................................................. 63
DISEASES- MALARIA REEMERGING ..................................................................................................... 64
DISEASES: MALARIA DRUG RESISTANCE.......................................................................................... 65
DISEASES: MALARIA IMPACT- ECON .................................................................................................. 66
DISEASES: HIV IMPACT- ECON, POVERTY ......................................................................................... 67
DISEASES IMPACT: TERRORISM ........................................................................................................... 69
DISEASE IMPACT- AFRICAN ECON ........................................................................................................ 71
EMERGING DISEASES IMPACT- EXTINCTION................................................................................... 72
KALA-AZAR IMPACT- DEATH TOLL...................................................................................................... 73
DISEASE IMPACT- GLOBAL ECONOMY ............................................................................................... 74
DISEASE IMPACT- RACE WARS ............................................................................................................... 75
SOLVENCY- EMERGING DISEASES ........................................................................................................ 76
SOLVENCY: EMERGING DISEASES ....................................................................................................... 78

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BIOTERRORISM
BIOTERRORISM: AFRICA = BREEDING GROUND ........................................................................... 79
BIOTERRORISM: AFRICA = BREEDING GROUND ........................................................................... 81
BIOTERRORISM: AFRICA= BREEDING GROUND ............................................................................ 83
BIOWEAPONS- ACCESSIBLE ..................................................................................................................... 84
BIOWEAPONS- STRONG SURVEILLANCE KEY.................................................................................. 85
BIOWEAPONS: STRONG SURVEILLANCE KEY................................................................................. 87
BIOWEAPONS- US VULNERABLE ............................................................................................................ 88
BIOTERRORISM: US VULNERABLE ...................................................................................................... 89
BIOWEAPONS: NOT DETECTABLE NOW ............................................................................................ 90

GENOCIDE
GENOCIDE: CAUSED BY DISEASES ....................................................................................................... 91
GENOCIDE: RISK HIGH .............................................................................................................................. 92
GENOCIDE: RISK HIGH .............................................................................................................................. 93
GENOCIDE OUTWEIGHS ............................................................................................................................ 94
GENOCIDE: IMPACT- HEALTH ............................................................................................................... 95
GENOCIDE: IMPACT- WOMEN ................................................................................................................ 96
GENOCIDE: IMPACT- EXTINCTION ...................................................................................................... 97
GENOCIDE: IMPACT- EXTINCTION ...................................................................................................... 98
GENOCIDE- DISEASE SURVEILLANCE CRITICAL............................................................................ 99
GENOCIDE: DISEASE SURVEILLANCE CRITICAL.......................................................................... 100
GENOCIDE: DISEASE SURVEILLANCE CRITICAL......................................................................... 102
SOLVENCY- BIOWEAPONS ...................................................................................................................... 103

SOFT POWER
SOFT POWER UNIQUENESS- DRAINED NOW ................................................................................... 104
SOFT POWER- LINK .................................................................................................................................... 105
SOFT POWER LINK ..................................................................................................................................... 106
SOFT POWER LINK ..................................................................................................................................... 107
SOFT POWER LINK ..................................................................................................................................... 109
SOFT POWER LINK ..................................................................................................................................... 110
SOFT POWER- AFRICA KEY .................................................................................................................... 111
SOFT POWER IMPACT- HEGE ................................................................................................................ 112
SOFT POWER- HEGE .................................................................................................................................. 114
SOFT POWER IMPACT- TERRORISM ................................................................................................... 115

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SOFT POWER- TERORRISM..................................................................................................................... 116


SOFT POWER- IRAQ STABILITY ............................................................................................................ 117

US KEY
US KEY- BIOWEAPONS .............................................................................................................................. 119
US KEY- BIOWEAPONS .............................................................................................................................. 119
US KEY- BIOTERRORISM ......................................................................................................................... 122
US KEY- HEGEMONY ................................................................................................................................. 123
US KEY- HEGEMONY ................................................................................................................................. 124
US KEY- HEGEMONY ................................................................................................................................. 125
US KEY- INFRASTRUCTURE.................................................................................................................... 126
US KEY- TECH ............................................................................................................................................... 127
US KEY- MODELING ................................................................................................................................... 128
US KEY- MODELING ................................................................................................................................... 129
US KEY- DOMESTIC EXPERIENCE........................................................................................................ 130
US KEY: SPILLOVER................................................................................................................................... 131
US KEY: SUPERIOR SCIENCE.................................................................................................................. 131

CDC KEY
CDC KEY: STAFF/TECH ............................................................................................................................. 132
CDC KEY: GLOBAL RECOGNITION...................................................................................................... 133
CDC KEY: EMPIRICALLY SOLVES ....................................................................................................... 134
CDC KEY: GOOD STAFF/TECH ............................................................................................................... 136
US KEY-COOPERATION ............................................................................................................................ 136
AT: DOMESTIC SURVEILLANCE IS ENOUGH .................................................................................. 138

SOLVENCY
SOLVENCY- EMPIRICALLY ..................................................................................................................... 139
SOLVENCY- KEY TO RAPID RESPONSE.............................................................................................. 140
SOLVENCY- EARLY DETECTION .......................................................................................................... 141
SOLVENCY- DRUG RESISTANCE ........................................................................................................... 142
SOLVENCY- COOPERATION ................................................................................................................... 144
SOLVENCY- LABS ........................................................................................................................................ 145
SOLVENCY- EFFICIENT ............................................................................................................................ 146
SOLVENCY- INTEGRATION ..................................................................................................................... 147
SOLVENCY- INNOVATION KEY ................................................................................................................ 148

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SOLVENCY- SATELLITES ......................................................................................................................... 149


SOLVENCY- ANIMALS ............................................................................................................................... 150
SOLVENCY- ANIMALS ............................................................................................................................... 151
SOLVENCY- ANIMALS ............................................................................................................................... 152
SOLVENCY- ANIMALS ............................................................................................................................... 154
SOLVENCY- LOCAL PROGRAMS ........................................................................................................... 155
CDC KEY: GENERAL .................................................................................................................................. 157

DOD KEY
DOD KEY ......................................................................................................................................................... 158
DOD EMPIRICALLY SOLVE ..................................................................................................................... 159
DOD KEY ......................................................................................................................................................... 160
DOD KEY ......................................................................................................................................................... 161
AT: DOD WONT COOPERATE WITH CDC ......................................................................................... 162
AT DOD HURTS GLOBAL DISEASE EFFORTS ................................................................................... 163
CDC & DOD COLLABORATION GOOD ................................................................................................ 164
CDC AND DOD COOPERATION............................................................................................................... 165
SOLVENCY- SATELLITES ......................................................................................................................... 166

ANSWERS TO.
MULTILATERAL PERM SOLVES- SPENDING, TRADEOFF........................................................... 167
PERM SOLVESCOOPERATION KEY TO GLOBAL DISEASE SURVEILLANCE .................. 168
PERM SOLVES- GLOBAL COOPERATION KEY ................................................................................ 169
AT: JAPAN CP ............................................................................................................................................... 170
AT: EUROPE CP ........................................................................................................................................... 171
AT: CHINA ..................................................................................................................................................... 172
AT: SPENDING.............................................................................................................................................. 173
AT: BAD TRAINING .................................................................................................................................... 174
AT: UNILATERAL CP ................................................................................................................................. 175
A2: QUARANTINE........................................................................................................................................ 176
AT: BIOPOWER ............................................................................................................................................. 177
AT: POLITICS- PLAN POP ........................................................................................................................ 178
AT SECURITIZATION ................................................................................................................................. 179
AT: SECURITIZATION............................................................................................................................... 180
AT SECURITIZATION ................................................................................................................................. 182
AT SECURITIZATION ................................................................................................................................. 184

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AT PHARMACEUTICALS SOLVE............................................................................................................ 185

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OBSERVATION ONE: INHERENCY
FRAGMENTATION PLAGUES THE CURRENT AFRICAN DISEASE SURVEILLANCETHIS
CRUSHES THE ABILITY TO DETECT AND MONITOR DISEASES EFFECTIVELY.
Jonathan R. Davis and Joshua Lederberg (Editors), Forum on Emerging Infections, Board on Global
Health, Institute of Medicine (Authoring organization), 2001, Emerging Infectious Diseases from the
Global to the Local Perspective, p. 52-53, http://books.nap.edu/openbook.php?record_id=10084

As a region, Africa is characterized by the greatest infectious disease burden and,


overall, the weakest public health infrastructure among all regions in the
world. Frequently, vertically oriented disease surveillance programs at the
national level and above in Africa often result in too much paperwork, too
many different instructions, different terminologies, too many administrators,
and conflicting priorities. Streamlined communications, strengthened public
health surveillance, the use of standard case definitions, criteria for minimum data
requirements, and emphasis on feedback through integrated forms, as well as
research and training opportunities, are among the important tools available
to improve the situation. Yet, efforts to establish fully more effective public
health infrastructures may take a period of years to decades.
The aim in Africa is to identify a group of priority diseases categorized as
epidemic-prone diseases, diseases targeted for eradication or elimination, and other
diseases of public health importance. The challenge will be to integrate
surveillance and epidemic preparedness and response activities for these
priority diseases, especially when there are weakened ministries of health.
Bilateral and multilateral agreements, as well as partnerships with
nongovernmental organizations and commercial interests, are among the means
being explored to strengthen disease surveillance and response activities, to transfer
epidemiological and microbiological skills, and to facilitate timely recognition of
these disease outbreaks and their control. Among the promising roles provided by
global disease surveillance is the integration of new technology tools in resourcepoor environments, such as in sub-Saharan Africa, for the development of an earlywarning system based on remotely sensed (satellite) data for Rift Valley fever
surveillance.

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ADDITIONALLY, THE AFRICAN SURVEILLANCE SYSTEM LACKS TRAINED PERSONNEL
AND LAB FACILITIES.
Declan Butler, senior reporter at Nature, 3-2-06, Nature 440 pp. 6-7, Disease Surveillance needs a
revolution <http://www.nature.com/nature/journal/v440/n7080/full/440006a.html>

With avian flu spreading around the world at a frightening rate, scientists are
welcoming an international proposal for state-of-the-art labs to monitor
emerging diseases in developing countries. But they add that the bird-flu crisis has
exposed glaring deficiencies that demand a radical rethink of the world's veterinary
and disease-surveillance systems.
Avian flu is now endemic across large parts of Asia, and in the past few weeks has
exploded across Europe and into Africa. "H5N1 has focused the spotlight of the
world on disease surveillance, and it's showing up all the pimples and warts," says
Bill Davenhall, who develops health mapping schemes for countries and is head of
health at ESRI, a geographic information systems company in Redlands, California.
Developing countries, in particular, lack decent human-disease surveillance,
and animal monitoring is often virtually nonexistent, with few basic laboratory
and epidemiological resources available. "On the ground in Indonesia, there is no
systematic programme at all," says Peter Roeder, a field consultant with the United
Nations' Food and Agriculture Organization (FAO). "It's just a bloody mess."
It is a problem that the developed world cannot ignore, because a disease that
emerges in Bangkok or Jakarta could ultimately trigger a global disaster. So
researchers at the US Department of Defense have suggested setting up a
network of high-tech labs in developing countries to monitor cases of
infectious disease (see page 25). The labs would be modelled on the US network
of infectious-disease labs, such as the naval research unit NAMRU-2 in Jakarta.
But they would be funded by the international community
Such a network could vastly speed up and improve the diagnosis of viruses
such as H5N1 when outbreaks occur, says Roeder. He points out that
misdiagnosis of H5N1 as Newcastle disease in recent outbreaks in Nigeria and
India led to long delays in control measures.
Mark Savey, an epidemiologist who heads animal health at France's food-safety
agency, also welcomes the proposal, but cautions against the "mirage of
technology" in surveillance. "You don't need satellites, PCR and geographic
information systems to fight outbreaks," he says. The labs' top priority should
be building large teams of local staff, who are familiar with the region and its
practices, he argues. "If you do not have that, then surveillance will stay in the
Middle Ages."
Savey recalls his trip to Russia last summer as part of a European team
investigating outbreaks of avian flu. "You have a paper Michelin map; you have
people who speak the language; you put red circles on outbreaks; and you use a pen
and paper to compare them with things like the dates of market openings, and with
how outbreaks line up with railways." Such local knowledge is crucial to
interpreting data, he says. "If you don't know what the Trans-Siberian Express is

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like, with people cooped up for days, exchanging chickens and eggs at every stop,
you would never guess that it was the Trans-Siberian that mainly spread avian flu
across Russia."
Roeder agrees that the focus must be local. "No amount of setting international
guidelines and publishing global action plans is going to help when you have an
organization within the country that doesn't know what to do," he says

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ADVANTAGE ONE: DISEASES
THE DANGER OF NEW AND REMERGING DISEASES IS GROWINGTHEY QUICKLY
SPREAD ACROSS BORDERS MAKING THEM DIFFICULT TO CONTAIN.
US Government Accountability Office, 9-04, EMERGING INFECTIOUS DISEASES: Review of State
and Federal Disease Surveillance Efforts <http://purl.access.gpo.gov/GPO/LPS55456>
[Sigrist]
Infectious diseases account for millions of deaths every year. Although the
great majority of these deaths occur in developing countries, infectious
diseases are not confined by international borders and therefore present a
substantial threat to populations in all parts of the world, including the
United States. In recent years, the threat posed by infectious diseases has
grown. New diseases, unknown in the United States just a decade ago,
such as West Nile virus and severe acute respiratory syndrome (SARS),
have emerged, and known infectious diseases once considered in decline
have reappeared with increased frequency. Furthermore, there is always
the potential for an infectious disease to develop into a widespread
outbreakwhich could have significant consequences. The Centers for
Disease Control and Prevention (CDC) estimates that if an influenza
pandemic1 were to occur in the United States, it could cause an estimated
314,000 to 734,000 hospitalizations and 89,000 to 207,000 deaths, with
associated costs ranging from $71 to $167 billion.2 In addition to naturally
occurring infectious disease outbreaks, there is also the threat posed by
the deployment of infectious disease pathogens3 as weapons of war or
instruments of terror.
SPECIFICALLY, SUB SAHARAN AFRICA HAS BECOME AN IDEAL INCUBATOR FOR THESE PATHOGENS TO
GROW STRONGER.
The Baltimore Sun, 05- 16-05
http://seattletimes.nwsource.com/html/nationworld/2002276179_diseases16.html?syndication=rss
Some of the viruses are notorious, such as Ebola and HIV. Others have less familiar names: Marburg and Lassa fever. But
they all have emerged in recent decades from sub-Saharan Africa, perplexing scientists and, in the case of

HIV, killing millions. Africa is recognized as an ideal incubator for new pathogens: It has rapidly growing
human populations and high biodiversity, along with widespread poverty, poor medical care and, in many
countries, armed conflict that forces civilians to flee far from their homes. "For every virus that we know about, there are
hundreds that we don't know anything about," said Dr. Dan Bausch, a professor at the Tulane School of Public Health
and Tropical Medicine who studies Marburg, Ebola and other emerging diseases in Africa. "Most of them, we probably don't even
know that they're out there." Scientists remain especially baffled by Marburg. Since 1967, the Marburg virus and its equally lethal
cousin, Ebola, have killed more than 1,600 people. The latest Marburg outbreak has killed at least 277 people in Angola, hundreds of
miles from where it last emerged four years ago, in the Democratic Republic of Congo. "To be honest with you, I have no indication
what the source is," said Dr. Pierre Formenty, the World Health Organization's senior Marburg expert, speaking from the epicenter of
the outbreak, in Uige, Angola. "That was not our first priority. Now we are working on it."

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SUBPOINT A: SUPERDISEASES
SEVERAL FACTORS INFLUENCE THE GROWTH AND SPREAD OF PATHOGENS- POPULATION GROWTH,
CLIMATE CHANGE, DRUG RESISTANCE, LIVESTOCK HANDLINGARE ONLY A FEW OF THE THINGS THAT
CONTRIBUTE TO MUTATIONS OF DISEASES.
Denise Grady, staff writer, 08/20/02, Managing Planet Earth

http://query.nytimes.com/gst/fullpage.html?sec=health&res=9C0CE6D6103DF933A1575BC0A9649C8B6
3
Researchers say West Nile may be just one example of an infectious disease whose incidence and
geographic range have expanded because of human activities affecting the mosquitoes, birds, rodents and
other animals that help spread the infection. Since the mid-1970's -- a time when it was widely assumed that most infectious
diseases had been conquered or at least controlled -- a troubling array of previously unknown diseases has emerged, including Lyme
disease, AIDS, mad cow disease, the Ebola virus, Legionnaires' disease and a host of others. In addition, old diseases like yellow
fever, malaria and dengue fever have reappeared in their former haunts and spread to new areas. Some microbes, like the ones that
cause tuberculosis, malaria and food poisoning, have become dangerously drug resistant. In a 2000 report, the World Health

Organization identified a half-dozen factors that could affect the distribution and emergence of infectious
diseases. The factors include ecological changes like those from global warming and changes in land use;
human factors like population growth, migration, war, sexual behavior, intravenous drug use and
overcrowding; international travel and commerce; technological and industrial factors like food processing,
livestock handling and organ transplants; microbial changes like the development of antibiotic resistance;
and breakdowns in public health measures like sanitation, vaccination and insect control.

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THESE MUTATIONS ARE GROWING THREATENING AS DISEASES ARE BECOMING INCREASINGLY DRUG
RESISTANCE.
David L Heymann and Gunal R Rodierthe, WHO's Executive Director for Communicable Diseases, Dec. 01, The Lancet, Hot
spots in a wired world: WHO surveillance of emerging and re-emerging infectious diseases <http://www.3eme-cycle.ch/biologie/JCVillars06/S1%20Heymann/104_Lancet_Hot%20SpotsInAWiredWorld_2001.pdf>
On another front, resistance

to inexpensive and effective


antimicrobial drugs has emerged and spread at an alarming
rate, raising the prospect that many common diseases could
become prohibitively expensive or impossible to treat.27 The
bacterial infections that contribute most to human disease
are also those in which emerging resistance is of most
concern: diarrhoeal diseases such as dysentery, respiratory
tract infections, including pneumococcal pneumonia and
multidrug-resistant tuberculosis, sexually transmitted
infections such as gonorrhoea, and a host of hospitalacquired
infections that are notoriously difficult and
expensive to treat. Among the major infectious diseases, the

development of resistance to drugs commonly used to treat


malaria is of particular concern, as is the emerging resistance
to anti-HIV drugs. Most alarming of all are microbes such as
Staphylococcus aureus and Salmonella typhi that have
accumulated resistance genes to virtually all currently
available drugs and have the potential to cause untreatable
infections, thus raising the spectre of a post-antibiotic era.

Even if the pharmaceutical industry were to step up efforts


to develop new drugs immediately, current trends suggest
that some diseases may have very few and, in some cases, no
effective therapies within the next 10 years.27 Moreover, if
current trends continue, many important medical and
surgical procedures, including cancer chemotherapy, bone
marrow and organ transplantation, and hip and other joint
replacements, could no longer be undertaken out of fear that
the associated compromise of immune function might place
patients at risk of acquiring a difficult to treat and ultimately
fatal infection. Opportunistic infections in AIDS patients
would likewise become an especially difficult challenge.

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EVENTUALLY THESE MUTATIONS WILL GET OUT OF CONTROLCULMINATING IN PLANETARY


EXTINCTION.

South China Morning Post 96


((Hong Kong) January 4, 1996 SECTION: Pg. 15 HEADLINE: Leading the way to a cure for AIDS BYLINE: Kavita Daswani meets
a scientist working on a super vaccine to fight AIDS and more deadly viruses yet to come, l/n)
Despite the importance of the discovery of the "facilitating" cell, it is not what Dr Ben-Abraham wants to talk about. There is a
much more pressing medical crisis at hand - one he believes the world must be alerted to: the possibility of a virus
deadlier than HIV. If this makes Dr Ben-Abraham sound like a prophet of doom, then he makes no apology for it. AIDS, the
Ebola outbreak which killed more than 100 people in Africa last year, the flu epidemic that has now affected 200,000 in the former
Soviet Union - they are all, according to Dr Ben-Abraham, the "tip of the iceberg". Two decades of intensive study and research in the
field of virology have convinced him of one thing: in place of natural and man-made disasters or nuclear warfare,
humanity could face extinction because of a single virus, deadlier than HIV. "An airborne virus is a lively,
complex and dangerous organism," he said. "It can come from a rare animal or from anywhere and can

mutate constantly. If there is no cure, it affects one person and then there is a chain reaction and it is
unstoppable. It is a tragedy waiting to happen." That may sound like a far-fetched plot for a Hollywood film, but Dr Ben -Abraham
said history has already proven his theory. Fifteen years ago, few could have predicted the impact of AIDS on the world. Ebola has
had sporadic outbreaks over the past 20 years and the only way the deadly virus - which turns internal organs into liquid - could be
contained was because it was killed before it had a chance to spread. Imagine, he says, if it was closer to home: an outbreak of that
scale in London, New York or Hong Kong. It could happen anytime in the next 20 years - theoretically, it could happen tomorrow.
The shock of the AIDS epidemic has prompted virus experts to admit "that something new is indeed happening and that the threat
of a deadly viral outbreak is imminent", said Joshua Lederberg of the Rockefeller University in New York, at a recent
conference. He added that the problem was "very serious and is getting worse". Dr Ben-Abraham said: "Nature isn't benign. The

survival of the human species is not a preordained evolutionary programme. Abundant sources of genetic
variation exist for viruses to learn how to mutate and evade the immune system." He cites the 1968 Hong Kong flu
outbreak as an example of how viruses have outsmarted human intelligence. And as new "mega-cities" are being developed in the
Third World and rainforests are destroyed, disease-carrying animals and insects are forced into areas of human habitation. "This

raises the very real possibility that lethal, mysterious viruses would, for the first time, infect humanity at a
large scale and imperil the survival of the human race," he said.

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SUB POINT B IS RE-REMERGING DISEASES- THE FLU


[MUTATION OF THE AVIAN FLU IS INEVITABLEIT IS ONLY A MATTER OF TIME UNTIL IT IS AIRBORNE.
Satish Chandra, Deputy National Security Advisor of India Center for Strategic Decision Research, 2004
[Global Security: A broader Concept for the 21st Century, 5/7, http://www.csdr.org/2004book /chandra.htm]
If the possibility of the collapse of the thermohaline circulation system is alarming, the possibility of a human-to-human

transmittable bird flu pandemic is a nightmare. What makes it so frightening is the fact that it could happen
at any time and that we are ill prepared to face it. At current mortality rates, it could result in the sudden death of 15 to 20
percent of mankind. The most severe health crisis in recent years in terms of numbers of deaths was the 19181919 influenza
epidemic, which in the space of one year caused an estimated 40 million deaths worldwide. Begun in Kansas in March 1918, the
epidemic spread to Europe and then to India, Australia, and New Zealand. The virulence and mortality rate of the first wave of the
disease, in the spring of 1918, was only slightly above normal levels but the second wave, which began in the fall of 1918, was
extraordinarily deadly, with mortality rates of 5 to 20 percent above normal levels. It is believed that the fall strain of the virus came
about through genetic mutation and that the genetic structure of the virus was a form of a swine and avian influenza strain. Since 1918,
the world has seen several influenza outbreaks, most notably the 1957 Asian flu outbreak and the 1968 Hong Kong flu outbreak, each
of which killed a million people. While WHO now has an Influenza Surveillance Program in place as well as an Influenza Pandemic
Preparedness Plan, we still need to examine the possibility of the highly pathogenic H5N1 bird flu becoming transmittable from
human to human, the outcome of such a situation, and what must be done to address the possibility. Since the end of 2003, outbreaks
of the highly pathogenic H5N1 strain of avian influenza, or bird flu, have occurred in eight Asian countries, resulting in the loss of 100
million poultry birds. The implications for human health are worrisome because of the extreme pathogenic

nature of this virusit has the capability to infect humans and cause severe illness, with mortality rates of
60 to 70 percent. It has already infected humans three times in the recent past: In 1997 and 2003 in Hong Kong and in 2004 in
Vietnam and Thailand. So far the disease has been transmitted only to humans who came in contact with dead or diseased poultryit
has not yet mutated to being capable of human-to-human transmission. The Likelihood of a Pandemic Since the H5N1 strain has not
been eliminated from its avian hosts, it is obviously endemic. The risk, therefore, that the virus could take on a new

form that would make it capable of human-to- human transmission is considerable, especially because mass
vaccinations of chickens, aimed at mitigating the disaster facing poultry farmers, has allowed the virus to
continue to circulate among the vaccinated birds. It can thus linger indefinitely in poultry, making the gene
mutation required to make it transmittable from human to human an even greater possibility. It could be
said that there are three prerequisites for the start of a pandemic: 1) a new virus must emerge against which the general
population has little or no immunity; 2) the new virus must be able to replicate in humans and cause disease; and 3) the new virus
must be efficiently transmitted from one human to another. Dr. Anarji Asamoa Baah, Assistant Director General, Communicable
Diseases, WHO, asserts that, regarding H5N1, the first two prerequisites have already been met, and it is known

that the virus can become more transmittable via two mechanisms, adaptive mutation and genetic reassortment. Dr. Baah has further contended that re-assortment of H5N1 with a human influenza virus can take
place in humans without prior adaptation in other species such as swine. It is clear, therefore, that 1) the H5N1 virus
will continue to circulate for a very long time in poultry birds; 2) the threat to public health will be there as long as the virus continues
to circulate in poultry birds; 3) should the virus become transmittable from human to human, the consequences for human health
worldwide, in the words of Dr. Baah, could be devastating; and 4) the world needs to be prepared to respond to the next influenza
outbreak. During an Influenza Pandemic Preparedness meeting in Geneva in March 2004, the head of the World Health Organization
warned, We know another pandemic is inevitable. It is coming we also know that we are unlikely to have enough
drugs, vaccines, healthcare workers, and hospital capacity to cope in an ideal way. On the basis of an epidemiological model project,
WHO scientists predict that an influenza pandemic
1AC

will result in 57 million to 132 million outpatient hospital visits, 1 million to 2.3 million admissions, and between 280,000 and
650,000 deaths in less than two years. The impact on poor nations would be much greater. But I submit that these projections are gross
underestimates given the fact that the 19181919 influenza epidemic, with mortality rates of a maximum of 20 percent above normal
level, caused as many as 40 million deaths. With mortality rates in excess of 60 percent, the H5N1 virus is bound to be much more
deadly, particularly because in todays world of air connectivity, the spread of H5N1 would be much more rapid
than that of the 1918 influenza epidemic. Indeed, the death toll could run into hundreds of millions.

AVIAN BIRD FLU WILL KILL BILLIONS.


Satish Chandra, Center for Strategic Decision Research, 2004
[Global Security: A broader Concept for the 21st Century, May 7th http://www.csdr.org/2004book /chandra.htm]
This scenario, as frightening as it is, pales in comparison with what could overtake us by 2007 if the highly
pathogenic form of bird flu H5N1 becomes transmittable human to human; all it would take for this to

happen is a simple gene shift in the bird flu virus, which could happen any day. In a globalized world

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linked by rapid air travel, the disease would spread like a raging forest fire. If it did, it would overwhelm
our public health system, cripple our economies, and wipe out a billion people within the space of a few
monthsa 60 percent mortality rate is estimated.

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SURVEILLANCE IS CRITICAL TO MONITOR ANIMAL TRANSFERRED PATHOGENS.


Paul Rincon, BBC News science reporter, 2/20/06, ("'Faster emergence' for diseases",
http://news.bbc.co.uk/2/hi/science/nature/4732924.stm)
New infectious diseases are now emerging at an exceptional rate, scientists have told a leading conference in St Louis, US.
Humans are accumulating new pathogens at a rate of one per year, they said.
This meant that agencies and governments would have to work harder than ever before to keep on top of the threat, one
expert told the BBC.

Most of these new infectious diseases, such as avian influenza and HIV/Aids, are
coming from other animals. "This accumulation of new pathogens has been going
on for millennia - this is how we acquired TB, malaria, smallpox," said Professor Mark
Woolhouse, an epidemiologist at the University Of Edinburgh, UK. "But at the moment, this accumulation does seem to be
happening very fast. "So it seems there is something special about modern times - these are good times for pathogens to be
invading the human population." Professor Woolhouse has catalogued more than 1,400 different agents of disease in
humans; and every year, scientists are discovering one or two new ones.
Some may have been around for a long time and have only just come to light. Others that have emerged recently are entirely
new, such as HIV; the virus that causes Sars, and the agent of vCJD. The

difference today, say researchers,


is the way humans are interacting with other animals in their environment. Changes in
land use through, for example, deforestation can bring humans into contact with new pathogens; and, likewise, agricultural
changes, such as the use of exotic livestock. Other important drivers include global travel, global trade and hospitalisation.

The fast rate at which pathogens are appearing means public health experts will
need to work harder than ever to control the spread of emerging disease threats. "The
sort of image I want to get away from is the famous statement from the 1960s when the US Surgeon General said, 'diseases
were beat'," Professor Woolhouse told the BBC News website. "Pathogens

are evolving ways to combat


our control methods. The picture is changing and looks as if it will continue to. We're going to have to
run as fast as we can to stay in the same place." He added: "We need surveillance.
Surveillance in most parts of the world for infectious disease is really quite poor particularly surveillance for infectious diseases in animals such as vermin like rats."
Experts were speaking on the subject at the American Association for the Advancement of Science (AAAS) annual meeting
in the Missouri city of St Louis.

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ADVANTAGE TWO: BIOTERRORISM


RISK OF A BIOTERROR ATTACK IS HIGH WITH THE WIDESPREAD OFMATERIALS, INFORMATION, AND
RECRUITMENT IN ABUNDANCE.
Bruce jones biosecurity nonststate actors & the need for global cooperation 10/1/06

http://www.blackwellsynergy.com/action/showFullText?submitFullText=Full+Text+HTML&doi=10.1111%2Fj.17477093.2006.00016.x&cookieSet=1
Unfortunately, both the risk

of a bioterror attack and the potential destruction such an attack could cause are

significantand rising.
In assessing the risk of a given type of attack, there are three ingredients to measure: the availability of the relevant materials (from
small arms to "loose nukes"); the availability of know-how to overcome the obstacles to using those materials to effect an attack; and
the existence of actors with the motive to use them. In the case of bioterrorism, all three ingredients are very much

present.
First, there is no shortage of supply. The biological materials for potentially deadly attacks are tremendously widespread. By
one estimate, there are more than 10,000 facilities worldwide that legally and legitimately possess materials that, if
weaponized, could cause enormous loss of life, morbidity, and erosion of health. Many of these facilities are agricultural and
commercial, not engaged in high-tech bioengineering or advanced processes that could reasonably be expected to come with detailed
tracking of materials and effective security arrangements.
Second, there is no shortage of know-how. One of the great advantages of the biological and health industry is its
widening base of scientists worldwidean advantage that has an obvious downside, in the existence [in] of a large number of
individuals whose knowledge can be tapped for nefarious purposes. Moreover, the technological know-how and
materials for weaponizing several biological agents is increasingly available, even to individuals. In preparing background materials
for the High-Level Panel, we were warned by some of the world's leading scientists that it would be only a matter of years before the
tools required for weaponization were available through the Web. As we completed our work, some of these same scientists alerted us
to the fact that they had been mistaken: materials are already available on the Web, often for as little as $50,000.
Third, there is no shortage of groups with motiveat least, as far as we know. Certainly, senior al-Qaeda officials have
stated publicly and in captured correspondence between themselves their interest in obtaining nuclear, biological, and
chemical materials for use in large-scale terrorist attacks. But the history of modern terrorism suggests that we should be
every bit as concerned by groups we don't yet know about. Given the widespread availability and relatively easy accessibility of
materials, and the accessibility of equipment and know-how to weaponize them, even fairly unsophisticated groups pose a
threat. Indeed, as the science and the technology develops, we face the prospect that eventually small groups and even individuals
will possess the technological ability to threaten even powerful states.

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A BIOTERRORIST ATTACK WOULD RESULT IN EXTINCTION AS THE ATTACK CANT BE CONTAINED AND
WILL SPREAD QUICKLY.
Richard Ochs, president of CWWG (Chemical Weapons Working Group), 2002 "biological weapons must be abolished
immediately" <http://www.freefromterror.net/other_articles/abolish.html>

Of all the weapons of mass destruction, the genetically engineered biological weapons, many without a known
cure or vaccine, are an extreme danger to the continued survival of life on earth. Any perceived military value or
deterrence pales in comparison to the great risk these weapons pose just sitting in vials in laboratories.
While a "nuclear winter," resulting from a massive exchange of nuclear weapons, could also
kill off most of life on earth and severely compromise the health of future generations, they are easier to control.
Biological weapons, on the other hand, can get out of control very easily, as the recent anthrax attacks has demonstrated.
There is no way to guarantee the security of these doomsday weapons because very tiny amounts can be
stolen or accidentally released and then grow or be grown to horrendous proportions. The Black Death of the
Middle Ages would be small in comparison to the potential damage bioweapons could cause.
Abolition of chemical weapons is less of a priority because, while they can also kill millions of people outright, their
persistence in the environment would be less than nuclear or biological agents or more localized. Hence, chemical weapons would
have a lesser effect on future generations of innocent people and the natural environment. Like the Holocaust, once a localized
chemical extermination is over, it is over. With nuclear and biological weapons, the killing will probably never end. Radioactive
elements last tens of thousands of years and will keep causing cancers virtually forever.
Potentially worse than that, bio-engineered agents by the hundreds with no known cure could wreck even greater calamity on the
human race than could persistent radiation. AIDS and ebola viruses are just a small example of recently emerging plagues with no
known cure or vaccine. Can we imagine hundreds of such plagues? HUMAN EXTINCTION IS NOW POSSIBLE.

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LUCKILY, DISEASE SURVEILLANCE IS AN OPPORTUNITY TO TAP INTO THE PUBLIC HEALTH SYSTEM AS AN
INTELLIGENCE RESOURCE IN ORDER TO PREVENT AND RAPIDLY RESPOND TO A POTENTIAL ATTACK.
PRNewswire, 8-4,-2005, Nexus (C-5)
"Better medical surveillance tools and stronger links between law enforcement and national health authorities are needed
to help protect the world against attacks from terrorists using chemical or biological weapons," emergency
preparedness specialist Michael J. Hopmeier told a recent conference on integrating intelligence, policing and health, co-hosted by the
Public Health Agency of Canada.
"The public health system presents an enormous untapped resource for intelligence gathering and the
protection of national security," said Hopmeier, President of Unconventional Concepts Inc., a Mary Esther, Florida- based
engineering and scientific consulting firm specializing in crisis management and integrated federal/civilian disaster response.
"Beyond the roles in prevention and protection played by the public health sector, and their obvious

implications for national security, there is also an enormous infrastructure for early warning detection of
terrorist threats," Hopmeier said. "For that reason, public health agencies can contribute to both intelligence
collection and national security

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THUS WE OFFER THE FOLLOWING PLAN:


The United States Federal Government should substantially increase its public health assistance to Sub-Saharan Africa by
fully funding the creation of disease surveillance laboratories in Sub-Saharan Africa under the authority of the Department of
Defense.

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OBSERVATION TWO: SOLVENCY
EMPIRICALLY, THE DOD HAS BEEN EFFECTIVE AT PREVENTING AND TREATING DISEASE OUTBREAKS IN
AFRICA.
Patrick W. Kelley, M.D., Dr. P.H., Colonel and Director, Division of Preventive Medicine Walter Reed Army Institute of Research,
Institute of Medicine (Authoring organization), 2001, Emerging Infectious Diseases from the Global to the Local Perspective, p. 57,
http://books.nap.edu/openbook.php?record_id=10084

An example of recent DOD involvement in Africa was the outbreak of Rift


Valley fever in 19971998 in East Africa. Approximately 80,000 people ultimately contracted Rift
Valley fever, resulting in hundreds of deaths. In addition to the direct toll on the human population, there was a tremendous
toll on the animal population in this pastoral economy. Using

its laboratory in Kenya, DOD was


able to quickly assist with the initial epidemiological and entomological
investigations. At the time that the outbreak surfaced Kenya had no
laboratory capacity for the diagnosis of Rift Valley fever. Specimens had to be
sent to either South Africa or CDC to make the diagnosis. Using resources at
its laboratory in Cairo, DOD was able to quickly transfer technology for rapid
diagnosis to Kenya so that the outbreak could be defined rapidly and locally.
Experts in remote sensing also collected data to establish indicators that are
evident at least 3 or 4 months before outbreaks. In the future this will enable
the government to initiate immunizations for animals and thus prevent the
amplification of the virus and its transmission to humans. DOD also provided
access to the Rift Valley fever vaccine for at-risk laboratory workers in Kenya.

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DOD LABORATORIES ARE CAPABLE OF STREAMLINING THE AFRICAN SURVEILLANCE SYSTEM, AND OFFER
THE BEST TECHNOLOGY AND PERSONNEL TRAINING.
Patrick W. Kelley, M.D., Dr. P.H., Colonel and Director, Division of Preventive Medicine Walter Reed Army Institute of Research,
Institute of Medicine (Authoring organization), 2001, Emerging Infectious Diseases from the Global to the Local Perspective, p. 56,
http://books.nap.edu/openbook.php?record_id=10084

A major asset is the DOD network of overseas laboratories in Egypt, Kenya,


Thailand, Indonesia, and Peru. These are medical research and development laboratories that in some
cases were established more than 50 years ago and that exist primarily for the purpose of product development. For example,
the key studies conducted for the licensure of the hepatitis A and the Japanese encephalitis vaccines were done at these
laboratories.
These laboratories have, in some instances, a biosafety level 3 capability. The laboratory in Cairo, Egypt, can if necessary,
adapt to a biosafety level 4 capability. Although located in 5 countries, these laboratories have active research programs in
about 31 countries; they

have established extensive networks in their regions and have


formal relationships with many ministries of health and the WHO.
The laboratories have tremendous depth. In almost every case they have expertise in
virology, bacteriology, parasitology, other aspects of microbiology, veterinary
medicine, and epidemiology. Although their primary purpose was to support
product development, increasingly they are becoming involved with
surveillance. In all, about 700 people work at these laboratories and are
backed up by more than 800 more DOD scientists working on issues related to
emerging infections.
The laboratories have additional assets: they are networked with state-of-theart communications technologies and possess cutting-edge field diagnostic
reagents that are field oriented, rapid, and invaluable in the response to
emerging infectious diseases. In addition, the laboratories have access to
special drugs and vaccines that might be of critical importance in regions with
outbreaks of unusual pathogens.

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FINALLY, THE US HAS TO ACTONLY THE US CAN ENSURE GLOBAL DISEASE COOPERATION.
David P. Fidler, professor of law, University of Indiana, 3/6/05, Germs, Norms, and Power: Global Healths Political Revolution,
http://www2-test.warwick.ac.uk/fac/soc/law/elj/lgd/2004_l/fidler/

Dramatic change marks the history of health as an issue in international


relations. Healths emergence as a foreign policy concern in the mid-19th
century, when European nations began to confront cooperatively the cholera
menace, represents one such dramatic transition in how health was
conceptualised and approached internationally. Subsequent treaties and
international health organisations also transformed health as a foreign policy
concern. Technological developments, especially antibiotics and vaccines, also
produced change for public health globally.
These examples of changes in international health reveal and obscure. They reveal that health has long been a foreign policy
issue. Given this history, health as foreign policy is not a novel idea. The examples obscure that health has historically been
relegated to the foreign policy fringe of technical assistance and humanitarianism. The lack of interest in health by those
studying foreign policy and international relations compounded the neglect (Lee, K and Zwi, A, 2003, p 13; Kickbusch, I,
2003, p 192). Given this situation, health as foreign policy was not an important diplomatic activity.
Dramatic change has, however, again visited health as an issue in international relations. In the past decade, health emerged
from obscurity and neglect to affect many foreign and international policy agendas. Health now features prominently in
debates concerning national and homeland security, international trade, economic development, globalisation, human rights,
and global governance. The attention health has received in the past ten years in national and international politics is
unprecedented. Kickbusch (2003, pp 192-93) captured this change:

The protection of health is no longer seen as primarily a humanitarian and technical issue relegated to a
specialised UN agency, but more fully considered in relation to the economic, political,
and security consequences for the complex post-Cold War system of
interdependence. This has led to new policy and funding initiatives at many
levels of governance and a new political space within which global health
action is conducted.
Health as a global issue has undergone a political revolution in the last decade. Healths emergence into the
high politics of international relations is a complicated and controversial development. Global
healths political revolution means that traditional approaches to, and attitudes about, public health have been ripped
from their moorings and set afloat on a volatile sea. This article examines global healths political revolution by analyzing its
components and how they relate to each other in an attempt to understand the meaning of this revolution for global healths
future.
Revolutions constitute radical changes within existing political systems, and they typically involve three elements: (1) a crisis
with the status quo; (2) a challenge from normative ideas different from those operative in the existing system; and (3) the
application of material power to install the new ideas as the basis for future action. The article explores each of these
elements in connection with global healths transformation as an issue in international relations.
The crisis comes from threats posed by infectious diseases (germs). The mounting microbial menace has stimulated ferment
among policy responses that seek to supercede existing strategies and alter how state and non-state actors address pathogenic
threats (norms). The competing ideas require material resources and capabilities to contain and mitigate the microbial
challenge to health (power).
How germs, norms, and power converge shapes the nature of global healths political revolution. I argue that the political
revolution remains enigmatic, and the enigma raises questions about the revolutions impact and sustainability. Global

healths political revolution serves as a window on the future of not only the
protection of health but also 21st century world politics.

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INHERENCY- DOD LABS NEED FUNDING AND LABS


DOD Funding and lab revitalization needed.
Institute of Medicinte, 2001 (Perspectives on the Department of Defense Global Emerging Infections Surveillance and Response
System: A Program Review) [http://books.nap.edu/openbook.php?record_id=10203&page=161]
[The [Committee on Emerging Microbial Threats to Health] is concerned that some of these [DoD overseas
medical research] laboratories have been closed in the past, for reasons related both to insufficient
funding and changes in mission priorities, and that further closings could jeopardize the United States
ability to detect and respond to emerging infectious disease threats. A new DoD research facility, the ninth
largest biomedical research facility in the country, was recently completed in Maryland (Walter Reed Army
Institute of Research, 1998). The facility houses Army and Navy medical research and development
command headquarters, as well as the GEIS Central Hub. This facility is an outstanding resource
domestically. It reflects an important investment in DoD laboratory infrastructure. Other DoD laboratories
are also in need of revitalization. GEIS would benefit from increased capacity within existing laboratories
and the introduction of additional DoD laboratories overseas, particularly in areas of high biodiversity and
other locations where the potential for the emergence of infectious diseases is high. At a minimum, it is
important to GEIS that existing laboratory facilities be maintained.
Lose of laboratories and resources in the squo
Institute of Medicinte, 2001 (Perspectives on the Department of Defense Global Emerging Infections Surveillance and Response
System: A Program Review) [http://books.nap.edu/openbook.php?record_id=10203&page=161]
[At the time of preparation of the 1992 IOM report, seven overseas laboratories were in existence (IOM,
1992). By the time that Presidential Decision Directive NSTC-7 was released in 1996, there were six
laboratories. At the time of this review, five overseas laboratories remain. Domestic

capabilities have also been curtailed through the closure of the Letterman Army
Institute of Research (GEIS, 1998). This is a discouraging trend that does not favor
the success of GEIS. Loss of laboratory infrastructure, particularly overseas, limits
the DoDs global emerging infectious disease surveillance and response capacity and,
accordingly, GEIS prospects.]

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INHERENCY- DOD FRAGMENTED


Inh- DOD lacks integration
Institute of Medicinte, 2001 (Perspectives on the Department of Defense Global Emerging Infections Surveillance and Response
System: A Program Review) [http://books.nap.edu/openbook.php?record_id=10203&page=161]
[At

some DoD laboratories, in the United States and overseas, the committee noted
a lack of full integration between DoD research and infectious disease surveillance
priorities. Establishing GEIS within the existing framework of the DoD laboratories can benefit the
research and infectious disease surveillance missions of the DoD, respectively. GEIS can benefit from
the scientific and technical facilities, staff expertise, established research efforts, and
working relationships already in existence. In return, GEIS can strengthen and build
partnerships and can provide surveillance information useful in guiding the
development of future research projects, maximizing benefits to the U.S. military.
Finding a balance between these missions is important to the success of both. Each mission is critically
important and is essential to national security. The observed discontinuity benefits neither and harms
both. If GEIS is to be of optimal benefit, its mission will need to be fully understood,

accepted, and balanced against the needs and resources of other DoD laboratory
stakeholders.
GEIS is not optimally positioned to receive or provide direction, which weakens its effectiveness overall.
Clear and consistent channels for reporting GEIS information to higher command authorities are also not
sufficiently defined. It is important that GEIS management authority is commensurate with GEIS
management responsibility if the information that GEIS generates is to result in timely action

CDC/DoD

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INHERENCY- INTEGRATION

The lack of sufficient support for surveillance in Africa has contributes to the spread of disease
Jonathan R. Davis and Joshua Lederberg (Editors), Forum on Emerging Infections, Board on Global Health, Institute of Medicine
(Authoring organization), 2001, Emerging Infectious Diseases from the Global to the Local Perspective, p.1,
http://books.nap.edu/openbook.php?record_id=10084

Specific factors are responsible for the emergence of infectious diseases. With proper
epidemiological investigations and laboratory surveillance, the determinants of disease
outbreaks can be identified, as most emerging infections (even those resistant to antimicrobial
agents) usually originate in one location and then disseminate to new areas. Complacency about
vaccination and antibiotic use, however, and the lack of investment in surveillance and control programs
have exacerbated the spread of many diseases. Climate variability and natural disasters also
play a role in the emergence of many infectious diseases. For example, the traditional
meningitis A belt was limited to Saharan Africa. Recently, however, there have been
epidemics occurring farther south, in Uganda, Kenya, and Tanzania, and these are likely
related to droughts in those areas. In some countries, devastating earthquakes and floods have
contributed to outbreaks of cholera, malaria, TB, and diarrheal diseases.

