Biosecurity discourses and practices gained currency during the past half-century. This chapter examines biosecurities as a constellation of constructs of concern to the broader field of Security Studies. It begins by tracing the development of biosecurity across agricultural, infectious disease, and defense industries before considering how communication scholars have applied empirical, interpretive, and critical lenses to aspects of biosecurity. It then explores how the concerns of biosecurity have coalesced into a new evolving paradigm for public health. Through a mini-analysis of the World Health Organization’s 2007 report, A Safer Future, it tracks how the paradigm of health security both continues and disrupts previous conceptions of public health, while offering opportunities for communication scholars to study and intervene in material and symbolic formations about pathogens and new forms of life.
In the spring of 1918, the inappropriately named “Spanish” flu manifested as a mild influenza that might have otherwise passed without special notice. But the following fall, a more virulent strain of the flu resurged simultaneously in several locations around the globe. By now, the story of the 1918 flu is well rehearsed: The H1N1 virus spilled out in several waves to kill an estimated fifty to one hundred million people, triggering contamination anxiety and disrupting public life and social ritual (Koszarski, 2005). By the time it disappeared in March 1920, the virus had infected between 2.5 and 5 percent of humanity (Spinney, 2017, pp. 4–5) (Figure 13.1). Over time, the scourge faded in public memory, but the once “forgotten” influenza pandemic of 1918 (Crosby, 1983), which felled more people than each of the First and Second World Wars, was reanimated into material and symbolic life a century later when scientists sequenced its genes (Kaiser, 2005). Social scientists and humanists turned to the past to find lessons about immunity and social responses to emerging infectious disease (CDC, 2018; Spinney, 2017).
Figure 13.1 Red Cross Workers Prepare Masks for Flu Protection
In this way, as a pandemic that took the lives of people in their prime from the indigenous residents of Bristol Bay, Alaska, to villagers in Shansi, China, to fit soldiers on WWI European battlefronts, the Spanish flu is a useful entrée into a conversation about biosecurity. This is because it foreshadows the global, political, racial, social, and economic stakes of infection, illuminating concerns that would later be recognized as falling under the umbrella of biosecurity. In this case, a novel infection with a high mortality rate fanned the globe and exacerbated social and political tensions while overwhelming local health systems worldwide, even though its war-time appearance meant that its scope and severity were often hidden or downplayed to international audiences.
A century later, a fictional pandemic animated a high-level U.S. thinktank tabletop- simulation designed to prepare government leaders to respond to the security challenges posed by emerging infectious disease. Called Clade X, the name given the made-up virus by organizers at the Johns Hopkins Center for Health Security (Figure 13.2), the scenario drew from a similar nexus of biological, ecological, and political factors that contributed to the 1918 H1N1 virus (CDC, 2018; Myers, 2018). In this simulation, Clade X spread quickly, had no known treatment or preventative mechanism, and rapidly overwhelmed health care systems. Engineered by a fictitious terrorist splinter group, dubbed “A Brighter Dawn,” in a Swiss laboratory, Clade X also infected its hosts through respiratory droplets, the same as the Spanish flu, and produced tensions among nation states, eventually prompting military action. But in a twenty-first-century twist, Clade X, a paraflu virus causing respiratory symptoms similar to influenza viruses, included deliberate gene insertions, which were intended to heighten neurological virulence from the real-world virus, Nipah. Coincidentally, Nipah had killed several people in India the same week as the exercise (Sun, 2018).
Figure 13.2 Lead Participants Enact a Mock Meeting during Clade X, 2018
The simulation script made clear that Clade X was only “moderately contagious” and “moderately lethal” (Sun, 2018), yet the scenario produced a familiar scene to viewers of biothriller entertainment media: The exercise predicted 150 million dead, with “health-care systems collapsed, panic spread, the U.S. stock market crashed” (Sun, 2018). The U.S. President, politicians, and Supreme Court Justices were all incapacitated. “It’s fiction, but America just got wiped out by a manmade terror germ,” announced one headline (Regalado, 2018), while another declared the exercise a “mock, yet entirely plausible, pandemic” (Myers, 2018). If the purpose of Clade X was to convince leaders to act to minimize future outbreaks, news coverage pushed the persuasive power of the exercise by touting the verisimilitude of the simulation. Although the toll of the 1918 flu had been downplayed under the cloak of war-time secrecy, the predicted death toll of Clade X was trumpeted via social and conventional media.