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INHERENCY- STAFF
Africa lacks the professionals needed for disease surveillance
Jonathan R. Davis and Joshua Lederberg (Editors), Forum on Emerging Infections, Board on Global Health, Institute of Medicine
(Authoring organization), 2001, Emerging Infectious Diseases from the Global to the Local Perspective, p. 52-53,
http://books.nap.edu/openbook.php?record_id=10084
At a time when increasing attention is focused on many of the recently emerging infections (monkeypox virus, Rift Valley
fever virus, filiovirus, Vibrio cholerae O139, and penicillin-resistant Streptococcus pneumoniae) and reemerging infectious
diseases (malaria, tuberculosis, yellow fever, and trypanosomiasis) continually incubating and bursting forth from Africa,

major gaps exist in surveillance, research and training programs, and the availability of
qualified professionals concerned with infectious diseases in Africa. The infrastructure and
level of support for surveillance, research, and training on emerging infectious diseases in
Africa are extremely limited. There is a shrinking number of trained infectious disease
specialists in Africa, from the community health worker, to the laboratory technician, to
professionals in the specialized professions of virology, microbiology, medical entomology,
epidemiology, and public health. The latter point was emphasized at the workshop on which this report is based, as
none of the African scientists invited to make presentations at the workshop were available owing to exigent schedules and
demanding workloads for the qualified few, in addition to difficulty in obtaining government permission to travel and
technological obstacles to effective communication. The challenge ahead will be to broaden the base of

qualified personnel at all levels in Africa.

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INHERENCY- SURVEILLANCE NEEDED


Stronger Surveillance needed nowemerging and reemerging diseases threaten population.
Tom Davis, Chairman of theCommittee on Government Reform (House of Reps)4-25-06
[http://www.gpoaccess.gov/congress/index.html]

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INHERENCY- LABS NEEDED


A1
Laboratories with trained personnel working locally are the single greatest need
Declan Butler, senior reporter at Nature, 3-2-06, Nature 440 pp. 6-7, Disease Surveillance needs a revolution
<http://www.nature.com/nature/journal/v440/n7080/full/440006a.html>
With avian flu spreading around the world at a frightening rate, scientists

are welcoming an international


proposal for state-of-the-art labs to monitor emerging diseases in developing countries. But they add
that the bird-flu crisis has exposed glaring deficiencies that demand a radical rethink of the world's veterinary and diseasesurveillance systems.
Avian flu is now endemic across large parts of Asia, and in the past few weeks has exploded across Europe and into Africa.
"H5N1 has focused the spotlight of the world on disease surveillance, and it's showing up all the pimples and warts," says
Bill Davenhall, who develops health mapping schemes for countries and is head of health at ESRI, a geographic information
systems company in Redlands, California.
Developing countries, in particular, lack decent human-disease surveillance, and animal

monitoring is often virtually nonexistent, with few basic laboratory and epidemiological
resources available. "On the ground in Indonesia, there is no systematic programme at all," says Peter Roeder, a field
consultant with the United Nations' Food and Agriculture Organization (FAO). "It's just a bloody mess."
It is a problem that the developed world cannot ignore, because a disease that emerges in Bangkok or Jakarta could ultimately
trigger a global disaster. So researchers at the US Department of Defense have suggested setting up a network
of high-tech labs in developing countries to monitor cases of infectious disease (see page 25). The
labs would be modelled on the US network of infectious-disease labs, such as the naval research unit NAMRU-2 in Jakarta.
But they would be funded by the international community
Such a network could vastly speed up and improve the diagnosis of viruses such as H5N1 when
outbreaks occur, says Roeder. He points out that misdiagnosis of H5N1 as Newcastle disease in recent outbreaks in
Nigeria and India led to long delays in control measures.
Mark Savey, an epidemiologist who heads animal health at France's food-safety agency, also welcomes the proposal, but
cautions against the "mirage of technology" in surveillance. "You don't need satellites, PCR and geographic
information systems to fight outbreaks," he says. The labs' top priority should be building large
teams of local staff, who are familiar with the region and its practices, he argues. "If you do not have

that, then surveillance will stay in the Middle Ages."


Savey recalls his trip to Russia last summer as part of a European team investigating outbreaks of avian flu. "You have a
paper Michelin map; you have people who speak the language; you put red circles on outbreaks; and you use a pen and paper
to compare them with things like the dates of market openings, and with how outbreaks line up with railways." Such local
knowledge is crucial to interpreting data, he says. "If you don't know what the Trans-Siberian Express is like,
with people cooped up for days, exchanging chickens and eggs at every stop, you would never guess that it was the TransSiberian that mainly spread avian flu across Russia."
Roeder agrees that the focus must be local. "No amount of setting international guidelines and publishing global action plans
is going to help when you have an organization within the country that doesn't know what to do," he says

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A1
More Laboratories are needed in developing countries
J. P. Chretien et al., at US Department of Defense Global Emerging Infections Surveillance and Response System, senior reporter at
Nature, 3-2-06, Nature 440 pp. 6-7, Global network could avert pandemics
<http://www.nature.com/nature/journal/v440/n7080/full/440006a.html>
NAMRU-2 and NAMRU-3 are two of the few remaining overseas infectious-disease research laboratories that the US military
established decades ago. The

world needs such laboratories now, more than ever, as


platforms for sustained epidemic detection and response for avian influenza, and as-yetunknown diseases. The time has come to build on their experience and create a new
generation of multilateral, WHO-aligned laboratories as a front-line defence against
future pandemics.
During the Second World War, the Navy established NAMRU-2 in Guam to study infectious-disease threats in the Pacific. Relocated
several times for strategic and diplomatic reasons, the laboratory settled in Indonesia in 1970 after helping the government to control a
plague outbreak there. Since then, NAMRU-2 has operated continuously in collaboration with the Indonesian Ministry of Health and
other governmental and non-governmental organizations.

The NAMRU laboratories and the Armed Forces Research Institute of Medical
Sciences, a US Army-affiliated facility in Bangkok, Thailand, were each set up following joint US and
host-country concerns over a specific disease, but they have since conducted broadranging research. With state-of-the-art capabilities, access to areas with high disease
rates, and strong cooperation between US and host-country personnel, the
laboratories conducted field studies that led to vaccines for hepatitis A and Japanese
encephalitis, treatments for malaria, cholera, typhoid fever and leptospirosis, and
other lasting contributions. The laboratories never lost sight of important local diseases that posed little threat to US
troops, and retained their welcome even when diplomatic relations worsened. As testimony to this, NAMRU-3 continued operations
despite a diplomatic break between the United States and Egypt after the Six-Day War in 1967.
The US military built two more infectious- disease laboratories that remain today, in Kenya and Peru. But during

the
second half of the century, more labs were closed than opened. Laboratories in Panama, Puerto
Rico, Brazil, Congo, Uganda, Ethiopia, Malaysia and other countries folded for various reasons, including budget cuts and changing
strategic needs. In the late 1970s, the United States even contemplated closing, or turning over to civilian contractors, all of its
overseas military research laboratories. That plan was dropped after vigorous opposition from leaders in tropical medicine, in
universities, government and industry, and from the host countries.

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INHERENCY- LABS NEEDED


Laboratories do not have enough support for effective disease surveillance
Ruth L. Berkelman et al., Rollins Professory of Public Health at Emory University, Ralph T. Bryan, Medical Epidemiologist for
Science and Public Health at CDC, Michael T. Osterholm, Director of the Center for Infectious Disease Research and Policy at the
University of Minnesotat, 4/15/94, Infectious Disease Surveillance: A Crumbling Foundation, Science magazine, p. 369, JSTOR

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INHERENCY- LABS NEEDED


Disease surveillance needs more support and laboratories
Ruth L. Berkelman et al., Rollins Professory of Public Health at Emory University, Ralph T. Bryan, Medical Epidemiologist for
Science and Public Health at CDC, Michael T. Osterholm, Director of the Center for Infectious Disease Research and Policy at the
University of Minnesotat, 4/15/94, Infectious Disease Surveillance: A Crumbling Foundation, Science magazine, p. 369, JSTOR

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INHERENCY- FUNDING NEEDED


Insufficient funding dooms disease surveillance effectiveness
But many feel that alongside setting up local centres, epidemiology

needs a fundamental overhaul. Even in


developed countries, the field has been chronically underfunded, says Antoine Flahault, director of
Sentinelles, France's national disease surveillance network. He adds that he is jealous of the multimillion-dollar satellites that
climate scientists enjoy and the powerful accelerators being built for physicists. In comparison, epidemiologists "are
still in the nineteenth century", he says.
Flahault points out that his own national flu-monitoring system relies on a few hundred volunteer doctors submitting patient
data to an online database. From these data, Flahault's team tries to build up a picture of disease across the country, spotting
outbreaks and predicting when the year's flu season will hit.

The 122-city programme run by the US Centers for Disease Control and Prevention is the only
one in the world where disease reports are made in real time, Flahault points out. And such lack of
data prevents the field from developing sophisticated models of communicable disease. "It's as if
we were trying to study the weather, but collected data only when there was a heatwave or storm," he says.
Ward Hagemeijer, the bird-flu programme manager at Wetlands International in Wageningen, the
Netherlands, also complains of the general lack of resources. He has been on recent missions to sample H5N1
in affected countries, but says he has been unable to get his African samples sequenced because

certified labs have been too busy analysing samples from European outbreaks.
CDC requires more investment for its international efforts in preventing diesease
Campaign for Public Health, nonprofit organization, 4-20-07CENTERS FOR DISEASE CONTROL AND PREVENTION
PROFESSIONAL JUDGMENT FOR FISCAL YEAR 2008 <http://www.fundcdc.org/documents/CDCFY2008PJ_000.pdf>
But CDC

must also expand and sustain its capability to address another health protection imperative
the imperative of preparedness for the urgent threats that have become more prominent in the
dawn of the 21st century. Our new world has been characterized 3 as flat; more people in more countries are highly interconnected
because they can access technologies, communication tools, and economic opportunities that a decade ago were not even imagined.
Unfortunately, this flat world is also small; and as we have learned with SARS, terrorist attacks, disease outbreaks, and other threats
to health can be globalized overnight. In this flat and small world, one thing is certain - the problems that

affect peoples health and safety are big now, and likely to get even bigger in scale and impact. These
problems include extreme poverty for approximately 1.1 billion people who are at high risk for
malnutrition, vaccine preventable diseases, tuberculosis, HIV, malaria, neglected tropical diseases,
and many other preventable conditions that are part of CDCs portfolio of responsibilities. They also
include climate change and the emergence of extreme weather patterns in communities around the
globe; though the health effects of climate change are neither known nor predictable, there is certainly ample reason to be concerned
if the patterns observed in the first years of this century continue. And of course ideological extremism and the conflict it engenders is
now a frightening global force directly affecting some countries and indirectly affecting virtually all of them. Any one of these
extremes poses a significant challenge to peoples health, and the simultaneous intersection of all three is awesome: terrorism,
infectious diseases outbreaks and pandemics, and natural disasters that affect a greater number of
Americans and people around the globe are the likely outcomes for which CDC and its partners must prepare. These urgent threats can
affect anybody, anywhere, at any time. And, as we saw with SARS, Hurricane Katrina, and the events of 9/11/01, these
healththreatening events also threaten our economic and homeland security. Preparing people and communities is an

imperative function of CDC and our public health network, but requires a sustainable investment in
our research, programs, and support to state, local, tribal, territorial, and international health agencies on the frontlines. And
again, the time for action is now. Lives are at stake especially those of the most vulnerable people in our society.
INHERENCY- FUNDING
08 budget cuts essential funding for CDC
Trust for Americas Health, non-profit policy advocates, 2-5-07, Cuts Proposed in the Presidents Budget to Disease Prevention
and Bioterrorism Preparedness Programs Jeopardize the Health of Americans, TFAH Warns
<http://healthyamericans.org/newsroom/releases/release020507.pdf>

The proposed budget includes $5.7 billion for discretionary health programs at CDC, still $600
million below FY 2006 level. This is not acceptable. CDC is faced with unprecedented challenges and
responsibilities, such as chronic disease prevention, elimination of health disparities, bioterrorism
preparedness, and combating the obesity epidemic. CDC funds health promotion efforts in schools and
workplaces; initiatives to prevent heart disease, cancer, stroke, and other chronic diseases; programs

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to expand immunization rates; and also monitors and combats environmental effects on health. More
than 70 percent of CDC's budget supports state and local health organizations and academic institutions
08 budget cuts millions in CDC disease prevention and preparedness programs
Trust for Americas Health, non-profit policy advocates, 2-5-07, Cuts Proposed in the Presidents Budget to Disease Prevention
and Bioterrorism Preparedness Programs Jeopardize the Health of Americans, TFAH Warns
<http://healthyamericans.org/newsroom/releases/release020507.pdf>

Trust for Americas Health (TFAH) today expressed concern over cuts proposed in the
Administrations fiscal year (FY) 2008 budget to key disease prevention and public health
preparedness programs. The FY 2008 budget includes a cut of $99 million to zero out the
Prevention Health and Health Services Block Grant from the Centers for Disease Control and
Prevention, which states use to support disease prevention efforts. Most other chronic disease programs remained
essentially flat funded for a third year in a row. Programs dedicated to bioterrorism and public health
preparedness capabilities, specifically programs intended to support upgrading state and local
capabilities and hospital readiness, experienced a $185 million cut. This represents a more
than 25 percent cut from the public health preparedness funding level in FY 2005. The
reduction of the bioterrorism and public health preparedness programs is particularly
troubling, said Richard Hamburg, Director of Government Relations at TFAH. We are cutting core boots-on-the-ground
support for emergency disaster response, leaving the country at unnecessary levels of risk.

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INHERENCY- NOT A PRIORITY


The US prioritizes other bioterrorism efforts over disease surveillance
David P. Fidler, Professor of Law and Ira C. Batman Faculty Fellow, Indiana University School of LawBloomington, Spring
2002, Chicago Journal of International Law, US commitment to eradicating bioterrorism trades off with initiating foreign public
health surveillance
<http://academic.udayton.edu/health/syllabi/Bioterrorism/2PublicHealth/PHealth01.htm>

The focus on homeland defense will filter through to US attitudes toward the role of
international law in public health. The United States will attempt to use international law to
fight bioterrorism rather than to grapple with the global crisis in naturally occurring
infectious diseases. Making sure bioterrorism is criminalized globally will supercede the need
to build a global infectious disease surveillance system. Given the fusion of public health and national
security in the wake of bioterrorism, the United States will not hesitate to use its power, influence, and
resources to make the fight against bioterrorism central to its outlook on the role of
international cooperation and international law in global public health.
Infectious disease problems in the developing world will be even less important to the United
States in the post-anthrax world than they were previously. The lack of US leadership and engagement with
global public health will handicap efforts by other states, international organizations, and
non- governmental organizations to advance multilateral cooperation on global public health
problems. Even if the 2001 anthrax attacks prove to be an isolated phenomenon, the experience of bioterrorism on US soil
will distract US attention from traditional public health challenges around the world. The slow, frustrating, and incomplete
progress made in raising US awareness about the global crisis in infectious diseases in the 1990s may now be another victim
of bioterrorism in the United States.

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INHERENCY- PERSONNEL, SUPPORT


A9
Developing countries lack the personnel and support for surveillance

US Government Accountability O ffice, 9-04 , EMERGING INFECTIOUS DISEASES: Review of State and Federal Disease
Surveillance Efforts <http://purl.access.gpo.gov/GPO/LPS55456>

[Sigrist]

On the other hand, efforts

to enhance international disease surveillance


challenges. Foremost among these are limitations in the amount
of surveillance information that many countries can collect and therefore
share with international partners. Many developing countries lack health
care infrastructures and the ability to administer simple diagnostic tests
for diseases such as tuberculosis. We have previously reported that few
developing countries have public heath laboratories.48 Also, many
developing countries lack the ability to compile basic health indices, such
as death rates, causes of death, or general disease burden. Furthermore,
even countries with public health infrastructures may lack developed
surveillance systems for reporting crucial disease information to
still face

authorities. For example, officials in China noted that during the first
SARS outbreak, a large number of cases in Beijing were not reported
because there was no system to collect this information from hospitals in
the city.
A lack of sustained support for trained personnel, equipment, and coordination hampers disease surveillance
Gary Cecchine AND, Ph.D. Biology, Melinda Moore, M.D., Harvard Medical School; M.P.H., Harvard School of Public
Health, 2006, Infectious Disease and National Security: Strategic Information Needs, RAND National Research Defense
Institute, < http://www.rand.org/pubs/technical_reports/2006/RAND_TR405.pdf>
Global disease surveillance is conducted through a loose framework of formal, informal, and ad hoc arrangements that the
U.S. General Accounting Office, now the U.S. Government Accountability Office (GAO), has characterized as a network of
networks (U.S. General Accounting Office, 2000a). Historically, surveillance systems have been
developed mainly to address specific diseases. Those that are targeted for eradication or elimination, such as
polio, tend to receive sustained financial and technical support, while surveillance for other diseases, including emerging
diseases, has received limited support (U.S. General Accounting Office, 2001). The lack of adequate sustained
support for surveillance adds to the challenge of controlling emerging diseases. Surveillance
systems in all countries suffer from a number of common constraints, but these constraints are more prevalent in
the poorest countries, where annual per capita expenditure on all aspects of health care is less than 30 U.S. dollars,
representing 23 percent of these nations gross domestic product (United Nations Development Programme, 2005). The

most common constraints are shortages of human and material resources: Trained personnel
and laboratory equipment are lacking in many cases (U.S. General Accounting Office, 2001). Poor
coordination of surveillance activities also constrains global disease surveillance. This poor
coordination is caused by multiple reporting systems, unclear lines of authority, and incomplete participation by affected
countries (U.S. General Accounting Office, 2001), resulting in knowledge gaps about putative outbreaks. Therefore,

shortcomings in surveillance reporting of infectious disease seem to exist for two main
reasons: Some nations are either unable or unwilling to report.
INHERENCY- RESOURCES
Animal disease surveillance and research lacks resources in Africa
The East Africa Standard, Nairobi newspaper, 1-31-07, Lexis, Why Animal Diseases are a Menace

Animal diseases constrain livestock enterprises yet they are not given the attention they deserve. The
global animal health product market was worth $15 billion in 2005, of which Western Europe, North
America, East Asia, Latin America and Eastern Europe held 97 per cent, leaving three per cent to
Africa and South Asia.
The global veterinary pharmaceutical industry puts about 10 per cent (about $1.5 billion or Sh105 billion))
annually into research and development. Public-sector contributions to animal health research come mainly from
wealthy economies and target their domestic priorities such as bovine spongiform encephalopathies (BSEs). UK's research budget for
BSEs in 2005-06 was $25.7 million (Sh1.8 billion).

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Compare this with the estimated $20 million (Sh1.4 billion) allocated over 10 years by the Animal Health
Programme of the Department for International Development to research in developing countries.
Many developing countries are stuck in a time warp of outdated, poorly-funded service delivery
systems that are incompatible with the needs of their poorer clients.
Science has a lot to offer. New, cost-effective approaches to animal health service delivery are critical
to poverty reduction, with greater incorporation of accessibility, acceptability and sustainability.
Essential to these are disease surveillance, priority setting, interventions and an understanding of how innovation systems
can ensure that new tools reach the poor.

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INHERENCY- RESOURCES
CDC has been effective, but requires more resources to meet the challenges of emerging diseases and bolster current efforts
Campaign for Public Health, nonprofit organization, 4-20-07CENTERS FOR DISEASE CONTROL AND PREVENTION
PROFESSIONAL JUDGMENT FOR FISCAL YEAR 2008 <http://www.fundcdc.org/documents/CDCFY2008PJ_000.pdf>

People have never expected more from CDC than they do today. From A to Z from anthrax to
obesity to zoonotic disease outbreaks - the urgent health problems that we must address are large in
scope and will likely increase, not decrease, in complexity over time. The stakes are very high and
fast-enough action is imperative. We know our resources and our reach will never be commensurate with our
aspirations, so we have committed to focusing our efforts in priority areas where we can have the biggest impact on
peoples health and safety in the shortest possible time. We have engaged public health leaders, key partners, and the public
in developing our goals and objectives to make our priorities clear. CDCs Health Protection Goals balance our mission to
address both urgent threats and urgent realities in four thematic areas (Healthy People in Every Stage of Life, Healthy People
in Healthy Places, Global Health, and Preparedness). They reinforce Secretary Leavitts priorities and our nations Healthy
People Goals. We 4 are aligning our current resources, our partnerships, and our collaborations to support achievement of
these goals, and developing measures to make our progress transparent. Achieve Results on the Frontlines of Public Health
The most powerful way to achieve national improvements in health is to target programs to
those people who experience the greatest health disparities in their own community. In fact, for
virtually every priority area in CDCs Health Protection Goals, success will depend on reducing or eliminating
one or more major disparity in health status in one or more target populations. Through its
research and many years of successful demonstration projects, CDC has supported projects
that are effective in improving health and reducing many disparities, but, with a few
exceptions, we have never been resourced to bring these programs to a scale to achieve the
national impact we know is possible. Not knowing what to do to solve a health problem is frustrating, but not
being able to do what we know will work is tragic. We know what works, and in many cases we have
prototypes that can be scaled up. To illustrate how better results could be achieved, CDCs REACH US
(www.cdc.gov/reach) is one prototype of the kind that could be quickly expanded and adapted to bring innovative solutions
to some health disparities to scale nationally. In 40 communities across the United States, CDC has funded community
coalitions that design, implement, and evaluate community-driven strategies to eliminate health disparities in key health
areas, such as heart disease, diabetes, breast and cervical cancer, immunizations, infant mortality, and HIV/AIDS among
African Americans, American Indians, Alaska Natives, Asian Americans, Pacific Islanders, or Hispanics/Latinos. CDC
provides technical support and modest financial support to help communities develop effective interventions, transition to
sustainable local support, evaluate results, and disseminate strategies that work. Many of the REACH communities have
chosen to target more than one health priority area and/or more than one racial/ethnic group, proving that more holistic
approaches to solving health problems than CDCs traditional diseasespecific funding sources easily permit are desired by
communities and can be successful. Likewise, WISEWOMAN, Steps to a Healthier US, our participatory community-based
prevention research centers, and many similar projects effectively translate the research conducted by CDC, NIH, AHRQ,
and academicians around our country. CDC has proven that - with community engagement, effective

governmental public health leadership, multi-sector public, academic, and private


partnerships, communication tools, and social marketing - a modest investment can reduce or
eliminate health disparities, improve health, and save lives. We can rapidly deploy similar
methods to address a wider set of health challenges among infants, children, adolescents,
adults, and older adults to achieve our Health Protection Goals in many more communities and in specific
environments (e.g. schools, institutions, homes, hospitals, churches, worksites, senior centers). It is my professional judgment
that bringing these successful approaches to scale in communities across our nation is the most cost-effective and rapid way
to translate science into better health for our nation and to solve some of our most vexing health disparities.

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INHERENCY- RESOURCES
The CDC needs more resources to improve its disease surveillance capability
Campaign for Public Health, nonprofit organization, 4-20-07CENTERS FOR DISEASE CONTROL AND PREVENTION
PROFESSIONAL JUDGMENT FOR FISCAL YEAR 2008 <http://www.fundcdc.org/documents/CDCFY2008PJ_000.pdf>

The nation and world look to CDC and our public health network to rapidly detect, investigate, respond to
and control emerging health threats, including those associated with microbes, natural disasters, and
chemical and radiation events. Our nations preparedness has greatly benefited from government
investments in terrorism and pandemic influenza preparedness but recent events illustrate that
vulnerabilities remain and highlight the need for even greater capacity, speed and coverage across our
public health network. Glaring gaps that require new and sustained support for us to achieve our
preparedness goals in areas include: Pathogen Detection pathogen discovery methods that allow CDC to accelerate
the complete genomic and phenotypic characterization of unknown or re-emerging pathogens, including their susceptibility to
antimicrobials point-of-care rapid diagnostic tests for viral, bacterial, mycobacterial, and fungal pathogens
to allow early detection of exposures and enable early treatment of affected people upgrades to convert slow,
imprecise and labor-intensive laboratory methods into efficient, reproducible, rapid and scalable approaches to detecting
infectious, environmental and occupational exposures, similar to leaps we recently made in our ability to detect and
characterize botulinum and anthrax toxin through mass spectrophotometry and resources to cascade these capabilities to state
and local laboratory net
Lacking resources prevents effective disease surveillance in Africa
Peter Nsubuga et al., Epidemiology Program Office at Centers for Disease Control and Prevention, 12-27-02, Polio eradication
initiative in Africa: influence on other infectious disease surveillance development,
<http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=140011#B14>

total of 25 (78%) of the 32 countries had combined AFP surveillance with surveillance for
other infectious diseases. The most common diseases added to surveillance for AFP were other childhood vaccinepreventable diseases: measles in 24 (96%) and neonatal tetanus in 22 (88%). The other diseases added to the AFP
surveillance programs tended to be epidemic-prone diseases (e.g., cholera in 17 [68%], meningitis in 16 [64%], or yellow
fever in 11 [44%]), and depended on the epidemiological patterns in the responding countries.
When the respondents were asked to illustrate major contributions attributable to the AFP surveillance programs, 12 (38%)
described an improvement of national disease surveillance (Table 2). Other contributions cited were improved infrastructure
or resources, increased awareness regarding surveillance or capacity building, and increased personnel for surveillance.

Major constraints to general disease surveillance that were identified included a lack of staff
to perform surveillance, a shortage or lack of funds, lack of vehicles or fuel, lack of training,
and a lack of political commitment.
Our survey revealed that, among the African countries that conducted AFP surveillance and reported to WHO in 1999, the
majority had designated surveillance officers, vehicles, and annual budgets. Moreover, most of the national polio eradication
programs combined the surveillance for and response to AFP with other infectious diseases. Our investigation also
revealed that certain countries that had prudently added other diseases to their AFP

surveillance programs were also able to perform AFP surveillance adequately. However, the
survey also indicated that additional staff, funds, and political commitment might be required
if infectious disease surveillance and response is to improve in Africa.
[] <CONTINUED>

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<CONTINUED>
Contributions that were identified and attributable to the presence of AFP surveillance programs indicate that polioeradication programs have gone beyond a purely vertical approach (i.e., disease-specific) toward one that is more horizontal
(i.e., systems development). Improvements of infrastructure, capacity building, and provision of

personnel can be used to develop the overall surveillance system for infectious diseases as long
as the categorical program policies clearly support this approach. A lack of resources (e.g., staff,
funds, vehicles, or fuel) were the main constraints to infectious disease surveillance that were identified in
the survey interestingly, training was not identified as a top constraint, possibly indicating that
trained personnel already exist, at least within the AFP surveillance program. Managers of categorical programs
are often uneasy regarding entrusting others with gathering surveillance data that are crucial to targeting and evaluating their
programs. Therefore, ongoing training monitoring and periodic external evaluations should provide the quality assurance and
credibility that integrated surveillance and response programs will need to reassure managers that they are basing decisions
on reliable information.

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INHERENCY- INFRASTRUCTURE
There is a need for better infrastructure to gather information on diseases in other countries
Gary Cecchine AND, Ph.D. Biology, Melinda Moore, M.D., Harvard Medical School; M.P.H., Harvard School of Public
Health, 2006, Infectious Disease and National Security: Strategic Information Needs, RAND National Research Defense
Institute, < http://www.rand.org/pubs/technical_reports/2006/RAND_TR405.pdf>
While most

respondents converged around the need for timely, accurate, complete (i.e., sufficiently
detailed), understandable, and actionable information related to infectious disease threats, not
surprisingly, their information needs naturally focused in particular on areas directly related to the mission of their offices or agencies,
or their own specific responsibilities. For example, regional focus was particularly important to individuals and offices with specific
regional responsibilities; detailed health information was needed by those with specific health-related responsibilities; and non-health
contextual information was most needed by the diplomatic and intelligence communities. Most respondents described needs for
information about disease outbreaks that are occurring. Virtually all interviewees described needs in terms of
human disease, most added the need for animal disease information, and a few mentioned an additional need for information on
plant diseases. Ideally, these stakeholders would like information that reflects disease and outbreaks

down to the community, rather than strictly national, level. Some recognized the shortcomings of
sentinel surveillance, i.e., noncomprehensive disease surveillance from selected health service sites,
emphasizing that such systems may miss important disease occurrence. Some respondents also noted
the need for information on medical and health infrastructure in countries where outbreaks occur,
including medical practices and government responses to the outbreaks. Several respondents described the
need for information on relevant policies and decisionmaking in such countries, as well as the broader social, economic, political, and
military context of disease outbreaks. They recognized that such information was unlikely to come from

traditional public health sources.

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DISEASES- DISEASE RESISTANCE GROWING


A 13
Many diseases are developing resistances to drugs
David L Heymann and Gunal R Rodierthe, WHO's Executive Director for Communicable Diseases, Dec. 01, The Lancet, Hot
spots in a wired world: WHO surveillance of emerging and re-emerging infectious diseases <http://www.3eme-cycle.ch/biologie/JCVillars06/S1%20Heymann/104_Lancet_Hot%20SpotsInAWiredWorld_2001.pdf>
On another front, resistance to

inexpensive and effective


antimicrobial drugs has emerged and spread at an alarming
rate, raising the prospect that many common diseases could
become prohibitively expensive or impossible to treat.27 The
bacterial infections that contribute most to human disease
are also those in which emerging resistance is of most
concern: diarrhoeal diseases such as dysentery, respiratory
tract infections, including pneumococcal pneumonia and
multidrug-resistant tuberculosis, sexually transmitted
infections such as gonorrhoea, and a host of hospitalacquired
infections that are notoriously difficult and
expensive to treat. Among the major infectious diseases, the

development of resistance to drugs commonly used to treat


malaria is of particular concern, as is the emerging resistance
to anti-HIV drugs. Most alarming of all are microbes such as
Staphylococcus aureus and Salmonella typhi that have
accumulated resistance genes to virtually all currently
available drugs and have the potential to cause untreatable
infections, thus raising the spectre of a post-antibiotic era.

Even if the pharmaceutical industry were to step up efforts


to develop new drugs immediately, current trends suggest
that some diseases may have very few and, in some cases, no
effective therapies within the next 10 years.27 Moreover, if
current trends continue, many important medical and
surgical procedures, including cancer chemotherapy, bone
marrow and organ transplantation, and hip and other joint
replacements, could no longer be undertaken out of fear that
the associated compromise of immune function might place
patients at risk of acquiring a difficult to treat and ultimately
fatal infection. Opportunistic infections in AIDS patients
would likewise become an especially difficult challenge.

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DISEASES- NEW DISEASES EMERGING


B1
The danger of new diseases and outbreaks is growing

US Government Accountability O ffice, 9-04 , EMERGING INFECTIOUS DISEASES: Review of State and Federal Disease
Surveillance Efforts <http://purl.access.gpo.gov/GPO/LPS55456>

[Sigrist]

Infectious diseases account for millions of deaths every year. Although the
great majority of these deaths occur in developing countries, infectious
diseases are not confined by international borders and therefore present a
substantial threat to populations in all parts of the world, including the
United States. In recent years, the threat posed by infectious diseases has
grown. New diseases, unknown in the United States just a decade ago,
such as West Nile virus and severe acute respiratory syndrome (SARS),
have emerged, and known infectious diseases once considered in decline
have reappeared with increased frequency. Furthermore, there is always
the potential for an infectious disease to develop into a widespread
outbreakwhich could have significant consequences. The Centers for
Disease Control and Prevention (CDC) estimates that if an influenza
pandemic 1 were to occur in the United States, it could cause an estimated
314,000 to 734,000 hospitalizations and 89,000 to 207,000 deaths, with
associated costs ranging from $71 to $167 billion .2 In addition to naturally
occurring infectious disease outbreaks, there is also the threat posed by
the deployment of infectious disease pathogens3 as weapons of war or
instruments of terror.

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DISEASES- EMERGING NOW


There are many different factors contributing to the emergence of new diseases that can be easily spread to the US
Jonathan B. Tucker, Ph.D. Director, Chemical & Biological Weapons Nonproliferation Program, Center for Nonproliferation Studies
Monterey, Institute of International Studies, 10-3-01, Subcommittee on Labor, Health and Human Services, Education, and Related
Agencies of the U.S. Senate Committee on Appropriations, Improving Infectious Disease Surveillance to Combat Bioterrorism and
Natural Emerging Infections
<http://cns.miis.edu/research/cbw/testtuck.htm>
In parallel to the emerging threat of bioterrorism, the United States faces a growing problem of infectious
disease from natural sources. During the 1960s and 70s, powerful antibiotic drugs and vaccines appeared to have
banished the major infectious scourges from the industrialized world, leading to a sense of complacency and neglect of
programs for disease surveillance and prevention. Over the past two decades, however, several well-known diseases, such as
tuberculosis, malaria, and cholera, have re-emerged in more virulent or drug-resistant forms or have spread geographically.
At the same time, scientists have identified a host of previously unknown infections, including Legionnaire's disease, AIDS,
Lyme disease, Sin Nombre virus, hepatitis C, "mad cow disease," Nipah virus, and new strains of influenza. AIDS was not
recognized until the 1980s, yet it now infects some 36 million people worldwide and kills 3 million annually. Since 1980, the
U.S. death rate from AIDS and other infectious diseases has increased by about 4.8 percent per year, compared with an
annual decrease of 2.3 percent for the 15 years before 1980.[3] Several factors have contributed to the problem of emerging
infections: The inappropriate use of antibiotic drugs has fostered the evolution of resistant

strains of tuberculosis and other bacterial diseases, even as the development of new
generations of antibiotics has lagged. Ecosystem disturbances, such as clearing rainforests for
economic gain or human settlements, have altered the geographical distribution of disease
vectors such as rodents, monkeys, and mosquitoes, increasing their contact with humans.
Rapid population growth and rural-urban migration have given rise to "megacities" in the
developing world with poor public health infrastructure, enabling diseases that once remained
isolated in rural areas to spread to large urban populations.
The collapse of public health systems in Russia and other parts of the former Communist
world have fostered the spread of diseases such as AIDS and drug-resistant tuberculosis.
The rising volume of tourism, trade, and imported agricultural goods associated with
economic globalization has created new opportunities for the introduction into the United
States of disease vectors and microbial pathogens from other parts of the world.
Because most U.S. cities are within a 36-hour commercial flight of any part of the globe, or
less than the incubation period of many infectious diseases, infected individuals may not be
visibly ill when they cross a U.S. border. The risk of disease importations is greatest in major hubs of global
commerce such as New York City, Los Angeles, and Miami. Indeed, the source of the 1999 outbreak in New York of West
Nile encephalitis, a viral disease never before seen in the Western Hemisphere, may have been travelers from the Middle East
who were incubating the disease or a stray infected mosquito on an airplane. Having spread widely over the past three years,
West Nile virus is now permanently entrenched in the United States.
A future emerging infection introduced into our country could be far more deadly. In the worst-case scenario, a new pathogen
would have the attributes of the 1918 strain of influenza virus, or Spanish Flu, which was highly transmissible through the air
and uncharacteristically lethal to young, healthy people. This disease caused a global pandemic that claimed more than 20
million lives in less than two years. The speed at which the U.S. public health system could identify and contain such an
outbreak would mean the difference between life and death for a large number of Americans.

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G7
Disease surveillance identifies new diseases and mutating strains
David L Heymann and Gunal R Rodierthe, WHO's Executive Director for Communicable Diseases, Dec. 01, The Lancet, Hot
spots in a wired world: WHO surveillance of emerging and re-emerging infectious diseases <http://www.3eme-cycle.ch/biologie/JCVillars06/S1%20Heymann/104_Lancet_Hot%20SpotsInAWiredWorld_2001.pdf>
In the volatile new milieu of emerging, adapting, and highly
mobile pathogens, the best defence is good infectious disease intelligence, on a global scale, gleaned through sensitive
surveillance. Surveillance systems keep the world
alert to changes in the infectious disease threat and provide the background data needed to detect an unusual event, whether
involving an upsurge in cases of a well-known
endemic disease, the appearance of a previously unknown pathogen, or an
outbreak caused by the deliberate use of a biological agent to cause harm. Because susceptibility to infectious diseases and
the opportunities for
infection rapidly increase with poverty, poverty remains the variable most
frequently associated with the occurrence of infectious diseases.21 Not surprisingly, outbreaks of both newly identified
diseases and well-known epidemic-prone diseases occur most
frequently in countries that lack the epidemiological and laboratory
capacity to detect them quickly and contain their spread (figure 2). For this reason, continuing surveillance, supported by
strengthening of national capacities, is further needed to keep the international community prepared to provide assistance, in
the interest of defending global health security, whenever needed.

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Climate change provides perfect conditions for pathogen replication <B4>
Science in Africa March 2005 http://www.scienceinafrica.co.za/2005/march/envirodisease.htm

A rise in the incidence of new and previously suppressed infectious diseases is being
linked by scientists with the dramatic environmental changes now sweeping the planet.
Deforestation, road and dam building, urban sprawl, natural habitats destruction for agriculture, mining and the pollution of coastal
waters are promoting conditions under which new and old pathogens can thrive. A case in point is
the highly pathogenic Nipah virus which until recently was found in Asian fruit bats. In the late 1990s it emerged as an often-fatal
disease in humans. This has been linked with a combination of forest fires in Sumatra and the clearance of natural forests in Malaysia
for palm plantations. Bats, searching for fruit, were forced into closer contact to domestic pigs giving the virus its chance to spread to
humans via people handling swine. Climate

change may aggravate the threats of infectious diseases


in three ways, experts suggest. Firstly, by increasing the temperatures under which many
diseases and their carriers flourish, and secondly by further stressing and altering habitats.
For example, the geographic range and seasonality of two of the world's most serious mosquito-borne infections, malaria and
dengue fever, are very sensitive to changes in climate. Thirdly, climate change may increase the number of
environmental refugees who are forced to migrate to other communities, even countries. These are among the findings from the
United Nations Environment Programme (UNEP) in its latest "Global Environment Outlook Year Book 2004/2005" under the section
"Emerging Challenges-New Findings". The report is based on new research by leading experts in the field including Tony McMichael
of the Australian National University, Bernard Goldstein of the University of Pittsburgh, and Jonathan Patz of the University of
Wisconsin. Klaus Toepfer, UNEP's Executive Director, said: "It promises to be a momentous year for the United Nations as a whole
and UNEP in particular. In September, nations will gather in New York for a meeting of the General Assembly to evaluate how far we
have gone in achieving the Millennium Development Goals." "A Task Force, appointed by Secretary General Kofi Annan, has
concluded that the environment is the cornerstone upon which the Goals are likely to stand or fall. The report on the rise of infections
underlines this fact. MDG 6 calls on the global community to reverse the spread of HIV/AIDS, malaria and other diseases", he said.
Mr. Toepfer added: "If environmental degradation is not checked then, it is clear from these new findings that this will be harder and
tougher to achieve. There are implications for many of the other goals, from poverty eradication to the delivery of universal primary
education for all. People who are sick are less able to work and children who are ill find it harder to attend and concentrate at school."
The issue of environmental degradation and a rise of many new and old infectious diseases is a complex, sometimes subtle, one that is
causing increasing concern among scientists and disease specialists.

Overall, it seems intact habitats and


landscapes tend to keep infectious agents in check, whereas damaged, altered and
degraded ones shift the natural balance thereby triggering the spread to people of new and
existing diseases. Environmental disruption and change, and the poor handling of human and animal wastes are also to blame.
International travel, technological change and the globalization of trade in agricultural and other products favours the spread of
disease. In a paper in the Philosophical Transactions of the Royal Society, Prof. McMichael argues that the emergence of many
infectious diseases 5,000 to 10,000 years ago was a result of humans coming into increasing contact with animals as people
established settlements. The main cause of long-distance spread of infectious diseases, from around 500 years ago, was through war
and conquest during the period of European exploration and imperialism in Latin America, the Caribbean, Africa, Asia and the
Pacific. Today, the changing pattern of infectious diseases is as much due to environmental change as to trade, travel, migration and
social conditions, according to Prof. McMichael.

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An increase in climate change increases the spread of disease <B4>
Medical News Today, 05-04-07, http://www.medicalnewstoday.com/articles/71847.php

As the Earth's temperatures continue to rise, we can expect a significant change in infectious disease
patterns around the globe. Just exactly what those changes will be remains unclear, but scientists agree they will not be for the
good. "Environmental changes have always been associated with the appearance of new diseases or the
arrival of old diseases in new places. With more changes, we can expect more surprises," says Stephen
Morse of Columbia University, speaking at the 107th General Meeting of the American Society for Microbiology in Toronto.
In its April 2007 report on the impacts of climate change, the Intergovernmental Panel on Climate Change (IPCC) warned that
rising temperatures may result in "the altered spatial distribution of some infectious disease vectors," and
will have "mixed effects, such as the decrease or increase of the range and transmission potential of malaria
in Africa." "Diseases carried by insects and ticks are likely to be affected by environmental changes because these creatures are
themselves very sensitive to vegetation type, temperature, humidity etc. However, the direction of change - whether the diseases will
increase or decrease - is much more difficult to predict, because disease transmission involves many factors, some of which will
increase and some decrease with environmental change. A combination of historical disease records and present-day ground-based
surveillance, remotely sensed (satellite) and other data, and good predictive models is needed to describe the past, explain the present
and predict the future of vector-borne infectious diseases," says David Rogers of Oxford University, also speaking at the meeting. One
impact of rising global temperatures, though, can be fairly accurately predicted, says Morse. In the mountains of endemic areas,
malaria is not transmitted above a certain altitude because temperatures are too cold to support mosquitoes. As temperatures rise,

this malaria line will rise as well. "One of the first indicators of rising global temperatures could be malaria
climbing mountains," says Morse. Another change could be the flu season. Influenza is a year-round event
in the tropics. If the tropical airmass around the Earth's equator expands, as new areas lose their seasons they may also begin to see
influenza year-round. And extreme weather events will also lead to more disease, unless we are prepared. As the
frequency, intensity, and duration of extreme weather events change, water supplies become more at risk, according Joan Rose of
Michigan State University. "Hurricanes, typhoons, tornados and just high intensity storms have exacerbated an aging drinking and
wastewater infrastructure, enhanced the mixing of untreated sewage and water supplies, re-suspended pathogens from sediments and
displaced large populations to temporary shelters. We are at greater risk than ever before of infectious disease
associated with increasing extreme weather events," says Rose. There will also be indirect effects of climate

change on infectious disease as well. For instance, says Morse, the effect of global warming on agriculture
could lead to significant changes in disease transmission and distribution. "If agriculture in a particular area begins
to fail due drought, more people will move into cities," says Morse. High population densities, especially in developing countries, are
associated with an increased transmission of a variety of diseases including HIV, tuberculosis, respiratory diseases (such as influenza)
and sexually transmitted diseases. "I'm worried about climate change and agree that something needs to be done," says Morse.
"Otherwise, we can hope our luck will hold out."

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Climate change increase disease transmission and Africa cannot adapt <B4>
The Guardian 04/06/07

http://commentisfree.guardian.co.uk/andrew_scott/2007/04/by_andrew_scott_director_of.html
This year's G8 has a focus on Africa - one of the regions highlighted in the IPCC report to be most vulnerable to climate change - but
will our world leaders put climate change at the top of their agenda? Surely they have a moral obligation to do so. Sub-saharan

Africa has little capacity to introduce adaptation schemes, water resources are becoming increasingly
scarce and dry areas are forecast to get drier. A high percentage of people are already suffering as they are
poor or marginalised. According to World Health Organisation figures, climate change already claims the
lives of 150,000 people a year through natural disasters, disease and malnutrition. As temperatures rise we
could see an increase in disease, malnutrition and water borne diseases. While we cannot reverse the damage already
done, we can take steps to make a discernible difference for the future; but only if our political leaders and policy makers take action
now, and we also make a personal pledge to cut our emissions. International action on climate change has so far focused on mitigation
- addressing the causes by reducing greenhouse gas emissions. This report makes clear that action to adapt is also unavoidable. But the
poor in developing countries are least able to adapt. The IPCC finds that people living in the world's mega-deltas, such as Bangladesh,
are particularly vulnerable.

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Increase in temperature leads to diseases and we have a moral obligation to decrease transmission rate <B4 and B10>
MSNBC 11/14/06 http://www.msnbc.msn.com/id/15717706/

A warmer world already seems to be producing a sicker world, health experts reported Tuesday, citing
surges in Kenya, China and Europe of such diseases as malaria, heart ailments and dengue fever. Climate
affects some of the most important diseases afflicting the world, said Diarmid Campbell-Lendrum of the World Health Organization.
The impacts may already be significant. Kristie L. Ebi, an American public health consultant for the agency, warned climate
change could overwhelm public health services. The specialists laid out recent findings as the two-week U.N. climate
conference entered its final four days, grappling with technical issues concerning operation of the Kyoto Protocol, and trying to set a
course for future controls on global greenhouse gas emissions. Scientists attribute at least some of the past centurys 1-degree rise in
global temperatures to the accumulation in the atmosphere of carbon dioxide and other heat-trapping gases, byproducts of power
plants, automobiles and other fossil fuel-burning sources. The Kyoto accord requires 35 industrial nations not including the United
States, which rejects the pact to reduce such emissions by an average 5 percent below 1990 levels by 2012. President Bush says
such emissions cuts would harm the U.S. economy and complains that poorer countries also should be covered. In Nairobi, the Kyoto
parties are discussing what quotas and timetables should follow 2012 and how to draw the United States into a plan for mandatory
emissions caps. Britains environment secretary, David Miliband, an early arrival for high-level talks here, said participation of the
United States, the worlds biggest emitter, was essential. I cant think of a greater legacy for the last two years of the Bush
presidency than to work on a bipartisan basis with Democrats as well as Republicans for a deal to cut emissions, Miliband said.

Besides disrupting normal climate zones, continued temperature rises will increase threats to human
health, particularly in lower income populations, predominantly within tropical-subtropical countries, a
U.N. network of climate scientists has projected. Those problems are arising in parts of the world that have contributed
little to global warming, Campbell-Lendrum noted. Its a global issue and a global justice issue, one that demands
action by the industrial north to alleviate the disease burden on the south, the WHO scientist said.
Global warming causes the mosquitoes population to grow, increase the spread of malaria <B4>
MSNBC 11/14/06 http://www.msnbc.msn.com/id/15717706/

In Kenya, where temperature increases have tracked the global average, malaria epidemics have occurred
in highland areas where cooler weather historically has kept down populations of disease-bearing
mosquitoes, said Solomon M. Nzioka, a Kenyan Health Ministry consultant. Research shows that even a seemingly
small rise in temperatures can produce a 10-fold increase in the mosquito population, he said. Highland malaria
seems to be on the increase in the rainy season and when temperatures are high, Nzioka said. The WHOs Dr. Bettina Menne
said malaria, which two decades ago was present in only three southeastern European countries, has spread
north to Russia and a half-dozen other nearby countries. Russian news media reported in September that larvae of the
anopheles mosquito, the malaria carrier, had been found in Moscow. Menne cited a threat from other mosquito-borne
diseases as well. Theres an increased risk of local outbreaks, especially in the Mediterranean, of dengue
and West Nile virus, she said. China is trying to track excess deaths from rising average temperatures, said Jin Yinlong of
Chinas Institute for Environmental Health. Authorities are particularly concerned about surging mortality from strokes and heart
disease under warming conditions, he said. Global warming has been linked to more prolonged heat waves. A study of three Chinese
cities found annual excess deaths totaled between 173 and 685 per million residents, Jin said. Projected over the huge Chinese
population of 1.3 billion, this could amount to as many as Rising global temperatures may be helping to spark a population boom in
insects and disease-carrying animals, creating unexpected threats to human populations, a number of scientific reports say.

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Many changes in human factors can increase the spread rate of emerging disease
Denise Grady, staff writer, 08/20/02, Managing Planet Earth

http://query.nytimes.com/gst/fullpage.html?sec=health&res=9C0CE6D6103DF933A1575BC0A96
49C8B63

Researchers say West Nile may be just one example of an infectious disease whose incidence and
geographic range have expanded because of human activities affecting the mosquitoes, birds, rodents and
other animals that help spread the infection. Since the mid-1970's -- a time when it was widely assumed that most infectious
diseases had been conquered or at least controlled -- a troubling array of previously unknown diseases has emerged, including Lyme
disease, AIDS, mad cow disease, the Ebola virus, Legionnaires' disease and a host of others. In addition, old diseases like yellow
fever, malaria and dengue fever have reappeared in their former haunts and spread to new areas. Some microbes, like the ones that
cause tuberculosis, malaria and food poisoning, have become dangerously drug resistant. In a 2000 report, the World Health

Organization identified a half-dozen factors that could affect the distribution and emergence of infectious
diseases. The factors include ecological changes like those from global warming and changes in land use;
human factors like population growth, migration, war, sexual behavior, intravenous drug use and
overcrowding; international travel and commerce; technological and industrial factors like food processing,
livestock handling and organ transplants; microbial changes like the development of antibiotic resistance;
and breakdowns in public health measures like sanitation, vaccination and insect control.
Societal changes, such as increase agriculture, has brought humanity into close contact with emerging disease
Stephen S. Morse, Ph.D. The Rockefeller University, New York, 01/09/1995, Center for Disease Control, Factors in the Emergence
of Infectious Disease http://www.cdc.gov/ncidod/EID/vol1no1/morse.htm

Ecological changes, including those due to agricultural or economic development, are among the most
frequently identified factors in emergence. They are especially frequent as factors in outbreaks of
previously unrecognized diseases with high case-fatality rates, which often turn out to be zoonotic
introductions. Ecological factors usually precipitate emergence by placing people in contact with a natural
reservoir or host for an infection hitherto unfamiliar but usually already present (often a zoonotic or arthropodborne infection), either by increasing proximity or, often, also by changing conditions so as to favor an
increased population of the microbe or its natural host (2,4). The emergence of Lyme disease in the United States and
Europe was probably due largely to reforestation (14), which increased the population of deer and the deer tick, the vector of Lyme
disease. The movement of people into these areas placed a larger population in close proximity to the vector. Agricultural
development, one of the most common ways in which people alter and interpose themselves into the
environment, is often a factor (Table 2). Hantaan virus, the cause of Korean hemorrhagic fever, causes over 100,000 cases a
year in China and has been known in Asia for centuries. The virus is a natural infection of the field mouse Apodemus agrarius. The
rodent flourishes in rice fields; people usually contract the disease during the rice harvest from contact with infected rodents. Junin
virus, the cause of Argentine hemorrhagic fever, is an unrelated virus with a history remarkably similar to that of Hantaan virus.
Conversion of grassland to maize cultivation favored a rodent that was the natural host for this virus, and human cases increased in
proportion with expansion of maize agriculture (15). Other examples, in addition to those already known (2,15), are likely to appear
as new areas are placed under cultivation.

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Monoculture plants are more likely to be wiped out by disease <B2>
Juliet E. Carroll, Prof. at Cornell University, Monoculture and Disease Epidemics,
http://carroll1.cc.edu/~jclausz/msamanual/epidemiology.html
It is known that some disease epidemics move more rapidly through a population of the same species of plants than through a mixed
population. During an epidemic, the rate of disease progress in a monoculture of crop plants can be predicted in order to efficiently
manage the disease with a minimum number of fungicide applications. In natural ecosystems disease epidemics are rare unless they
result from introduced pathogens against which the native plant has no resistance. This was the case for the chestnut blight which
killed American chestnut trees throughout their natural range in North America. Today this tree exists in forests as a shrub, sprouting
from the root system, its stems eventually succumbing to the fungal blight. The fungus Rhizoctonia solani causes damping off of
seedlings. Damping off is a disease of seedlings characterized by the collapse of the hypocotyl or stem at the soil line, seedlings so
affected fall over and die. Rhizoctonia will quickly move through a flat of seedlings, killing them in its path. However, in a mixture of
different species of seedlings its progress may differ and it may not kill all the species that are germinating.

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More Diseases are emerging that can be transmitted from animals to humans
Jonathan R. Davis and Joshua Lederberg (Editors), Forum on Emerging Infections, Board on Global Health, Institute of Medicine
(Authoring organization), 2001, Emerging Infectious Diseases from the Global to the Local Perspective, p.11,
http://books.nap.edu/openbook.php?record_id=10084

In both developing and developed countries a number of new zoonoses (diseases transmitted
from animals to humans) have emerged. These have been caused by either newly discovered pathogens or
agents that are already known, often appearing in animal species in which the disease had not previously been detected.

Zoonotic disease agents have also reemerged in some areas after being absent for many years,
sometimes decades. Examples of emerging and reemerging zoonotic disease agents include
equine morbillivirus, Japanese encephalitis virus, and Australian bat lyssavirus in Australia,
equine encephalitis virus in Colombia and Venezuela, enterohemorrhagic Escherichia coli in
Japan, the bovine spongiform encephalopathy agent in the United Kingdom, and dengue virus
in South America.
A dramatic example of a recent zoonotic disease outbreak was the occurrence of H5N1 influenza A virusthe so-called
avian or bird fluin Hong Kong in 1997 (Figure 6), which resulted in the slaughter of millions of chickens. Hong Kong is
particularly vulnerable to infectious diseases because it is densely populated (6.68 million population in 1998), is in the
crossroads between the East and the West, encounters a heavy volume of international travel, and has live poultry markets in
close proximity to residential areas, which facilitate the spread of the virus from infected chickens to humans (see Chapters
4). Intense media attention to the outbreak highlighted the power of telecommunications to transmit images and mobilize and
accelerate the response to an outbreak.

The juxtaposition of human and animal populations increases the likelihood of such
outbreaks. Another example is Argentine hemorrhagic fever (AHF), which has been a major public health concern since
1955. The Argentine government is effectively using the AHF vaccine to reduce the incidence of disease. The incidence of
AHF, however, has gradually increased among adult agricultural workers in rural areas, indicating an occupational exposure
to the virus, and the focal incidence of AHF correlates well with the distribution of rodent infestation. The affected area in
Argentina has gradually been extending and now covers approximately 150,000 square kilometers (58,000 square miles)
including densely populated areas in parts of Argentina where the population at risk is approximately 5 million

The emergence of zoonoses is likely to persist owing to increased human-to animal


interactions, increased production and manufacture of animal-derived food products, changes
in food-processing practices, and encroachment of human populations into feral animal
habitats, as well as increased global trade and ransportation of animals and animal products.
Zoonotic outbreaks emphasize the importance of a robust public health infrastructure for disease surveillance and the need for
international efforts and multidisciplinary collaboration to address such public health threats. Apart from human and animal
health and welfare, due consideration must be given to the economic and political effects of zoonotic disease outbreaks

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Population growth has causes diseases to spread quickly
Stephen S. Morse, Ph.D. The Rockefeller University, New York, 01/09/1995, Center for Disease Control, Factors in the Emergence
of Infectious Disease http://www.cdc.gov/ncidod/EID/vol1no1/morse.htm
Human population movements or upheavals, caused by migration or war, are often important factors in disease emergence. In many
parts of the world, economic conditions are encouraging the mass movement of workers from rural areas to cities. The United Nations
has estimated that, largely as a result of continuing migration, by the year 2025, 65% of the world population (also expected to be
larger in absolute numbers), including 61% of the population in developing regions, will live in cities (24). As discussed above for
HIV, rural urbanization allows infections arising in isolated rural areas, which may once have remained obscure and localized, to
reach larger populations. Once in a city, the newly introduced infection would have the opportunity to spread locally among the
population and could also spread further along highways and interurban transport routes and by airplane. HIV has been, and in Asia is
becoming, the best known beneficiary of this dynamic, but many other diseases, such as dengue, stand to benefit. The frequency of the
most severe form, dengue hemorrhagic fever, which is thought to occur when a person is sequentially infected by two types of dengue
virus, is increasing as different dengue viruses have extended their range and now overlap (25). Dengue hemorrhagic fever is now
common in some cities in Asia, where the high prevalence of infection is attributed to the proliferation of open containers needed for
water storage (which also provide breeding grounds for the mosquito vector) as the population size exceeds the infrastructure (19). In
urban environments, rain-filled tires or plastic bottles are often breeding grounds of choice for mosquito vectors. The resulting
mosquito population boom is complemented by the high human population density in such situations, increasing the chances of stable
transmission cycles between infected and susceptible persons. Even in industrialized countries, e.g., the United States, infections such
as tuberculosis can spread through high-population density settings (.g., day care centers or prisons) (12,26-28). Human behavior can
have important effects on disease dissemination. The best known examples are sexually transmitted diseases, and the ways in which
such human behavior as sex or intravenous drug use have contributed to the emergence of HIV are now well known. Other factors
responsible for disease emergence are influenced by a variety of human actions, so human behavior in the broader sense is also very
important. Motivating appropriate individual behavior and constructive action, both locally and in a larger scale, will be essential for
controlling emerging infections. Ironically, as AIDS prevention efforts have demonstrated, human behavior remains one of the
weakest links in our scientific knowledge.

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Global warming increase disease range, pre-emptive medicine is need <B4>


USA Today; 05/23/2007

http://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=J0E165288205607&site=ehost-live
Will global warming bring malaria to Montana? Place your bets. Scientists attending a meeting here of the American Society for
Microbiology won't make predictions, but they say changes in the environment are sure to have ripple effects that

pose new concerns for future outbreaks of infectious diseases. Animals and insects can change their
behaviors and expand their geographic range in response to changes in the climate and other environmental
influences, experts said Tuesday. "Infectious diseases are a moving target," said microbiologist Rita Colwell of the
University of Maryland. "As climate changes, so do infectious diseases." Warmer temperatures may lure germs of
the tropics further north, said microbiologist Stephen Morse of Columbia University. Yellow fever has "largely disappeared in the
U.S., but I don't see any reason why warmer temperatures couldn't bring it back," he said. People in areas where malaria is

common often head for higher ground during the mosquito season, he said, but as the global climate heats
up, malaria could follow them up the mountainside. Flu is a winter disease in North America, but occurs year-round in
the tropics. So, Morse said, "if we get to have a more tropical climate here, we can expect influenza to circulate year-round."

Colwell says a strategy of "pre-emptive medicine" is needed, in which public-health experts consider
factors that will make a disease outbreak likely, then take steps to minimize its effect. "If we could predict the
conditions conducive to a cholera epidemic, we could provide safe drinking water, vaccines, medications," she said. "We could target
it, rather than taking a shotgun approach." Terry Yates of the University of New Mexico said scientists at his university have
developed a model using environmental data to predict with 94% accuracy the severity of hantavirus in humans for the coming year.
The warm, wet winters caused by El Nioo produce large populations of the white-footed deer mice that carry the virus, he said, and
factors such as land use, which may affect animals that compete with the deer mice for food, also play a role. Studies show the more
infected mice there are, the more human infections can be expected. Extreme weather conditions such as floods and hurricanes not
only cause immediate death and injury but also can result in a spike in infectious diseases, said Joan Rose of

Michigan State University. Respiratory infections, diarrhea and other diseases increase as people are forced
into crowded shelters and water supplies are contaminated, she said. Worldwide environmental degradation
caused by deforestation, soil erosion, lack of sanitation and access to safe water are danger signs that
suggest that "we are at greater risk than ever before of infectious diseases associated with increasing
extreme weather events," Rose said.

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Sub-Saharan Africa is a breeding ground for hard to identify emerging diseases <B1>
The Baltimore Sun, 05- 16-05
http://seattletimes.nwsource.com/html/nationworld/2002276179_diseases16.html?syndication=rss
Some of the viruses are notorious, such as Ebola and HIV. Others have less familiar names: Marburg and Lassa fever. But
they all have emerged in recent decades from sub-Saharan Africa, perplexing scientists and, in the case of

HIV, killing millions. Africa is recognized as an ideal incubator for new pathogens: It has rapidly growing
human populations and high biodiversity, along with widespread poverty, poor medical care and, in many
countries, armed conflict that forces civilians to flee far from their homes. "For every virus that we know about, there are
hundreds that we don't know anything about," said Dr. Dan Bausch, a professor at the Tulane School of Public Health
and Tropical Medicine who studies Marburg, Ebola and other emerging diseases in Africa. "Most of them, we probably don't even
know that they're out there." Scientists remain especially baffled by Marburg. Since 1967, the Marburg virus and its equally lethal
cousin, Ebola, have killed more than 1,600 people. The latest Marburg outbreak has killed at least 277 people in Angola, hundreds of
miles from where it last emerged four years ago, in the Democratic Republic of Congo. "To be honest with you, I have no indication
what the source is," said Dr. Pierre Formenty, the World Health Organization's senior Marburg expert, speaking from the epicenter of
the outbreak, in Uige, Angola. "That was not our first priority. Now we are working on it."

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Influenza runs rampant even in the US

http://www.cdc.gov/flu/about/disease.htm
Most people who get influenza will recover in a few days to less than 2 weeks, but some

people will develop lifethreatening complications (such as pneumonia) as a result of the flu. Millions of people in the United States
about 5% to 20% of U.S. residents will get influenza each year. An average of about 36,000 people
per year in the United States die from influenza, and more than 200,000 have to be admitted to the hospital
as a result of influenza. Anyone can get the flu (even healthy people), and serious problems from influenza can happen at any
age. People age 65 years and older, people of any age with chronic medical conditions, and very young children are more likely to get
complications from influenza. Pneumonia, bronchitis, and sinus and ear infections are three examples of complications from flu. The
flu can make chronic health problems worse. For example, people with asthma may experience asthma attacks while they have the flu,
and people with chronic congestive heart failure may have worsening of this condition that is triggered by the flu.

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The US spends 10 billion dollars every year on Influenza; a world out break could cost hundreds of billions
George Bush, President of the United States, 11/1/05, < http://www.whitehouse.gov/homeland/pandemic-influenza.html>
Although remarkable advances have been made in science and medicine during the past century, we are constantly reminded that we
live in a universe of microbes - viruses, bacteria, protozoa and fungi that are forever changing and adapting themselves to the human
host and the defenses that humans create.
Influenza viruses are notable for their resilience and adaptability. While science has been able to develop
highly effective vaccines and treatments for many infectious diseases that threaten public health, acquiring these tools is an ongoing
challenge with the influenza virus. Changes in the genetic makeup of the virus require us to develop new vaccines on an annual basis
and forecast which strains are likely to predominate.

As a result, and despite annual vaccinations, the U.S. faces a burden of influenza that results in
approximately 36,000 deaths and more than 200,000 hospitalizations each year. In addition to this human
toll, influenza is annually responsible for a total cost of over $10 billion in the U.S.
A pandemic, or worldwide outbreak of a new influenza virus, could dwarf this impact by overwhelming
our health and medical capabilities, potentially resulting in hundreds of thousands of deaths, millions of hospitalizations, and
hundreds of billions of dollars in direct and indirect costs. This Strategy will guide our preparedness and response
activities to mitigate that impact.

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DISEASES: INFLUENZA IMPACT- DEATH TOLL


EVEN A MILD INFLUENZA PANDEMIC WOULD KILL MILLIONS.
Michael T. Osterholm, Ph.D., M.P.H (The New England Journal of Medicine), 5/5/05, < Preparing for the next Pandemic Volume
352:1839-1842, Number 18, http://content.nejm.org/cgi/content/full/352/18/1839>
Annual influenza epidemics are like Minnesota winters all are challenges, but some are worse than others. No matter how well we
prepare, some blizzards take quite a toll. Each year, despite our efforts to increase the rates of influenza vaccination in our most
vulnerable populations, unpredictable factors largely determine the burden of influenza disease and related deaths. During a

typical year in the United States, 30,000 to 50,000 persons die as a result of influenza virus infection, and
the global death toll is about 20 to 30 times as high as the toll in this country. We usually accept this outcome as
part of the cycle of life. Only when a vaccine shortage occurs or young children die suddenly does the public demand that someone
step forward to change the course of the epidemic. Unfortunately, the fragile and limited production capacity of our 1950s egg-based
technology for producing influenza vaccine and the lack of a national commitment to universal annual influenza vaccination mean that
influenza epidemics will continue to present a substantial public health challenge for the foreseeable future.

An influenza pandemic has always been a great global infectious-disease threat. There have been 10
pandemics of influenza A in the past 300 years. A recent analysis showed that the pandemic of 1918 and
1919 killed 50 million to 100 million people,1 and although its severity is often considered anomalous, the pandemic of
1830 through 1832 was similarly severe it simply occurred when the world's population was smaller. Today, with a world
population of 6.5 billion more than three times that in 1918 even a relatively "mild" pandemic could
kill many millions of people.

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DISEASES: BIRD FLU- DEATH TOLL


Renowned expert Robert G. Webster says, 50% of the world population could die if bird flu genetic code joins with the human
flu and becomes air born
Jim Avila and Meredith Ramsey, 3/14/06 < Renounced Bird Flu expert warns: Be prepared
http://abcnews.go.com/WNT/AvianFlu/story?id=1724801>

Right now, H5N1, a type of avian influenza virus, has confined itself to birds. It can be transmitted from
bird to human but only by direct contact with the droppings and excretions of infected birds.
But viruses mutate, and the big fear among the world's scientists is that the bird flu virus will join the
human flu virus, change its genetic code and emerge as a new and deadly flu that can spread through the air
from human to human.
If the virus does mutate, it does not necessarily mean it will be as deadly to people as it is to birds. But experts such as Webster
say they must prepare for the worst.
"I personally believe it will happen and make personal preparations," said Webster, who has stored a three-month supply of food and
water at his home in case of an outbreak.
"Society just can't accept the idea that 50 percent of the population could die. And I think we have to face that
possibility," Webster said. "I'm sorry if I'm making people a little frightened, but I feel it's my role."

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Bird flu could cause the economy 4.4 trillion dollars and 142 million lives
CNN.com , 2.16.06 , <Bird flue could take 142 million lives
http://www.cnn.com/2006/HEALTH/conditions/02/15/birdflu.cost/index.html>

As many as 142 million people around the world could die if bird flu turns into a "worst case" influenza
pandemic, according to a sobering new study of its possible consequences.
And global economic losses could run to $4.4 trillion -- the equivalent of wiping out the Japanese
economy's annual output.
The study, prepared for the Sydney, Australia-based Lowy Institute think tank, says there are "enormous uncertainties" about whether
a flu pandemic might happen, and where and when it might happen first. But it says even a mild pandemic could kill 1.4

million people and cost $330 billion.


In its "ultra" or worst-case scenario, Hong Kong's economy is halved, the large-scale collapse of Asian economic activity
causes global trade flows to dry up, and money flows out to safe havens in North America and Europe. Deaths could top 28 million in
China and 24 million in India.
The report's release in Sydney Thursday comes as two more countries in Europe -- Germany and Austria -- report that the
deadly H5N1 bird flu virus has been detected in wild fowl.

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DISEASES- RIVER BLINDNESS

River blindness is spreading rapidly in Sub-Saharan Africa because disease spread is not monitored <B1>
The Science Daily 06-28-07
http://www.sciencedaily.com/releases/2007/06/070627142914.htm

A 20-year effort to control the spread of onchocerciasis, or river blindness, in African communities is
threatened by the development of drug resistance in the parasite that causes the disease, a study by McGill
University researchers has found. Weve found the first evidence of resistance, where the adult parasites continue to reproduce and
transmit the disease, and in some communities it seems to be getting worse, said Dr. Roger Prichard, James McGill Professor in the
Universitys Institute of Parasitology, whose findings appear in the June 16 edition of The Lancet. River blindness, which is the
second-leading infectious cause of blindness worldwide after trachoma, is caused by the filarial nematode parasite, a worm transmitted
by black fly bite. It leads to visual impairment, blindness, and, in some cases, pathological changes in the skin. Adult worms can
survive as long as 10 to 15 years in a human host, releasing millions of tiny worms (microfilariae) each year. An estimated 37
million people are infected worldwide, primarily in Sub-Saharan Africa but also in parts of Central and South
America and, to a lesser extent, the Middle East. This finding has important implications for this disease re-

emerging and becoming a serious scourge, said Dr. Prichard, warning that health organizations need to
begin closely monitoring for the spread of drug resistance and new drugs need to be developed. Dr. Prichard
and his colleagues studied 2,501 infected people from 20 communities in Ghana, West Africa. Of those communities, 19 had been
receiving annual doses of ivermectin, the only widely available drug used to treat onchocerciasis. Although ivermectin wiped out the
microfilarial stage of the parasite in 99 per cent of those treated, four communities experienced significant repopulation and in two
communities, the prevalence of the parasite had doubled between 2000 and 2005, the researchers found. Two McGill graduate
students, Mike Y Osei-Atweneboana and Jeff K.L. Eng, conducted the bulk of the research in collaboration with research institutions
and health authorities in Ghana. If left unchecked, Dr. Prichard warned, drug resistance could spread to communities where ivermectin
treatment has successfully controlled the disease since the drug was introduced in the late 1980s, when, in an unprecedented move,
Merck announced that it would provide the drug at no cost for as long as necessary.

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DISEASES- MALARIA REEMERGING


Malaria is a reemerging deadly disease that is resistance and causes economic decline
Donald J. Krogstad, Johns Hopkins University, 1996, Malaria as a Reemergin Disease,
http://epirev.oxfordjournals.org/cgi/reprint/18/1/77

Malaria is a clear example of a reemerging disease. The annual number of cases (incidence) fell sharply
30-35 years ago as the result of a malaria eradication campaign (1, 2). At that time, malaria was
eliminated from Europe, most Asian regions of the USSR, the United States, and most of the
Caribbean (3). However, it was not eradicated in Southeast Asia, South America, or Africa, and has reemerged in Sri Lanka,
Madagascar, and elsewhere (3). Thus, the incidence of malaria today is greater than 40 years ago and is
increasing because of antimalarial drug resistance (4, 5), insecticide resistance (6), and the effects of
civil strifedislocation of susceptible refugee populations from nonendemic areas to areas with malaria ransmission (7, 8). The
incidence of malaria complications (morbidity) and deaths (mortality) is likewise increasing because
of drug resistance (9). These changes also reflect the failure thus far of alternative control strategies,
such as vaccine development. The net result is that the increasing morbidity and mortality of malaria
affect not only the health of the developing world, but also (prevent) its economic development. This
review begins by examining the two major reasons that the malaria eradication campaign was unsuccessful, antimalarial drug
resistance and insecticide resistance. It then examines alternative malaria control strategies such as the development of antimalarial
agents effective against drug-resistant parasites, of bednets and curtains impregnated with pyrethroid insecticides, and of malaria
vaccines, concluding with a discussion of the balance that will likely be necessary between basic and applied research for effective
malaria control.
Malaria is a reemerging disease
Anthony S. Fauci, National Institutes of Health, July 1998, New and Reemerging Diseases: The Importance of Biomedical
Research, http://ftp.cdc.gov/pub/EID/vol4no3/adobe/fauci.pdf

Until relatively recently, AIDS was virtually the only emerging disease with global impact that
was widely discussed in the United States; however, other diseases such as malaria and TB have actually
caused more illnesses and deaths over the past 2 decades. Malaria kills up to three million
persons each year, most of them children in sub-Saharan Africa. In the past year, NIH has worked with
research
organizations and donor agencies from around the world to form a coalition called the
Multilateral Initiative on Malaria. This unprecedented initiative will enhance international
collaborations, encourage the involvement in malaria research of scientists from malariaendemic countries, and identify additional malaria research resources. In addition, NIH has bolstered
its long-term commitment to malaria research. NIH-supported malaria projectsmany in collaboration with other
government and international agenciesinclude 1) a new repository of materials available to researchers worldwide; 2)
basic, field-based, and clinical research on all phases of malaria research; and 3) projects to determine the genetic sequences
of important malaria species.

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DISEASES: MALARIA DRUG RESISTANCE


Malaria is becoming antibiotic resistant
Gail H. Cassell and John Mekalanos, PhD American Medical Association, 2001, Development of Antimicrobial Agents in the Era
of New and Reemerging Infectious Diseases and Increasing Antibiotic Resistance, http://jama.ama-

assn.org/cgi/content/full/285/5/601
The reasons for the increase in incidence of infectious diseases are not fully understood. Changes in
human demographics and behavior (eg, increasing use of day care facilities, a risk factor for otitis media);
technology and industry; economic development and land use (possibly accounting for an increase in zoonotic
diseases); international travel and commerce; and breakdown of public health measures are thought to
contribute to new infectious diseases and reemergence of infectious diseases thought to have been
controlled.4 For example, tuberculosis, malaria, and cholera have reemerged or spread geographically
since 1973, often in more virulent forms
Malaria, a re-emerging disease, is difficult to combat
Phillipe J. Guerin, Prominent Scholar, 2002, Malaria: current status of control, diagnosis, treatment, and a proposed agenda for
research and development, http://www.accessmed-msf.org/upload/ReportsandPublications/25920021619148/malaria.pdf

Malaria is now on the rise again; since it is appearing in areas where it had disappeared, it is
classified by some as a re-emerging disease. In general though, malaria has been a submerged disease, because lack of
investment even in data collection has led people to conclude that it is being tackled effectively.2 Despite global economic
development, more people die from malaria nowadays than 40 years ago. The current failure to
control malaria through effective vector control and treatment of the disease results mainly from an
inability to deliver appropriate case-management to a significant proportion of patients, particularly
at the periphery of health systems. This paper attempts to define some of the essential research questions that must be
addressed if we are to combat malaria.
Malarias resistance is underestimated
Phillipe J. Guerin, Prominent Scholar, 2002, Malaria: current status of control, diagnosis, treatment, and a proposed agenda for
research and development, http://www.accessmed-msf.org/upload/ReportsandPublications/25920021619148/malaria.pdf
In general, the effects of resistance to antimalarial drugs on malaria morbidity and mortality are
underestimated.7 The single well-documented study to date on the effect on mortality of resistance to chloroquine concluded that
the development of resistance had resulted in a four to eight fold increase in mortality.8 Inadequate
epidemiological data create many problems, justifying inaction and preventing the policy changes that would allow deployment of
effective treatments. Malaria-endemic countries are among the poorest in the world . In 1995, income was only a
third that of nonendemic countries, irrespective of geographical location.9

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[B20] and [B18]
Malaria kills the global economy
Jeffrey Sachs and Pia Malaney, Harvard University, Center for International Development, John F. Kennedy School of Government,
2/7/02, The economic and social burden of malaria, http://www.rbm.who.int/cmc_upload/0/000/015/330/415680a_r.pdf

Throughout history, malaria has suppressed the economic linkages


between malarious and non-malarious regions. In previous
centuries this isolating effect may have served to protect malarious
countries from European colonizers. But in todays globalized
economy, the isolation has more negative effects41. Although direct
measurement of the impact of disease on decision-making by
foreign investors is difficult to gauge, failure of investment is likely
to be one of the most costly effects of malaria with respect

to longterm
growth. Investors from non-malarious regions tend to shun
malarious regions for fear of contracting the disease a fear that
is sadly well grounded in reality, as evidenced recently by the
experience of Billiton, a London-based mining and metals
company. In a US$1.4 billion joint venture investment to build an
aluminium smelter in Mozambique, the largest foreign investment
so far in that country, the company was faced with 7,000 cases of
malaria in two years, and the death of 13 expatriate employees42.
[B18] and [B20]
The global economy suffers from malaria
Jeffrey Sachs and Pia Malaney, Harvard University, Center for International Development, John F. Kennedy School of Government,
2/7/02, The economic and social burden of malaria, http://www.rbm.who.int/cmc_upload/0/000/015/330/415680a_r.pdf

Industries such as tourism are particularly hard hit by malaria


transmission, as is becoming clearer in countries such as
Mozambique and South Africa as they attempt to encourage
investment in these areas with limited success. Investments in all
sorts of production in mining, agriculture and manufacturing
may similarly be crippled if the labour force faces a heavy
disease burden, or if the burden raises the costs of attracting the
needed labour to a malarious region. In an economic era in which
international trade and finance is critical for economic
development, these adverse effects on foreign trade and investment
are likely to be of tremendous macroeconomic importance.

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DISEASES: HIV IMPACT- ECON, POVERTY


[B22] and [B18] and [B17]
HIV/AIDS destroys the economy and causes poverty
Stelios H. Zanakis, Department of Decision Science and Information Systems, 2/1/07, Socio-economic determinants of HIV/AIDS
pandemic and nation efficiencies, European Journal of Operational Research,
http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6VCT-4J7H45R1&_user=4257664&_coverDate=02%2F01%2F2007&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000022698&_vers
ion=1&_urlVersion=0&_userid=4257664&md5=6c50ca8b532d92f28a421f4bba2870cc
Children may be left without parents, increasing the orphanhood levels. In

2001, 13.2 million children lost at


least one parent to AIDS. The AIDS mortality of parents eventually will result in
family nutrition declination, economic status deterioration, and increasing number
of children out of school (especially girls), which leads to the de-education of the future
generation (Breuer, 2000).
Extant research points to increasing incidence of HIV/AIDS among low income
minorities, identifying HIV/AIDS as a disease of poverty (Brunswick and Flory, 1998 and
Guillies et al., 1996). There are huge disparities in HIV epidemiology between developed and developing
countries (De Cock and Weiss, 2000). In developed countries, the possibility of HIV/AIDS
infection in ethnic minority and poorer populations is higher than the rest of
population, due to their difficulty to reach the benefits of therapy (Piot et al., 2001).

[B22] and [B18]


The economic impacts of diseases like HIV are deadly
Anne C. Conroy, Malcolm J. Blackie, Alan Whiteside, Justin C. Malewezi and Jeffrey D. Sachs, 2006, Poverty, AIDS, and Hunger:
Breaking the Poverty Trap in Malawi

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DISEASES IMPACT: TERRORISM


[C]
Diseases have a parallel with terrorism
John Richards, CD Howe Institute, 2006, Thinking about Development Strategy,

http://scholar.google.com/scholar?q=There+is+a+grisly+parallel+between+terrorism+and%2C+on+the+oth
er+hand%2C+AIDS%2C+new+diseases+such+as+ebola%2C+and+virulent+mutations+&hl=en&lr=&btn
G=Search, GoogleNews
There is a grisly parallel between terrorism and, on the other hand, AIDS, new diseases such as
ebola, and virulent mutations of the pathogens causing tuberculosis, malaria, and other well known
infectious diseases. Deaths attributed to the former have forced us to take seriously the politics of the Muslim world; deaths
caused by the latter are doing the same for the politics of sub-Saharan Africa. Contending with these threats to world
health requires policies to grapple with stagnant and impoverished economies (which encourage large-scale
migration and hence rapid spread of disease) and poorly governed states (which are unable to undertake effective public
health programming).
AIDS and terrorism are directly linked in Africa- AIDS creates orphans who are uniquely vulnerable to terrorism recruitment
{terror stuff}

VOA News, 1/28/05


http://www.voanews.com/english/archive/2005-01/2005-01-28-voa43.cfm?CFID=133150803&CFTOKEN=98390804

A new report warns of the possible link between AIDS orphans and future
terrorists. The report was presented at the World Economic Forum in Davos, Switzerland.
The Global Business Coalition on HIV/AIDS says, It is undeniable that AIDS, and the deadly
conflicts that have ravaged Africa, have created a steady stream of orphans that can be exploited
and used for terrorist activities.
The report says evidence can be found in the many child soldiers. It says, Hundreds of
thousands of children as young as 10 years old have been forced to fight in Angola,
Ethiopia, Uganda, Sierra Leone, Rwanda, Sudan, Congo and other African
countries. It says, In Liberia, children have been forced to wear wigs and womens dresses in an effort to confuse opposing
fighters.
The report AIDS, Economics and Terrorism in Africa warns, The use of children to commit terrorist acts is not new. The Islamic
Jihad has been running schools to teach children how to become suicide bombers.
Among those praising the coalitions findings is Albina du Boisrouvray, founder of the FXB Foundation, which cares for AIDS
orphans around the world.
"Weve been lobbying very actively, relentlessly, to the past 10 years to make this link between the growing number of AIDS orphans
and terrorism," she says.
Its estimated there

are about 13 million AIDS orphans in sub-Saharan Africa.

Ms. du

Boisrouvray believes the actual figure is much higher than UN estimates. She says when a credible
organization raises the issue of AIDS orphans and terrorists people in power will listen.
She says, "So when a group like the Global Business Coalition brings this forward in a report and speaks at Davos, where all the
shakers and the decision makers and the big money givers are there at last they put something that weve been trying to really raise
as a very urgent issue to be put on the agenda of governments."
She agrees with the coalitions findings that AIDS

orphans are vulnerable for exploitation by


terrorists.
"Youre going to have these little kids in order to survive will go to anybody wholl
take them in and turn them into human bombs," she says.
The Global Business Coalition on HIV/AIDS says, however, there is hope. It writes, While the link between AIDS,
economics and terrorism is a clear and emerging threat, it is not one without
solutions. AIDS is a preventable disease.

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DISEASE IMPACT- AFRICAN ECON

Disease outbreaks significantly hamper African economies


Gary Cecchine AND, Ph.D. Biology, Melinda Moore, M.D., Harvard Medical School; M.P.H., Harvard School of Public
Health, 2006, Infectious Disease and National Security: Strategic Information Needs, RAND National Research Defense
Institute, < http://www.rand.org/pubs/technical_reports/2006/RAND_TR405.pdf>
Economic Loss. As detailed in examples later in this chapter, an outbreak of diseaseor even the perceived
threat of an outbreakcan have significant repercussions on trade and travel for the affected
nation. The economic effects of infectious diseaseswhether endemic, e.g., malaria, or epidemic,
e.g., choleracan be devastating. As just one example, it has been estimated that Africas gross

domestic product would be nearly one-third higher if malaria alone had been eliminated
several decades ago (U.S. General Accounting Office, 2001). Many of these effects are indirect (e.g., loss of
productivity and commerce), but there are also direct economic costs (e.g., culling of animal
herds and medical costs of treating humans) that may affect security and relationships
between nations in need and those able to provide assistance to control outbreaks. (For examples
of both direct and indirect costs, see Brower and Chalk, 2003; Cash and Narasimhan, 2000; Enemark, 2004; Frist, 2005;
Heymann, 2003; United Nations Security Council, 2000; U.S. General Accounting Office, 2001; U.S. National Intelligence
Council, 2000; White House, 2004; and Wilson, 2003a.) In addition, the UN estimated in 2002 that $20 billion would be
needed by 2007 to provide adequate prevention and care for populations affected by HIV/AIDS in low- and and middleincome countries (UNAIDS, 2002; see also World Health Organization, 2002).
Avian Flu with few infections in human had devastating economic consequences
Patricio V. Marquez AND, Lead Health Specialist, ECA, The World Bank, Alberto Gonima, World Bank Consultant, 11-26-05,
BRIEF FOR THE RUSSIAN AUTHORITIES ON HARMONIZED INFECTIOUS DISEASES SURVEILLANCE INFORMATION
SYSTEMS IN THE WORLD: ANOTHER CHALLENGE FOR THE G-8 GROUP,
< http://siteresources.worldbank.org/INTRUSSIANFEDERATION/Resources/Surveillance_Systems_eng.pdf>
The

continuing outbreaks of highly pathogenic avian influenza (HPAI) in several Southeast


Asian countries that begun in late 2003, and have occurred more recently in Europe, have
been disastrous to the poultry industry in the two regions and have raised serious global public health concerns.
Recent increases in the number of known cases of avian influenza (AI) transmission have raised concerns over the potential
emergence of a pandemic, which could have devastating effects on human health, animal health, and human livelihoods. At
the same time, it is important to emphasize that there are many uncertainties about whether and when a pandemic might occur
as well as about its potential impact. Nearly 140 million domestic poultry have either died or been destroyed and over 120
people have contracted the infection, of which 63 have died as of November 2005. The geographical spread of

HPAI, the human dimension and the huge social and economic impact are unprecedented.
Economic losses to the Asian poultry sector alone are estimated at around $10 billion. Despite
control measures the disease continues to spread, causing further economic losses and
threatening the livelihood of hundreds of millions of poor livestock farmers, jeopardizing
smallholder entrepreneurship and commercial poultry production, and seriously impeding
regional and international trade and market opportunities. The rural poor, who rely for a
larger share of their income on poultry, have been particularly hard hit with income losses.

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EMERGING DISEASES IMPACT- EXTINCTION


There are many new emerging diseases because of rainforest development, could lead to extinction <B7>
Rhett A. Butler, Loss of Species for Forest Regeneration Mongabay.com, A Place Out of Time: Tropical Rainforests and the Perils
They Face. 9 January 2006. .

The emergence of tropical diseases and outbreaks of new diseases, including nasty hemorrhagic fevers like
ebola and lassa fever, are a subtle but serious impact of deforestation. With increased human presence in
the rainforest, and exploiters pushing into deeper areas, man is encountering "new" microorganisms with
behaviors unlike those previously known. As the primary hosts of these pathogens are eliminated or reduced through forest
disturbance and degradation, disease can break out among humans . Although not unleashed yet, someday one of
these microscopic killers could lead to a massive human die-off as deadly for our species as we have been
for the species of the rainforest. Until then, local populations will continue to be menaced by mosquitoborne diseases like dengue fever, Rift Valley fever, and malaria, and water-borne diseases like cholera.
Many emergent and resurgent diseases are directly linked to land alterations which bring humans in closer
contact with such pathogens. For example, malaria and snailborne schistosomiasis have escalated because of the creation of
artificial pools of water like dams, rice paddies, drainage ditches, irrigation canals, and puddles created by tractor treads. Malaria is a
particular problem in deforested and degraded areas, though not in forested zones where there are few stagnant ground pools for
mosquito breeding. These pools are most abundant in cleared regions and areas where tractors tear gashes in the earth. Malaria is
already a major threat to indigenous peoples who have developed no resistance to the disease nor any access to antimalarial drugs.
Malaria alone is cited as being responsible for killing an estimated 20 percent of the Yanomani in Brazil and Venezuela. Malaria
caused by unicelluar parasites transferred in the saliva of mosquitoes when they biteis an especially frightening disease for its drugresistant forms. Thanks to poor prescribing techniques on the part of doctors, there are now strains in Southeast Asia reputed to be
resistant to more than 20 anti-malarial drugs. There is serious concern that global climate change will affect the

distribution of malaria, which currently infects roughly 270 million people worldwide and kills 1-2 million
a year 430,000-680,000 children in sub-Saharan Africa alone.

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KALA-AZAR IMPACT- DEATH TOLL


The Kala-azar disease is killing thousands in Africa <B1>
BBC 12/23/2003 http://newsvote.bbc.co.uk/mpapps/pagetools/print/news.bbc.co.uk/2/hi/africa/3342975.stm

Doctors working in Sudan say they are concerned a deadly disease is sweeping through the population in
the south. The medical emergency relief charity, Medecins Sans Frontieres, say thousands of people could already be
suffering Between 1985 and 1993, a similar epidemic in southern Sudan killed an estimated 100,000 people. Kala-azar is a
parasitic disease that weakens the immune system and is transmitted by the bite of the sandfly. It is fatal if
untreated. Most people die from common infections the immune system can no longer handle, like
pneumonia, diarrhoea and tuberculosis. The spread of the disease has been exacerbated by the civil war,
chronic food shortages and mass population movement. MSF health advisor Kees Keus, who has just been in the upper
Nile region of Bimbim, says the evidence points to this being a new epidemic in a population with little acquired resistance to kalaazar. "We know from our experience in other places how devastating this can be. It is vital that we quickly
discover the extent of the problem in this area." The MSF say they have seen 150 new patients in the past week in the area.
Twenty more arrive every day. Most say they have already lost at least one member of their family to the disease. There are reports of
many more cases in the larger towns in the region but so far, doctors have been unable to get access. MSF have called for a concerted
effort by aid agencies working in the region to try and control the spread of the disease. There is no vaccine, but it can be cured with
drug injections and over 30 days of intense feeding.

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DISEASE IMPACT- GLOBAL ECONOMY


J5- Health creates strong markets for US goods.
Board on International Health, 1997 (America's Vital Interest in Global Health: Protecting Our People, Enhancing Our
Economy, and Advancing Our International Interests) [http://www.nap.edu/readingroom/books/avi/4.html]
[Clearly, it is desirable in itself that all populations achieve better health. But healthier populations abroad would
also constitute more vibrant markets for U.S. goods and services. Health, like education, is an

investment in human capital, and targeted health investments can help to break cycles of
poverty and political instability around the world and contribute to national and global
economic development. U.S. businesses are adapting to meet the rapid globalization of the world economy, and
demands for health and medical services are growing in the many countries with a rising standard of living. Political and
regulatory barriers, however, deter the United States and other industrial countries from developing drugs, vaccines, and
medical devices for these markets. These distortions need to be overcome if U.S. markets are to expand effectively overseas
and compete in the area of health goods and services. Examples of current constraints include failure to respect and enforce
intellectual property rights, pricing restrictions, patent infringements, and lack of harmonization in regulatory and
enforcement standards.]

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DISEASE IMPACT- RACE WARS

Disease Outbreaks create social and political instability


Gary Cecchine AND, Ph.D. Biology, Melinda Moore, M.D., Harvard Medical School; M.P.H., Harvard School of Public
Health, 2006, Infectious Disease and National Security: Strategic Information Needs, RAND National Research Defense
Institute, < http://www.rand.org/pubs/technical_reports/2006/RAND_TR405.pdf>
Social and Governmental Disruption. It has been documented that infectious

diseases cause significant social


disruption through fear and anxiety about a disease (based on accurate or inaccurate information), the
loss of people in key social positions due to illness or death, discrimination against
groups affected by a disease, and the loss of the majority of (or entire) specific
demographic groups. (For examples of social disruption, see Chyba, 1998; Elbe, 2002; Enemark, 2004; Heymann,
2003; Ostergard, 2002; Shisana, Zungu-Dirwayi, and Shisana, 2003; Store, Welch, and Chen, 2003; UNAIDS, 2004; U.S.
National Intelligence Council, 2000; White House, 2004; and Wilson, 2003a.) Consider HIV/AIDS: In 2003, there were 3
million new infections in sub-Saharan Africa (UNAIDS, 2002, 2004). Since it was first diagnosed in 1981, HIV/AIDS has
accounted for approximately 20 million deaths worldwide. Between 34.6 and 42.3 million people were living with

HIV/AIDS in 2003, and the disease had orphaned approximately 12 million children in subSaharan Africa alone (UNAIDS, 2004). Half of new infections occur among 15- to 24-year-olds
(UNAIDS, 2004), a traditionally productive segment of society. The reduction of this demographic
group can lead to economic loss due to reduced productivity, but it also represents the
loss of a core group of parents, social leaders, and key members of society, such as
teachers and soldiers. Ministries of defense in some sub-Saharan African countries report HIV prevalence averages of
2040 percent in their armed services, potentially affecting their military capabilities (UNAIDS, 2002). Not surprisingly,

HIV/AIDS in sub-Saharan Africa has been associated with the destabilization of


infrastructures needed for governance (Heymann, 2003), as well as with the disruption of
cohesion and stability of families, communities, and nation-states (Heymann, 2003; Shisana,
Zungu-Dirwayi, and Shisana, 2003; Store, Welch, and Chen, 2003). As a society is degraded by infectious
disease, its populace may lose confidence in a government that seems unable to control
the disease. Such a loss in confidence, it has been asserted, results in a degradation of a
governments legitimacy and may lead to increased migration or increased vulnerability
to economic or military competition from other nations. (For examples of government disruption and
instability, see Brower and Chalk, 2003; Enemark, 2004; Heymann, 2003; Huang, 2003; Ostergard, 2002; United Nations
Security
Rifts in African unity lead to racial wars.
Payne Lucas, 8/93, Africare

In Liberia, if something could have been done years ago to strengthen a more genuine sense of
shared nationhood and destiny, thousands of slaughtered civilians might be alive today. At the very
least, had there been an international early-warning system that could have detected the Liberian catastrophe in the embryo
stage, we might not be shaking our heads at the most recent massacre of women and children.

And there is South Africa. If any nation on earth is capable of showing us how to live together, it may well be this
benighted and beloved land. Apartheid has brought out the worst in many South Africans, but it has also brought out the best
in many others. More to the point, the majority of South Africans -- white and black -- appear to have

decided that they have only two options: either share the country as equals or resort to a full-fledged
race war.

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SOLVENCY- EMERGING DISEASES

New diseases are emerging that cannot be controlled by conventional means, we must work to control disease on a global level
Ellen Silbergeld, Ph.D., University of Maryland School of Medicine, 03/18/01
http://www.tradeobservatory.org/headlines.cfm?refID=16436
For the past few years, we have been witnessing an agricultural holocaust in the original sense of that term -- burnt
animal sacrifice. Last month's outbreak of foot-and-mouth disease in Britain, which authorities are saying could lead to the
incineration of up to 1 million farm animals, follows upon mad cow disease in several parts of Europe, and Nipah virus among pigs in
Indonesia -- all fresh evidence of the increased power and mobility of the microscopic agents of disease that
threaten our food supply and, in some cases, our health. We humans are in many ways a species of Gullivers,

bound and occupied by an army of the very small organisms that really rule this planet. Viruses, bacteria
and parasites have been joined by the recently recognized and still mysterious prions (the proteins responsible for
mad cow disease) to comprise a micro-army that can bring down economies, country by country. The world is
a fully globalized marketplace for the very small. National borders can constrain trade in goods and currency, but they are
useless against disease. Pathogens move freely and widely, carried by travelers, humans and others, as well as by the wind. They
hitchhike across continents in animal feed , as the foot-and-mouth virus seems to have done; they cross oceans, as the West Nile virus
did, apparently taking advantage of the coincident movement of an Asian mosquito and an African bird; they shuttle up and down
continental coasts on ocean currents, as the toxic algae did, bringing death to more than 400 sea lions in California's Monterey Bay in
1998. We must realize that we cannot block diseases by closing borders, by signing or banning trade

agreements, by national policies or by local practice. We must fashion a global response to a global
problem. Antiglobalism must give way to a planetary perspective on public health.
Global Surveillance is need to limit the spread of disease, U.S system is most effectice
Ellen Silbergeld, Ph.D., University of Maryland School of Medicine, 03/18/01
http://www.tradeobservatory.org/headlines.cfm?refID=16436
Some officials, including Germany's new minister for agriculture, Renate Kuenast of the Green Party, propose to lock out the rest of
the world, calling for a return to primitive agrarian communities that consume only what they can locally grow. For urbanized
societies that have grown dependent upon the world's bounty, this is hardly feasible. Still another response is the "burn the witch"
policy: If the world is swarming with pathogens, then kill them all; deploy antibiotics, antimicrobials, disinfectants in everything we
build and use. There is a huge market of "antibacterial" soaps available in the United States; and it is possible, amazingly and
improvidently, to purchase bathroom fixtures impregnated with antimicrobial chemicals. All of these bring with them the risk of
increased antibiotic resistance. Rather than killing animals from countries with identified outbreaks of disease, we
need to globalize national systems of food safety and food animal monitoring. Rather than spraying tourists with
disinfectant, as the United States has started to do to travelers from the EU, we need to harmonize inspections and
regulations at ports before disease breaks out. Rather than seeing food safety as separate from environmental concerns, we
need a consistent and prudent policy to restrain the use of antibiotics. The United States has been a leader in the
movement to improve disease surveillance so far. The Emerging Infectious Diseases Network, organized by the Centers
for Disease Control and Prevention (CDC), is a model for the rest of the world. Its capacity to monitor and track new

pathogens is what helped U.S. scientists counter West Nile virus quickly and effectively after it was first
identified in the Western hemisphere 1 1/2 years ago. The CDC continues to coordinate national surveillance of that disease
in mosquitoes, birds and humans. That attention to the emergence and movement of new pathogens must be
adopted and supported worldwide, if only for our own protection. Such international organizations that do exist to
coordinate global health and food safety -- the <CONTINUED>

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<CONTINUED>
World Health Organization and the Food and Agriculture Organization -- have too often become the targets of antiglobalists from
Jesse Helms to Ralph Nader. We need to be as global as the viruses, as persistent as prions and as adaptable as
the bacteria. We need more globalism, not less, if we are to make the world safer for us to live out our lives in recognition of what
we really are -- the hosts of the very small. They own our planet, and we pretend otherwise at our peril.

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SOLVENCY: EMERGING DISEASES

Every emerging disease spreads for a reason, by monitoring diseases we can pinpoint this quickly
Stephen S. Morse, Ph.D. The Rockefeller University, New York, 01/09/1995, Center for Disease Control, Factors in the Emergence
of Infectious Disease http://www.cdc.gov/ncidod/EID/vol1no1/morse.htm

Infectious diseases emerging throughout history have included some of the most feared plagues of the past.
New infections continue to emerge today, while many of the old plagues are with us still. These are global
problems (William Foege, former CDC director now at the Carter Center, terms them global infectious disease threats). As
demonstrated by influenza epidemics, under suitable circumstances, a new infection first appearing
anywhere in the world could traverse entire continents within days or weeks. We can define as emerging infections
that have newly appeared in the population, or have existed but are rapidly increasing in incidence or geographic range (1,2).
Recent examples of emerging diseases in various parts of the world include HIV/AIDS; classic cholera in
South America and Africa; cholera due to Vibrio cholerae O139; Rift Valley fever; hantavirus pulmonary syndrome; Lyme
disease; and hemolytic uremic syndrome, a foodborne infection caused by certain strains of Escherichia coli (in the United States,
serotype O157:H7). Although these occurrences may appear inexplicable, rarely if ever do emerging infections

appear without reason. Specific factors responsible for disease emergence can be identified in virtually all
cases studied (2-4). Table 1 summarizes the known causes for a number of infections that have emerged recently. I have
suggested that infectious disease emergence can be viewed operationally as a two-step process: 1) Introduction of the agent
into a new host population (whether the pathogen originated in the environment, possibly in another
species, or as a variant of an existing human infection), followed by 2) establishment and further
dissemination within the new host population ( adoption ) (4). Whatever its origin, the infection emerges when it reaches a
new population. Factors that promote one or both of these steps will, therefore, tend to precipitate disease emergence. Most emerging
infections, and even antibiotic-resistant strains of common bacterial pathogens, usually originate in one geographic location
and then disseminate to new places (5).
Disease surveillance detects emerging diseases among wildlife
T. Morner et al., Department of Wildlife at National Vetrinary Institute in Upsala, Sweden, 4-21-02,(Scientific and Technical
Review). 2002 Apr;21(1):67-76
< http://www.oie.int/eng/publicat/rt/2101/T.%20M%D6RNER.pdf>

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BIOTERRORISM: AFRICA = BREEDING GROUND

Africa remains an essential hotspot for terrorist recruitment and training- only solving fundamental problems like poverty
and stability can prevent future terrorism. {terror stuff}
Princeton N. Lyman, former U.S. Ambassador to South Africa and Nigeria, Ralph Bunche Senior Fellow and Director of Africa
Policy Studies at the Council on Foreign Relations, J. Stephen Morrison is Director of the Africa Program and Task Force on
HIV/AIDS at the Center for Strategic and International Studies, Foreign Affairs, Jan/Feb 04
Ebsco
THE U.S. GOVERNMENT may have recognized the need to go after al Qaeda infrastructure in East Africa, but the potential for

the growth of Islamic extremism and other sources of terrorism elsewhere on the continent has not
registered sufficiently on its radar screen. By far the most troubling case is Nigeria. With nearly 133 million
people, nearly 67 million of whom are Muslim, Nigeria is Africa's most populous nation and possesses its second-largest Muslim
population (after Egypt). It is also a crucial economic partner of the United States, providing seven percent of its oil. Yet
Washington has done little to check rising instability there in recent years. The country's GDP has fallen by
two-thirds in the past 20 years, creating a level of poverty unprecedented in its history. Partly as a result,

Nigeria has come under intense pressure from two disaffected minorities: radical Islam in the north and a
collection of tribal groups in the southeast. Simmering communal conflict was responsible for 10,000 deaths between 1999
and 2003.
Nigeria's Islamic challenge comes from a combination of religious, political, and economic factors. Northern Nigeria, populated by the
Hausa-Fulani, is primarily Muslim and has connections to both influential Muslim brotherhoods in western Africa and centers of
Islamic learning in the Middle East. After Nigeria became independent in 1960, northerners dominated the political and military
establishment. Throughout this period, however, Nigeria retained a delicate balance between Muslims and the largely Christian
population of the south. That balance is being sorely tested today as a more fundamentalist brand of Islam asserts itself in key areas of
the country.
This resurgence is partly the outcome of an internal debate -- begun in the 1960s and fueled by religious scholars funded by Saudi
Arabia -- over the purity of Nigerian Islam. But an equally important factor is the changed political and economic fortunes of the
north. In 1999, after nine years of particularly rapacious rule by the Muslim military leader Sani Abacha, Nigeria regained democratic
institutions. The winner of the ensuing elections was General Olusegun Obasanjo, a southerner and born-again Christian. Obasanjo
proceeded to purge the military of politically oriented officers -- the majority of whom were northern Muslims. He also instituted a
program to investigate past corruption and bring perpetrators to justice. Politically, militarily, and economically, northerners felt their
influence decline.
Soon, a northern governor decided to challenge Obasanjo by introducing Islamic criminal law (shari'a) in his state. No one anticipated
the tremendous popularity of this move. Shari'a offered a sense of hope to people faced with rising crime and increasing instability.
Within a few months it had been adopted in 12 of Nigeria's 36 states. The shari'a movement remains a potent force in Nigerian politics
and society, unsettling relations between Muslims and Christians and increasing tension between the north and south of the country.
Northern Nigerians often consider Washington to be colluding in their political and economic decline. Many people, for example, saw
the U.S.-run program to improve the military's capacity for peacekeeping (instituted after Obasanjo's election victory) as an attempt to
assist the president in purging northern leadership. U.S. policies in the Middle East have also stirred anti-American feelings: tens of
thousands of Nigerians flocked to rallies against the Iraq war.
To date, there is no evidence that terrorist cells have penetrated northern Nigeria, nor that terrorist and
criminal syndicates have linked up. But the situation is increasingly dangerous. The Bush administration singled
out Nigeria as a country with significant impact and deserving of "focused attention" in its 2002 National Security Strategy. But the
United States is poorly positioned to address the anti-American attitudes that create a fertile breeding ground
for terrorism. The U.S. embassy lacks a single American speaker of Hausa, the main language of northern Nigeria; has no
consulate or other permanent representation in the north; and, until recently, possessed only a poorly staffed and unimaginative public
diplomacy program.
U.S. relations with the Nigerian military are also fragile. On the one hand, Washington looks to Nigeria to carry much of the
peacekeeping burden in West Africa -- most recently in Liberia -- and has provided aid for this purpose. But on the other hand, the
U.S. Congress has prohibited further training of the Nigerian military because of human rights concerns, thus compromising the U.S.
ability to reach out to a new generation of Nigerian military officers from both north and south.
The growing armed uprising in Nigeria's delta region, the source of the country's oil and home to the largest concentration of U.S.
investment on the continent, compounds the danger to American interests. Conflict arises there from grievances over the sharing of oil
wealth, environmental damage, and corruption. Much onshore oil activity has been shut down and considerable amounts of oil have
been stolen to buy arms. Nigeria has increasingly relied on its armed forces to restore order, but the army's record of indiscriminate
violence often only feeds the discontent. Washington should be more actively engaged in helping the Nigerian government and the oil
companies to address the deep resentments that feed this situation. Yet -- like in the north -- there is no permanent U.S. embassy
presence in the delta region.
The United States has also done little to help Nigeria out of its severe economic depression, which is
indirectly responsible for much of the tension in the country. Currently, President Obasanjo is working with the United
Kingdom, the World Bank, and the International Monetary Fund to bring transparency to the oil sector and make strategically
important economic reforms. Washington should actively support these reforms and be prepared to take the lead in debt rescheduling
and other forms of economic support.

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South Africa, meanwhile, is another country that faces the threat of rising Islamist extremism. In the 1990s, a
small radical Islamic group, the People Against Gangsterism and Drugs (PAGAD), emerged. PAGAD started out as a vigilante
organization seeking to combat the growing drug trade in poor townships near Cape Town, but it was subsequently hijacked by radical
elements. After PAGAD became openly critical of U.S. policies in the Middle East and Israel, some people suspected the influence of
Saudi-financed imams, who accompanied new mosques built in the Cape Muslim area. The group staged several demonstrations
against the American and Israeli embassies and even threatened the life of the American consul general in Cape Town. PAGAD is also
suspected of carrying out a series of bar and nightclub bombings that took place in the late 1990s.

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BIOTERRORISM: AFRICA = BREEDING GROUND


AIDS allows terrorism to flourish in Africa- it creates orphans that are ripe for terrorist recruitment and fosters a state of
lawlessness and corruption that allows terrorist activities to go unchecked. Star this card, I think. {terror stuff}
Julie A. Kendall, Commander, U.S. Navy, 5/29/03
http://handle.dtic.mil/100.2/ADA420439
As HIV/AIDS has continued to ravage Nigeria, its effects have been exacerbated by the severe droughts and lack of clean water that
prevent people from being able to care for themselves, or even to take medications to treat the diseases symptoms. Malnutrition and
starvation also prevent those who are sick from taking medicines. Nigerias relatively poor roads, bridges and infrastructure
complicate peoples abilities to receive medical treatment.
Like many African states , Nigeria enjoyed dramatic socioeconomic progress during the latter half of the 20 th Century following colonial independence and a shift toward
democracy and self-government, but this often led to increased chaos and instability as people flocked to cities in
search of employment opportunities. This massive, disorganized influx overwhelms metropolitan areas in
terms of services and housing and leads to overcrowding, resulting in resource and service shortages. 10 In
turn, tensions in cities rise as people try to cope with the ensuing newness and uncertainty of living in an

unfamiliar environment. The AIDS virus easily flourishes in these chaotic, unstable metropolitan areas as
it ultimately unravels the fabric of society and negates achievements, leading one African newspaper to poignantly
remark that Africans have lost the 20 th Century.11 HIV/AIDS is devastating the Nigerian healthcare system as it
overloads medical resources, filling hospitals with terminally ill patients. It is obliterating an entire
generation of workers in their prime productive years and creating massive absenteeism in the workplace
from not only employee sickness, but also from time spent arranging and attending funerals. In particular,
it is wreaking havoc on the Nigerian education system, killing teachers and forcing students to drop out to
caretake sick parents. 12 It is seriously affecting African industry and agriculture as workers become sick
and die: in some areas, corporate knowledge of community farming has been lost, leading to loss of farms and
property. 13 Physical infrastructure breaks down because workers cannot keep up with the building or
repair of roads and bridges. Tourism and commercial enterprise are affected as travelers shun countries with high
rates of infection and businesses avoid sending employees to areas out of fear of contracting the virus. Women bear an unequal part
of the burden not only are they infected at a greater rate than men, they also are more likely to stay home from work or school to
care for family members, even if they are infected themselves. Many lose property upon the death of a husband in illegal property
snatching, leaving
little hope for material support. 14 Perhaps the most troubling result of the disease are the millions of orphans
created (a figure expected to exceed 15 million this year 15) which profoundly exacerbates the loss of family and
social structure. HIV/AIDS is also beginning to hollow out Nigerias military forces because the country
cannot field enough conscripts or recruits due to a lack of healthy young men, posing challenges for the multinational
oil companies whose personnel depend on Nigerias military for protection. 16 This also further undermines the states
ability to protect itself, to respond to crisis and to provide security for its own people and institutions.
HIV/AIDS creates lawlessness, drains funds from other critical areas and increases corruption. As people
become discontented with the states inability to adequately handle the magnitude of the diseases effects, they may turn to
disobedience. With so many areas of society affected, the state is increasingly unable to effectively function, so it

disintegrates and ultimately fails, leaving its people in chaos and complicating the political environment for
its allies and neighbors. How terrorists exploit instability People who look at Central and Southern Africa and say, its far away,
its distant, its remote... we said the same thing about terrorists it happened in Africa, its distant and remote... George Tenet,
Director of Central Intelligence 17
Terrorists, like water, seek the lowest level for their existence, establishing
themselves in areas that provide cover and ease of operation for their planning. They also recruit people ready to
espouse a cause, willing and able to die. While terrorists flourish worldwide, struggling African nations such as Nigeria

may potentially harbor larger numbers due to their relatively chaotic and unstable societies, a critical factor
with dangerous consequences. Youth bulges provide an eager and energetic pool of prospective
terrorist group members and the stunning numbers of orphans expected in African nations may become
armies of
recruits on the streets of those countries. While young men in their twenties make strong, resilient cell members, even
teens and children can be used for dangerous, frequently suicidal missions, partly because their youth
makes them less likely to question their orders, and partly because their extreme youth makes them less
likely to attract the attention of the authorities. 18 This critical weakness shakes the foundation of daily life and allows
terrorists to exploit the vulnerabilities in the gaps and seams of a societys fabric. Cells can employ orphans because they are
disconnected and easily influenced. These youth have little to risk: they have nothing and so have nothing to
Hordes of angry, resentful, disillusioned young males are ripe for terrorist teachings. When faced with

lose.
the

bleakprospects of disease, death and unemployment, little competes with the terrorists promise of

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immortality, approval by ones peers, and religious sanctification. 19 Although some of the worlds more
infamous terrorists come from positions of wealth, most recruits are drawn more from less fortunate than from
comfortable middle-class environments - many who have known only absolute destitution and for whom terrorism
represents the only way to lash out at societys injustices. 20 The relative wealth and promising financial prospects of
a terrorist group hold tremendous appeal for these marginalized people. Another critical factor is the lack of
oversight and lawlessness that provide facile conditions for camouflaging funds: monies can be quietly sent to Muslim charities, or
traded in small arms, diamonds and gold. In chaotic societies, people attract scant attention as they blend into the
local scene, disappearing into civilian life and leaving little trace as they come and go. Hundreds of companies
worldwide form a shadow network capable of providing money and logistical support for continued attacks by Al Queda... many of
these suspected front companies... are in countries with few regulations and can pick up and disappear overnight. 21 Bribes are
another effective way of doing business: with little or no income, it is easier to look the other way, especially when that is the local
norm. Weapons and contraband can be easily smuggled for relatively small cost in a society whose members

have become accustomed to closing their eyes to corruption in order eke out an existence for themselves
and their families. Finally, terrorists can easily exploit porous ports and borders to transport contraband,
information, and people. Lax law enforcement means transnational networksencounter little resistance in
traversing boundaries of nations that have no effective way of policing their borders, especially in a nation
as vast as Nigeria.

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Terrorists are opening up recruiting bases in Africa <terror stuff>
Andrew Feickert, Specialist in National Defense Foreign Affairs, Defense, and Trade Division, 8/26/05 < U.S. Military Operations in
the Global War on Terrorism: Afghanistan, Africa, the Philippines, and Colombia
http://64.233.169.104/search?q=cache:7RM34CA4mfgJ:www.fas.org/sgp/crs/natsec/RL32758.pdf+Al+Qaeda+bases+in+africa+February+16+2005&hl=en&ct=clnk&cd=3&gl=us> <pg 12>
The United States is deeply concerned about the potential for Africa to become
a breeding ground for terrorists citing its vast ungoverned spaces and unprotected borders. Somalia has been
referred to as a lawless haven for terrorists,
79 and reports suggest that Al Qaeda has opened recruiting bases in Nigeria, Somalia, Tanzania, anUganda.80

One report suggests that there is evidence of 17 training centers in Kenya, Possibly set up by
groups related to Al Qaeda.81 The U.S. European Command (U.S. EUCOM), which oversees military
operations in most of Africa, has reported that nearly 400 foreign fighters captured in Iraq have
come from Africa and that some of these veterans of Iraq are returning to places like Morocco and Algeria where their
acquired skills, such as operational planning and bomb making, could be used against their respective governments.82 While
terrorism is cited as the primary reason for U.S. military operations in Africa, access to Africas oil which presently
accounts for 15 percent of the U.S. oil supply and could reach 25 percent by2015 is also considered a primary factor for
growing U.S. military involvement in the region.83
Economic inequality by globalization creates an African breeding ground for terrorism {terror stuff}
Tedd Robert Gurr, The international summit on democracy, terrorism and security, editor: Peter R. Neumann, 8/11/05, < Addressing
the Causes of terrorism http://www.safe-democracy.org/docs/CdM-Series-on-Terrorism-Vol-

1.pdf> <pg 22>


The counterpart to successful integration into the global economy is the growth of weak globalisers
who become less competitive, whose populations behave falling or stagnant incomes, and as a result experience growing
unemployment, political tension, and religious fundamentalism. A number of African and Muslim countries have
steadily deglobalized over the last 25 years. The general effects are an increase in inequalities and social
polarization among states. Such growing inequality may lead to terrorist acts justified by the perpetrators

in the name of a more equitable distribution of wealth.

Poverty is the greatest cause of terrorism {terror stuff}


BBC NEWS, 3/22/02, <Poverty fueling terrorism http://news.bbc.co.uk/1/hi/world/1886617.stm>

World leaders meeting at a development summit in Mexico have called for increased aid to
poor countries to help stamp out extreme poverty as a motivation for terrorism. "Poverty in
all its forms is the greatest single threat to peace, security, democracy, human rights and the
environment," the head of the World Trade Organisation (WTO), Michael Moore, told delegates. US President George
W Bush, who arrived at the venue in Monterrey on Thursday night, is due to address the conference on Friday. Leaders from
50 states attending the final two days of the week-long meeting are expected to sign an agreement on Friday calling on
wealthy countries to help reduce the poverty gap, and for poorer nations to use foreign aid more efficiently. At the opening of
the summit on Thursday, UN Secretary-General Kofi Annan said it was in the interests of rich states to help poorer countries.

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BIOWEAPONS- ACCESSIBLE
Accessible equipment and modest knowledge make extinction by biological weapons all the more probable {C4 or C5}
Jason Matheny , Department of Agriculture and resource Economics, university of Maryland, 10/7/06 reducing the risk of human
extinction, http://www.acceleratingfuture.com/papers/extinction.htm
Of current extinction risks, the most severe may be bioterrorism. The knowledge needed to synthesize a virus is modest compared to
that needed to build a nuclear weapon; the necessary equipment and materials are increasingly accessible; and because biological
agents are self-replicating, a single weapon can have an exponential effect on a population (Warrick, 2006). Current U.S. biodefense
efforts are funded at $6 billion per year to develop and stockpile new vaccines and treatments, monitor biological agents and emerging
diseases, and strengthen the capacities of local health systems to respond to pandemics (Schuler, 2004).

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BIOWEAPONS- STRONG SURVEILLANCE KEY

Weak surveillance risks bioterrorism {C4}


Jonathan B. Tucker, Ph.D., Director of the Chemical & Biological Weapons Nonproliferation Program at the Center for
Nonproliferation Studies at the Monterey Institute of International Studies, 10/3/01 Improving Infectious Disease Surveillance to
Combat Bioterrorism and Natural Emerging Infections (Testimony), Subcommittee on Labor, Health and Human Services, Education,
and Related Agencies of the U.S. Senate Committee on Appropriations, , http://cns.miis.edu/research/cbw/testtuck.htm
the possibility that terrorists might escalate their horrific campaign of death and destruction by resorting to the
use of unconventional weapons, including biological pathogens. Although experts disagree over the ease with which terrorists
could acquire and use biological weapons, many studies have concluded that the threat of bioterrorism against the
United States is growing, and that the nation is not adequately prepared to handle even a medium-sized biological attack. With
a potential health emergency in the making, time is of the essence in reducing our vulnerability to this threat, and
I believe there is much we can do in the near-term. It is important to note that bioterrorism and the growing challenge of natural
emerging infectious diseases are two sides of the same coin. Both phenomena would manifest themselves in the form of an
unusual outbreak of infectious disease -- one that would have to be rapidly detected, identified, and contained to
minimize the harmful consequences. Because some of the most deadly biological warfare agents, such as
anthrax and plague, respond to antibiotics administered during the early phase of infection, prompt detection and
treatment of an outbreak could save many lives. With a contagious agent, rapid containment by isolation and vaccination could
prevent further spread. The threats of emerging infections and bioterrorism can both be addressed most
effectively by strengthening the nation's public health systems, which have been allowed to atrophy over the past
several decades.[1] Back in the 1950s and 60s, publicly supported community hospitals and public health laboratories
supported an effective early-warning network for detecting and containing epidemics. Since then, however, the
shift to privatized medicine and managed care has largely eliminated this system. Shortages of manpower and infrastructure
in the nation's public health departments have also impeded effective epidemiological surveillance, leaving the
public more vulnerable to serious outbreaks of infectious disease.[2]

Disease surveillance is key to solve bioterrorism

Joseph P. Dudley, Ph.D., Biologist; Wildlife Ecologist; former Diplomacy Fellow,


American Association for the Advancement of Science, 11/04, BioScience, Volume 54,
Issue 11, Global Zoonotic Disease Surveillance: An Emerging Public Health and Biosecurity Imperative, [adit]
In addition to the threats presented by emerging and rapidly evolving natural disease
organisms are those posed by laboratory cultures of genetically modified, weaponized strains
of disease pathogens created and developed for use as biological weapons against humans,
domesticated livestock, or crops. The anthrax letter bomb attacks of SeptemberOctober 2001 demonstrated the
critical need for recognizing that zoonotic disease surveillance and information systems are important
elements of our public health and homeland security infrastructure, the nation's first line of defense and
response against terrorist attacks involving bioweapon diseases (Dudley 2003). The deliberate or accidental
release of weaponized disease pathogens could have devastating direct effects on biodiversity
and agricultural productivityand possibly even more devastating indirect effects on wildlife,
including some endangered species, should these become targeted for extirpation because they
could become reservoirs or vectors of bioweapon disease pathogens.
There is currently no single entity within the government with command and control
responsibility and regulatory authority for managing the growing nationwide health problems
associated with diseases that are passed between wildlife, domesticated animals, and humans
(Benjamin et al. 2003). Federal agencies in the United States that have a role in the international monitoring of zoonotic
and animal diseases of public health significance, or regulatory authority over potential means through which such diseases
could be introduced from overseas, include the US Department of Agriculture's Animal and Plant Health Inspection Services,
the Centers for Disease Control and Prevention, the US Public Health Service, the US Fish and Wildlife Service, the US
Geological Survey, the Department of Homeland Security, the Department of the Army, and the Department of Defense.

Each of these federal agencies has at least two, and in some instances four or more, different
component organizations involved in the prevention, monitoring, surveillance, evaluation,
identification, or control of zoonotic pathogens or foreign animal diseases.
International organizations, multilateral organizations, nongovernmental organizations, and
national organizations involved in zoonotic disease surveillance monitoring efforts include the

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World Health Organization, the United Nations Food and Agriculture Organization, the World Organisation for Animal
Health (formerly known as the Office International Epizooties, or OIE), the IUCNWorld Conservation Union, and the
newly chartered European Centre for Disease Prevention and Control.
Although there is considerable cooperation and collaboration among individuals within the
infectious disease surveillance and response communities, the degree of formal organizational
collaboration and coordination is frequently limited. None of these entities has the mandate or
mechanisms to actively seek out and disseminate information on emerging wildlife diseases and zoonoses
to all interested public and private sector organizations and agencies.
Those government agencies and multilateral organizations

that do perform such functions


typically operate under institutional or diplomatic constraints that do not permit the
dissemination of critically important unconfirmed information on disease outbreaks. Yet
such information could constitute an early warning system for diseases such as avian influenza
or citrus sudden-death virus, for which the confirmation of outbreaks through official
channels may be suppressed. Governments may, for example, seek to avoid externally imposed bans on the export
of economically important animal or plant products, as happened with the pandemic outbreaks of avian influenza in Asia
during 2003 and 2004.

Decisionmakers and governments must be encouraged to achieve greater levels of effectiveness


in the surveillance and monitoring of infectious diseases in humans, wildlife, crops, and livestock.
Information technology tools and methods now available can enhance communication and
coordination among all stakeholders in the wildlife health, agriculture, and public heath
sectorsincluding federal and state government agencies, multilateral organizations, the
public health community, nongovernmental organizations, private sector corporations, and
scientific and professional organizations. For such efforts to be effective, however, clear policy
mandates must be in place to encourage and ensure the rapid worldwide sharing and
dissemination of information on infectious disease outbreaks.
b.6

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BIOWEAPONS: STRONG SURVEILLANCE KEY

Increased support in disease surveillance is necessary to prevent a bioterror attack

Njugana, Masters Degree in Biotechnology 005, Institute for Security Studies, African
Security Review, Volume 14, Issue 1,
James Thuo

Infectious diseases can undermine the security of a country whether these diseases are
deliberately inflicted by biological warfare or occur naturally . While the Biological and Toxins Weapons
Convention (BTWC) prohibits the development and use of biological weapons, the defence against a natural or intentional
epidemic is the same: a robust global public health surveillance system and the ability to respond efficiently and effectively
to disease outbreaks. The state has an important role in combating the threat of deliberate disease

because it has the moral duty to protect its citizenry.


An effective way of countering the threat of deliberate disease is to establish and maintain
disease surveillance and control programmes. Most of the publications on epidemics in eastern Africa indicate
that very little disease surveillance is done at present.33 Where gains were made in control and eradication,
they were later lost through neglect of control protocols such as vaccinations and control of livestock movements between
endemic and non-endemic areas. There seems be unanimous agreement among observers that the
main reason for the failure of surveillance and control systems is lack of funding. This is blamed
on reduced funding for the responsible government organs and agencies owing to shrinking economies. National

governments and other interested stakeholders will have to find the required funds, for if
infectious diseases are not eradicated or at least maintained at minimum levels, an added
threat will be their use as biological weapons, endangering people away from the endemic
areas.34 Observers have expressed the view that disease surveillance should be intensified and
coordinated beyond the divide of national boundaries. Surveillance programmes should be
part of the public health management systems. The ideal situation requires setting up local and international
surveillance/response teams. Teams endowed with the necessary techniques and resources should be
put in place so that they can deal with epidemics when they occur. This will ensure that
expertise in dealing with these diseases is available uniformly throughout the region.35 It is also
important to register the groups/individuals engaged in these emergencies to minimise chances of hazardous materials being
acquired by groups whose intent would be to cause disease outbreaks. Vaccination programmes have to be maintained
because failure to do so may lead to a loss of the gains previously achieved in terms of disease control. Besides, for every
case of sickness encountered, prevention is cheaper than cure. Some authors encourage joint veterinary and human disease
surveillance as a way of cost cutting for zoonotic disease control and such a team can be schooled to monitor biological
weapons as well (see the commentary by Dorothy Preslar in this issue of African Security Review).

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BIOWEAPONS- US VULNERABLE

Bioterrorism is the greatest threat to our fragile biological security; with many states unprepared for an attack we are all
vulnerable {C1}
Bruce jones biosecurity nonststate actors & the need for global cooperation 10/1/06

http://www.blackwellsynergy.com/action/showFullText?submitFullText=Full+Text+HTML&doi=10.1111%2Fj.17477093.2006.00016.x&cookieSet=1
Today, there is no greater threat posed by nonstate actors than that of bioterrorism. Our biological security
is fragile, and its erosion through the natural and man-made spread of infectious disease poses a mounting challenge to
national and global public health systems, as well as to international security. But equally, there is no [other] issue that
illustrates more vividly the need for and the potential of global cooperationor the hope it can provide. Here, the
analogy to eradicating disease is apt. It is, in the technical terms of economists and social scientists, a "weakest link public good"
that is, a benefit to all that can only be assured when all links in the chain are secured, when the very last country has been able to
eradicate an existing disease. The tremendous accomplishments of the global public health community in eradicating smallpox is an
overused but nevertheless compelling reference point. In biodefense terms, every state and population is vulnerable as

long as any one state or population remains under-defended against the spread of infectious disease. No
amount of national defense can alter this basic reality.
Risk and potential destruction from a bio terror attack are high and rising with widespread materials, information, and
manpower in abundance for bioterrorists {C1}
Bruce jones biosecurity nonststate actors & the need for global cooperation 10/1/06

http://www.blackwellsynergy.com/action/showFullText?submitFullText=Full+Text+HTML&doi=10.1111%2Fj.17477093.2006.00016.x&cookieSet=1
Unfortunately, both the risk of a bioterror attack and the potential destruction such an attack could cause are
significantand rising.
In assessing the risk of a given type of attack, there are three ingredients to measure: the availability of the relevant materials (from
small arms to "loose nukes"); the availability of know-how to overcome the obstacles to using those materials to effect an attack; and
the existence of actors with the motive to use them. In the case of bioterrorism, all three ingredients are very much

present.
First, there is no shortage of supply. The biological materials for potentially deadly attacks are tremendously widespread. By
one estimate, there are more than 10,000 facilities worldwide that legally and legitimately possess materials that, if
weaponized, could cause enormous loss of life, morbidity, and erosion of health. Many of these facilities are agricultural and
commercial, not engaged in high-tech bioengineering or advanced processes that could reasonably be expected to come with detailed
tracking of materials and effective security arrangements.
Second, there is no shortage of know-how. One of the great advantages of the biological and health industry is its
widening base of scientists worldwidean advantage that has an obvious downside, in the existence [in] of a large number of
individuals whose knowledge can be tapped for nefarious purposes. Moreover, the technological know-how and
materials for weaponizing several biological agents is increasingly available, even to individuals. In preparing background materials
for the High-Level Panel, we were warned by some of the world's leading scientists that it would be only a matter of years before the
tools required for weaponization were available through the Web. As we completed our work, some of these same scientists alerted us
to the fact that they had been mistaken: materials are already available on the Web, often for as little as $50,000.
Third, there is no shortage of groups with motiveat least, as far as we know. Certainly, senior al-Qaeda officials have
stated publicly and in captured correspondence between themselves their interest in obtaining nuclear, biological, and
chemical materials for use in large-scale terrorist attacks. But the history of modern terrorism suggests that we should be
every bit as concerned by groups we don't yet know about. Given the widespread availability and relatively easy accessibility of
materials, and the accessibility of equipment and know-how to weaponize them, even fairly unsophisticated groups pose a
threat. Indeed, as the science and the technology develops, we face the prospect that eventually small groups and even individuals
will possess the technological ability to threaten even powerful states.

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BIOTERRORISM: US VULNERABLE

Bioterrorism is the worlds greatest threat {C-1}


Jocelyn Gecker, News 24, 01/03/2005, <Bioterror the biggest threat http://www.news24.com/News24/World/News/0,,2-101462_1669685,00.html>
Lyon - Interpol sounded an "urgent" warning on Tuesday that bioterrorism [is] was the world's greatest security

threat and that police across the globe were ill-equipped to handle an attack.
At a meeting hosted by the global police agency, Interpol, police and security officials shied from publicly detailing specific
threats.
But, they warned that al-Qaeda had clearly stated its intention to use biological weapons and that Iraq had become the
breeding ground for terrorist groups.

"There is no criminal threat with greater potential danger to all countries, regions and people in the
world than the threat of bioterrorism," said Interpol secretary-general Ronald K Noble in opening remarks.
"And, there is no crime area where the police generally have as little training than in
preventing - or responding to - bioterrorist attacks," he added.
"The threat of bioterrorism is real," he said, noting that al-Qaeda had posted how-to instructions for making
biological weapons on the internet.
Bioweapons must be stopped immediately.
Richard Ochs, Depleted Uranium Task Force, Military Toxics Project; former President,6/9/02, F
http://www.freefromterror.net/other_articles/abolish.html [adit]

There are many people who believe it is their God-given right to do whatever is deemed necessary
to secure their homeland, their religion and their birthright. Moslems, Jews, Hindus, ultra-patriots
(and fundamentalist Christians who believe that Armageddon is Gods prophesy) all have access to
the doomsday vials at Fort Detrick and other labs. Fort Detrick and Dugway employees are US
citizens but may also have other loyalties. One or more of them might have sent the anthrax letters
to the media and Congress last year. Are we willing to trust our security, NO -- trust human survival
to people like this? Human frailty, duplicity, greed, zealotry, insanity, intolerance and ignorance, not
to speak of ultra-patriotism, will always be with us. The mere existence of these doomsday weapons
is a risk too great for rational people to tolerate. Unless guards do body crevice searches of lab
employees every day, smuggling out a few grams will be a piece of cake. Basically, THERE
CAN BE NO SECURITY. Humanity is at great risk as we speak. All biological weapons must
be destroyed immediately. All genetic engineering of new diseases must be halted. All
bioweapons labs must be dismantled. Fort Detrick and Dugway labs must be decommissioned and
torn down. Those who continue this research are potential war criminals of the highest order. Secret
bioweapons research must be outlawed. The US, as the worlds leading creator of doomsday
diseases, must lead the way and show the example. The US must not only obey the Convention
Against Biological Weapons, which it has been violating, but it must sign the Biological Weapons
Inspection Treaty, which it has been opposing. International delegations must be allowed to inspect
and oversee the destruction of these labs and inventories. The doctrine of military deterrence must
give way to the logic of human survival. Human survival must come before national sovereignty.

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BIOWEAPONS: NOT DETECTABLE NOW

Bio-weapons low detect ability makes them more of a threat than explosive {C-1}
Ian Robertson, Toronto Sun, 7/18/06 <Lil bug, big peril Lexus Nexus>
A suicide terrorist infected with a deadly virus would be harder to detect than one packing
explosives, a Toronto Police expert told an FBI conference yesterday.
And Sgt. Chris May, a manager in the 4-year-old Special Operations Response Team, warned there would be more

victims of a "bio-terrorist," including rescuers -- even cops with gas masks and ordinary
protection gear.
Preparing cops, firefighters, paramedics, forensic experts and coroners to handle the stress must form part of any training to
fight a covert bio-terrorism attack on North America, May said.
"This isn't a warm and fuzzy briefing," May told more than 250 delegates at the FBI's national academy associate's annual
training conference, held here for the first time outside the U.S. "There has to be some recognition that some people will die."

Even trained "hazmat" teams may hesitate to act -- especially if forced to leave obviously
doomed colleagues and victims to die while helping others, May said.
But such delays would risk the further spread of a deadly virus, at a time when buildings and groups of
infected people must be isolated while experts try to determine what they're dealing with and how to quash it, he said. Policymakers must also have alternate sites and staff, in case police stations, hospitals or teams become contaminated by infected
suspects or sites.
"Who would think someone will deliberately infect people and send them out to infect others?" May asked. "Before 9/11,
who would have thought people would hijack aircraft and smash them into buildings?"
After hijackers flew planes into New York and Pennsylvania on Sept. 11, 2001 and several U.S. buildings were infected with
anthrax powder, he said police here scrambled to deal with more than 300 "white powder" calls within six weeks.
None were deadly substances, but May emphasized the next threat could be real.
"I don't know if there will be a bio-terror attack and I don't know when there will be a (flu) pandemic, but I know there
will be one [a bio-terror attack] eventually," ex-Ontario chief coroner James Young told delegates.

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GENOCIDE: CAUSED BY DISEASES


Genocide stems from infectious diseases
Charles L. Briggs, 1997, (University of California, Chair of the Anthropology Department, 1997, Introduction: The Power of
Discourse in (Re)creating Genocide,

http://docserver.ingentaconnect.com/deliver/connect/routledg/13504630/v3n3/s6.pdf
?expires=1184894248&id=38654485&titleid=81&accname=Dartmouth+College&ch
ecksum=361927B85C80B25FC5FA931F4296E697)
A small community of scholars gathered at the University of California, San
Diego in April 1996 to explore these sorts of issues. Without pretending to
represent all the situations that demand scrutiny, they focused on cases ranging
from the `classic genocides that took place in Germany, Cambodia, Burundi
and Bosnia to accusations of genocide stemming from infectious diseases,

radioactive contamination, paramilitary and state repression, terrorism, and


ethnic violence.
Genocide becomes a rational public policy for killing those with diseases
Roy Schwartzman, University of South Carolina, Communication Studies Department, 1993, Holocaust and Genocide Studies,
http://hgs.oxfordjournals.org/cgi/reprint/10/2/185.pdf

Perpetrators frequently see genocidal killing as healing, and regard political and social decay
as
illness and disease. This mindset becomes part of the political discourse when a defined
group becomes the bearer of "sickness," "disease," and "infection." The discourse
of diseaseand surgical metaphors for problems stated in medical terms
can become transmuted into a rational public policy that embraces killing and murder
as solutions.

Genocide is the pathway of ridding disease


Berel Lang, Professor of Humanities at Trinity College in Haverford, 6/15/90, Act and Idea in Nazi Genocide,
http://books.google.com/books?id=g1y0sE1qmNUC&pg=PA18&lpg=PA18&dq=disease+discourse+genocide&source=web&ots=jbt
5c7PY8w&sig=qpRcsFsVdhtvhngYweDVGqG6icM#PPA262,M1

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GENOCIDE: RISK HIGH


[F3]A high risk of genocide occurs under many factors
Barbara Harff, Senior Associate CIDCM and Professor of Political Science at the U.S. Naval Academy, 1955, No Lessons Learned
from the Holocaust? Assessing Risks
of Genocide and Political Mass Murder since 1955

All episodes of genocide and political mass murder of the last half-century have been carried out by elites
or rival authorities in the context of internal war and regime instability. The motive common to such
elites is the destruction in whole or part of collectivities that challenge their claim to authority or stand in the
way of an ideology-driven desire to create a society purified of undesirable classes or communal groups.
The structural model tested here identifies six causal factors that jointly differentiate with 74% accuracy
the 35 serious civil conflicts since 1955 that led to episodes of genocide and politicide from 91 others that
did not have genocidal consequences. The risk factors include the extent of political upheaval and the
occurrence of prior geno-/politicides. The probability of mass murder is highest under autocratic
regimes and is most likely to be set in motion by elites who advocate an exclusionary ideology, or represent an ethnic
minority, or both. International economic interdependencies sharply reduce the chances that internal war and regime instability will
have genocidal consequences.

[F1]The risk of genocide is not to be taken lightly


Alison Desforges, Director of ongoing research project in Rwanda documenting genocide, Human Rights Worker, 1999, Leave None
to Tell the Story: Genocide in Rwanda, https://teacherweb.com/VA/PaulVIHighSchool/MrFabris/rwanda.pdf
Such readiness to admit error is welcome from staff, but the ultimate responsibility naturally rests with the secretary-general. His

decision not to inform the council fully about the situation limited the possible courses of action open
to council members. Even if discussion of the risks of massive slaughterand of genocidehad not altered
the policies of such members as the U.S., the U.K., and France, it might have prompted action by members who
ultimately behaved responsibly after April 6. Had these members, the representatives of the Czech Republic, Argentina, Nigeria, New
Zealand, and Spain been apprised of the preparations, they might have countered the inertia of others. And had the general

public been alerted to the genocidal plans, some citizens and nongovernmental organizations would
have had the chance to use the information to press their governments to take the issue seriously.

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GENOCIDE: RISK HIGH

[F1]There are great risks of genocide


Jack A. Goldstone and Jay Ulfeder, Goldstone is a Hazel Professor of Public Policy at George Mason University and a senior
member of the Political Instability Task Force, Ulfeder is the director or Research for Science Applications International Corp.,
9/20/2005, How to Construct Stable Democracies, The Center for Strategic and International Studies and MIT

The risks of an institutional structure that allows for the rise of a dominant chief executive are
twofold. First, once elected, such dominant executives may be tempted to maintain their power
indefinitely and extend it over greater reaches of society and the economy; this can either provoke
rebellion or result in a slide to outright dictatorship. Second, in situations of factional competition, a dominant
chief executive office becomes a prize worthy of an all-out battle to secure. In contrast, a more diffused or
weaker system of executive authority might allow different groups to share power. The [End Page 16] combination of
factional competition and a dominant chief executive authority was determined to elicit the highest
risk of instability. By contrast, the stability of liberal democracies appears to result from their combination of fair and open
competition among groups and a strongly constrained executive that diminishes the threat of winner-take-all political battles.

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GENOCIDE OUTWEIGHS

The Genocide outweighsit is more than just a body count.


DAVID P. EISENMAN , an associate natural scientist at the RAND Corporation and an assistant professor for the Division of
General Internal Medicine and Health Services UCLA, 2007, http://health.enotes.com/public-healthencyclopedia/genocide [adit]

Assessment is equally important after a genocide occurs. The methods, effects, and outcomes of
all public health interventions must be assessed objectively. Epidemiologic studies to determine
and quantify the public health impact of genocide can be performed, as has been done in numerous
studies of international and civil wars. The public health impact of genocide goes beyond the
number of people killed. It must also be understood for its long-term effect on public health,
including the destruction of medical facilities; the killing and flight of physicians, nurses and
other health care professionals; the psychological impact on the survivors; and the
interruption of programs for immunizations, infectious disease prevention, and prenatal care.
Public health can also inform other types of assessments, such as retrospective studies to
determine and identify the conditions, risk factors, and precursors that led to genocide.

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GENOCIDE: IMPACT- HEALTH


[F3]Genocide threatens the health of people
Breslow, Professor Emeritus, Health Services, UCLA School of Public Health, 2002, Genocide http://health.enotes.com/publichealth-encyclopedia/genocide
Genocide is the deliberate and systematic destruction of a group of people defined by their nationality, or by their ethnic, cultural, or
religious background. While public health has long been concerned with the promotion, provision, and protection of a population's
health during war and conflict, genocide became of interest to the field of public health only in the late twentieth century. The

public health impact of genocide is enormous; in the last half of the twentieth
century alone, dozens of genocidesaccounting for over 23 million deaths
occurred, including in Bosnia-Herzegovina, Rwanda, Burundi, Cambodia, and Bangladesh. Recognizing the
relationship between public health and genocide is important because of the
contributions public health professionals can make to preventing and mitigating
genocide and its impact.
Genocide may include a direct assault on public health as it did in

Bosnia-Herzegovina. There, public health came face


to face with genocide when acts were committed to destroy the public health of the population,
thereby threatening to destroy people through inflicting serious harm to their health.
Food, fuel, electricity, running water, and medical supplies were cut off from Sarajevo and
its environs during the siege of that city. Since many things are essential to public health, including housing, nutrition, sanitation, and
access to public health, any acts committed to destroy or seriously undermine the conditions needed for health are potentially acts of
genocide if they are committed against a specific population. For instance, during the siege of Sarajevo, waterborne

diseases such as hepatitis A increased because the sanitation systems no longer


worked properly, 10 percent of the city's population was moderately malnourished, and the combined effects
of malnutrition, cold, and lack of adequate medical care led to increased illness and
deaths.

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GENOCIDE: IMPACT- WOMEN


[F3]Women suffer from Genocide
Africa News, The Impact of Women on Policy Formulaton, 2/4/07, LexisNexis

During the genocide, women were targeted based not only upon their ethnicity, but also their gender. Many were
subjected to sexual assault, torture, rape and forced incest. Not even the country's first female Prime Minister,
Agathe Uwilingiyimana was exempt from this humiliation. In the years leading up to the genocide, she was frequently depicted in
extremist literature and political cartoons as being sexually promiscuous and a threat to the nation.

Women who survived the genocide lost husbands, children, relatives, and communities. They endured
systematic rape and torture, witnessed unspeakable cruelty, besides losing livelihoods and property. In addition to this
violence, women faced displacement, family separation, and food insecurity, all of which resulted in postconflict psychological trauma.
Their social structures were destroyed; their relationships and traditional networks were severed. To
bring back their lost treasure and position in society, Rwandan women had to think differently of themselves and develop skills they
would not otherwise have acquired.

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GENOCIDE: IMPACT- EXTINCTION


[F3]Genocide is synonymous to extinction
Jonathan Schell, Author of the Bulletin of Atomic Sciences, Februrary 2007, Bulletin of Atomic Sciences; EBSCOhost
In other words., historically, the peril of human extinction

in a nuclear holocaust is the middle term that links genocide and ecocide.The antecedents to the event of 1945,
the event itself, and the sequel exhibit a common theme. All are acts of extermination, which is something quite specific,
something quite new, that needs to be clearly distinguished from other evils. Extermination almost always involves mass
killing.
Let me quote something that Secretary of State Condoleezza Rice said a few years ago about the possibility that Iran would obtain
nuclear arnis: "If they do acquire WMD [weapons of mass destruction] their weapons will be unusable, because any attempt to use
them will bring national obliteration " [is] a perfect synonym for genocide.

[F3]Genocide means extinction


John W. Burton, Associate Professor of Anthropology, Connecticut College, New London, November 1990, The Journal of Modern
African Studies; The Development and Cultural Genocide in Sudan

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GENOCIDE: IMPACT- EXTINCTION


[F3]Genocide is comparable to extinction
Dugger, Shorenstein Center on the Press, Politics, and the Public Policy at Harvard, 1996 (Ronnie, Genocide,
Human Survival, Strozier and Flynn, eds., pp. 66-67)

War, and the

The rest of our moiling current world history as tribal, ethnic/racial and religious amity or conflict
organically rises and unfolds from the other accreted, layered foundations of enclosurism which have evolved
from our beginnings lost in time, limiting each persons circle of identification and ethical concern to the person within his or her own
enclosures. It is harmonizing and logical simply to fit those various kinds of our grouped identities into the model of nationalistic
Enclosurism.
Seeing all this as evolutionary, we may, if we will, be optimistic. We can perceive progressively enlarging concentric
circles of family, families, settlements, tribes, tribes of tribes, cities, city-states, nations, alliances of nations, empires, alliances of
empires, single-issue treaty-signing communities of nations, the League of Nations, the United Nations. But if we look ahead

from our present disorder a mere fifty years, a normal adult lifetime, to the exponential
multiplication of every human need as world population increases to between 9 and 15 billion, we
must at least conjecture that we are in true danger of terminal evolutionary maladaptation.
The United Nations is not the United Human Species, its still the United Nations, its very name a misrepresentation, a
hope misdescribed as a fact. Neither the nations nor the states are united. The UN is a confederation, it is not a federation; the unit of
rule is still the state. Almost every attempted international remedy for famine, war, or mass, (which are, in each case, the national
interest), by the law of unintended consequences, and by the far more destructive law of unforeseeable interactions, As the
international ethicist and economist Hasan Ozbekhan has perceived, international society is now so tumultuous that

we are compelled to stop trying to solve world problems because the ferocious turbulence forces us to
aim lower, at just coping. The weapons-making industries observe no national boundaries or ethical norms. As the costs
per death of nuclear, chemical, and especially biological weapons plummet, more and more states
have the power to kill any set of other states, and well-financed religious and ideological faiths and cults can kill
whatever thousands or tens of thousands or millions of people they may select as representatives of whatever they wish
to exterminate. In the economic sphere where the daily well-being of humankind should abide, 1.3 billion people live in what
the World Bank calls absolute poverty. With no governing force in the world curbing them, multinational corporations
continue to ravage the environment of the world, exploit the cheapest and lead organized workers, and amass larger and larger
government-threatening treasures of irresponsible wealth and power. Nationalistic, tribal, ethnic, religious, and

corporate Enclosurism, low-cost killing technology, and the ever-widening world-wide gap between
the royally rich and the pitifully poor are propelling us zig-zag into hell on earth, more mass poverty
and revolution, more mass murder, the murder of whole cities, whole nations seen merely as welldefined targets, whole peoples, whole continents.
We must try something that we have never tried before. I believe the only something new that might
become large and strong enough swiftly enough to give us some surcease from the mass violence and some advance toward an ethical
system of worldwide economic governance is a worldwide breakthrough to minimalist international values. Paradigm shifts do

occur quite suddenly. Minimalist international humanism, which we might well rename personalism,
is the only plausible foundation for our personal and common security which we can realistically
imagine constructing in the time we may have left before maladaptive disaster.
For example, it is the received doctrine that U.S. (or any other states) foreign policy
abroad should be guided by the national interest but in minimalist humanist ethics it should also
be guided go by the interests and well-being of people abroad. As the President of the United States has a
Secretary and Department of State, he should also have what we might call a Secretary and Department Concerning the Interests and
Wellbeing of People Abroad. Likewise, other states. If the Americans led in such a new direction many nations

would follow, with consequences we might barely imagine.


The United Nations should announce that it will accept individual volunteers from any nation and train and equip them for
service in

a UN military force that could engage, not only in peacekeeping, but also in active military
intervention to stop genocides and mass murders while they are happening. Surely it would please most of us
to speculate that we would have the idealism and the courage to volunteer or that we have when we were younger. That really would
be fighting for the human race.

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[F2]Disease Surveillance is key to detect and stop genocide


Lester Brewslow, Professor Emeritus, Health Services, UCLA School of Public Health, 2002, Genocide,
http://health.enotes.com/public-health-enyclopedia/genocide
[F2]Disease Surveillance is key to addressing Genocide
Brian M. Willis and Barry S. Levy, Brian Willis works with the CDC, Barry Levy is the past president of the American Public Health
Association, 8/2/2000, Recognizing the Public Health Impact of Genocide, http://jama.ama-assn.org/cgi/reprint/284/5/612.pdf

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Early warning systems prevent the genocide and civil wars that result from refugee migration
Jeff Grabmeister, Ohio State University, 9/28/98, (Early Warning Systems May Help Predict Potential Refugee Crisis,
http://cmtoolkit.sais-jhu.edu/index.php?name=cp-signs)

When natural disasters like hurricanes or floods threaten, experts can usually give
people early warnings so they have time to prepare. Now social scientists are
working to develop similar early warning systems that can forecast political and
social disasters that are sometimes deadlier and more costly than natural calamities. In one new model,
researchers have identified some of the important factors that may predict refugee
migrations within a country or from one country to another. Refugee migrations
are not random occurrences -- they stem from political and social problems that can
be predicted, said Craig Jenkins, a professor of sociology and a researcher at Ohio State Universitys Mershon Center for
International Security. We think it is as important to predict refugee migrations as it is to
predict hurricanes. Jenkins developed the model with Susanne Schmeidl from the Swiss Peace Foundation in Bern,
Switzerland. The model will be published this year as a chapter in the book Preventive Measures: Building Risk Assessment and Crisis
Early Warning Systems (John Davies and Ted Gurr, editors; Rowman and Littlefield, 1998). Using 1971-1995 data from the United
Nations and other sources, Jenkins and Schmeidl identified both long-term, root causes of refugee migrations as well as the more
immediate factors that sparked the crises. They found that the major root causes included weak governments, long-standing ethnic
antagonisms and inequality, and poverty linked to economic dependence on other countries.

Large migrations were


often immediately preceded by some type of generalized violence: civil wars,
genocide or politicide in the affected countries, or foreign military interventions. One
unexpected finding was that population growth and density in a country was not related to refugee crises. Many policymakers have
argued that population pressure is one of the central sources of humanitarian crises, but we didnt find that, Jenkins said. It may be a
general symptom of less-developed countries, but not of crisis-prone countries in particular. Although most of the factors associated
with refugee problems are not surprising, Jenkins said there has never been a systematic effort to collect all the relevant data and use it
to forecast -- and possibly prevent -- social or political disasters. The United Nations and various humanitarian agencies currently do
international monitoring to predict when and where disasters will occur, Jenkins said. But they use the information mostly as a crisis
management tool, to plan for dealing with the disasters. We hope to develop warning systems that are more complete and accurate so
that we can identify potential trouble spots long before they erupt and possibly prevent problems from occurring, he said. Of course,
compared <CONTINUED>

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to forecasting a hurricane, there is a much larger margin of error when youre trying to predict forced migrations. But were taking
small steps that may eventually help us prevent or at least mitigate some of these social and political disasters. There

is a
huge need to predict and prevent refugee problems, according to Jenkins. In 1970, there
were about 14 million people worldwide who were displaced from their homes, either to
other countries or within their own. By 1990, that number had skyrocketed to 39 million. The number
dropped slightly between 1990 and 1995. Jenkins said he is now working to improve the model in order to make it more accurate. One
avenue he is exploring is identifying the factors that lead to political meltdown in a country. Political instability and violence in a
country often lead to refugee problems. The

need for humanitarian early warning is great, he said.


Once political violence has broken out, its usually too late to de-escalate the
conflict. We need to develop better information on the root causes, especially inequalities and ethnic problems. And we also need
better information about conflict escalation and the factors that immediately precede refugee migrations.

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Uses of disease surveillance is applicable to genocide
David P. Eisenman, Associate natural scientist RAND Corporation, Encyclopedia of Public Health, 2002,

http://health.enotes.com/public-health-encyclopedia/genocide
The precursors, processes, and consequences of genocide are increasingly being understood,
and public health contributes to this understanding in a distinct manner from other disciplines, such as
the law profession and the human rights field. Specifically, public health brings to the study of genocide the unique
tools of epidemiology, which is the study of the distribution of disease and the factors associated with
a disease within a population.
The work that public health professionals do to examine, prevent, and mitigate genocide can be understood in terms of the three
traditional core functions of public health: assessment, policy development, and assurance of services. Assessments can be performed
through data collection and analysis intended to identify, document, and notify the public about potential or ongoing genocide. Here
the public health principles of disease and injury surveillance can be applied to violence against a

population, and the traditional tools of public healthsuch as case reports and surveillance studies
are well suited to this function. A genocide may have early warning signs that public health professionals
can detect, such as escalating violence, increased refugee flows out of a country, and increasing
systematic discrimination. In those cases where a war strategy targets the health of an entire group of people, public health
professionals are best able to recognize the nature of the genocide.

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SOLVENCY- BIOWEAPONS
Syndromic disease surveillance may help identify bioterrorism faster than traditional laboratory disease servalance { c5}
NewsRx.com 8/04/06 DISEASE SURVEILLANCE; Syndromic surveillance may not mitigate effects of waterborne disease outbreaks,
Nexus Lexus
"Syndromic surveillance is the gathering of data for public health purposes before laboratory or clinically confirmed information is
available. Interest in syndromic surveillance has increased because of concerns about bioterrorism,"
investigators in the United States report. According to M. Berger and colleagues at the San Francisco Department of Public
Health, "In addition to bioterrorism detection, syndromic surveillance may be suited to detecting waterborne disease outbreaks.
"Theoretical benefits of syndromic surveillance include potential timeliness, increased response capacity,

ability to establish baseline disease burdens, and ability to delineate the geographical reach of an outbreak."
Satellite surveillance in Africa makes detection of bioterrorism faster{C-5}
WASHINGTON & PRINCETON, N.J.--(BUSINESS WIRE)--Oct. 5, 2005 Americom Government Services to support Global
disease Detectiion Network for the center for disease Control and Prevention <http://www.americom-gs.com/media/2005/2005-105.html> [O Brien]
wholly-owned subsidiary of SES AMERICOM, announced today it received a five-year contract to support the Centers
for Disease Control and Prevention's (CDC) Global Disease Detection initiative designed to recognize infectious disease
outbreaks faster and improve the overall ability to control and prevent such health risks. AGS will provide
satellite communication services to link 16 locations in Africa and the Caribbean and streamline CDC

communications, which are currently carried over disparate networks.


Through the Global Disease Detection initiative, CDC connects medical doctors and researchers around the
world to evaluate bioterrorism-associated or emerging infectious diseases. AGS will be provisioning the voice, data
and video conferencing services for the network using robust satellite technology to ensure dependable communication for the
numerous disparate networks. The network will utilize transponders on SES AMERICOM satellites AMC-12 and AMC-6 with
coverage across the Atlantic Ocean and throughout North America.
Better medical surveillance allows for faster response against bioterrorists
PRNewswire, 8-4,-2005, Nexus (C-5)
"Better medical surveillance tools and stronger links between law enforcement and national health authorities are needed
to help protect the world against attacks from terrorists using chemical or biological weapons," emergency
preparedness specialist Michael J. Hopmeier told a recent conference on integrating intelligence, policing and health, co-hosted by the
Public Health Agency of Canada.
"The public health system presents an enormous untapped resource for intelligence gathering and the
protection of national security," said Hopmeier, President of Unconventional Concepts Inc., a Mary Esther, Florida- based
engineering and scientific consulting firm specializing in crisis management and integrated federal/civilian disaster response.
"Beyond the roles in prevention and protection played by the public health sector, and their obvious

implications for national security, there is also an enormous infrastructure for early warning detection of
terrorist threats," Hopmeier said. "For that reason, public health agencies can contribute to both intelligence
collection and national security

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U.S soft power is down the drainpolls prove
JOSHUA KURLANTZICK, scholar in the Carnegie Endowments China Program. special correspondent for The New
Republic, senior correspondent for The American Prospect, 2006,Global Trends [adit]
Australia is not Cuba, a nation with a history of
horrendous relations with the United States. It is
not even France or Brazil, states whose interactions
with America tend to fluctuate between moderately
warm and icy cold. Yet precisely because Australia

has been such a close US ally, the results of a poll


taken in early 2005 by the Lowy Institute, a
respected Australian research organization, are
shocking. In this survey, barely more than

half the
Australians polled had positive feelings about the
United States, although 84 percent saw Japan positively
and 86 percent viewed the United Kingdom
positively. Worse, 57 percent of Australians perceived

Americas foreign policies as a potential


threatequivalent to the percentage of Australians
worried about the rise of Islamic fundamentalism.
This despite the fact that, in 2002, a massive bomb
in Bali planted by radical Islamists killed more than
200 people, most of them Australians.

Australia is not unique. Polls taken in many


nations suggest that anti-Bush administration sentiment,
which developed between 2002 and 2004,
has mutated and strengthened into a broader antiAmericanism. Indeed, while previously publics in
many countries differentiated between their dislike
for George W. Bushs foreign policies and their personal
respect and even love for American people,
American values, American culture, and American
companies, these distinctions may be disappearing.
A study released in August by Anholt-GMI, an
organization that ranks the brands of nations,

found that respondents from a range of countries


ranked the United States only eleventh overall in
terms of its cultural, political, popular, and business
attractiveness. The United States was last in the rating
for cultural heritage, which the surveys author
said reflected widespread skepticism about Americans
wisdom, intelligence, and integrity. Americas
governance, its cultural heritage, and its
people are no longer widely respected or admired
by the world, Simon Anholt, the author, bluntly
told the Financial Times.

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d.1
Surveillance programs are instrumental at establishing international partnerships Bulleten of Bulletin

of the World
Health Organization, March 2007, The importance of militaries from developing countries in global infectious disease
surveillance. [adit]
By allowing the Thai Government
to monitor the HIV epidemic in a large,
national sample of young men, the RTA
HIV screening programme has proven

a useful complement to the Ministry


of Public Health HIV surveillance programmes.
The Ministry of Public Health
and RTA staff, often in collaboration
relations with WHO have facilitated
international partnerships. The United
States Department of Defense - Global
Emerging Infections Surveillance and
Response System coordinates global influenza
surveillance for the United States
military through the Military Health
System and the Department of Defense
overseas laboratories, which conduct
influenza surveillance with many partner
countries and contribute to the WHO
Global Influenza Surveillance network.

Assuring potential partners that surveillance


will support WHO efforts has been
especially important in certain regions.
For example, NAMRU-3, a WHO regional
reference laboratory for influenza,
has helped countries throughout the
Middle East and north Africa to develop
national influenza laboratories.
d.1
Surveillance is essential to improve international relations
Mark S. Smolinski, senior advisor of U.S surgeon general Margaret A. Hamburg, member of the Coordinating Committee
of the Homeland Security Project, NT senior scientist. and Joshua Lederberg, The Nobel Prize in Physiology or Medicine,

2003

[adit]

Amelioration of major health risks and problems in any country, therefore, is a global good that may
indirectly benefit the United States. Moreover, in an era of heightened concern regarding
international networks of terrorism and nations with weapons of mass destruction, leadership in
addressing the infectious disease problems of other countries can build trust and goodwill
toward the United States. Repeatedly, U.S. efforts to monitor and address infectious disease threats
in other countries have been welcomed and have increased understanding and improved relationships
between countries. The need for an adequate global response to infectious disease threats,
therefore, derives from the United S tates humanitarian, economic, and national security interests.

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d.1
U.S foreign health assistance amplifies soft power
Daniel M. Fox, PhD and Jordan S. Kassalow, OD, MPH, October 2001, Making health a priority of U.S policy, American Journal of
public health [adit]

http://www.ajph.org/cgi/content/full/91/10/1554
This country's humanitarian

commitment to reduce human suffering justifies action to integrate


health and foreign policy. Moreover, leadership by the United States in improving health in other
countries would deflect some of the increasing criticism abroad that this country prefers a
unilateral approach to world affairs.
The United States could exert leadership in several ways. Increased spending for research that addresses poor
health in other countries could deliver significant international public benefits, for example, by
allocating more resources to devise and test orphan drugs and vaccines. This country could also increase the
attention accorded to health on the human rights agenda. The United States could, moreover, offer
debt relief to poor countries contingent on their allocating new resources to projects that
promise to achieve measurable improvement in health status, for example, by increasing access to
primary health care and providing water that is safe to drink. (Several articles in this issue offer evidence in point.57) The
United States could implement many of these policies through partnerships for improving health
that involve multilateral institutions, the private sector, and nongovernmental organizations.
d.1
Disease surveillance is a unique leadership opportunity for the U.S
Dr. Andrew Fisher, Director, HIV/AIDS Operations Research Project, Population Council; Dr. Alfred V. u, Senior Advisor for
Child Survival, U.S. Agency for International Development; and Senior U.S. Adviser, UN Special Session on Children, Geoffrey D.

Dabelko, Director, Environmental Change and Security Project (co-chair); and Steven Durand, Senior Program Officer,
Population Resource Center (co-chair) November 16 2001, U.S. Foreign Policy and Global Health: Addressing Issues of
Humanitarian Aid and Political Instability, Population Resource Center, the Environmental Change and Security Project, and the
Conflict Prevention Project
http://www.wilsoncenter.org/index.cfm?event_id=6832&fuseaction=events.event_summary

Kassalow called health a "unique leadership opportunity" for the United States, and he detailed
five key areas for expanded activity: * approaching health as a global public good and linking
it with health and poverty reduction; * linking health to human rights; * funding and facilitating
accelerated research and development on orphan drugs and vaccines as well as universal access to these products; * tying
debt relief to health through measurable objectives in health system development; and * replicating and expanding
on those public/private health partnerships already in place. Among Kassalow's specific

recommendations were: an increase in U.S. global health spending by at least $1 billion


annually; funding of USAID for HIV/AIDS treatment and prevention in India, China, and Russia; and the
endorsement of the President and Secretary of State for global health's priority in U.S. foreign
policy. "American foreign policy works best when it combines high moral ideals with real-world interests," said Kassalow.
"Like the Marshall Plan, a foreign policy that seriously invests in global health would be a high
point in the ethical life of this country and a wonderful example of service to mankind as an
investment in our future."
http://www.milbank.org/reports/Foreignpolicy.html good article on global health policy and its benefits

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d.1
U.S leadership in public health is a unique opportunity to irrefutably create a positive international framework
Jordan S. Kassalow, co-founder and Chairman of Scojo Foundation, created the Global Health Policy program at the
Council on Foreign Relations, graduate of the University of Vermont, May 2001, Why Health Is Important to U.S. Foreign
Policy, council on foreign relations, http://www.milbank.org/reports/Foreignpolicy.html [adit]
In the international arena, these diseases threaten ordered existence by exacerbating political
instability, disenfranchising those without social capital, and stunting economic growth. The
result is to make countries more vulnerable to violence and war and to aggravate their effects. The importance of these
threats is reflected in the addition of health issues to bilateral agendas between the U.S. and other countries and to
multilateral summits like the G-8 and OECD. As a result, these issues now demand more U.S. foreign
policy resources in terms of both money and the time of senior officials, as well as increased
expertise and coherence in the U.S. approach to its international health policy.
These challenges offer a great opportunity. In many regions of importance to the United States,
U.S. leadership is resented or resisted. Public health, however, is a unique site in foreign
policy. Here U.S. leadership in international health affairs can provide an unequivocally
positive framework for pursuing what is in our interest as well as that of the world. This can be

an important component of a response to the inequities of globalization.


Leadership, not unilateral action, is essential because this is an enormous global problem that
can be managed only through concerted international action. The United States must appreciate the
centrality of partner governments, the United Nations system, development banks, foundations, the private sector, and
NGOs. Success will require financial and scientific action by all these stakeholders. It also requires collaboration with the
UN system, especially in the developing world.
d.1
A U.S led global health initiative spurs cooperative international engagementMarshall plan proves
Jordan S. Kassalow, co-founder and Chairman of Scojo Foundation, created the Global Health Policy program at the
Council on Foreign Relations, graduate of the University of Vermont, May 2001, Why Health Is Important to U.S. Foreign
Policy, council on foreign relations, http://www.milbank.org/reports/Foreignpolicy.html [adit]
Thus viewed, global health issues have a range of implications for U.S. foreign policy. First, there is

a unique opportunity to lead in the area of cooperative international engagement by placing


health on the agenda of global public goods. It is not beyond the reach of political will to tip the
scales toward a healthier world. The history of the Marshall Plan, a clear example of how a balance of
motives can underlie U.S. foreign policy, illustrates that political leadership is necessary to raise the
salience of international issues and to galvanize public support for cooperative engagement. One
essential ingredient of such an initiative is leadership to match our unprecedented technical
capacity and to allow us to apply this capacity to its logical extent. That means providing health care as a
global public good: one that benefits everyone, but that no single country yet has the incentive to provide.
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The provision of health

as a global public good requires investment in basic public health


infrastructure to detect threats and protect the population. Access to safe food and proper nutrition, clean
water, and proper sewage disposal has been and will continue to be the major contributor to efforts to control endemic
disease, along with efforts to control disease vectors. There is broad international agreement that a

significant role for states is to ensure conditions that allow their citizens and other legitimate
residents to enjoy the highest attainable level of health. This broad agreement acknowledges the variability
in human capacity to achieve the WHO ideal of "complete physical, mental and social well being, not just the absence of
disease." It also clarifies the principle that a nation's health policy must be focused more broadly than on access to health care
and must accord high priority to population-oriented public health.

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d.1
U.S led initiative reverses the soft power drain
Jordan S. Kassalow, co-founder and Chairman of Scojo Foundation, created the Global Health Policy program at the Council on
Foreign Relations, graduate of the University of Vermont, May 2001, Why Health Is Important to U.S. Foreign Policy, council on
foreign relations, http://www.milbank.org/reports/Foreignpolicy.html [adit]

Adopting a foreign policy stance that gives greater priority to health issues would require
reassessing the way the U.S. relates to the rest of the world. We need to be humble with our
power. At present, international goodwill toward the United States is rapidly diminishing. Brent
Scowcroft, national security advisor to the Reagan and Bush administrations, is succinct in his
diagnosis: "We don't consult, we don't ask ahead of time. We behave to much of the world like
a latter-day colonial power. It's a very dangerous thing that's happening" (Marshall and Mann 2000).
We have to be interested in what others think about their own future, rather than projecting
our solutions onto them.
Furthermore, ethical or humanitarian motives suggest that the United States should see itself in a
facilitative role, prepared to engage with state and non-state partners in changing perceptions
of what the global system should and can achieve for the disadvantaged. This requires a
reassessment of the rights and responsibilities of nation-states, transnational businesses, an
increasingly globalized civil society, and multilateral organizations. All need to work more
closely together and transcend their traditional weaknesses, while looking to the United States for a
steady commitment, the ability to listen as well as to lead, and clear signals that it is looking for results over the long term.
d.1
U.S initiative in global health strengthens the diminished U.S leadership
National Academy Press, 1997, Americas vital interest in global health.
However, the potential of United States to deliver solutions for health is currently compromised,
both at home and abroad. At home, an effective public policy in health is impeded within our
government by fragmentation of responsibilities, division of authority between domestic and international
health activities, and lack of coordination among U.S. government agencies. There is currently no effective, single locus of
government activities directed toward fundamental and developmental research and application in support of global health.
As a result, government-funded activities remain disarticulated, there is no overall strategy in place, and there is inadequate
communication and coordination among those carrying out research and development in international health in government,
academia, and industry (see, for example, IOM, 1996c). The health consequences of this fragmentation are profound.
Abroad, the influence of the United States is also weakened and its effectiveness blunted, not only
by the lack of involvement and leadership in global health, but also by America's failure to
meet its treaty obligations to the major UN organizations. At the time of the drafting of this report (January
1997), the United States is $1.7 billion in arrears in its assessed contribution to the UN and an
estimated $145 million in arrears to WHO (assuming payment of $87 million toward the 1996 arrears of $107 million), a
major share of the total arrears to both agencies. In contrast, all of the other major industrial nations make

full and timely payment of their obligations to these organizations. It is difficult for America
to have its views respectfully considered by the international community or to exert leadership
on the global stage when it has unilaterally defaulted on its commitments to the major
international institutions.

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U.S health leadership would create an exclusive opportunity to increase Soft power
Peter Chalk, is an analyst at RAND specializing in South East Asia, international terrorism and emerging threats, Jennifer
Brower, Masters of Divinity degree from Union Theological Seminary, 2003, The Global Threat of New and Reemerging
Infectious Diseases: Reconciling U.S. National Security [adit]

d.1

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African humanitarian aid is a unique opportunity for the U.S to make a politically significant gain in U.S soft power
William R. Kenan Jr. Professor of American Studies yale, 2004, A prayer for Marie: creating an effective African
standby force,
http://findarticles.com/p/articles/mi_m0IBR/is_4_34/ai_n9522622/pg_9 [adit]

The African Standby Force initiative is a unique opportunity for the international community
to engage the African Union and achieve a consensus solution to a vexing problem. Conversely, once
this capability is achieved, it is not an excuse for its disengagement from Africa. Even with the
successful training and fielding of an African Standby Force, any long-term success will ultimately
succumb to international disengagement. Many requirements will remain for the international
community--requirements that African countries do not have the capacity to meet. For example,
strategic airlift, early warning, limited technical and logistical capacities, and AU command and control
are all gaps that the African Union has identified as requiring international assistance. (39)
The United States should not feel compelled to fill every void, nor take on this daunting initiative alone--but
it is one in which we should actively participate. For much of the 20th century, the international community,
as well as the American people, carne to expect US moral leadership in humanitarian work as a

reflection of our national character and status as a great power. Participating in the
development of the ASF perpetuates that expectation. Moreover, it provides an opportunity
for the United States to achieve an intriguing result--expending a relatively miniscule amount of American hard
power for a potentially significant gain in American soft power

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Softpower is necessary to prevent counter coalitions and the loss of hegepax Britannica proves
Joseph S. Nye, Harvard University Kennedy School of Government Dean, former National Intelligence Council Chairman, former
Clinton Administration Assistant Secretary of Defense, Winter 2002/2003, Limits of American Power, Political Science Quarterly
117.4, p. [adit]
A good case can be made that inequality of power can be a source of peace and stability. No

matter how power is


measured, some theorists argue, an equal distribution of power among major states has been
relatively rare in history, and efforts to maintain a balance have often led to war. On the other hand, inequality of
power has often led to peace and stability because there was little point in declaring war on a
dominant state. The political scientist Robert Gilpin has argued that Pax Britannica and Pax Americana, like the Pax
Romana, ensured an international system of relative peace and security. And the economist Charles
Kindleberger claimed that for the world economy to be stabilized, there has to be a stabilizer, one
stabilizer. Global governance requires a large state to take the lead. But how much and what kind of
inequality of power is necessaryor tolerableand for how long? If the leading country
possesses soft power and behaves in a manner that benefits others, effective countercoalitions
may be slow to arise. If, on the other hand, the leading country defines its interests narrowly and
uses its weight arrogantly, it increases the incentives for others to coordinate to escape its
hegemony.
Pax Britannica in the nineteenth century is often cited as an example of successful hegemony,
even though Britain ranked behind the United States and Russia in GNP. Britain was never as superior in productivity to the
rest of the world as the United States has been since 1945, but Britain also had a degree of soft power. Victorian culture was
influential around the globe, and Britain gained in reputation when it defined its interests in ways that benefited other nations
(for example, opening its markets to imports or eradicating piracy). America lacks a global territorial empire

like Britain's, but instead possesses a large, continental-scale home economy and has greater
soft power. These differences between Britain and America suggest a greater staying power for American hegemony.
Political scientist William Wohlforth argues that the United States is so far ahead that potential rivals find it
dangerous to invite America's focused enmity, and allied states can feel confident that they can continue to
rely on American protection. Thus the usual balancing forces are weakened.
d.1
Loss of hege leads to global instability and nuclear war
Niall Ferguson, New York University History Professor & Stanford University Hoover Institution Senior Fellow, SeptemberOctober 2004, A World Without Power, Foreign Policy [adit]
So what

is left? Waning empires. Religious revivals. Incipient anarchy. A coming retreat into fortified
cities. These are the Dark Age experiences that a world without a hyperpower might quickly find
itself reliving. The trouble is, of course, that this Dark Age would be an altogether more dangerous one than the Dark Age of the
ninth century. For the world is much more populous--roughly 20 times more--so friction between the world's disparate "tribes" is
bound to be more frequent. Technology has transformed production; now human societies depend not merely on freshwater and the
harvest but also on supplies of fossil fuels that are known to be finite. Technology has upgraded destruction , too, so it is
now possible not just to sack a city but to obliterate it. For more than two decades, globalization--the integration of
world markets for commodities, labor, and capital--has raised living standards throughout the world, except where countries have shut
themselves off from the process through tyranny or civil war. The reversal of globalization--which a new Dark Age would
produce--would certainly lead to economic stagnation and even depression. As the United States sought to
protect itself after a second September 11 devastates, say, Houston or Chicago, it would inevitably become a less open
society, less hospitable for foreigners seeking to work, visit, or do business. Meanwhile, as Europe's Muslim enclaves grew,
Islamist extremists' infiltration of the EU would become irreversible, increasing trans-Atlantic tensions over
the Middle East to the breaking point. An economic meltdown in China would plunge the Communist system
into crisis, unleashing the centrifugal forces that undermined previous Chinese empires. Western
investors would lose out and conclude that lower returns at home are preferable to the risks of default abroad. The worst effects of the
new Dark Age would be felt on the edges of the waning great powers. The wealthiest ports of the global economy--from
New York to Rotterdam to Shanghai--would become the targets of plunderers and pirates. With ease, terrorists
could disrupt the freedom of the seas, targeting oil tankers, aircraft carriers, and cruise liners, while Western nations
frantically concentrated on making their <CONTINUED>

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<CONTINUED>
airports secure. Meanwhile, limited

nuclear wars could devastate numerous regions, beginning in the


Korean peninsula and Kashmir, perhaps ending catastrophically in the Middle East. In Latin America,
wretchedly poor citizens would seek solace in Evangelical Christianity imported by U.S. religious orders. In Africa, the great
plagues of AIDS and malaria would continue their deadly work. The few remaining solvent airlines would
simply suspend services to many cities in these continents; who would wish to leave their privately guarded safe havens to go there?
For all these reasons, the prospect of an apolar world should frighten us today a great deal more than it frightened the heirs of
Charlemagne. If the United States retreats from global hegemony--its fragile self-image dented by minor setbacks on the
imperial frontier--its critics at home and abroad must not pretend that they are ushering in a new era of multipolar
harmony, or even a return to the good old balance of power. Be careful what you wish for. The alternative to unipolarity
would not be multipolarity at all. It would be apolarity--a global vacuum of power. And far more dangerous forces than rival
great powers would benefit from such a not-so-new world disorder.
d.1

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SOFT POWER- HEGE


Soft power reduces counter balancing hege, which prevents a complete loss of hege
Joseph S. Nye, Harvard University Kennedy School of Government Dean, former National Intelligence Council Chairman, former
Clinton Administration Assistant Secretary of Defense, Winter 2002/2003, Limits of American Power, Political Science Quarterly,
[adit]
Nonetheless, if American

diplomacy is unilateral and arrogant, our preponderance would not


prevent other states and nonstate actors from taking actions that complicate American
calculations and constrain its freedom of action. For example, some allies may follow the
American bandwagon on the largest security issues but form coalitions to balance American
behavior in other areas such as trade or the environment. And diplomatic maneuvering short of alliance
can have political effects. As William Safire observed when Presidents Vladimir Putin and George W. Bush first met, Well
aware of the weakness of his hand, Putin is emulating Nixon's strategy by playing the China card. Pointedly, just before
meeting with Bush, Putin traveled to Shanghai to set up a regional cooperation semi-alliance with Jiang Zemin and some of
his Asian fellow travelers. Putin's tactics, according to one reporter, put Mr. Bush on the defensive, and Mr. Bush was at
pains to assert that America is not about to go it alone in international affairs.
Pax Americana is likely to last not only because of unmatched American hard power but also to the extent that the United
States is uniquely capable of engaging in strategic restraint, reassuring partners and facilitating cooperation.The open and
pluralistic way in which U.S, foreign policy is made can often reduce surprises, allow others to have a voice, and contribute
to soft power. Moreover, the impact of American preponderance is softened when it is embodied

in a web of multilateral institutions that allow others to participate in decisions and that act as
a sort of world constitution to limit the capriciousness of American power. That was the lesson the
United States learned as it struggled to create an antiterrorist coalition in the wake of the September 2001 attacks. When
the society and culture of the hegemon are attractive, the sense of threat and need to balance it
are reduced. Whether other countries will unite to balance American power will depend on
how the United States behaves as well as the power resources of potential challengers.

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SOFT POWER IMPACT- TERRORISM


d.1
only soft power can stop terrorism through international co-op
Joseph S. Nye, Harvard University Kennedy School of Government Dean, former National Intelligence Council Chairman, former
Clinton Administration Assistant Secretary of Defense, Summer 2004, Soft Power and American Foreign Policy, Political Science
Quarterly 119.2, p. EBSCO [adit]
Some hard-line skeptics might say that whatever the merits of soft power, it has little role to play in the current war on terrorism.
Osama bin Laden and his followers are repelled, not attracted by American culture, values, and policies. Military power was essential
in defeating the Taliban government in Afghanistan, and soft power will never convert fanatics. Charles Krauthammer, for example,
argued soon after the war in Afghanistan that our swift military victory proved that "the new unilateralism"
worked. That is true up to a point, but the skeptics mistake half the answer for the whole solution. Look again at Afghanistan.
Precision bombing and Special Forces defeated the Taliban government, but U.S. forces in Afghanistan

wrapped up less than a quarter of al Qaeda, a transnational network with cells in sixty countries. The
United States cannot bomb al Qaeda cells in Hamburg, Kuala Lumpur, or Detroit. Success against them
depends on close civilian cooperation, whether sharing intelligence, coordinating police work across borders, or
tracing global financial flows. America's partners cooperate partly out of self-interest, but the
inherent attractiveness of U.S. policies can and does influence the degree of cooperation. Equally
important, the current struggle against Islamist terrorism is not a clash of civilizations but a contest whose outcome is closely tied to a
civil war between moderates and extremists within Islamic civilization. The United States and other advanced democracies will
win only if moderate Muslims win, and the ability to attract the moderates is critical to victory. We
need to adopt policies that appeal to moderates and to use public diplomacy more effectively to explain our common interests. We
need a better strategy for wielding our soft power. We will have to learn better how to combine hard and soft power if
we wish to meet the new challenges
Terrorism causes global nuclear war
Mohamed Sid-Ahmed, Egyptian Political Analyst, Al-Ahram Newspaper, 8/26/2004,
http://weekly.ahram.org.eg/2004/705/op5.htm
What would be the consequences of a nuclear attack by terrorists? Even if it fails, it would further exacerbate the
negative features of the new and frightening world in which we are now living. Societies would close in on
themselves, police measures would be stepped up at the expense of human rights, tensions between civilizations and

religions would rise and ethnic conflicts would proliferate. It would also speed up the arms race and
develop the awareness that a different type of world order is imperative if humankind is to survive. But the
still more critical scenario is if the attack succeeds. This could lead to a third world war, from which no one will
emerge victorious. Unlike a conventional war which ends when one side triumphs over another, this war will be without winners
and losers. When nuclear pollution infects the whole planet, we will all be losers.

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SOFT POWER- TERORRISM

d.1
Only soft power can solve for terrorism
Joseph Nye, Harvard University Kennedy School of Government Dean, former National Intelligence Council Chairman, former
Clinton Administration Assistant Secretary of Defense, July/August 2003, US Power and Strategy After Iraq, Foreign Affairs 82.4,
[adit]
Although the new unilateralists are right that maintaining U.S. military strength is crucial and that pure multilateralism is
impossible, they make important mistakes that will ultimately undercut the implementation of the new security strategy. Their first

mistake is to focus too heavily on military power alone. U.S. military power is essential to global
stability and is a critical part of the response to terrorism. But the metaphor of war should not blind Americans to
the fact that suppressing terrorism will take years of patient, unspectacular civilian cooperation with other
countries in areas such as intelligence sharing, police work, tracing financial flows, and border controls.
For example, the American military success in Afghanistan dealt with the easiest part of the problem: toppling an oppressive and
weak government in a poor country. But all the precision bombing destroyed only a small fraction of al
Qaeda's network, which retains cells in some 60 countries. And bombing cannot resolve the problem
of cells in Hamburg or Detroit. Rather than proving the new unilateralists' point, the partial nature of the success
in Afghanistan illustrates the continuing need for cooperation. The best response to transnational
terrorist networks is networks of cooperating government agencies.

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SOFT POWER- IRAQ STABILITY


d.1
U.S soft power key to Iraqi stability
Joseph S. Nye, Harvard University Kennedy School of Government Dean, former National Intelligence Council Chairman, former
Clinton Administration Assistant Secretary of Defense, Summer 2004, Soft Power and American Foreign Policy, Political Science
Quarterly 119.2, [adit]
According to the National Security Strategy, the greatest threats the American people face are transnational
terrorism and weapons of mass destruction, and particularly their combination. Yet, meeting the challenge posed by
transnational military organizations that could acquire weapons of mass destruction requires the cooperation of
other countriesand cooperation is strengthened by soft power. Similarly, efforts to promote democracy in Iraq and
elsewhere will require the help of others. Reconstruction in Iraq and peacekeeping in failed states are far more

likely to succeed and to be less costly if shared with others rather than appearing as American
imperial occupation. The fact that the United States squandered its soft power in the way that it went to war meant that the
aftermath turned out to be much more costly than it need have been.
Iraqi instability would cause a catastrophe in the middle east and destroys hegemony
Ali-Asghar Kazemi, Islamic Azad University in Tehran International Relations Professor, 3/18/06, http://www.bitterlemonsinternational.org/previous.php?opt=1&id=124
While the likelihood of an uncontained civil war in Iraq does not seem that high, the collapse of the fragile regime and
widespread chaos throughout the country is still a plausible scenario. The collapse of Iraq could produce a number of
decisive short and long-term consequences at the national, regional and international levels. At the national
level, the most urgent outcome of the crisis is the mounting of new obstacles to the formation of a
Shi'ite-led government based on one that has been accused of an anti-Sunni attitude and incompetence in
maintaining law and order. Outgoing PM Ibrahim al-Jaafari is already under serious pressure from all sides, including secular Shi'ites
and the Kurds, to withdraw his candidacy for the premiership. The Sunni faction in the parliament (with 44 seats) may harden its
position regarding participation in a national unity government and the legitimacy of the political process. The situation could

either lead various factions in Iraq to pursue their own cause and establish independent governments
in some sort of loose federalism, as the Kurds have already done, or precipitate the fall of the entire country into the
hands of extremists. This latter would be indeed the most horrible outcome, unleashing Muslim fundamentalist
forces throughout the greater Middle East. Of course, Sunnis would oppose the partition of Iraq, but Shi'ites ultimately
would not mind forming their own government aligned with Iran in the southern region of Iraq. This could, in turn, upset the delicate
ethnic and religious balance in neighboring countries. At the regional level, the victory of terrorist groups could
further fuel anti-American sentiments among traditional societies and impel Muslim fundamentalists to
destabilize the entire region. This could lead to total transformation, including structural changes, in
the Middle East political landscape. This would in turn put the fate of regional energy resources in the
hands of extremists. Though this development might not please the West and many other countries, the Iranian hard-line
government would at this point in time see it as a God-given opportunity. As a matter of fact, of all Iraq's neighbors

Iran's national interests would be most heavily affected by political, strategic and structural changes
in Iraq. With their long history of rivalry, hostilities and war, the fall of Iraq could produce a number of challenges and
opportunities for Iran. The major opportunity would be the total frustration of American designs for "regime change" in Iran through
some kind of intervention. The most threatening challenges could be the susceptibility of Iranian Kurds and
Arabs to appeals to join with their peers in a disintegrated Iraq. Evidently, then, the continued turmoil
and insurgency in Iraq offers immediate benefit for Iran, since the United States may not be tempted to use hard power
against it in the foreseeable future. But at the same time, if the chaotic situation continues and passes a certain
threshold, Sunni extremists could even endanger Shi'ite Iran. Among other states, Saudi Arabia has been at the
top of the list of targets of terrorists and fundamentalist groups for some time. The small states of the Persian Gulf are also most
vulnerable to such political upheaval. Eventually, Middle East peace plans and the democratization process would become targets and
victims of the rise of fundamentalism. Under such circumstances, Israel should look for a safe <CONTINUED>

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<CONTINUED>
place on the globe, since its nuclear deterrent would be no match for terrorism. At the international level, the fall of

Iraq could
deal the most serious blow to US strategy in the Middle East and end American hegemony in the
entire world. If the United States and allied forces in Iraq fail to contain and manage the crisis, we should expect
immediate repercussions in the form of a domino effect in other countries, beginning with Afghanistan. The
proliferation of radicalism could easily affect North Africa in the West and Muslim states in East and South Asia, including Pakistan,
India, Bangladesh, Malaysia and Indonesia. Those in the United States and other parts of the world who push for a quick withdrawal
of American troops from Iraq are evidently not conscious of these and other catastrophic ramifications.

d.1
Failure to deter a nuclear middle east results in extinction
Michael O'Loughlin, written many scholarly books and articles Journal of Palestine Studies, Vol. 13, No. 3. (Spring, 1984), pp.
134-136. [adit]
Yet, political and military conflict are

replete with instances of misperception


and human miscalculation. Moreover, in
the nuclear context, deterrent failure is
likely to be catastrophic. Under normal
conventional military capabilities, the
results have been devastating but survivable.
However, given the qualitative
difference between conventional and nuclear
weapons, deterrent failure in the
context of nuclear weapons may very well
mean virtual annihilation and extinction.
To be sure, Feldman explicitly argues that
nothing can eliminate this "error" factor.
And, he gives lip service to the potentially

disastrous consequences of deterrent


failure in a nuclearized Middle East. Yet,
he still argues that facing the risks of
nuclear annihilation are worth escaping
the certainty of continued, conventional
wars.

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US KEY- BIOWEAPONS
Bioterrorism threatens national securityproves US is key to stop use and proliferation of bioweapons
David P. Fidler, professor of law, University of Indiana, 3/6/05, Germs, Norms, and Power: Global Healths Political Revolution,
http://www2-test.warwick.ac.uk/fac/soc/law/elj/lgd/2004_l/fidler/
The impact on public health of fears about the proliferation and use of biological weapons has been significant in the 1990s
and early 2000s. These fears were growing before the anthrax attacks in the United States in 2001, and these attacks
accelerated fusion between public health and national security in policy efforts against weapons of mass destruction (WMD).
Prior to the last decade, public health was not part of national security and foreign policy on WMD because the approach to
the WMD threat was arms control (Fidler, D, 2003a). The WMD threat, especially bioterrorism, has

changed policy such that public health is now a central component of foreign policy, national
security, and homeland security efforts against the proliferation and use of WMD generally
and bioweapons specifically.
In the United States, the WMD and bioterrorism threats have affected policy from strategic doctrine to local public health
preparedness. The United States has located the bioterrorist threat within a strategic framework of
U.S. national security that President Bush controversially termed the axis of evil (Bush, G, 2002). Putting
aside the rhetoric, the substantive components of the axis form a post-9/11 strategic doctrine that

identifies threats to US national and homeland security and provides a blueprint for the
exercise of US power. The axis of evil highlights the policy interdependency of three factors: repressive regimes,
international terrorism, and WMD (Bush, G, 2002) (Figure1).

This strategic doctrine communicates that WMD proliferation and their use by state and nonstate actors constitutes a direct security threat to the United States. The doctrine resonates with
concerns about WMD generally and bioterrorism specifically that developed before George W. Bush was elected president.

The anthrax attacks of 2001 demonstrated bioterrorisms potential to inflict damage on a


country.
As a strategic doctrine, the axis of evil has generated diverse responses at different policy levels. The Bush
administrations strategy of pre-emptive self-defense against states that possess or pursue WMD and that support
international terrorism is one policy response (White House, 2002a, p 15). In terms of public health, the doctrine

supports the significant effort underway in the United States for public health preparedness
against future attacks using bioweapons (Office of Homeland Security, 2002, pp 43-44). Recognition of the
bioweapons threat extends beyond the United States because the World Health Organisation (WHO) has also become
engaged with public health preparedness against the intentional use of microbes as part of strengthening global health
security (WHO, 2002a, p 12).
US government is committed to defense against bioterrorism-Bush administrations security initiatives prove
David P. Fidler, professor of law, University of Indiana, 3/6/05, Germs, Norms, and Power: Global Healths Political Revolution,
http://www2-test.warwick.ac.uk/fac/soc/law/elj/lgd/2004_l/fidler/

The Bush administration has adopted neo-Westphalianism in its approach to both bioweapons
and emerging infectious diseases (Fidler, 2003b). Bush administration policy on national and
homeland security includes attention on, and funding for, defence against bioterrorism (White
House, 2002b; Office of Homeland Security, 2002). Perhaps more surprising is the Bush administrations neoWestphalianism concerning emerging infectious diseases, something the previous two Republican administrations did not
exhibit. The administration conceives of HIV/AIDS, for example, as a threat to U.S. national security and foreign policy
objectives, including fighting global terrorism, promoting trade liberalisation, increasing stability in hard-hit regions (eg subSaharan Africa), working with key powers such as China, supporting economic development in poor countries, and
advancing democracy globally (White House, 2002a, pp 10, 19, 22-23, 27). This neo-Westphalian approach to HIV/AIDS
explains why the Bush administrations proposed USD 15 billion, five-year Emergency Plan for AIDS Relief (Emergency
Plan) represents more than humanitarianism but forms part of a strategic outlook on the exercise of US power (Bush, G,
2003a). Secretary of State Colin Powell (2003) argued that [r]esponding to HIV/AIDS is not only a humanitarian and a
public health issue; HIV/AIDS also carries profound implications for prosperity, democracy and security. President Bush
(2003b) stressed the strategic nature of the Emergency Plan when he compared it to the Marshall Plan, the Berlin Airlift, and
the Peace Corps.
US KEY- BIOWEAPONS
US local, state, and federal government support of disease surveillance is key to ending bioweapon use.
Hearing Before the Subcommittee on Technology and Procurement Policy of the Committee on Government Reform:
House of Representatives, One Hundred and Seven Congress, First Session, 12/14/01, http://www.gpo.gov/congress/house
NASCIO agrees with the CDCs March assessment in terms of
the HAN initiative as well as the National Electronic Disease Surveillance
System. HAN and NEDSS is a great first start.
In Connecticut, if I can personalize this, the National Electronic
Disease Surveillance System will replace 18 stove-pipe systems

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with an integrated data repository for the sharing of this information.


So I think, as Dr. Baker said, it is a very complex process to
put that together, but I think the benefit will be great.

These goals which again are critically important for all health
departments in the Nation to have continuous high-speed access to
the Internet is going to require substantial investment for States
and local governments, which, again, they cannot bear alone. I
think, you know, as we go forward and look at the deployment of
those systems, the one fact that has to be considered is the current
networks that are available in the State and local governments.
Beyond HAN, really the way to do that is a coordinated integrated
State information architecture, and if I could talk specifically
about a couple of issues that NASCIO is involved with, there
is currently one with the criminal justice community, a global justice
initiative, to create a national natural integrated architecture
for justice systems. It doesnt appear, by my knowledge, those of
the CIOs that I have talked to, that this effort is under way for
the public health infrastructure.
While the initiatives going forward, again, are very critical, it is
unclear, I think, from many of our perspectives of how they plug
into the overall architecture. Standards are great, but certainly
local governments and State governments would like to have a say
in how those standards are put together and how they fit onto the
overall overriding architecture.
The justice integration architecture to me would be a blueprint
to follow for the public health systems. Again, as we look at those
initiatives such as anthrax, the ability to cross-communicate

information
in a very timely basis across multi jurisdictions, not just
health agencies, public safety, Governors, other departmental agencies
within States and local governments, particularly first responders,
the State CIOs and Federal homeland defense officials in
conjunction with Justice and CDC again may do well in considering
using the justice integrated architectural process here for creating
a public health information architecture that, again, fits in with an
overall State architecture and a homeland defense scenario. This
integration will allow for access as appropriate to vital alert and
response information by all affected State agencies.
Again, getting back to Connecticut, Connecticut, we had an anthrax
issue, a 94-year-old woman who passed away as a result of
the anthrax. We had a very excellent response by CDC, over 20
people responded; FBI, over 20 people responded. To think in context
of what advantage to the 1 event, 10 events, 1,000 events
across the country, our ability to communicate was not in place.
And I think that the infrastructure and architecture that we are
talking about in these networks will be the vehicle to do it. We are
just not going to have enough trained people to respond to these
situations. So the communication infrastructures will be vital in
any response, particularly if it is a national response.
State CIOs again want to be involved in the planning process.
And to sum up, I think, as we talk about communicating, it is not

just one way from the Federal Government down to the State and
local jurisdictions, it is multiway processing, down from the Fed, up
from the local, State to the Feds, again the sharing of information.
And summarizing, I have been asked by my Governor to ensure
an effective information communications infrastructure for responding
to the bioterror threat. As the Nations governments gear

up to prepare for the threat of bioterrorism, NASCIO believes the


path to efficient implementation of preparedness initiatives lies
with open coordination between all levels of government and views
toward information systems that emphasize open architectures
rather than closed, stove-pipe systems. To this end NASCIO

has
opened up communications with Director Ridges Office of Homeland
Security and would be pleased to coordinate and initiate coordinating relationships with CDC and others to more effectively

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implement our public health infrastructure improvements effort.


These efforts, we believe, are necessary to safeguard the American
public in every part of the Nation, in every State and every
county, and in every city.

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US KEY- BIOTERRORISM
US cooperation with international organizations is key to stop bioterrorism (H1)
Committee on Emerging Microbial Threats to Health in the 21st Century, Board on Global Health, Institute of Medicine, 3/18/03,
America Should Foster Systematic Effort to Combat Infectious Diseases Here, Abroad, Microbial Threats to Health: Emergence,
Detection, and Response, The National Academies Press,
http://www8.nationalacademies.org/onpinews/newsitem.aspx?recordid=10636
Similarly, global surveillance is key to responding to and containing microbial threats before isolated

outbreaks mushroom into regional or worldwide pandemics. The United States should work with key
international agencies, such as the World Health Organization, to build up existing surveillance
initiatives around the world focusing on microbial threats in developing nations. Assistance should
include financial and technical support. In the long run, America should take a leadership role in promoting a
comprehensive system of surveillance for global infectious diseases. "Still, this effort should be multinational
because it will require regional and global coordination, advice, and resources from participating nations," said committee co-chair
Joshua Lederberg, professor emeritus and Sackler Foundation Scholar, Rockefeller University, New York City. "In the context of
infectious diseases, we all share the same landscape."
US government must prevent use of bioweaponsnational security priority (H1)
Committee on Emerging Microbial Threats to Health in the 21st Century, Board on Global Health, Institute of Medicine, 3/18/03,
America Should Foster Systematic Effort to Combat Infectious Diseases Here, Abroad, Microbial Threats to Health: Emergence,
Detection, and Response, The National Academies Press,
http://www8.nationalacademies.org/onpinews/newsitem.aspx?recordid=10636
The nation should take decisive steps to fortify its public health system to tackle microbes that trigger infectious diseases such as
West Nile encephalitis, AIDS, and tuberculosis, says a new report from the Institute of Medicine of the National Academies. In
addition, the U.S. government should play a significant role in building the capacity of poor
countries to monitor, prevent, and respond to disease outbreaks. In the developing world, infectious diseases
kill one in every two people.
Microbial threats endanger public health across the globe. Moreover, the potential use of biological agents in
terrorist attacks or warfare underscores the urgent need for better strategies and tools to grapple with infectious diseases, the
report notes.

"Infectious diseases cross national borders and require a global response, but the United States
should help lead efforts to reverse the complacency in industrialized countries regarding this
problem," said Margaret Hamburg, vice president for biological programs, Nuclear Threat Initiative, Washington, D.C., and
co-chair of the committee that wrote the report. "On the whole, aggressively responding to microbial threats is in
America's economic, humanitarian, and security interests, and should be a national priority."

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US KEY- HEGEMONY
US must apply its superpower status to preserve global health stability
David P. Fidler, professor of law, University of Indiana, 3/6/05, Germs, Norms, and Power: Global Healths Political Revolution,
http://www2-test.warwick.ac.uk/fac/soc/law/elj/lgd/2004_l/fidler/
The growing germ threat and the normative ferment about responding to the threat bring the final factor in global healths
political revolution into play: power. Revolutions are struggles for power between the forces of the

status quo and the forces of radical change. The overthrow of the old by the new requires the
exercise of superior power. Effective responses to the global threat of pathogenic microbes
also require the harnessing of material capabilities, or put another way, the application of
power for global health purposes.
Recognition of the microbial menace and the related normative ferment in thinking about global health
has occurred during a time in which the United States emerged as the worlds hegemon,
creating what some perceive is a unipolar world. As the Bush administration argued, The United States
possesses unprecedentedand unequaledstrength and influence in the world (White House, 2002a, p 1). Both the axis
of evil and the axis of illness exist in a world in which US power is preponderant.
The simultaneous growth of the germ threat and the rise of the United States to hegemonic
status have placed U.S. power at the centre of concern in global healths political revolution.
The last decade has witnessed many attempts to persuade the hegemon to embrace global health more robustly than it has
done in the past (eg, Institute of Medicine, 1997; National Intelligence Council, 2000; Kassalow, J, 2001; Ban, J, 2001;
Brower, J and Chalk, P, 2003; Campbell, K and Zelikow, P, 2003). Much of this literature resonated with neoWestphalianism as arguments sought to convince the US government that global health and infectious disease control are in
the enlightened self-interest of the United States. The sub-title of the Institute of Medicines 1997 report on Americas Vital
Interest in Global Health captured the nature of these appeals to the self-interest of the United States: Protecting Our People,
Enhancing Our Economy, and Advancing Our International Interests.
Bushs progressive public health agenda stresses the magnitude of the US role in controlling global health issues
David P. Fidler, professor of law, University of Indiana, 3/6/05, Germs, Norms, and Power: Global Healths Political Revolution,
http://www2-test.warwick.ac.uk/fac/soc/law/elj/lgd/2004_l/fidler/
The importance of US power can also be seen in literature critical of the U.S. approach toward global health issues generally
and infectious disease problems specifically. The time, energy, and ink devoted to critical analysis of US policy on global
infectious disease problems, especially HIV/AIDS, underscores the US hegemonic position. The combination of the

severity of the pathogenic threat and the preponderance of US power makes the United States
something of an indispensable nation concerning the direction of global healths political
revolution.
Health as an issue in US foreign policy has, historically speaking, been considered a humanitarian and technical endeavour
not of central importance to US security, interests, and power. The first comprehensive attempt to elevate health as a matter
of U.S. foreign policy occurred during the Carter administration. At the beginning of his term, President Carter ordered a
review of U.S. policy on international health (White House, 1978, p xxiv). This review sought to give health a more
prominent role in U.S. foreign policy. The Carter administration justified this elevated role for health through appeals to U.S.
economic, security, and political interests and to human rights, particularly the human right to health. Health as foreign policy
to President Carter meant appealing to both Westphalian and post-Westphalian conceptualisations of health problems, but
Carters emphasis was on the human right to health: The right to health and our Nations moral commitment to help
guarantee that right form an integral part of the foreign policy of the Carter Administration (White House, 1978, p 1).
President Carters elevation of health did not resonate with the foreign policies of the next two administrations, and health did
not become an important U.S. foreign policy concern again until the Clinton administration. Rather than following Carters
emphasis on the right to health, the Clinton administration conceptualised infectious diseases as exogenous threats to U.S.
national interests, power, and security (National Science and Technology Council, 1995; National Intelligence Council,
2000). Neo-Westphalianism came of age during Clintons terms because his administration framed the threats from emerging
infectious diseases and bioweapons according to the Westphalian approach. Although the Clinton administration was not
hostile toward the right to health, this core of post-Westphalianism did not feature in the administrations attempts to increase
the profile of health as a U.S. national security and foreign policy concern.
Unlike the Republication administrations that followed Carter, the Bush administration has elevated health as

a national security and foreign policy concern beyond what the Carter and Clinton
administrations attempted. The fact that a neo-conservative, unilateralist-minded
administration has integrated health concerns into its national security and foreign policies in
a high-profile manner is evidence of the magnitude of the germ threat and the reality of global
healths political revolution.

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J4/J12/J14/J17-US industrial and communicative leadership is essential to global health.
Board on International Health, 1997 (America's Vital Interest in Global Health: Protecting Our People, Enhancing Our
Economy, and Advancing Our International Interests) [http://www.nap.edu/readingroom/books/avi/4.html]
[The United States has

the potential to improve global health by leading the effort to develop an


effective surveillance network, using its industrial expertise in the information and
communications technologies. Harnessing the global potential of these technologies will require collaboration
among the industries that will build, operate, provide, and use the services and information that will become available over
evolving national networks. It will also require cooperative efforts among all countriesbilaterally,
regionally, and through multilateral organizationsto facilitate the interconnection of their respective

networks and the sharing of information.


A special challenge is how to help developing countries to advance their capacities in the fields of information and
communications. The United States, particularly the corporate sector, has much to offer in this enterprise. To foster such
involvement, the U.S. government, along with its counterparts throughout the world, must ensure that the regulatory,
legislative, and market conditions necessary to attract private investment in telecommunications, information technology, and
information services are in place.]

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US KEY- HEGEMONY

US governments contributions to global health issues are a massive display of power


David P. Fidler, professor of law, University of Indiana, 3/6/05, Germs, Norms, and Power: Global Healths Political Revolution,
http://www2-test.warwick.ac.uk/fac/soc/law/elj/lgd/2004_l/fidler/
Global healths political revolution finds, thus, the hegemon engaged in health as foreign policy on both neo-Westphalian
and unique post-Westphalian terms. Even those not prone to praise the Bush administration acknowledge that its stance on
HIV/AIDS is groundbreaking. Kristof (2003, p A31) argued, for example, that Mr Bush is doing more about AIDS in Africa
than President Clinton ever did. The hegemons engagement involves not only proposals for increased

U.S. contributions to global health (Bush, G, 2003a) but also the integration of the HIV/AIDS
threat into overall national security and foreign policy objectives (White House, 2002a).
The Bush administration has taken health as foreign policy beyond the soft power leadership
role advocated by Kickbusch (2002, p 139) because it has conceptualised health threats as
directly relevant to hard and soft power interests of the United States. The unprecedented nature of the
Bush administrations incorporation of health into US foreign policy has, nevertheless, generated controversy for two basic
reasons. First, many global health advocates are unhappy with the Bush administrations health unilateralism, expressed in its
emphasis on domestic bioterrorism preparedness (Vedantam, S, 2003, p A08) and the manner in which it approaches the
global HIV/AIDS problem (eg distributing the vast majority of the Emergency Plans proposed sums bilaterally rather than
through the Global Fund) (Fidler, D, 2003d, p 141). Second, critics believe more is needed from the United States,
particularly financially, than the Bush administration has promised or delivered because the magnitude of global infectious
disease problem is enormous (Fidler, D, 2003d, p 142-43).
In sum, global healths political revolution involves the germ threat influencing how the worlds hegemon conceptualises
national security and foreign policy and how it exercises material power. Global health concerns are not

determining how the United States exercises its power; but, under Bush administration policy,
the United States cannot exercise its power today without confronting the global germ threat,
whether the issue is homeland security, trade liberalisation, aid to sub-Saharan Africa, or the
axis of evil.
Interestingly, the Bush administration has given the germ threat, especially HIV/AIDS in developing countries, such a
significant profile that it cannot, if it is sincere, afford to have its neo-conservative approach found wanting. Referring to the
Emergency Plan, Kristof (2003, p A31) warned that, unless President Bush delivers on his promises, then

it will all look like the most cynical of gesturesusing the great health tragedy of our age as a
cheap photo-op to drape the White House in compassion. The United States itself has raised
the stakes of global healths political revolution in framing the germ threat in a manner that
requires, practically and philosophically, the serious engagement of US power.

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US KEY- INFRASTRUCTURE

US-supported disease surveillance strengthen public heath infrastructure of other countries


Gary Cecchine AND, Ph.D. Biology, Melinda Moore, M.D., Harvard Medical School; M.P.H., Harvard School of Public
Health, 2006, Infectious Disease and National Security: Strategic Information Needs, RAND National Research Defense
Institute, < http://www.rand.org/pubs/technical_reports/2006/RAND_TR405.pdf>

Virtually all respondents offered suggestions and insights for improving global infectious disease
information. They generally framed their suggestions to address both bioterrorism and naturally occurring disease threats, easing
what some viewed as disproportionate attention to deliberate threats at the expense of more likely threat scenarios. A common
suggestion was for improved detection capacity and timeliness and transparency of disease reporting
by foreign governments. However, these are not necessarily within the direct purview of the United States. At least two
respondents called upon the United States to invest more in the disease surveillance activities of foreign
governments. This would serve the dual purpose of helping to strengthen foreign public health
infrastructures for the collective good and providing opportunities for more U.S. eyes and ears on
the ground working in mutually trusting relationships with their national counterparts, making
them potentially privy to early disease outbreak information. One State Department official also described his
plans for taking fuller advantage of embassy staff and the U.S. business community in foreign countries through better briefings to
sensitize them about possible disease threats and encourage them to report back. In contrast, two individuals from the intelligence
community commented that the current era of global communications limits the need for additional U.S. personnel in the field. Several
respondents commented on the need for different government agencies to understand and interact more fruitfully with one another.
One interviewee noted that there might not be sufficient focus on health at the highest levels in the U.S. government security
apparatus, which would be affirmatively demonstrated by the appointment of a dedicated health and medical expert to the National
Security Council.

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US KEY- TECH
Absent US science and technology, global health threatens failure.
Board on International Health, 1997 (America's Vital Interest in Global Health: Protecting Our People, Enhancing Our
Economy, and Advancing Our International Interests) [http://www.nap.edu/readingroom/books/avi/4.html]

America must engage in the fight for global health from its strongest basis: its preeminence in science and
technology. U.S. expertise in science and technology and its strength in biomedical, clinical, and health services
research and development are the engine that has helped power many of the advances in human
health and well-being of this century . Our leading research institutions, the N ational Institutes of Health and
universitiestogether with the C enters for Disease Control and Prevention, private-sector health industries, and many
U.S. foundations and nongovernmental organizationshave been major contributors to this process. The U.S. Agency for
International Development, in turn, has been the principal supportive institution for making many of those advances accessible to
developing countries. The United States has long experience in bringing a diversity of perspectivesboth public
and privatetogether with disciplined science to solve complex and critical problems. Without active

U.S. engagement and coordination, in concert with the complementary efforts of other nations, the
struggle to ensure health around the globe threatens to fragment or falter, with the likely outcome that our
own national health, economic viability, and security will suffer. This report outlines the compelling case for America's active
engagement in global health and offers recommendations on how this may best be achieved
J4/J12/J14/J17- US medical and technological leadership is essential to global health.
Board on International Health, 1997 (America's Vital Interest in Global Health: Protecting Our People, Enhancing Our
Economy, and Advancing Our International Interests) [http://www.nap.edu/readingroom/books/avi/4.html]

The United Statesin partnership with other nations and international organizationsshould lead from its
strengths in medical science and technology to play a central role in global health. The basic
medical knowledge being accrued by the National Institutes of Health and the expertise in disease
surveillance and prevention of the U.S. Centers for Disease C ontrol and Prevention are unique national
resources that help to create and sustain the international public good. In addition, the U.S. pharmaceutical, medical device,
and vaccine industries and academic sector are among the most innovative and productive in the world. The U.S. government
should engage these institutions to provide leadership in global health in at least five areas, as follows.

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US KEY- MODELING

US Public health is a prima facia issue in the international communityonly US cooperation will ensure global health
assistance (H2)
David P. Fidler, professor of law, University of Indiana, 3/6/05, Germs, Norms, and Power: Global Healths Political Revolution,
http://www2-test.warwick.ac.uk/fac/soc/law/elj/lgd/2004_l/fidler/

Dramatic change marks the history of health as an issue in international relations. Healths
emergence as a foreign policy concern in the mid-19th century, when European nations began
to confront cooperatively the cholera menace, represents one such dramatic transition in how
health was conceptualised and approached internationally. Subsequent treaties and
international health organisations also transformed health as a foreign policy concern.
Technological developments, especially antibiotics and vaccines, also produced change for
public health globally.
These examples of changes in international health reveal and obscure. They reveal that health has long been a foreign policy
issue. Given this history, health as foreign policy is not a novel idea. The examples obscure that health has historically been
relegated to the foreign policy fringe of technical assistance and humanitarianism. The lack of interest in health by those
studying foreign policy and international relations compounded the neglect (Lee, K and Zwi, A, 2003, p 13; Kickbusch, I,
2003, p 192). Given this situation, health as foreign policy was not an important diplomatic activity.
Dramatic change has, however, again visited health as an issue in international relations. In the past decade, health emerged
from obscurity and neglect to affect many foreign and international policy agendas. Health now features prominently in
debates concerning national and homeland security, international trade, economic development, globalisation, human rights,
and global governance. The attention health has received in the past ten years in national and international politics is
unprecedented. Kickbusch (2003, pp 192-93) captured this change:
The protection of health is no longer seen as primarily a humanitarian and technical issue relegated to a specialised
UN agency, but more fully considered in relation to the economic, political, and security

consequences for the complex post-Cold War system of interdependence. This has led to new
policy and funding initiatives at many levels of governance and a new political space within
which global health action is conducted.
Health as a global issue has undergone a political revolution in the last decade. Healths emergence into the high
politics of international relations is a complicated and controversial development. Global healths political
revolution means that traditional approaches to, and attitudes about, public health have been ripped from their moorings
and set afloat on a volatile sea. This article examines global healths political revolution by analyzing its components and
how they relate to each other in an attempt to understand the meaning of this revolution for global healths future.
Revolutions constitute radical changes within existing political systems, and they typically involve three elements: (1) a crisis
with the status quo; (2) a challenge from normative ideas different from those operative in the existing system; and (3) the
application of material power to install the new ideas as the basis for future action. The article explores each of these
elements in connection with global healths transformation as an issue in international relations.
The crisis comes from threats posed by infectious diseases (germs). The mounting microbial menace has stimulated ferment
among policy responses that seek to supercede existing strategies and alter how state and non-state actors address pathogenic
threats (norms). The competing ideas require material resources and capabilities to contain and mitigate the microbial
challenge to health (power).
How germs, norms, and power converge shapes the nature of global healths political revolution. I argue that the political
revolution remains enigmatic, and the enigma raises questions about the revolutions impact and sustainability. Global

healths political revolution serves as a window on the future of not only the protection of
health but also 21st century world politics.

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US KEY- MODELING
US leadership key to promotion of global disease surveillance systems (H2)
Committee on Emerging Microbial Threats to Health in the 21st Century, Board on Global Health, Institute of Medicine, 3/18/03,
America Should Foster Systematic Effort to Combat Infectious Diseases Here, Abroad, Microbial Threats to Health: Emergence,
Detection, and Response, The National Academies Press,
http://www8.nationalacademies.org/onpinews/newsitem.aspx?recordid=10636
Similarly, global surveillance is key to responding to and containing microbial threats before isolated

outbreaks mushroom into regional or worldwide pandemics. The United States should work with key
international agencies, such as the World Health Organization, to build up existing surveillance
initiatives around the world focusing on microbial threats in developing nations. Assistance should
include financial and technical support. In the long run,

America should take a leadership role in promoting a comprehensive system of surveillance for
global infectious diseases. "Still, this effort should be multinational because it will require regional and global coordination,
advice, and resources from participating nations," said committee co-chair Joshua Lederberg, professor emeritus and Sackler
Foundation Scholar, Rockefeller University, New York City. "In the context of infectious diseases, we all share the same landscape."
US role in global health work key to international interest in aid-CDC programs prove
Stephen B. Blount,, Director of the Office on Global Health at CDC, 5/2/07, Global Health, US Department of Health and Human
Services, http://www.hhs.gov/asl/testify/2007/05/t20070502a.html

CDC is committed to working with partners, both domestic and international, to achieve our goal of
Healthy People in a Healthy World. Through the leadership of the Coordinating Office for Global
Health (COGH), CDC is developing the first-ever agency-wide strategy to improve global health.
This strategy includes health promotion, health protection, and health diplomacy. Our health
promotion activities help prevent the major causes of global illness and death through the
implementation of proven interventions. Our commitment to health protection focuses on our collaborations within a
transnational network of countries and other organizations that are dedicated to protecting the health of Americans and the global
community from emerging threats. Finally, our health diplomacy efforts reflect our commitment to provide humanitarian leadership
by sharing tools that enable other countries to identify and act on their own health priorities. CDC also understands that our

global health work cannot be accomplished without strong global partnerships. Today,
approximately 30 of CDCs programs serve as World Health Organization (WHO) Collaborating
Centers. In this role, CDC efforts help to protect the worlds health by strengthening laboratory and
epidemiological capacity and improving control and prevention strategies for selected diseases. CDC
also works with a variety of sectors including government, private, and non-profits organizations. We
partner with Ministries of Health, the Pan American Health Organization, USAID, CARE, the Carter Center, and UNICEF, just to
name a few.

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US KEY- DOMESTIC EXPERIENCE


US keyit has had previous experience with disease surveillance (H6)
Cheryl Pellerin, BS, science journalism (cum laude), University of Maryland, 2007

http://healthyamericans.org/policy/criticalcare/GlobalDetection.pdf
One of the most significant US contributions to preparedness for an influenza
pandemic, the Global Disease Detection (GDD) Program, quickens our ability to recognize infectious
disease outbreaks, improves the ability to control and prevent them, and better detects emerging infectious
disease threats. In collaboration with host countries and the World Health Organization, CDC is

establishing GDD Centers across the globe to strengthen global capacity to detect and respond
to
infectious disease outbreaks. The GDD Centers build upon proven, effective interventions and
approaches including the Emerging Infections Program and the Field Epidemiology and
Laboratory
Training Program. GDD helps ensure that we have a strategic presence across the globe with
enhanced
disease surveillance and state-of-the-art laboratory and epidemiologic science that would
allow for the
broadest possible detection and response capacities before a significant event occurs.
Additional activities
include expanding and improving early warning systems; greater coverage and increased
capacity to
rapidly respond to and contain outbreaks; researching new viral strains; aiding in
collaborations with
multinational organizations; and increasing overall infectious disease diagnostic capacity.
Having CDC
staff on the ground was invaluable in providing initial response support for the December 2004 Tsunami,
particularly in Thailand, and during the current avian influenza threat.

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US Key: Spillover
US is key to prevent disease spillover (H7)
Population Council, 3/96, The National Science and Technology Council on Emerging and Reemerging Infectious Diseases,
Population and Development Review http://links.jstor.org/sici?sici=00987921%28199603%2922%3A1%3C175%3ATNSATC%3E2.0.CO%3B2-8
The modern world is a very small place, where any city in the world is only a plane ride away from any other. Infectious

microbes can easily travel across borders with their human or animal hosts. In fact, diseases that
arise from other parts of the world are repeatedly introduced into the United States, where they may
threaten our national health and security. Since 1973, more than 30 new pathogenic microbes have been
identified and numerous new diseases have reemerged. Without preventative public health measures
in the United States and abroad, uncontrolled outbreaks can grow into major epidemics. However, our
earlier success in controlling infections have bred complacency, and the components of the public system that protect the public from
infectious microbes have been neglected, concentrating their resources on a few targeted diseases.

US Key: Superior Science


US is key to disease surveillancesuperior science/technology proves (H8)
Population Council, 3/96, The National Science and Technology Council on Emerging and Reemerging Infectious Diseases,
Population and Development Review http://links.jstor.org/sici?sici=00987921%28199603%2922%3A1%3C175%3ATNSATC%3E2.0.CO%3B2-8
Thus the effort to build a global surveillance and response system is in accord with the national
security and foreign policy goals of the United States. Moreover, leadership in global infectious disease

surveillance and control is a natural role for the United States. American business leaders and
scientists are in the forefront of the computer communications and biomedical research
communications (both public and private sector) that provide the technical and scientific

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underpinning for disease surveillance. Furthermore, American scientists and public health professionals
have being among the most important contributors to the international efforts to eradicate small pox
and polio.

CDC Key: Staff/Tech


CDC key to skilled work force and effective disease technology (I3)
Committee on Emerging Microbial Threats to Health in the 21st Century, Board on Global Health, Institute of Medicine, 3/18/03,
America Should Foster Systematic Effort to Combat Infectious Diseases Here, Abroad, Microbial Threats to Health: Emergence,
Detection, and Response, The National Academies Press,
http://www8.nationalacademies.org/onpinews/newsitem.aspx?recordid=10636
Likewise, a skilled health care work force is essential. Knowledge of how to confront microbial threats

should be fully integrated into training programs for all health care professionals, the committee
said. Specifically, CDC, NIH, and the U.S. Department of Defense should expand existing programs
and develop new ones that educate health care workers about field-based and laboratory approaches
to preventing infectious disease in this country and abroad.
Also, health care professionals also should heed the importance of etiologic diagnosis, which identifies the microbial causes of
infectious diseases, the report says. Along with surveillance, such diagnoses are the cornerstone of control and prevention measures.
For various reasons, etiologic diagnoses have decreased significantly over the past decade. The result has been a dangerous overuse of

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broad-spectrum antibiotics to treat illness, fueling microbial resistance to therapeutic drugs. Public health

agencies and
professional societies should disseminate and publicize guidelines calling for widespread use of
etiologic diagnostic tools. Also, CDC and other federal agencies should work together with private
industry to develop and assess new diagnostic tests.
CDC committed staff is key to high quality global health results. (I3)
Stephen B. Blount,, Director of the Office on Global Health at CDC, 5/2/07, Global Health, US Department of Health and Human
Services, http://www.hhs.gov/asl/testify/2007/05/t20070502a.html
In FY 2007, CDC has devoted approximately $334 million to global health efforts, in addition to the approximately $815 million it
has received thus far in transfers from the Department of State, Office of the Global AIDS Coordinator, as part of the Presidents
Emergency Plan for AIDS Relief (PEPFAR). We strongly believe that program and scientific staff should be embedded in the
countries they serve. As of May 2007, the CDC has 166 staff working on assignments in 46 countries around

the world. Besides these assigned staff, the agency employs approximately 1,200 local staff in host
countries to support these programs and has approximately 40 staff detailed to work with our
international partners. It is this commitment of funding, staff, and resources that has produced
effective, efficient, and high quality global health results at CDC. Today, I will share with you some of our
greatest accomplishments.
CDC technology is key to the effectiveness of disease surveillance and to preventing massive disease outbreaks
Jonathan R. Davis, Senior Program Officer, and Joshua Lederberg, Sackler Foundation Scholar, The Rockefeller University, 2001,
Emerging Infectious Diseases From the Global to the Local Perspective: Workshop Summary, National Academy Press, www.nap.edu
The aim of Africa is to identify a group of diseases categorized as epidemic-prone diseases, diseases targeted for eradication or
elimination, and other disease of public health importance. The challenge will be to integrate surveillance and disease preparedness
and response activities for these priority diseases; especially when there are weakened ministries of health. Bilateral and multilateral
agreements, as well as partnerships with nongovernmental organizations and commercial interests, are among the means being
explored to strengthen disease surveillance and response activities, to transfer epidemiological and microbiological skills, and to
facilitate timely recognition of these disease outbreaks and their control. Among the promising roles provided by global

disease surveillance is the integration of new technology tools in resource-poor environments, such as
in Sub-Sahara Africa, of the development of an early-warning system based on remotely-sensed
(satellite) data for Rift Valley fever surveillance.

CDC Key: Global Recognition


CDC international communication key to effectiveness of disease surveillance systems (I1)
Committee on Emerging Microbial Threats to Health in the 21st Century, Board on Global Health, Institute of Medicine, 3/18/03,
America Should Foster Systematic Effort to Combat Infectious Diseases Here, Abroad, Microbial Threats to Health: Emergence,
Detection, and Response, The National Academies Press,
http://www8.nationalacademies.org/onpinews/newsitem.aspx?recordid=10636
At the outset, America has a lot of work to do domestically. Its ability to track and respond quickly to infectious diseases rests on a
public health infrastructure that has suffered from years of neglect, the report says. Efforts to prevent and control microbial threats
must be enhanced and expanded at all levels of government. Upgrades in everything from laboratory facilities to training programs
will require much larger, and sustained, investments. The National Institutes of Health, working with other federal research
institutions, also should develop a comprehensive research agenda for infectious-disease prevention and control.
The committee pointed out several major areas of concern. Reporting of infectious diseases by health care providers and clinical
laboratories to both state and local health officials remains inadequate, for instance. Open lines of communication and

solid working relationships among providers, laboratories, and public health authorities are critical
to maintaining effective infectious-disease surveillance systems and successfully carrying out
response activities. The Centers for Disease Control and Prevention should craft innovative strategies
to improve communication among these
groups.

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CDC Key: Empirically Solves


CDC key to implement disease surveillanceGDD initiatives prove (I2)
Stephen B. Blount,, Director of the Office on Global Health at CDC, 5/2/07, Global Health, US Department of Health and Human
Services, http://www.hhs.gov/asl/testify/2007/05/t20070502a.html
One of the most significant USG contributions to our preparedness for an influenza pandemic is the CDCs Global
Disease Detection (GDD) Program. This program improves our ability to recognize infectious disease

outbreaks faster and then better control and perhaps contain them. In collaboration with host
countries and the World Health Organization, CDC is establishing GDD Centers across the globe
that are already strengthening global capacity to detect and respond to infectious disease
outbreaks. The GDD Centers build upon proven, effective interventions and approaches
including the International Emerging Infections Program and the Field Epidemiology and
Laboratory Training Program. Having CDC staff on the ground was invaluable in providing initial response support
for the December 2004 Tsunami, particularly in Thailand, and is a mainstay of global response to the current avian influenza
outbreaks. During the past year, CDCs GDD staff helped countries respondin less than 48 hoursto all 28 human cases of
H5N1 influenza reported to WHO. The GDD Centers have collectively responded to more than 144 outbreaks of avian influenza,
hemorrhagic fever, meningitis, cholera and unexplained sudden death. CDC also helped train more than 230 participants from 32
countries in influenza pandemic response, contributing to the development of more than 1,000 local Rapid Response Teams that
are prepared act in the case of a pandemic.

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CDC Key: Good Staff/Tech


CDC key to skilled work force and effective disease technology (I3)
Committee on Emerging Microbial Threats to Health in the 21st Century, Board on Global Health, Institute of Medicine, 3/18/03,
America Should Foster Systematic Effort to Combat Infectious Diseases Here, Abroad, Microbial Threats to Health: Emergence,
Detection, and Response, The National Academies Press,
http://www8.nationalacademies.org/onpinews/newsitem.aspx?recordid=10636
Likewise, a skilled health care work force is essential. Knowledge of how to confront microbial threats

should be fully integrated into training programs for all health care professionals, the committee
said. Specifically, CDC, NIH, and the U.S. Department of Defense should expand existing programs
and develop new ones that educate health care workers about field-based and laboratory approaches
to preventing infectious disease in this country and abroad.
Also, health care professionals also should heed the importance of etiologic diagnosis, which identifies the microbial causes of
infectious diseases, the report says. Along with surveillance, such diagnoses are the cornerstone of control and prevention measures.
For various reasons, etiologic diagnoses have decreased significantly over the past decade. The result has been a dangerous overuse of
broad-spectrum antibiotics to treat illness, fueling microbial resistance to therapeutic drugs. Public health agencies and

professional societies should disseminate and publicize guidelines calling for widespread use of
etiologic diagnostic tools. Also, CDC and other federal agencies should work together with private
industry to develop and assess new diagnostic tests.
CDC committed staff is key to high quality global health results. (I3)
Stephen B. Blount,, Director of the Office on Global Health at CDC, 5/2/07, Global Health, US Department of Health and Human
Services, http://www.hhs.gov/asl/testify/2007/05/t20070502a.html
In FY 2007, CDC has devoted approximately $334 million to global health efforts, in addition to the approximately $815 million it
has received thus far in transfers from the Department of State, Office of the Global AIDS Coordinator, as part of the Presidents
Emergency Plan for AIDS Relief (PEPFAR). We strongly believe that program and scientific staff should be embedded in the
countries they serve. As of May 2007, the CDC has 166 staff working on assignments in 46 countries around

the world. Besides these assigned staff, the agency employs approximately 1,200 local staff in host
countries to support these programs and has approximately 40 staff detailed to work with our
international partners. It is this commitment of funding, staff, and resources that has produced
effective, efficient, and high quality global health results at CDC. Today, I will share with you some of our
greatest accomplishments.

US Key-Cooperation
US must play significant role in disease surveillance initiatives to protect global public health (H2)
Committee on Emerging Microbial Threats to Health in the 21st Century, Board on Global Health, Institute of Medicine, 3/18/03,
America Should Foster Systematic Effort to Combat Infectious Diseases Here, Abroad, Microbial Threats to Health: Emergence,
Detection, and Response, The National Academies Press,
http://www8.nationalacademies.org/onpinews/newsitem.aspx?recordid=10636
The nation should take decisive steps to fortify its public health system to tackle microbes that trigger infectious diseases such as
West Nile encephalitis, AIDS, and tuberculosis, says a new report from the Institute of Medicine of the National Academies. In
addition, the U.S. government should play a significant role in building the capacity of poor
countries to monitor, prevent, and respond to disease outbreaks. In the developing world, infectious diseases
kill one in every two people.

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Microbial threats endanger public health across the globe. Moreover, the potential use of biological agents in
terrorist attacks or warfare underscores the urgent need for better strategies and tools to grapple with infectious diseases, the
report notes.

"Infectious diseases cross national borders and require a global response, but the United States
should help lead efforts to reverse the complacency in industrialized countries regarding this
problem," said Margaret Hamburg, vice president for biological programs, Nuclear Threat Initiative, Washington, D.C., and
co-chair of the committee that wrote the report. "On the whole, aggressively responding to microbial threats is in
America's economic, humanitarian, and security interests, and should be a national priority."

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AT: DOMESTIC SURVEILLANCE IS ENOUGH


G7
Disease surveillance abroad is key to domestic disease prevention

US Government Accountability O ffice, 9-04 , EMERGING INFECTIOUS DISEASES: Review of State and Federal Disease
Surveillance Efforts <http://purl.access.gpo.gov/GPO/LPS55456>

[Sigrist]

The efforts to build disease surveillance capacities abroad, which were


discussed above, may also help domestic disease surveillance efforts.
According to a recent IOM report, surveillance of and response to
emerging infectious diseases in other parts of the world can directly
benefit the United States as well as the country in which the disease is
detected.47 According to the IOM, some disease outbreaks that have been
detected internationally allowed the United States to develop diagnostic
tests, prepare for influenza outbreaks, or recognize zoonotic threats like
avian influenza. Similarly, the IOM points out that coordination between
U.S. and European sentinel surveillance systems have allowed several
countries, including the United States, to remove products from the
market that were contaminated with pathogens.

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EMPIRICALLY SURVEILLANCE IS SUCCESSFUL AT CONTAINING DISEASES- INFLUENZA PROVES.
Fortune, Volume 151, Issue 5, 3/7/2005
In order to buy time with such defenses, we'd need to spot a virulent new flu strain before it spreads much. The World
Health Organization's flu-surveillance network , which includes 112 labs in 83 countries, serves as the planet's
influenza radar. Set up in 1952, it's a well-tuned machine. In 1997 the system played a key role in
identifying and stopping the spread of the H5N1 strain in Hong Kong . In 2003 it helped arrest another
novel bird flu, H7N7, in Europe. (Like H5N1, the H7N7 strain can sicken humans who are in close contact with infected
poultry--it is thought to have killed one of 83 infected people.)
Disease Surveillance is empirically effective at preventing the spread of diseases
Jonathan R. Davis and Joshua Lederberg (Editors), Forum on Emerging Infections, Board on Global Health, Institute of Medicine
(Authoring organization), 2001, Emerging Infectious Diseases from the Global to the Local Perspective, p. 55,
http://books.nap.edu/openbook.php?record_id=10084

The smallpox response model has been used, for example, to respond to meningitis in the sub-Saharan
meningitis belt, where periodic, irregular, and large meningitis epidemics occur. A vaccine against

meningitis is available, but it is ineffective in young children, so emergency


mass campaigns are used to control the disease. Over the last decade, WHO,
USAID, and other organizations have developed surveillance-based
thresholds for the initiation of mass vaccinations, accompanied by
appropriate laboratory confirmation. On the basis of some model data
obtained over the last 10 years, it is known that a rapid response is
essential for the effectiveness of this strategy.
Data from Ghana gathered in 1996 and 1997 suggest that about 5,000 cases
of meningitis and 304 deaths were prevented by the reaction of the Ghana
Ministry of Health. If 85 percent vaccine coverage could have been achieved
within 1 week after the epidemic was identified, substantially more cases
and deaths could have been avoided. These data provide an example of the
effective use of surveillance data to detect a problem and also to assess the
effectiveness of a public health response to that problem.

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SOLVENCY- KEY TO RAPID RESPONSE


G7
Disease Surveillance is key to early response disease prevention
Dr. Harold M Koeing, Chairman and president of Center for Science-Based Public Policy, 5-23-03, The Washington Times, China
and SARS, A 26
<http://www.questia.com/PM.qst?a=o&d=5001933804>
[Sigrist]

Disease surveillance represents a fundamental building block against threats of infectious disease, whether
naturally occurring or deliberately caused. Timely surveillance enables rapid detection, investigation and
early response, which is essential to limit casualties, manage public concerns and contain disease spread.
Public health authorities worldwide must have the capacity to respond rapidly with a full range of tools. Such surveillance needs
to be linked to emerging knowledge and technology, especially in the current context of bioweapon threats.
Recent events demonstrate the need to coordinate surveillance activities, not only with public health officials, but with law
enforcement and the intelligence community, which heretofore have remained separate.

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Early detection key for containing epidemics (G-7)


Mark Jerome Walters, Professor of Journalism, University of South Florida, 2003, Six Modern Plagues: and how we are
causing them, p. 155
But even in age of mounting epidemics there is hope. With early detection, many epidemics
will be contained. For those that are not, medical technology may offer some respite. Changes in personal behavior
alone can greatly reduce the risks of many diseases, such as HIV/AIDS. Mad cow disease was quelled simply by
banning the feeding of meat and bone meal to cattle, allowing them to be herbivores again. As
the overuse of antibiotics has caused many bacteria to become resistant, using antibiotics more sparingly may help roll back
the tide of some untreatable bacterial infections.

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SOLVENCY- DRUG RESISTANCE


G 13
Disease surveillance can counter drug-resistant diseases
David Mabey et al., Research Unit at London School of Hygiene and Tropical Medicine, 3-04, Diagnostics for the Developing
World, <http://www.who.int/std_diagnostics/publications/Diagnostics%20for%20the%20developing%20world.pdf>
Improving disease surveillance. Surveillance

is the cornerstone of successful disease control and elimination


programmes, as it enables programme managers to monitor the effectiveness of intervention
strategies and identify which populations require continuing interventions. In the case of smallpox, the
clinical features
were sufficiently distinctive that surveillance could be based on clinical findings alone. The same is true of measles and guinea worm.
In the case of polio, the clinical diagnosis of acute flaccid paralysis is strongly suggestive, but there are other causes of this syndrome
and, as the incidence of polio decreases, the proportion of cases of flaccid paralysis due to polio also decreases. There is, therefore, a
need to confirm suspected cases in the laboratory for example, by electron microscopy of a faecal sample. The clinical

features of many other important infectious diseases are insufficiently distinctive for surveillance
purposes, especially in the early stages, and it is for these diseases that diagnostic tests are needed.
The rise of drug resistance threatens many diseasecontrol programmes, including those for malaria
and TB, and dramatically increases the cost and complexity of cure. Surveillance for drug resistance
is fundamental to the refinement of treatment strategies and to the allocation of scarce resources.
Periodic monitoring of susceptibility in clinically significant bacterial isolates would provide the necessary information. For example,
the WHO and the International Union Against Tuberculosis and Lung Disease (IUATLD) have sponsored the Global Project on AntiTuberculosis Drug Resistance Surveillance since 1994. Through a supranational laboratory network, which helps national laboratories
to conduct quality-assured drug-susceptibility testing on TB isolates, the project has now completed three rounds of global
surveillance5. Unfortunately, funding is not available for conducting such surveys systematically for other diseases in most developing
countries.
Surveillance quickly detects antimicrobial resistance in diseases
Jonathan R. Davis and Joshua Lederberg (Editors), Forum on Emerging Infections, Board on Global Health, Institute of Medicine
(Authoring organization), 2001, Emerging Infectious Diseases from the Global to the Local Perspective, p.14,
http://books.nap.edu/openbook.php?record_id=10084

Equally troubling is the increase in the spread of drug-resistant microbes in humans (Table 3).
Through the inappropriate use of antibiotics and normal microbial evolution, a growing
number of infectious microorganisms are becoming drug resistant. For example, a resistant strain of
the TB bacterium, Mycobacterium tuberculosis, recently appeared in the United States. Penicillin resistance has also
been seen in strains of the microorganisms that cause pneumonia, meningitis, and middle-ear
infections. In Argentina the rate of penicillin resistance among respiratory system pathogens, such as Streptococcus
pneumoniae (24 percent) or Haemophilus influenzae (15 percent), is, on average, similar to that observed in Europe and the
rest of the Americas; however, an alarming proportion of enteropathogenic isolates, like Salmonella and Shigella are resistant
to first-line drugs. This phenomenon has not been observed in other regions. Hospitals worldwide are facing

unprecedented crises from the rapid emergence of antibiotic-resistant microorganisms.


Infectious diseases such as cholera, malaria, and tuberculosisonce thought to be nearly
eradicated, particularly in developed countries are making a comeback (Figure 7). In addition,
the agents responsible for endemic and new diseases, including pneumonia and HIV/AIDS, are
starting to develop drug resistance as well.
Drug-resistant forms of these diseases can become untreatable in any country. The impact of this trend could be reduced through
better prescription practices, better training for health workers, better public education, and greater control over the availability of
nonprescription drugs. National surveillance systems are needed to detect and respond to antimicrobial

resistance in its early stages.

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G 16
Advanced detection from surveillance leads to effective disease control and outbreak response programs

US Government Accountability O ffice, 9-04 , EMERGING INFECTIOUS DISEASES: Review of State and Federal Disease
Surveillance Efforts <http://purl.access.gpo.gov/GPO/LPS55456>

[Sigrist]

Disease surveillance provides information for action against infectious


disease threats. Basic infectious disease surveillance activities include
detecting and reporting cases of disease, analyzing and confirming this
information to identify possible outbreaks or longer-term trends, and
applying the information to inform public health decision-making. When
effective, surveillance can facilitate (1) timely action to control outbreaks,
(2) informed allocation of resources to meet changing disease conditions
and other public health threats, and (3) adjustment of disease control
programs to make them more effective.
Disease surveillance is crucial for monitoring new diseases and early response
Patricio V. Marquez AND, Lead Health Specialist, ECA, The World Bank, Alberto Gonima, World Bank Consultant, 11-26-05,
BRIEF FOR THE RUSSIAN AUTHORITIES ON HARMONIZED INFECTIOUS DISEASES SURVEILLANCE INFORMATION
SYSTEMS IN THE WORLD: ANOTHER CHALLENGE FOR THE G-8 GROUP,
< http://siteresources.worldbank.org/INTRUSSIANFEDERATION/Resources/Surveillance_Systems_eng.pdf>
In recent years, the outbreak of mad cow disease in Europe and the multicountry spread
of SARS are sobering reminders that globalization increases the risks of importation

and
exportation of infectious diseases across borders and among continents. Infectious
disease surveillanceincluding surveillance of know communicable diseases (especially
those with high epidemic potential), early recognition of new infections, and monitoring
of the growing resistance to antimicrobial medications is critical for the early detection
and prevention of epidemics. Information from infectious disease surveillance is also
important to determine national burdens of disease, health planning, health resource
allocation, and advocacy.

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SOLVENCY- COOPERATION
G 16
WHO can cooperate with researchers and industry to prevent anticipated epidemics
David L Heymann and Gunal R Rodierthe, WHO's Executive Director for Communicable Diseases, Dec. 01, The Lancet, Hot
spots in a wired world: WHO surveillance of emerging and re-emerging infectious diseases <http://www.3eme-cycle.ch/biologie/JCVillars06/S1%20Heymann/104_Lancet_Hot%20SpotsInAWiredWorld_2001.pdf>

When outbreaks occur, disease-specific networks of


partners help WHO mount a rapid response, while
standardised protocols for containment, based on widespread
experience, facilitate prompt, coordinated action. For some
of these infections, such as epidemic meningitis, influenza,
and yellow fever, WHO also collaborates with researchers and
industry to anticipate future outbreaks and ensure that
adequate emergency vaccine supplies are available when
needed. Such procedures proved instrumental in the quick
detection and containment, through mass vaccination, of the
potentially explosive outbreak of urban yellow fever in Cte
dIvoire in September 2001.

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SOLVENCY- LABS
G6
Laboratories strengthen surveillance in developing countries through the CDC
J. P. Chretien et al., at US Department of Defense Global Emerging Infections Surveillance and Response System, senior reporter at
Nature, 3-2-06, Nature 440 pp. 6-7, Global network could avert pandemics
<http://www.nature.com/nature/journal/v440/n7080/full/440006a.html>

Building on the existing military laboratories, DoD-GEIS developed surveillance networks


that monitor host-country populations in clinics, hospitals and communities in areas where
disease epidemiology was largely unknown. From the beginning, influenza, with its ever-present pandemic
threat, was the top priority. Current DoD-GEIS influenza surveillance networks include patient enrolment sites in more than
3
20 countries in South America, the Middle East, sub-Saharan Africa and central and southeast Asia . In several countries,
including Indonesia, the networks are the WHO's only information source on circulating strains, essential for vaccine
development and pandemic preparedness. Collaboration with the US Centers for Disease Control and

Prevention has strengthened these networks in Indonesia and elsewhere. The laboratories also
respond to outbreaks of other diseases at the request of host countries or the WHO by sending
their own field epidemiologists to the scene, or by providing definitive testing. They often
identify diseases where they were not previously known to occur.
Training personnel from the host country in surveillance and outbreak response is important. Graduates of outbreak courses,
often Ministry of Health staff, have gone on to apply the lessons to real epidemics. And in Peru and Egypt, the military

laboratories assisted host countries in developing nationwide surveillance systems, which are
now under host-country control.
CDC and GDD needs 13 more regional response centers to be effective
Campaign for Public Health, nonprofit organization, 4-20-07CENTERS FOR DISEASE CONTROL AND PREVENTION
PROFESSIONAL JUDGMENT FOR FISCAL YEAR 2008 <http://www.fundcdc.org/documents/CDCFY2008PJ_000.pdf>

CDC is a major partner in our nations frontline against emerging international health
threats. CDCs Global Disease Detection program, in partnership with host country
governments and the WHO, is a key component of this effort and forms the foundation of
a transnational detection, prevention and response network to address emerging health
threats including pandemic influenza. With current funding levels, CDC has established 5
regional response Centers, but needs 18 three in each WHO region - to complete the
network and properly protect the nation. The existing Centers have already proven their
effectiveness and impact on detecting and responding to outbreaks including avian
influenza, aflatoxin poisoning, Rift Valley fever, Ebola and Marburg virus outbreaks, and
many other serious infectious diseases and environmental health threats. The Centers

also provide a platform for regional training, surveillance, research, and health diplomacy
activities that help promote sustainable health development in the targeted regions.

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SOLVENCY- EFFICIENT

An accurate and efficient method of reporting disease surveillance from other countries is needed
Gary Cecchine AND, Ph.D. Biology, Melinda Moore, M.D., Harvard Medical School; M.P.H., Harvard School of Public
Health, 2006, Infectious Disease and National Security: Strategic Information Needs, RAND National Research Defense
Institute, < http://www.rand.org/pubs/technical_reports/2006/RAND_TR405.pdf>

Stakeholders from across a wide range of disciplines and sectors, including health, agriculture, foreign affairs,
homeland security, and intelligence, have expressed the need for timely, accurate, complete, and
understandable information that is delivered in a way that meets a wide range of requirements and
does not overwhelm. These requirements range from technical disease and surveillance data to
information about the social and political contexts related to outbreaks and subsequent responses.
They range from raw data to synthesized analysis products, and from push to pull mechanisms of delivery. While each sector has
its own focus and responsibilities, the information needs of policymakers across sectors were characterized more by their similarities
than by their differences. The stakeholders we interviewed expressed a strong desire for a centralized

system that provides needed information to all stakeholders. An ideal system to collect, analyze, and
disseminate infectious disease information would be (1) robust, drawing information from a wide
range of sources and collecting information that is accurate and complete; (2) efficient, constituting a
single, integrated source of timely information available to all stakeholders; (3) tailored to meet
individual stakeholder needs and preferences; and (4) accessible, notwithstanding the need for
protection of sensitive data.

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Observations and communications integration needed to protect public health {A4}
Committee on government reform, April 25, 2006, Strengthening disease surveillance: eighth report <
http://www.gpoaccess.gov/congress/index.html> <pg 8>
Pieces of this planned health monitoring system can be assembled at different times and places, but no fully

national system
yet integrates the observations and communications needed to protect public health from rapidly
emerging biological hazards. Successfully operating the elaborate, elegantly sensitive surveillance network of the future will
require unprecedented levels of human skill, fiscal resources, medical information and intergovernmental cooperation
African disease surveillance requires integration to be more effective
Jonathan R. Davis and Joshua Lederberg (Editors), Forum on Emerging Infections, Board on Global Health, Institute of Medicine
(Authoring organization), 2001, Emerging Infectious Diseases from the Global to the Local Perspective, p. 54,
http://books.nap.edu/openbook.php?record_id=10084

The difficulties with surveillance in Africa are well known. In the context of the multiple epidemics that
have been recognized over the past decade, numerous assessments of surveillance systems have revealed problems essentially
across the board.

Individuals who are part of vertically oriented programs at the national level and above try to
communicate with district officials and health facilities at the local level, resulting in too much
paperwork, too many different instructions, different terminologies, too many administrators,
and conflicting priorities.
The time is right to move toward integrated disease surveillance and epidemic preparedness
and response in Africa. A number of important things that leverage the opportunities for
success in this area are happening. One of the first efforts was streamlining of the
communication and conduct of public health surveillance, with the use of standard case
definitions, minimum data requirements, and an emphasis on integrated forms, feedback, and
training. No single approach is likely to fit all countries, yet WHO is committed to providing support to all of its member
states.

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The adoption of the most recent and advanced procedures are crucial to strengthen disease surveillance
Patricio V. Marquez AND, Lead Health Specialist, ECA, The World Bank, Alberto Gonima, World Bank Consultant, 11-26-05,
BRIEF FOR THE RUSSIAN AUTHORITIES ON HARMONIZED INFECTIOUS DISEASES SURVEILLANCE INFORMATION
SYSTEMS IN THE WORLD: ANOTHER CHALLENGE FOR THE G-8 GROUP,
< http://siteresources.worldbank.org/INTRUSSIANFEDERATION/Resources/Surveillance_Systems_eng.pdf>
Given the above situation, there

is an urgent need to develop strategies and initiatives to support the


harmonization and development of standardized infectious disease surveillance information
systems as part of global disease information sharing network to monitor and control the
diseases, in line with the G8 members and international surveillance standards like the EU communicable disease
surveillance system Acquis, thereby contributing towards improved global and regional prevention and control of infectious
diseases and NCDs. The surveillance information harmonization efforts should be geared to

strengthen the institutional structure, capacity and the legal framework of the current
infectious disease surveillance systems in conformity with G-8 directives in terms of structure, function, capacity,
effectiveness and resources. The infectious disease surveillance information systems should be an
integral part of national health information systems development initiatives and would be
linked with rapid and standardized methods of routine analysis of surveillance data. Among the
strategies to be agreed and implemented are: Reengineering and automation of countries infectious
disease and NCDs surveillance information systems and protocols to increase the speed and
efficiency of collection and analyses of epidemiological and statistical data. This should be done by
addressing critical capacity weaknesses and key constraints at national and regional levels of the Health Information and
Statistics Systems, to support investigation and diagnosis of the incidence, focalization of the response and systematic and
continuous public health interventions. Selection and adoption of best of breed health information

systems available in G-8 countries at the point of service in outpatient, emergency and
hospitalbased surveillance and sentinel physician networks to support epidemiologists and
clinicians in the screening, diagnosis, detection and control of outbreaks, and respective
automation of mandatory disease notification and statistical reporting processes, in linkage
with the state service statistics and civil registries for cross reference on citizens ID, birth and
death registries databases.

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SOLVENCY- SATELLITES

Satellites greatly enhance the accuracy and timeliness of disease surveillance


Lt Col Debra Niemeyer, USAF, BSC Program Executive Office for Chemical & Biological Defense, 4-2-02, Society Scope, Volume 6
Number 1 Rediscovering Remote Sensing: Infectious Disease Surveillance
< http://www.safmls.org/Scopes/Scope%20-%202003%20Winter.pdf>
Satellites have been used over the last 30 years to examine and map terrestrial features, and to study properties of the earths
surface. Recently, researchers have explored using remotely sensed data to evaluate associations

between vector- and waterborne diseases, habitat changes, human health and transmission
risks. With the wealth of archival sensor data, and on-going efforts to launch improved sensor
systems, we need to devote our efforts and resources to exploring remote sensing applications to better assess
environmental hazards and prevent disease. A new application of an existing technology, remote sensing will improve force
protection by enhancing our ability to prevent, monitor and record untoward exposure of our Armed Forces to chemical,
biological and similar hazards (Public Law 105-85 (10 USC 1074f), Section 765, available at: http://
www4.law.cornell.edu/uscode/10/1074f.html). Through assessment of archival, baseline and documented

changes of environmental factors, we can improve epidemiological surveillance for a variety of


hazards, man-made and naturally occurring, prior to and during deployments. Through
linkage of satellite imaging and other disparate data with electronic medical surveillance
systems, we will be able to use smaller, expeditionary personnel packages and equipment
footprints to provide near- to realtime assessment in garrison and in theater. Discussion will focus
on the application of remotely sensed data for monitoring distribution of communicable diseases.

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SOLVENCY- ANIMALS
Surveillance is critical to early detection of diseases among animals
T. Morner et al., Department of Wildlife at National Vetrinary Institute in Upsala, Sweden, 4-21-02,(Scientific and Technical
Review). 2002 Apr;21(1):67-76
< http://www.oie.int/eng/publicat/rt/2101/T.%20M%D6RNER.pdf>

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SOLVENCY- ANIMALS

Satellites are effective in the surveillance of animal diseases


T. Morner et al., Department of Wildlife at National Vetrinary Institute in Upsala, Sweden, 4-21-02,(Scientific and Technical
Review). 2002 Apr;21(1):67-76
<
http://www.oie.int/eng/publicat/rt/2101/T.%20M%D6RNER.pdf>

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SOLVENCY- ANIMALS
Laboratories will be able to monitor and research animal diseases
T. Morner et al., Department of Wildlife at National Vetrinary Institute in Upsala, Sweden, 4-21-02,(Scientific and Technical
Review). 2002 Apr;21(1):67-76
< http://www.oie.int/eng/publicat/rt/2101/T.%20M%D6RNER.pdf>

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Surveillance is key in solving for animal transferred pathogens
Paul Rincon, BBC News science reporter, 2/20/06, ("'Faster emergence' for diseases",
http://news.bbc.co.uk/2/hi/science/nature/4732924.stm)
New infectious diseases are now emerging at an exceptional rate, scientists have told a leading conference in St Louis, US.
Humans are accumulating new pathogens at a rate of one per year, they said.
This meant that agencies and governments would have to work harder than ever before to keep on top of the threat, one
expert told the BBC. Most of these new infectious diseases, such as avian influenza and HIV/Aids, are coming
from other animals. "This accumulation of new pathogens has been going on for millennia - this is
how we acquired TB, malaria, smallpox," said Professor Mark Woolhouse, an epidemiologist at the University Of
Edinburgh, UK. "But at the moment, this accumulation does seem to be happening very fast. "So it seems there is something
special about modern times - these are good times for pathogens to be invading the human population." Professor Woolhouse
has catalogued more than 1,400 different agents of disease in humans; and every year, scientists are discovering one or two
new ones.
Some may have been around for a long time and have only just come to light. Others that have emerged recently are entirely
new, such as HIV; the virus that causes Sars, and the agent of vCJD. The difference today, say researchers, is the
way humans are interacting with other animals in their environment. Changes in land use through, for
example, deforestation can bring humans into contact with new pathogens; and, likewise, agricultural changes, such as the
use of exotic livestock. Other important drivers include global travel, global trade and hospitalisation. The fast rate at

which pathogens are appearing means public health experts will need to work harder than ever to
control the spread of emerging disease threats. "The sort of image I want to get away from is the famous
statement from the 1960s when the US Surgeon General said, 'diseases were beat'," Professor Woolhouse told the BBC News
website. "Pathogens are evolving ways to combat our control methods. The picture is changing and looks as
if it will continue to. We're going to have to run as fast as we can to stay in the same place." He added:
"We need surveillance. Surveillance in most parts of the world for infectious disease is really quite
poor - particularly surveillance for infectious diseases in animals such as vermin like rats." Experts
were speaking on the subject at the American Association for the Advancement of Science (AAAS) annual meeting in the
Missouri city of St Louis.

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Locally-based programs are critical to the success of disease surveillance


Jonathan R. Davis and Joshua Lederberg (Editors), Forum on Emerging Infections, Board on Global Health, Institute of Medicine
(Authoring organization), 2001, Emerging Infectious Diseases from the Global to the Local Perspective, p.14,
http://books.nap.edu/openbook.php?record_id=10084

Even with extensive intranational and cross-national cooperation, local surveillance remains
the most important function in the early warning of and response to infectious diseases. At the
local level, disease intelligence functions enhance the ability to assess indicator events. Individuals
in charge of surveillance systems at the local level must work closely with their colleagues in the agricultural and veterinary
sciences and those who are conducting disease surveillance in related fields. These systems must also adapt to changing
patterns of health care, for example, the trend toward patients calling nurses for assistance rather than visiting a general
practitioner's office, where surveillance data might be collected. Local efforts need to be integrated so that local, national, and
international efforts are not competing or being duplicated. Databases must be interrelated and designed so that they can be
linked while protecting confidentiality and privacy.

Local efforts also reveal much about behavioral change measures that might be required. For
example, revised guidelines for dengue control elevate behavioral change indicators to the
same level as entomological or epidemiological indicators, using as a model behavioral surveillance for
HIV/AIDS. This requires more bottom-up surveillance programs , modeled after many nutrition and child
health programs, in which indicators can be used at the household level; for example, households can determine whether
removing domestic containers that may be sources of mosquito breeding is either improving the dengue situation or making
the dengue situation worse. This is an important approach, as it paves the way for consumer-based control measures for other
diseases, such as the use of insecticide-treated mosquito nets or the use of domestic aerosols for the control of malaria in
Africa.

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CDC KEYBEST
J17-CDC sets the benchmark for disease surveillance.
EVM, a specialized group within the
European Federation of Pharmaceutical Industries and Associations (EFPIA), 11-02 (Communicable disease surveillance in
Europe: Developing the basis for rational disease prevention strategies, 3) [http://www.evm-vaccines.org/pdfs/surveillance.pdf]

At the national level, the example of the U.S. Centres for Disease Control and Prevention (CDC) represents an
ambitious and comprehensive effort to monitor health, to investigate health
problems, and to issue recommendations for prevention and treatment. The CDC
combines technical excellence and independence from health care providers, payers, and commercial
interests, thereby providing irrefutable data and providing objective advice. Analyses are
readily made available through Internet sites. It is therefore fair to say that the CDC
represents todays benchmark for surveillance and for health information.
The CDC is providing support for integrated laboratories and surveillance now, but more is needed for an effective system
Jonathan R. Davis and Joshua Lederberg (Editors), Forum on Emerging Infections, Board on Global Health, Institute of Medicine
(Authoring organization), 2001, Emerging Infectious Diseases from the Global to the Local Perspective, p. 54,
http://books.nap.edu/openbook.php?record_id=10084

The transition to integration is happening. Most countries have existing systems for some
disease surveillance. Recently, polio eradication has become a major focus of new efforts, which
should establish an infrastructure for future responses. Surveillance for cholera, meningitis,
neonatal tetanus, typhoid fever, yellow fever, dysentery, malaria, and measles is needed at
various levels in many countries. Some countries, such as Tanzania, are requesting help with integrated disease
surveillance. As development of public health infrastructures progresses over a period of years to
decades, additional diseases can be added to the system. Currently, 15 polio laboratories are functioning,
and 7 bacterial meningitis laboratories have been established, as have 5 diarrheal disease laboratories and 2 laboratories that
are monitoring antimicrobial resistance.

Support from CDC for these efforts provides technical, epidemiological, and laboratory
expertise in polio eradication and measles elimination programs, as well as in programs that
address other vaccine-preventable childhood diseases; expansion of laboratory and technical
capacity; development of training materials and other material support; and laboratory
training and support. USAID and the United Nations Foundation have provided additional resources. National
governments have exhibited a willingness to contribute actively to this effort.
The partners are in the process of defining indicators that would suggest progress and success. The

level of integration
of the current polio efforts are actively being measured. In addition, the number of outbreak
investigations and the effectiveness of those responses are actively being monitored in a
number of countries, and laboratory confirmation of suspected outbreaks is being obtained at
the national level. The quality and frequency of feedback instruments are also being assessed. Clearly, improvements in
communications technologies will aid these efforts. The key elements needed to design the ideal system and
to develop the strategies for making the transition from existing systems to strengthened
laboratory resources have been identified. Finally, the resources to begin this effort are
available, but they are certainly not sufficient to sustain an effective system.

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CDC international communication key to effectiveness of disease surveillance systems (I2)
Committee on Emerging Microbial Threats to Health in the 21st Century, Board on Global Health, Institute of Medicine, 3/18/03,
America Should Foster Systematic Effort to Combat Infectious Diseases Here, Abroad, Microbial Threats to Health: Emergence,
Detection, and Response, The National Academies Press,
http://www8.nationalacademies.org/onpinews/newsitem.aspx?recordid=10636
At the outset, America has a lot of work to do domestically. Its ability to track and respond quickly to infectious diseases rests on a
public health infrastructure that has suffered from years of neglect, the report says. Efforts to prevent and control microbial threats
must be enhanced and expanded at all levels of government. Upgrades in everything from laboratory facilities to training programs
will require much larger, and sustained, investments. The National Institutes of Health, working with other federal research
institutions, also should develop a comprehensive research agenda for infectious-disease prevention and control.
The committee pointed out several major areas of concern. Reporting of infectious diseases by health care providers and clinical
laboratories to both state and local health officials remains inadequate, for instance. Open lines of communication and

solid working relationships among providers, laboratories, and public health authorities are critical
to maintaining effective infectious-disease surveillance systems and successfully carrying out
response activities. The Centers for Disease Control and Prevention should craft innovative strategies
to improve communication among these
groups.

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DOD KEY
DOD laboratories serve as training sites for their regions and provide standard procedures to streamline outbreak
investigation
Patrick W. Kelley, M.D., Dr. P.H., Colonel and Director, Division of Preventive Medicine Walter Reed Army Institute of Research,
Institute of Medicine (Authoring organization), 2001, Emerging Infectious Diseases from the Global to the Local Perspective, p. 58,
http://books.nap.edu/openbook.php?record_id=10084
A different approach to infectious disease surveillance is under way in the Caribbean, in collaboration with PAHO's
Caribbean Epidemiology Center (CAREC). In 1997, CAREC brought together the national epidemiologists

and laboratory directors from its 21 member countries and said that by the year 2000 they
wanted to have in place a surveillance system capable of monitoring trends and impacts of
emerging infectious diseases and providing timely, relevant, and accurate feedback. The
concept was one of hierarchical, laboratory-based surveillance, with CAREC the regional pinnacle of the
hierarchy.

DOD donated equipment for a website to CAREC so that it can receive data from its member
countries and report back to them. DOD then sponsored a meeting of the 21 countries for a
week of training in the use of automated equipment and other aspects of informatics for public
health reporting. Each independent country took home two computers. Subsequently, DOD is providing
additional equipment to each independent country and an additional week of training to
further support the surveillance system. The reporting system is based on CDC's Public
Health Laboratory Information System (PHLIS). The PHLIS program is capable of integrating into one system
reports from multiple types of reporting.

DOD laboratories also serve as training sites, offering a number of courses in outbreak
investigation, for example, throughout Southeast Asia. The aim is to transfer epidemiological
and microbiological skills and to facilitate timely recognition of outbreaks and control. These
courses should also bring some uniformity to the outbreak investigation process.
DOD has effectively established real-time disease surveillance integrated into the public health system of other countries
Patrick W. Kelley, M.D., Dr. P.H., Colonel and Director, Division of Preventive Medicine Walter Reed Army Institute of Research,
Institute of Medicine (Authoring organization), 2001, Emerging Infectious Diseases from the Global to the Local Perspective, p. 5758, http://books.nap.edu/openbook.php?record_id=10084

DOD is also establishing a syndromic surveillance system, called the Early Warning Outbreak
Recognition System (EWORS), in Indonesia. Several sites around the Indonesian archipelago once
every 24 hours report syndromic data to a central point in Jakarta, where a DOD laboratory is
collocated with the Indonesian Ministry of Health. The system is focused on hospitals located around
Indonesia, where nurses collect syndromic data from patients. These data are entered into a database
where one can enter not only the signs and symptoms but also the specific working diagnosis. In
almost real time the frequencies of various syndromes can be tracked across the archipelago.

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DOD EMPIRICALLY SOLVE


The DOD has empirically used its network of laboratories to treat and prevent disease in Africa
Patrick W. Kelley, M.D., Dr. P.H., Colonel and Director, Division of Preventive Medicine Walter Reed Army Institute of Research,
Institute of Medicine (Authoring organization), 2001, Emerging Infectious Diseases from the Global to the Local Perspective, p. 57,
http://books.nap.edu/openbook.php?record_id=10084

An example of recent DOD involvement in Africa was the outbreak of Rift Valley fever in
19971998 in East Africa. Approximately 80,000 people ultimately contracted Rift Valley fever, resulting in
hundreds of deaths. In addition to the direct toll on the human population, there was a tremendous toll on the animal
population in this pastoral economy. Using its laboratory in Kenya, DOD was able to quickly assist

with
the initial epidemiological and entomological investigations. At the time that the outbreak
surfaced Kenya had no laboratory capacity for the diagnosis of Rift Valley fever. Specimens
had to be sent to either South Africa or CDC to make the diagnosis. Using resources at its
laboratory in Cairo, DOD was able to quickly transfer technology for rapid diagnosis to
Kenya so that the outbreak could be defined rapidly and locally. Experts in remote sensing
also collected data to establish indicators that are evident at least 3 or 4 months before
outbreaks. In the future this will enable the government to initiate immunizations for animals
and thus prevent the amplification of the virus and its transmission to humans. DOD also
provided access to the Rift Valley fever vaccine for at-risk laboratory workers in Kenya.

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DOD KEY
DOD-run laboratories provide essential professionals, communication, and surveillance resources in the regions they are
located
Patrick W. Kelley, M.D., Dr. P.H., Colonel and Director, Division of Preventive Medicine Walter Reed Army Institute of Research,
Institute of Medicine (Authoring organization), 2001, Emerging Infectious Diseases from the Global to the Local Perspective, p. 56,
http://books.nap.edu/openbook.php?record_id=10084

A major asset is the DOD network of overseas laboratories in Egypt, Kenya, Thailand,
Indonesia, and Peru. These are medical research and development laboratories that in some cases were established
more than 50 years ago and that exist primarily for the purpose of product development. For example, the key studies
conducted for the licensure of the hepatitis A and the Japanese encephalitis vaccines were done at these laboratories.
These laboratories have, in some instances, a biosafety level 3 capability. The laboratory in Cairo, Egypt, can if necessary,
adapt to a biosafety level 4 capability. Although located in 5 countries, these laboratories have active research programs in
about 31 countries; they have established extensive networks in their regions and have formal

relationships with many ministries of health and the WHO.


The laboratories have tremendous depth. In almost every case they have expertise in virology,
bacteriology, parasitology, other aspects of microbiology, veterinary medicine, and
epidemiology. Although their primary purpose was to support product development,
increasingly they are becoming involved with surveillance. In all, about 700 people work at
these laboratories and are backed up by more than 800 more DOD scientists working on issues
related to emerging infections.
The laboratories have additional assets: they are networked with state-of-the-art
communications technologies and possess cutting-edge field diagnostic reagents that are field
oriented, rapid, and invaluable in the response to emerging infectious diseases. In addition, the
laboratories have access to special drugs and vaccines that might be of critical importance in
regions with outbreaks of unusual pathogens.
DOD laboratories focus on treatment and surveillance of drug-resistant malaria
Patrick W. Kelley, M.D., Dr. P.H., Colonel and Director, Division of Preventive Medicine Walter Reed Army Institute of Research,
Institute of Medicine (Authoring organization), 2001, Emerging Infectious Diseases from the Global to the Local Perspective, p. 57,
http://books.nap.edu/openbook.php?record_id=10084

A major focus at DOD overseas laboratories is dra[u]g-resistant malaria.


This is because DOD operates the largest malaria drug development
program in the world and needs up-to-date information on resistance
patterns. DOD also has a surveillance program for antibiotic-resistant
enteric agents and for hemorrhagic fevers, including dengue, and influenza.
In addition, DOD supports regional syndromic sentinel surveillance
networks.

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DOD KEY
DoD has unique laboratory capabilities
Institute of Medicinte, 2001 (Perspectives on the Department of Defense Global Emerging Infections
Surveillance and Response System: A Program Review)
[http://books.nap.edu/openbook.php?record_id=10203&page=161]

[The DoD is one of several U.S. government agencies that have a significant interest in, and responsibility
for, addressing emerging infectious diseases. Each agency brings to the table important resources

and certain limitations, and each fills a particular niche. The DoD, for its part, possesses
unique laboratory capabilities, many situated in diverse forward locations, and has a vested
interest in addressing emerging infectious diseases as a matter of national security (NIC,
2000).]

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AT: DOD WONT COOPERATE WITH CDC


CDC and DOD increasing working together for global health
Institute of Medicinte, 2001 (Perspectives on the Department of Defense Global Emerging Infections Surveillance and Response
System: A Program Review) [http://books.nap.edu/openbook.php?record_id=10203&page=161]
[The relationship between the Centers for Disease Control and Prevention (CDC) and the DoD

is an important one and warrants particular attention. The DoD and the CDC have, in the past,
provided each other with backup support and entered into collaborative relationships on an asneeded basis. Recent changes in the missions of both the CDC and the DoD are bringing their
respective program interests and spheres of operation into increasingly close contact. Through
GEIS, the DoD has expanded its role overseas to include emerging infectious disease surveillance,
response, and training and capacity building (GEIS, 1998). Conversely, the CDC has recently developed a
global infectious disease strategy that formalizes CDC interests and operations in emerging infectious
diseases internationally and increases its research presence (Dowell, 2001). The committee is aware that
the CDC plans to locate its first international surveillance program in Thailand and is considering the
development of a site in Kenya as well. GEIS is active in both Thailand and Kenya.]

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AT DOD HURTS GLOBAL DISEASE EFFORTS

The DOD actively supports WHO efforts to integrate disease surveillance in developing countries
Patrick W. Kelley, M.D., Dr. P.H., Colonel and Director, Division of Preventive Medicine Walter Reed Army Institute of Research,
Institute of Medicine (Authoring organization), 2001, Emerging Infectious Diseases from the Global to the Local Perspective, p. 57,
http://books.nap.edu/openbook.php?record_id=10084

Currently, DOD is trying to support WHO's efforts to link military public health laboratories
together to conduct surveillance on antibiotic resistance or other types of medical surveillance.
Military hospitals often serve as a good source of surveillance data in less developed countries
because of the quality of their facilities.

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CDC & DOD COLLABORATION GOOD


The CDC has at best, weak collaboration with the DOD
National Academic Press, 02
The CDC should produce a comprehensive description of its research program, including statements of the goals of the
program and how the plans now undertaken will meet those goals. In addition, the CDC should continue and complete
development of the individual projects in the research program.
The CDC should consider engaging protocol design consultants representing broad scientific expertise who would provide
immediate and direct consultation on specific technical matters of study design and execution.

The CDC should continue and strengthen collaboration with DoD and NIH wherever possible,
including for example much more extensive use of DoD databases such as the Defense Medical
Surveillance System (DMSS).
The CDC and the DOD have collaborated in the past.
CDC 01

For the past 2 years, a team of investigators from the Centers for Disease Control and Prevention (CDC) has
collaborated with scientists from the National Institutes of Health (NIH), the Food and Drug Administration, the
Department of Defense (DOD), academic centers, and international partners to undertake a research agenda
on variola virus, the etiologic agent of smallpox. Objectives of the program derive from a 1999 Institute of
Medicine report that addressed the scientific needs for live variola virus (1). Progress in addressing these objectives has been
peer reviewed annually by both a select committee organized by CDC and the World Health Organization (WHO) Advisory
Committee on Variola Virus Research (2,3). A summary of accomplishments from the first years efforts was published in
2001 (4).

The CDC and the DOD have collaborative networks of centers.


US Medicine, 01

The Department of Defense and Centers for Disease Control and Prevention (CDC) last month
launched a collaborative network of centers of excellence for immunization, responding to particular
problems created, ironically, by the very efficacy of past vaccines.
The two agencies held opening ceremonies Sept. 6
WASHINGTON- at the Walter Reed Army Medical Center here for the lead agent and first of 50 planned DoD Vaccine
HealthCare Centers (VHC) that will be closely associated with CDC's Clinical Immunization Safety Assessment Centers
(CISAC).

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CDC AND DOD COOPERATION


The CDC and the DOD have collaborated before.
US Department of Defense, 04
WASHINGTON, Aug. 11, 2004 A

new program starting today to develop a new defense against anthrax


will depend on servicemembers' donated plasma to be most effective.
The greatest number of the 1.2 million people vaccinated against anthrax a deadly disease that can be used in biological
warfare is in the military. Their blood plasma the straw-colored fluid part of the blood can be used to make a new medication
called anthrax immune globulin, said Army Col. John D. Grabenstein, the deputy director of the Military Vaccine Agency, in
a telephone interview.
Unlike a vaccine that prevents disease, the anthrax immune globulin will be used to treat "people who develop a severe
anthrax infection," Grabenstein noted. They would receive the globulin along with antibiotics "to give anthrax- infected
patients their best chance for survival."
The Centers for Disease Control and Prevention is in charge of the program. The CDC, part of the U.S.

Health and Human Services Department, is the lead federal agency in protecting people's health and
safety. DoD responded to HHS' call for assistance by agreeing to distribute information to
servicemembers.
"The plasma part of the blood has a lot of antibodies in it," Grabenstein said. "Antibodies are proteins that people use to
defend themselves from infection." From that plasma, CDC can derive the medication to treat severe cases of anthrax.

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SOLVENCY- SATELLITES
G 20
Satellites have been critical to disease surveillance
Cheryl Pellerin, USINFO Staff Writer, 5-22-07, Federal Information and News Dispatch, Inc., International Laboratory Network
Watches for Disease Outbreaks; U.S. Defense Department labs are cornerstone of global surveillance, Lexis
For about 10 years, through the GEIS program, NASA scientists have been

using satellite climate observations -near-real-time vegetation measurements, sea-surface temperatures and more -- to monitor rainfall
conditions in East Africa that are associated with the outbreak of diseases, including Rift Valley fever.
"These are areas that undergo frequent droughts and flood events," said Assaf Anyamba, a research scientist with the Goddard Earth
Sciences and Technology Center, in a recent USINFO interview. "For example, two years ago there was a huge drought in eastern
Africa. This year there are huge floods. These changes in climate are resulting in the emergence of various types of diseases."
Every month, Anyamba and his colleagues submit disease risk maps based on satellite observations of rainfall and vegetation. Last

year, the U.S. National Oceanic and Atmospheric Administration issued an unscheduled advisory
about an El Nia +/- o weather pattern, indicating that warmer-than-normal sea surface temperatures
across the equator could affect global tropical rain patterns.
"When we first saw the El Nia +/- o emerging from the Pacific and the Indian Ocean beginning to warm," Anyamba said, "we issued
an early warning. As we began to see the rain, we issued another early warning, showing that the rainfall was on the scale of [a Rift
Valley fever outbreak there in] 1997-1998. As the land began to green up, because these areas were very dry, you had conditions that
were conducive to the emergence of mosquito vectors [virus carriers] and their propagation."

In that series of warnings, Anyamba and his colleagues provided the forecast that helped Kenya,
Somalia and Tanzania prepare for the Rift Valley fever outbreak that is occurring now, and allowed
international partners -- WHO, the U.N. Food and Agriculture Organization and others -- to help
mitigate the outbreak by arriving with personal protective equipment, such as gloves, masks and
mosquito nets, to protect against the spike in malaria cases that occurs during flooding rains.
December is a month of sacrifice for Muslim populations in the region, and because blood and tissues from sick animals can infect
people who handle them, the government temporarily banned the slaughter of camels, sheep, goats and cattle, saving potentially
thousands of lives.
Ten years earlier, during the 1997-1998 outbreak, WHO estimated that there were 89,000 human cases of Rift Valley fever and up to
250 resulting deaths in eastern Kenya and southern Somalia, one of the largest outbreaks of the fever in recorded history.

"The advantage we had this year," Anyamba said, "is the mechanism in place to do observations. It
has lessened the impact in terms of the loss of human lives because we have an early-warning system
in place."

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MULTILATERAL PERM SOLVES- SPENDING, TRADEOFF


J5
Perm avoids link to tradeoff/spending multilateral support buffers against funding fluctuations
J. P. Chretien et al., at US Department of Defense Global Emerging Infections Surveillance and Response System, senior reporter at
Nature, 3-2-06, Nature 440 pp. 6-7, Global network could avert pandemics
<http://www.nature.com/nature/journal/v440/n7080/full/440006a.html>

The United States may decide in the future to establish more broad-based overseas laboratories, but
we should not expect one country to build and sustain the network entirely on its own. Affiliation with a
single country can complicate work where relations between sponsor and host are strained. And as we have seen, even a wealthy
country with vested interest in global epidemic preparedness may withdraw support for productive overseas laboratories.

Multilateral support would buffer against funding fluctuations. An instructive example is the
International Centre for Diarrhoeal Disease Research in Dhaka, Bangladesh. Supported by dozens of
donor countries and organizations, and governed by a multinational board, this centre has conducted
important research on cholera and other diseases for 28 years.

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PERM SOLVESCOOPERATION KEY TO GLOBAL DISEASE SURVEILLANCE

I4- coperation k
David Satcher, US Surgeon General, Assistant Secretary of Health, 3-3-98, (Testimony on Global Health: the United States Reponse
[sic] to Infectious Diseases by David Satcher, M.D., Ph.D.) Senate [http://www.hhs.gov/asl/testify/t980303d.html]
[From the beginning, the basic principles of the EID Task Force and the working group on emerging diseases have been collaboration
and coordination. We know that the challenge ahead outstrips the means available to any one agency, organization, or country.
However, if we pool our talents and resources, a great deal may be accomplished. This is well illustrated by the great success of
smallpox eradication and the ongoing polio and guinea worm eradication programs. Globally, polio cases have decreased by more
than 90% since 1988; and, $230 million will be saved by the United States annually, when the goal of polio eradication is achieved.
An estimated $1.5 billion will be saved globally.
These principles of collaboration and coordination are being applied both at home -- where U.S. agencies have coordinated the effort
to address emerging infectious diseases among themselves as well as at the state and local level -- and overseas, where U.S. agencies
are working with the World Health Organization (WHO) and other international partners to improve global health communications,
set standards for global surveillance of antimicrobial resistance, and share experience and training on disease prevention and control
on a regional basis. ]
I 4-coperation k
David Satcher, US Surgeon General, Assistant Secretary of Health, 3-3-98, (Testimony on Global Health: the United States Reponse
[sic] to Infectious Diseases by David Satcher, M.D., Ph.D.) Senate [http://www.hhs.gov/asl/testify/t980303d.html]
[I'd like to leave you with a special illustration that demonstrates what can be accomplished when international partners pool their
resources and expertise.
In the Sub-Saharan countries of Burkina Faso, Cameroon, Chad, Mali, Niger, and Nigeria J 12- Japan reliant on US training
, seasonal outbreaks of meningitis occur every 2 to 4 years, causing high morbidity and mortality in older children and young adults.
In 1996, there were about 154,000 cases of meningitis and 20,000 deaths in the largest meningitis epidemic yet recorded. To prevent a
predicted recurrence in 1997, the EID Task Force encouraged WHO and other partners to help prepare local public health workers for
the next meningitis season. The CDC-based WHO Collaborating Center for Control of Epidemic Meningitis provided the technical
lead.
The project involved five U.S. government agencies (CDC, FDA, NIH, USAID, DOD); several non-governmental organizations
(Medecins Sans Frontieres, CARE, Epicentre, and the Fondation Merieux); three WHO offices; and three vaccine manufacturers. In
addition, two other WHO Collaborating Laboratories -- in Oslo and Marseilles ? supplied diagnostic reagents and provided training in
laboratory diagnostics in the affected countries. Major funds were provided to WHO by the British Overseas Development Agency
and the Government of Japan.
The meningitis project was initiated in summer 1996. The number of cases in the "meningitis belt" countries was reduced from
approximately 154,000 since the winter of 1995-96 to 60,000 in the winter of 1996-97. We must interpret this result with some
caution, as some of the dramatic decline may be attributable to natural variation in disease patterns, as well as to improved detection
and control. Nevertheless, the project strengthened human and technical resources in the affected countries, and forged on-going links
among many international partners. ]

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J4/J12/J14/J17-Necessary Collaboration advances global health research.


Board on International Health, 1997 (America's Vital Interest in Global Health: Protecting Our People, Enhancing Our
Economy, and Advancing Our International Interests) [http://www.nap.edu/readingroom/books/avi/4.html]
[Medical research

into the control of infectious diseases is often not possible without


collaboration between nations. Many potentially threatening diseases, such as malaria and cholera,
must be studied abroad among populations in which the diseases are common. In the United States,
trials of vaccines and drugs against such diseases would not be statistically feasible, even though U.S. citizens have much to
gain from the resulting products. Tests of new drugs and vaccines can also be undertaken more cost-

effectively in populations in which disease rates are high. For example, whooping cough
(pertussis) is much more common in Scandinavian countries than in the United States, allowing
the efficient evaluation of multiple new acellular pertussis vaccines there. Thus, although trials of the
vaccine have been conducted abroad, their findings will benefit U.S. vaccine policy and safety.
Research collaborations between countries have other health benefits too. Some genetic diseases and cancers can only be
studied internationally, either because the number of people affected in the United States is relatively small or because the
appropriate registries and databases are not always available. As one example, Finland has extraordinary registries of health
statistics on large populations that make detailed analyses of risks for conditions such as cancer, heart disease, and depressive
disorders readily accessible. Examples of other international collaborative research activities that have been shown to be costeffective and productive are included in Table 4-4.

In order to maintain the necessary flow of knowledge to prevent diseases and save money, the
U.S. must continue to invest in research collaborations with its partners abroad. Failure to
maintain such links is likely to have damaging long-term consequences for health]

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AT: JAPAN CP
J 12- Japan reliant on US training
David Satcher, US Surgeon General, Assistant Secretary of Health, 3-3-98, (Testimony on Global Health: the United States Reponse
[sic] to Infectious Diseases by David Satcher, M.D., Ph.D.) Senate [http://www.hhs.gov/asl/testify/t980303d.html]
[Through the US-Japan Common Agenda and the U.S.-Japan Cooperative Medical Science Program, United States and Japanese
scientists have held three international conferences on infectious disease research and science policy. As the first follow-up action to
the July 1996 meeting in Tokyo of the Common Agenda ERIDS Working Group, a team from CDC and FDA was invited to Tokyo to
participate in an investigation of outbreak of E. coli O157:H7. Japan has sent one of its scientists to CDC for long-term training in
epidemiologic investigations. The level of engagement between the U.S. and Japan on infectious diseases and related issues is
substantial and growing. In addition, under the auspices of the U.S.-Japan Common Agenda ERIDS Working Group, NIAID is
working with Japan to develop an action plan to address the public health problem posed by E. coli O157:H7. A meeting of NIH, CDC
and Japanese scientists was held in Baltimore in 1997 to discuss research advances and opportunities to learn more about this shigalike toxin that causes the lethal hemolytic-uremic syndrome seen in outbreaks of food- borne diseases. ]
J12-Japan lacks crucial financial commitment.
Tadao Kakizoe, honorary president of the National Cancer Center and chairs the Health, Labor and Welfare Ministry's
Council for Cancer Control,7-1-07(Insights Into The World; Govt should lead fight against infectious diseases), lexis
The problem of infectious diseases clearly must be addressed on a global scale.
Key organizations for fighting the problem are the WHO and the Centers for Disease Control and Prevention (CDC) in the
United States. In Japan, the National Institute of Infectious Diseases (NIID), the main campus of which is located in
Toyama in Shinjuku Ward, Tokyo, is central to Japan's efforts to combat infectious diseases. While
collecting relevant information from across the country, the NIID has been cooperating closely with the WHO, CDC and
infectious disease surveillance and control organizations in many other countries. Among the major tasks being undertaken
by the NIID are the collection of information on outbreaks of infectious diseases both at home and abroad, analyses of the
data, diagnosing potential carriers of viruses and ensuring relevant information is accessible to the public. In addition, the
NIID is engaged in developing, producing and certifying vaccines, as well as identifying disease agents and working on a
range of research projects. It is also involved in the training of experts on infectious diseases. The institute has been
doing its utmost to carry out these tasks, despite budget and personnel limitations. Recent
accomplishments include the collection of information regarding the measles infection that was rampant among young people
in May, and ascertaining that two males who returned home in November from the Philippines, where they had been bitten
by a dog, had been stricken with rabies.
What is the government for? Yet the government has, year after year, cut back on NIID personnel,
despite the crucial research it undertakes. I will never be convinced of the merits of this approach. There

are also reportedly moves within the government to reorganize the NIID into an independent
administrative corporation, simply to improve budgetary efficiency . This leads me to wonder what the
government is for. Surely its primary duties are to ensure the safety and security of the people. The work of the NIID should
be considered akin to what we expect of the Self-Defense Forces.

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AT: EUROPE CP
ECDC will fail; 3 reasons,

Nature Immunology, 2005 (Fighting the good fight in Europe), [http://www.nature.com/ni/journal/v6/n1/full/ni01051.html]

The need to strengthen the Communicable Disease Networks and place European disease
surveillance on a stronger footing precipitated the establishment of the European
Center for Disease Prevention and Control (ECDC) by the European Parliament in April 2004. The ECDC will
pursue the same objectives as its US counterpart but, unlike the CDC, will function as a decentralized
agency coordinating existing European resources. As such, this EU-funded center will provide
rapid technical assistance during disease outbreaks by pulling together leading experts from around Europe to work with
national authorities in dealing with the particular problem. However,

the ECDC will have no


regulatory powers and will not run any independent laboratories, raising fears
about how effective it will be. The agency's role as coordinator may be made
difficult because disease surveillance, quality of data and available resources
vary across the EU. Increasingly, epidemiologists require expensive laboratory
techniques for their investigations, yet the ECDC lacks funding for
independent laboratories; its budget (4.8 million euros for 2005, rising to 29 million 2007) will be too small to
fund more than limited services in existing European laboratories. In comparison, the CDC received over 4 billion dollars
from the US government in
J14-China lacks necessary healthcare infrastructure.
David Ho, Irene Diamond Professor; Scientific Director, Aaron Diamond AIDS Center @ The Rockefeller University, 5-26-05
(Is China prepared for microbial threats?) [http://www.nature.com/nature/journal/v435/n7041/full/435421a.html]
China's recent SARS-fighting experience will give its pandemic response an edge. But this advantage will be offset by a
number of factors: China is likely to be hit first or early by the pandemic; its disease-surveillance

system and overall healthcare infrastructure are inadequate; the health authorities have yet to
come up with a detailed strategic preparedness plan; and it has limited technical resources to
produce enough vaccines and drugs to combat the pandemic. There is little doubt that China will be in
deep trouble if the flu pandemic were to strike in the next few years. It has a moral obligation to its own people, and to the
world, to rectify the situation as soon as possible.
J17-Current EU surveillance lacks systemic quality
EVM, a specialized group within the
European Federation of Pharmaceutical Industries and Associations (EFPIA), 11-02 (Communicable disease surveillance in
Europe: Developing the basis for rational disease prevention strategies, 4) [http://www.evm-vaccines.org/pdfs/surveillance.pdf]

The main weaknesses of the current communicable disease surveillance and health
information systems in Europe are the following: Todays surveillance networks are typically
project rather than programme-oriented. They are, therefore, either dependent upon the initiative of
individual investigators and are co-sponsored through grants, or they are requirements of a
national government that are funded by industry . Many surveillance networks have only
achieved a limited degree of harmonisation on methodologies and case definitions; standard operating
procedures are rare. There is no systematic quality assurance. Laboratory-based surveillance networks are
largely pathogen-specific and function in relative isolation, in spite of the fact that important synergies could be expected
from joining networks covered by one umbrella. There is only a limited common strategy for dissemination of surveillance
data or publication of health information. Efforts to establish an accessible common health information base, such as
EUPHIN, have not been sufficiently sustained.

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China is ill-suited for disease surveillance because it does not cooperate with international organization or other countries on reporting
Gary Cecchine AND, Ph.D. Biology, Melinda Moore, M.D., Harvard Medical School; M.P.H., Harvard School of Public Health, 2006, Infectious
Disease and National Security: Strategic Information Needs, RAND National Research Defense Institute, <
http://www.rand.org/pubs/technical_reports/2006/RAND_TR405.pdf>
SARS in China and Beyond. The world experience of the 2003 SARS outbreak that began in China underscored the consequences of a nation failing to
report an outbreak in a timely and accurate manner. The earliest human case of SARS is thought to have occurred in the
Guangdong province, China, in November 2002. It apparently spread to humans through the slaughter of infected animals in unsanitary and
crowded markets (Osterholm, 2005). The outbreak came to the attention of Chinese health officials as early as a month later (Huang,
2003). Because Chinese law regarding the handling of public healthrelated information mandated that information

about such outbreaks be classified as a state secret before being announced by the Ministry of Health, any physician
or journalist who reported on the disease would risk accusation of leaking state secrets. Therefore, although the Chinese
Ministry of Health was informed of the outbreak in January 2003, a news blackout persisted until February of that year (Huang, 2003),
and the provincial government did not show evidence of taking the public health threat seriously and responding in a
timely and appropriate manner. A contagious disease coupled with government inaction took a significant toll on the
frontline responders health care providers (Huang, 2003). By the end of February 2003, nearly half the 900 cases in the Guangdong province city of
Guangzhou were among health care workers (Pomfret, 2003). With a blackout on reporting about the disease within China, let alone the rest of the world,

carriers of the disease traveled to other cities, provinces, and countries, perhaps oblivious to the risk that they could
spread the disease. The SARS outbreak was eventually noticed by the WHO. Finally, WHO experts were invited to China, where they were given
access to Guangdong only after waiting eight days in Beijing. They were not allowed to inspect military hospitals in Beijing for another week, and by that
time the disease had already spread internationally (Huang, 2003). In addition to the delay in reporting to the WHO, the information

provided by Chinese officials was suspect, perhaps because they tried to avoid damage to Chinas international image,
as well as economic consequences that may have resulted from international reactions. When the WHO issued the first travel
advisory in its 55-year history, recommending that people not visit Hong Kong or Guangdong, the Chinese health minister promised that China was safe and
that the outbreak was under control. Earlier, the minister announced that only 12 cases of SARS had been identified in Beijing
when in fact in the citys No. 309 Peoples Liberation Army Hospital alone there were 60 SARS patients (Huang, 2003).
J14China lacks technical and human resources for disease surveillance.
David Ho, Irene Diamond Professor; Scientific Director, Aaron Diamond AIDS Center @ The Rockefeller University, 5-26-05 (Is China prepared
for microbial threats?) [http://www.nature.com/nature/journal/v435/n7041/full/435421a.html]

Despite a significant infusion of funds in 2003, the disease-surveillance system is still grossly underfunded, and
consequently lacks sufficient human resources and technical capacity. Sufficient resources must be allocated to
train enough professionals to safeguard against epidemic diseases. Currently, too few of China's health workers
have been properly trained to carry out the task. It is imperative that a cadre of medical and public-health
officers are formally trained in special programmes, such as those at the Epidemiologic Intelligence Service of
the US Centers for Disease Control or at the World Health Organization's office in Lyon. Trained individuals could, in turn, mentor others and so
build the critical mass of professionals necessary to rejuvenate the Chinese disease-surveillance network.
J14-China lacks necessary healthcare infrastructure.
David Ho, Irene Diamond Professor; Scientific Director, Aaron Diamond AIDS Center @ The Rockefeller University, 5-26-05 (Is China prepared
for microbial threats?) [http://www.nature.com/nature/journal/v435/n7041/full/435421a.html]
China's recent SARS-fighting experience will give its pandemic response an edge. But this advantage will be offset by a number of factors: China

is likely to be hit first or early by the pandemic; its disease-surveillance system and overall healthcare
infrastructure are inadequate; the health authorities have yet to come up with a detailed strategic preparedness
plan; and it has limited technical resources to produce enough vaccines and drugs to combat the pandemic.
There is little doubt that China will be in deep trouble if the flu pandemic were to strike in the next few years. It has a moral obligation to its own
people, and to the world, to rectify the situation as soon as possible.

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AT: SPENDING
J5- A2: Spending
David Satcher, US Surgeon General, Assistant Secretary of Health, 3-3-98, (Testimony on Global Health: the United States Reponse [sic] to Infectious
Diseases by David Satcher, M.D., Ph.D.) Senate [http://www.hhs.gov/asl/testify/t980303d.html]
[U.S. agencies are also engaging other nations in the effort to combat infectious diseases. Many governments view emerging infections as an economic issue
as well as a public health issue, because healthy people are more productive and more able to contribute to their country's economy. Moreover, outbreaks can
impede economic development by interfering with tourism and trade. Since 1995, emerging infectious diseases has become an agenda item at several
bilateral and multilateral meetings.]
J11-Historically, the American public supports aid.
Board on International Health, 1997 (America's Vital Interest in Global Health: Protecting Our People, Enhancing Our Economy, and Advancing
Our International Interests) [http://www.nap.edu/readingroom/books/avi/4.html]
The arrival of the 104th Congress in November 1994 provoked extensive reexamination of U.S. federal spending, including expenditures for
global health assistance and development. Congressional criticism of foreign assistance focused on its perceived inefficiencies and on bipartisan
concern that foreign assistance has traditionally followed the whims of shifting political alliances. A belief was also voiced that the
American public feels that foreign aid provides no benefit to the United States and is akin to pouring money down
a drain. A poll to test these assumptions was conducted in January 1995 by the Program on International Policy Attitudes, a joint
program of the Center for the Study of Policy Attitudes (CSPA) and the Center for International and Security Studies at Maryland of the University
of Maryland's School of Public Affairs.
The study results were surprising. Far from opposing foreign assistance, the Americans polledboth Republicans and

Democratsoverwhelmingly supported the principle of giving foreign assistance, provided that it is directed
toward helping the needy rather than merely funding political allies; promotes self-reliance rather than relief;
ensures that the money goes to the individuals in need rather than to corrupt governments; and places a high
priority on democratic governance and respect for human rights. Another striking lesson from this poll was that Americans
erroneously believe that the United States is spending far more on foreign aid than it is, and it is this misperception that underlies the public's
opposition to foreign aid.
J5- Prevention of disease through surveillance saves money.
Board on International Health, 1997 (America's Vital Interest in Global Health: Protecting Our People, Enhancing Our Economy, and Advancing
Our International Interests) [http://www.nap.edu/readingroom/books/avi/4.html]
By the same token, inadequate surveillance

can have disastrous consequences, both human and financial. For


example, AIDS was unrecognized until the 1980s. Its varied clinical expression and prolonged incubation
period made detection difficult in the early stages of the epidemic. If a global surveillance system with the capacity
to identify new diseases had been in place in the 1970s, AIDS might have been identified earlier, perhaps before
it became well established. Epidemiologists might then have gained a valuable head start in learning how the
disease was transmitted and prevented, and many lives around the world, including in the United States, might
have been saved. Given that the lifetime costs of treatment for HIV disease in the United Statesexcluding
indirect costshave been estimated to be more than $119,000 per person (Martin in Mann and Tarantola, 1996),
substantial savings might also have been made.
Today, the potential for another AIDS pandemic remains. If a cluster of cases of a new disease of unknown
origin occurs in a remote part of the world lacking modern communication, the international community may
not learn about it until the disease has spread widely.

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AT: BAD TRAINING

J1-A2: Bad Training


1. Training Effective
ISDR Bulletin, 3-04, (Documentation of IDSR Implementation in the African
and Eastern Mediterranean Regions, Issue 4, 2) [http://www.who.int/csr/labepidemiology/projects/en/IDSNewsIssue4.pdf]
[In 2002, the World Health Organization (WHO) headquarters and the WHO African and Eastern
Mediterranean regional offices initiated an effort to document IDSR implementation In six selected countries (see table). WHO, the Centers for Disease
Control and Prevention(CDC), and the Support for Analysis and Research in Africa (SARA) project developed a protocol to document experiences with
implementation of IDSR in the African and Eastern Mediterranean regions. From November to December 2002, teams from WHO, CDC, and SARA
visited six selected countries in the African andEastern Mediterranean regions. They conducted focus group discussions, key informant interviews, and
document reviews at the national, regional and districtlevels. Progress with IDSR implementation in the countries was observed in several areas: All six
countries conducted sensitization activities and assessments of national surveillance and response systems, and adapted the IDSR technical guidelines and
training materials. The timeliness and completeness of reporting surveillance data improved in all six countries. In Uganda, the completeness of reporting
improved from 2% in 1998 to 65% in 2002. Reports of suspected cases of yellow fever in Ghana increased by eightfold in the second half of 2002,
following IDSR sensitization of clinicians.]
US key to skilled work force and effective disease technology (H5)
Committee on Emerging Microbial Threats to Health in the 21st Century, Board on Global Health, Institute of Medicine, 3/18/03, America Should
Foster Systematic Effort to Combat Infectious Diseases Here, Abroad, Microbial Threats to Health: Emergence, Detection, and Response, The National
Academies Press, http://www8.nationalacademies.org/onpinews/newsitem.aspx?recordid=10636
Likewise, a skilled health care work force is essential. Knowledge of how to confront microbial threats should be fully

integrated into training programs for all health care professionals, the committee said. Specifically, CDC, NIH, and
the U.S. Department of Defense should expand existing programs and develop new ones that educate health care
workers about field-based and laboratory approaches to preventing infectious disease in this country and abroad.
Also, health care professionals also should heed the importance of etiologic diagnosis, which identifies the microbial causes of infectious diseases, the report
says. Along with surveillance, such diagnoses are the cornerstone of control and prevention measures. For various reasons, etiologic diagnoses have
decreased significantly over the past decade. The result has been a dangerous overuse of broad-spectrum antibiotics to treat illness, fueling microbial
resistance to therapeutic drugs. Public health agencies and professional societies should disseminate and publicize guidelines

calling for widespread use of etiologic diagnostic tools. Also, CDC and other federal agencies should work together
with private industry to develop and assess new diagnostic tests.

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AT: UNILATERAL CP

J16- Need Global Response; diseases spread regardless of borders


David P. Fidler, J.D. @ Indiana University School of Law, 1996(Globalization, International Law, and Emerging Infectious Diseases)
[http://www.cdc.gov/ncidod/EID/vol2no2/fidler.htm]
The growing literature on new and reemerging infectious diseases often emphasizes the global nature of their threat; the U.S. Centers for Disease
Control and Prevention (CDC) defines these diseases as diseases of infectious origin whose incidence in humans has

increased within the past two decades or threatens to increase in the near future" (1). The World Health
Organization has asserted that emerging infections represent a global threat that will require a coordinated,
global response (2). The threat is global because a disease can emerge anywhere on the planet and spread
quickly to other regions through trade and travel. The global challenge of emerging infections has serious consequences for
national and international law; a states ability to deal with them is eroded because microbes do not respect internationally recognized borders (3).
Experts grappling with these diseases no longer consider that the pursuit of a strictly national public health
policy is adequate. The need for global cooperation increases the importance of international law in the public
health arena. Part of the effort to create a global response to emerging infections should be an understanding of the problems that may arise
from relying on international law in dealing with these diseases. This article outlines issues that will have to be confronted in using international law
to combat emerging infections.

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A2: QUARANTINE

J10-Quarantine Carries a Stigma


CDC, 10-22-04 (Postexposure Prophylaxis, Isolation, and Quarantine To Control an Import-Associated Measles Outbreak --- Iowa, 2004)
[http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5341a3.htm]
Before antibiotics and vaccines, quarantine was used when direct medical countermeasures were not routinely
available. However, quarantine often was implemented in a manner that equated disease with crime; consequently,

quarantine acquired negative connotations associated with stigma and discrimination. For quarantine to be an effective
and acceptable public health tool, these negative connotations must be overcome by applying the measure equally and fairly
among all persons who have been exposed, and by using other approaches. These include providing education about the rationale for
using quarantine; offering acceptable alternatives to quarantine, when feasible, such as postexposure vaccination or obtaining serologic proof of
immunity; and applying due process measures, such as written notice and opportunities to appeal
J10-Quarantine infringes on Civil Liberties
Steve Urbon, Standard-Times senior correspondent, 2-14-3 (Area takes alert in stride)
[http://www.umassd.edu/cas/chemistry/singh/st_file/st_2_14_03.htm]
Civil rights activists in some cases have objected to people being rounded up, stripped and showered against their
will. But Capt. Chmiel said local health authorities have "certain powers to quarantine people." And in the case of the
decontamination tent, separate areas for men and women assure a measure of privacy.

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AT: BIOPOWER

Disease surveillance and bio-security are the best strategy for preventing disease outbreaks {G-9}
Science, 10/15/04, Volume 306, Issue 5695, pp. 398-9,
Animal health officials agree that the best ways to curtail H5N1 are increasing surveillance and improving biosecurity,
which includes a host of measures intended to prevent diseases from spreading among flocks and to the public. But
now, after years of debate, consensus is building that vaccination of at-risk poultry could also be a critical tool in averting a human pandemic.
Indeed, in September, alarmed at the spread of H5N1, the Paris-based World Organization for Animal Health (OIE) and the United Nations Food
and Agriculture Organization (FAO) strengthened a previous recommendation encouraging consideration of vaccination in conjunction with other
control methods.

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AT: POLITICS- PLAN POP
J11-Historically, Americans support health improvements
Board on International Health, 1997 (America's Vital Interest in Global Health: Protecting Our People, Enhancing Our Economy, and Advancing
Our International Interests) [http://www.nap.edu/readingroom/books/avi/4.html]
[In this report, the term "global health" refers to health problems, issues, and concerns that transcend national boundaries, may be influenced by
circumstances or experiences in other countries, and are best addressed by cooperative actions and solutions. The report argues that the direct
interests of the American people are best served when the United States acts decisively to promote health around the world. This country has a
strong humanitarian tradition, and the American people have long supported efforts to improve the health of
people around the world. Yet the United States now contributes a lower percentage of its gross domestic product (GDP) to foreign
assistance than any of the other top 20 industrial nations.]
J11-Historically, the American public supports aid.
Board on International Health, 1997 (America's Vital Interest in Global Health: Protecting Our People, Enhancing Our Economy, and Advancing
Our International Interests) [http://www.nap.edu/readingroom/books/avi/4.html]
The arrival of the 104th Congress in November 1994 provoked extensive reexamination of U.S. federal spending, including expenditures for
global health assistance and development. Congressional criticism of foreign assistance focused on its perceived inefficiencies and on bipartisan
concern that foreign assistance has traditionally followed the whims of shifting political alliances. A belief was also voiced that the
American public feels that foreign aid provides no benefit to the United States and is akin to pouring money down
a drain. A poll to test these assumptions was conducted in January 1995 by the Program on International Policy Attitudes, a joint
program of the Center for the Study of Policy Attitudes (CSPA) and the Center for International and Security Studies at Maryland of the University
of Maryland's School of Public Affairs.
The study results were surprising. Far from opposing foreign assistance, the Americans polledboth Republicans and

Democratsoverwhelmingly supported the principle of giving foreign assistance, provided that it is directed
toward helping the needy rather than merely funding political allies; promotes self-reliance rather than relief;
ensures that the money goes to the individuals in need rather than to corrupt governments; and places a high
priority on democratic governance and respect for human rights. Another striking lesson from this poll was that Americans
erroneously believe that the United States is spending far more on foreign aid than it is, and it is this misperception that underlies the public's
opposition to foreign aid.

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NGOs can maintain independence in the hegemonic power structure because they maintain a unique position with the threat of exposure
Brent J. Steele Ph.D. AND, Political Science and Assistant Professor of Political Science at Kansas University, Jacque L. Amoureux, Ph.D. Candidate
Department of Political Science Brown University expected 2009, 05, NGOs and Monitoring Genocide: The Benefits and Limits to Panopticism,
Millennium: Journal of International Studies, Vol. 34 No. 2, pp. 401-432
Further evidence supports the possibility that NGOs can be connected with hegemonic power structures. In the mid1970s, the US House of Representatives held several sets of hearings dealing with International Organizations and Human Rights in the World
Community. The purpose of the hearings was to reflect upon the most recent human rights catastrophes and to focus on how to lessen the likelihood of
their replication in the future. Several representatives of NGOs testified before the Subcommittee on International Organizations and Movements in
October of 1973. In his testimony, Martin Ennals of AI described how a relationship between national governments and
non-governmental organizations was mutually beneficial. In a prepared statement, Ennals stated: Your invitation is particularly
valuable to us as an example of the relationships which ought to exist between the formal governmental structure and
informal non-governmental organs of public opinion where human rights are concerned.36 Ennals also identified the
special strategic role NGOs could play in those areas that were beyond the reach of even a powerful state, noting that:
In some instances non-governmental presence can be more effective than that of governments. The doctrine of non-intervention
is clearly directed to governments, but well-informed non-governmental pressure carries with it no threat but that of
exposure.37 In 1974, another set of hearings were held dealing with Human Rights in the World Community, and again several NGO
representatives testified to the Congressional committee. The committee proposed funding for INGOs that worked in human rights. The committee
made sure, however, that conditions were attached to the funding which would maintain the autonomous nature of INGOs. Further evidence of a
cooperative relationship between congress and NGOs is that the report recommended that the Commission on Human Rights should conduct a thorough
study of the practice of torture based upon information received by specialized agencies and non-governmental organizations.38

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AT: SECURITIZATION
Even though NGOs are related to the exercise of hegemonic power, this position in the greater structure allows multiple methods of
surveillance to prevent the potential violent ends
Brent J. Steele Ph.D. AND, Political Science and Assistant Professor of Political Science at Kansas University, Jacque L. Amoureux, Ph.D. Candidate
Department of Political Science Brown University expected 2009, 05, NGOs and Monitoring Genocide: The Benefits and Limits to Panopticism,
Millennium: Journal of International Studies, Vol. 34 No. 2, pp. 401-432

A human rights Panopticism still results in a disciplined individual. Indeed, such a mode of analysis may be (will
be or has been) used for the purposes of profit and manipulation, with newly disciplined areas becoming stable situations ripe for
corporate exploitation. Additionally, while many will agree that hegemons use the discourse of human rights to justify
their policies, most would also agree that hegemonic adherence to human rights principles is chequered at best. In
light of these possibilities, let us reiterate that what we are proposing here, as mentioned in our introduction, is a human rights Panopticon as a mode-ofanalysis for understanding the alignment of interests when addressing the prevention of genocide. In such a context, hegemons have found
human rights NGOs useful because the latter perform a surveillance function, compelling those who would perpetrate
genocide to not do what they otherwise would do. Thus, in such instances the human rights panopticon functions as a lighter, cheaper and more rapid
form of power exercised by hegemons. Yet we recognise the tension which exists between human rights NGOs and hegemons. While both human
rights NGOs and hegemons will have an interest in the prevention of genocide, and the assistance of human rights NGOs
provides hegemons with a contextual advantage in such situations, in other contexts the interests of human rights NGOs and
hegemons will diverge.30 Many recent examples can be cited where the same human rights NGOs that provide

surveillance services in potential situations of genocide have criticised American policies as compromising human
rights principles. In the area of human rights, there are three potential avenues of surveillance. NGOs provide the first
avenue when their personnel record and capture images of abuse through various methods and these are then used
to publicise the atrocities. NGOs compile interviews with refugees, local officials, and medical personnel, and then organise these into reports
that summarise vital information for important international actors. They gather information from domestic groups within the societies where atrocities
occur, and the dissemination of information also serves to mobilise those domestic groups.31 The audience for NGO reports includes not

only international organisations and domestic political groups but important political actors within Western states.
Just as panoptic surveillance is generally effective when the Panopticon remains out of the subjects view, NGOs do not have to be in the area when the
abuses are committed, since the basis for their reports comes from the witnesses who are in the area of human rights abuse. Individuals in trouble (and
groups of individuals such as indigenous NGOs) are the eyewitnesses of genocide. NGOs collate this information into reports, and surveillance works to
discipline genocidaires because they do not know who will report on their activities. NGOs collect reports even without being at the scene of the
crime.32 Second, Western states may uncover abuses such as genocide through intelligence activities in the age of a

generalised surveillance society. Western governments have employed their general surveillance capabilities of
gathering and analysing evidence to uncover human rights abuses reported by human rights NGOs even if they
subsequently failed to take diplomatic or military action against the abusers. In the case of genocide in Rwanda, the US went
so far as to secretly dispatch a group of Marines on a reconnaissance mission inside Rwanda to verify reports of the mass murder of Tutsis by Hutus.
This mission along with satellite photos of mass graves and other intelligence verified the genocide in Rwanda.33 NGOs perform a third type

of surveillance when they formulate and promote reports on human rights abuses for prosecutorial purposes,
whether for domestic or international judicial bodies.34 For instance, during the Bosnian genocide human rights NGOs lobbied the US
and the United Nations (UN) to establish an International Tribunal, and they have provided evidence to this and many other courts. The evidence has
been purposely organised so as to facilitate identification of individual responsibility, tying individuals to particular crimes with evidence.35 Ad hoc
tribunals for Yugoslavia (International Criminal Tribunal for the former Yugoslavia) and Rwanda (International Criminal Tribunal for Rwanda), and the
referral of cases for Sudan and the Democratic Republic of the Congo to the International Criminal Court (ICC), assure potential perpetrators that their
crimes may be exposed and that they could be punished. As the human rights regime continues to develop and strengthen
accountability mechanisms, the threat of punishment may begin to loom larger. Surveillance efforts that collect evidence to be
used in judicial fora partially constitute and strengthen a Panoptic structure that works to enforce self-discipline. We begin to see how NGOs are

most effective when they work in tandem with governmental organisations.

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NGOs prevent atrocities classified as human rights abuses by discipline through panoptic monitoting
Brent J. Steele Ph.D. AND, Political Science and Assistant Professor of Political Science at Kansas University, Jacque L. Amoureux, Ph.D. Candidate
Department of Political Science Brown University expected 2009, 05, NGOs and Monitoring Genocide: The Benefits and Limits to Panopticism,
Millennium: Journal of International Studies, Vol. 34 No. 2, pp. 401-432

The perception of NGOs as autonomous makes them appear to be less of a threat to the sovereign integrity of
monitored units. Thus, to they extent that they serve hegemonic power, they do so as a lighter and more rapid form of that power. The same
is also true in their perceived independence from supranational organisations. The promotion and monitoring of
human rights advances a productive global economy and a (liberal) community of states by bringing states into the civilised world
defined, in part, by individual rights and a capitalist economy (also understood by liberals as individual economic freedom). Widespread and
severe human rights abuses, such as genocide, prevent states from creating and maintaining a market economy
that depends on predictability ensured by the rule of law. Human rights regimes act to increase global
productivity, and disciplinary discourse individualises and establishes what is normal by labeling human rights
violations as abnormal and immoral.
Hegemons in international society are susceptible to the same power structures they utilize and their abuses are prevented through the surveillance
of human rights NGOs
Brent J. Steele Ph.D. AND, Political Science and Assistant Professor of Political Science at Kansas University, Jacque L. Amoureux, Ph.D. Candidate
Department of Political Science Brown University expected 2009, 05, NGOs and Monitoring Genocide: The Benefits and Limits to Panopticism,
Millennium: Journal of International Studies, Vol. 34 No. 2, pp. 401-432
Consistent with other applications of panopticism, the application

of panopticism to world politics portrays hegemons as


part of power structures and as seeking to arrange those structures in their favor. We refer to a hegemon as a powerful
country (or countries) that has a selfawareness of its ideological hold,12 and seeks to and is often successful in influencing the actions of other
countries. Thus, we argue that just as within domestic society, international society features an order that accords some actors, more than others, the
self-identity of a capable agent. They are thus able to maintain power structures in their favour. Panoptic surveillance is an attractive means by
which to ensure and foster this ideological hold on power.13 However, precisely because they are constrained by their

position, hegemons are not all-powerful; they may be the object of the exercise of power by other actors even as
they exercise power. Foucault explains: One doesnt have here a power which is wholly in the hands of one person who can exercise it alone
and totally over others. Its a machine in which everyone is caught, those who exercise power just as much as those over whom it is exercised.14

Although there is certainly a hierarchy where some are privileged, the top and the bottom have a mutual
hold.15 And a disciplinary society features a surveillance that extends in all directions (as will become apparent later in
the paper): In the Panopticon each person, depending on his place, is watched by all or certain of the others. You have an apparatus of
total and circulating mistrust, because there is no absolute point. The perfected form of surveillance consists in a summation
of malveillance.16 With this in mind, we add to the applications of Panopticism the monitoring activities of human
rights NGOs as a further possible surveillance structure. Much of the work in International Relations on nongovernmental
organisations (NGOs) has focused on the ways in which they have influenced the policies of state agents examining the role
transnational advocacy networks played in changing state policy practices through lobbying,17 or
shaming18 and how NGOs have improved the human rights practices of particular states.19 What most of these
works have in common is that they investigate the influence NGOs have as an independent variable upon the decisions and practices of states.
And yet, along with causing states to reconsider their interests, NGOs can also serve the interests of some states. We argue that the NGO is also a
new veiled form of hegemonic power, one that provides a monitoring function which can fulfill the needs of hegemons.20 Through NGO

activities the abuse of human rights can be monitored, recorded, and publicised. Activities of possible human
rights abusers are made transparent through observation and data collection that is collated into dossiers and
then used both to make apparent the reach of NGOs gaze and to reform pariah states and groups into liferespecting members of the international community. This use of transparency increases discipline in areas of the world that
hegemons find difficult to control through traditional power practices. Human rights NGOs provide an effective tool for extending extending
hegemonic influence in a more rapid andeffective manner.

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The term, human rights is problematic as a narrow interpretation of rights, but is necessary to discuss the power relations of Western-based
hegemons and NGOs
Brent J. Steele Ph.D. AND, Political Science and Assistant Professor of Political Science at Kansas University, Jacque L. Amoureux, Ph.D. Candidate
Department of Political Science Brown University expected 2009, 05, NGOs and Monitoring Genocide: The Benefits and Limits to Panopticism,
Millennium: Journal of International Studies, Vol. 34 No. 2, pp. 401-432

We use the oft-contested terms human rights and human rights NGOs as they are understood within the
context of liberal Western values. Since we propose human rights as a form of discipline we are referring to
Western-based human rights defined narrowly as civil and political rights, marginalising other forms of human
rights, such as social, economic, and cultural (or group) interpretations. It is the liberal position summed up by liberal theorist Michael Ignatieff:
Activists who suppose that the Universal Declaration of Human Rights is a comprehensive list of all the desirable ends of human life fail to understand
that these ends liberty and equality, freedom and security, private property and distributive justice conflict, and because they do, the rights that
define them as entitlements are also in conflict. If rights conflict and there is no unarguable order of moral priority in rights claims, we cannot speak of
rights as trumps.21 In turn, we take the human rights NGOs which provide surveillance functions to be those Westernbased NGOs (what some have referred to as First World NGOs22) which reflect this Western-based preference for civil and political rights
protection/promotion. Human Rights Watch (HRW) and Amnesty International (AI) exemplify the NGOs which largely
constitute the Panoptic system of surveillance, disciplining subjects according to this narrow definition.23 Critics of
this conceptualisation of human rights and human rights NGOs conclude that the latter therefore represent doctrinalists of Western values, and that no
one should believe that the scheme of rights NGOs and Monitoring Genocide promoted by INGOs24 [like AI and HRW] does not seek to replicate a
vision of society based on the industrial democracies of the North.25 Like its critics we find this narrow definition problematic, but

for analytical purposes we use it here in our interpretation of a Western-based human rights regime.

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Discipline is a positive power and produces a particular subjectivity by strengthening social forces
Brent J. Steele Ph.D. AND, Political Science and Assistant Professor of Political Science at Kansas University, Jacque L. Amoureux, Ph.D. Candidate
Department of Political Science Brown University expected 2009, 05, NGOs and Monitoring Genocide: The Benefits and Limits to Panopticism,
Millennium: Journal of International Studies, Vol. 34 No. 2, pp. 401-432

The Panopticons first advantage is its efficient exercise of power; compelling subjects to self-police their actions.
Fewer people are needed to exercise this power and thus more people can be made subject to its exercise. The
Panopticons second advantage is its efficacity achieved through its preventative character, its continuous NGOs
and Monitoring Genocide functioning and its automatic mechanisms.8 Efficacy does not depend on whether physical
coercion is successfully executed or whether every prohibited act is actually met with punishment; rather, the
Panopticon prevents undesirable behaviors from occurring in the first place. In a panoptic structure subjects
become objects of knowledge to be studied; objects whose behaviour can be predicted and thus reformed. For
this reason Foucault characterises discipline as a positive power. Its function is not limited to circumscribing
action or increasing power for the sake of power. Discipline can produce a particular subjectivity; it makes
individuals and its aim is to strengthen the social forces to increase production, to develop the economy,
spread education, raise the level of public morality; to increase and multiply.9 Discipline is also corrective it seeks to
normalise society by defining normal and abnormal people (e.g., the delinquent, the pariah state) and treating the abnormal.

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NGO surveillance of governments and the threat of exposure have empirically countered the violent policies of governments
Brent J. Steele Ph.D. AND, Political Science and Assistant Professor of Political Science at Kansas University, Jacque L. Amoureux, Ph.D. Candidate
Department of Political Science Brown University expected 2009, 05, NGOs and Monitoring Genocide: The Benefits and Limits to Panopticism,
Millennium: Journal of International Studies, Vol. 34 No. 2, pp. 401-432
However, we do not see the media as an alternative factor that can explain this benefit of Panopticism better than NGO surveillance, but more as
an agency which interacted in concert with NGOs in two ways. First, it was the presence and improved coordination of NGOs in East Timor
from the late 1970s onward that then motivated the media to establish itself in the area. Second, the media
provided more immediate outlets to disseminate gathered NGO information.61 For example, Sidney Jones, the director of
HRW-Asia, was one of the main sources cited for information in New York Times dispatches from East Timor in September of 1999. On September
6 she is quoted as saying the situation shows every sign of being planned and coordinated (by the Indonesian militias) ahead of time.62 AI
reported in late September that, independence activists are being hunted down at checkpoints, on boats and in house-to-house searches. Militia and
members of the Indonesian army continue to intimidate, threaten and attack the displaced East Timorese with total impunity.63 The point here is
not necessarily that it was at bottom the NGOs that spurred the international community to get involved in East Timor in 1999, although that is
probably true. The aspects of this case we find most important are that, (1), the presence of a robust NGO network

could provide the eyes for those state and international organisation agents who got involved to know what was
going on, and, (2), the Indonesian militias via the authorities in Jakarta knew in 1999, unlike in 1975, that they
were being watched, and changed their behaviour as a result. The latter was most apparent in the first few
weeks of September when Habibie felt compelled to call press conferences to defend his countrys prerogative
to establish order in the area. Unlike the aftermath of 1975 the Indonesian government knew this time that
the coordinated NGO reports detailed the abuses, and thus Habibie acquiesced to the UN deployment of
peacekeepers in mid-September.
Geoffrey Robinson, a UN political affairs officer with the UN Mission in East Timor, noted that when he asked one diplomat: what it was that had
finally convinced his government that it must support intervention, his answer was unequivocal it was the NGOs. ... In the United States, much of
the work was done by private advocacy groups that had been working through the Catholic Church and Congress since the 1970s. Elsewhere,

NGOs such as Amnesty International had built up an unusually rich portrait of the human rights problem in
East Timor and had established channels of access not only to the media but to government decision makers
and officials at the United Nations.

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Pharmaceutical Industries are not willing to invest in vaccines due to financial risk
Jonathan R. Davis and Joshua Lederberg (Editors), Forum on Emerging Infections, Board on Global Health, Institute of Medicine (Authoring
organization), 2001, Emerging Infectious Diseases from the Global to the Local Perspective, p.14 - 15,
http://books.nap.edu/openbook.php?record_id=10084

More than 20 new infectious agents or diseases have been identified in the past 20 years, including toxic shock
syndrome, HIV/AIDS, hantavirus pulmonary syndrome, and Nipah virus, to name just a few (Table 4). Like the organisms themselves, the
challenges of detecting and preventing infectious diseases are constantly evolving. A strong, stable research and training
infrastructure is needed to investigate the mechanisms of molecular evolution, drug resistance, and disease transmission to produce the knowledge
that can lead to a vaccine or other effective means of preventing and treating an infectious disease. Just as an expanded research effort

led to the discovery of protease inhibitors as treatments for HIV/AIDS, a renewed commitment to research is
needed to ensure that similar successes are achieved for the numerous other infectious diseases currently
threatening the earth's human population. Although vaccines against acute respiratory infections, diarrheal diseases,
HIV/AIDS, malaria, TB, and dengue are desperately needed, vaccine development has lagged in the past 20 years.
Vaccines are in the pipeline for Chagas' disease, onchocerciasis and lymphatic filariasis, leishmaniasis, schistosomiasis, and malaria, but these are
in the predevelopment stage and still far from ready for use (WHO, 1999).
The rate of new antibiotic development has also slowed (Table 5). Industry is not always willing to invest in the
development of a new class of antibiotics as readily as it was 20 or 30 years ago because of the financial risks involved.
For example, the development of an antibiotic is an expensive process, and there is no guarantee that the antibiotic will remain effective before the
patent period is over and the investment has been regained
Vaccines and Immunizations are not effective in preventing diseases in developing countries
Jonathan R. Davis and Joshua Lederberg (Editors), Forum on Emerging Infections, Board on Global Health, Institute of Medicine (Authoring
organization), 2001, Emerging Infectious Diseases from the Global to the Local Perspective, p.14 - 15,
http://books.nap.edu/openbook.php?record_id=10084
Globally, the number of individuals covered by immunizations, in addition to immunizations against polio, has risen since the advent of the global
polio eradication initiative in 1990. However, standard immunizations for children are not as widespread as expected in

many less developed regions of the world, where the risk of infectious diseases remains high. High vaccine
costs, difficulties with administration (e.g., the logistics of refrigerating vaccines in tropical climates), and the number of
vaccinations that each individual needs pose challenges to the implementation of more widespread
immunization requirements, as well as posing challenges to immunization practices. In addition, when
immunization programs are working well, they are sometimes forgotten. As a result, countries that have
relaxed their immunization requirements are facing endemics and, in some cases, epidemics. For example, in Russia the
pertussis vaccine component was dropped from the standard diphtheria-pertussis-tetanus vaccine preparation, resulting in an emergence of
pertussis.

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