Bookended by a hundred years, the arc that runs from the 1918 flu to 2018’s make- believe Clade X chronicles an evolving set of consciousness about biological security, signifying a growing apparatus for detecting, addressing, imagining, and preparing for outbreaks of novel pathogens and other germ threats around the globe. At the same time that news of Clade X spread, other headlines announced actual outbreaks of Ebola, Nipah, and foodborne E(schericia) coli (Astor, 2018; Scutti & Goldschmidt, 2018; Sun, 2018), as well as rising tick- and mosquito-borne illnesses (Dengler, 2018). What has changed over the past hundred years is not only that novel diseases appear to be increasing at the same time as our twentieth-century defenses against them are faltering (Shah, 2017), but that the outbreaks are accompanied by an increasing set of surveillance practices designed to monitor, detect, and protect against emerging infectious disease and invasive species. The neologism that describes this work is biosecurity, a term that floats amid an array of related, contested, and sometimes interchangeable terms such as biosafety, biodefense, biorisk management, biopreparednes, and more recently, health security. What has come to be known as biosecurity is in fact a multivalent set of concerns—in that sense, biosecurities—that operate at the intersection of animal, plant, ecological, biological, economic, and political life, and supply an important set of texts, contexts, assemblages, materials, actors, and ecologies for communicative and rhetorical analysis and intervention.
In this chapter, I examine biosecurities as a constellation of constructs of concern to the broader field of Security Studies. I trace how communication scholars, in particular, have applied empirical, interpretive, and critical lenses to aspects of biosecurity, including pandemic preparedness and response and biological threat construction, and I explore how the concerns of biosecurity have coalesced into a new evolving paradigm for public health. In the third section of the chapter, I explore how the paradigm of health security both continues and disrupts previous conceptions of public health and how it offers opportunities for communication scholars to study and intervene in material and symbolic formations about pathogens and new forms of life. Ultimately, I argue that the current dominant paradigm of biosecurity merges cybernetic and biological perspectives on human vulnerability to subsume “health” under the aegis of national security with significant consequences for how healthcare and national security are conceived, practiced, and resisted. Throughout, I highlight the unique contributions of communication scholars to our understanding of how and with what consequence biosecurity threats are constituted, deployed, confronted, and resisted.
As far back as recorded history and millennia before germ theory was developed or the neologism biosecurity was coined, humans have devised and implemented numerous ever-evolving means of protection from contagion. Indeed, the roots of the term contagion, shared with the term contiguous, mean “to touch together,” hinting at the ancient observation that a group’s contact with outsiders could spread infection (Wald, 2008). In modern times, efforts to protect animals, crops, and human life became institutionalized. The Epidemic Intelligence Service (EIS) of the U.S. Centers for Disease Control and Prevention (CDC) attempted to monitor and protect against biological warfare in the 1950s during the Korean War before turning to infectious disease eradication programs in the 1960s and beyond (Pendergrast, 2010). Throughout the Cold War, concerns about the use of what was then called germ or bacteriological warfare loomed large in military and policy circles, even though biological weapons research and development often occurred more clandestinely than nuclear development, with its spectacular visibility (Miller et al., 2001). Within this discourse realm, biodefense was the preferred term to describe state responses to bioweapons development.
By contrast to the idea of biodefense as military protection, early uses of the term biosecurity appeared in agricultural discourse in the late twentieth century, where biosecurity stemmed from the economic motive of preventing loss of plants or animals from disease. For instance, the term headlined a 1980 Pennsylvania State University College of Agriculture report called “Biosecurity for Poultry,” which noted that the word could not be found in most dictionaries (Brunet, 1980). By the 1990s, agricultural journals and trade publications (see, e.g., Anderson, 1998; Thomson, 1991) featured articles addressing bovine biosecurity and similar means of ensuring livestock resistance to disease, with Anderson calling biosecurity “a new term for an old concept” (p. 61). Anticipating later developments in public health, the animal husbandry community spoke openly about herd “health security” in the mid- to late 1990s.
While the idea of biosecurity expanded within agricultural sciences, the late 1980s and the 1990s also marked a period of intensifying concern about biological warfare, biodefense, and bioterrorism, as many authors have chronicled (Ayotte, 2011; Fidler & Gostin, 2008; Guillemin, 2006; Keränen, 2011a, 2014a,b; Miller et al., 2001; Tucker, 2000; Wright, 2007). While concerns about state biological weapons programs had been managed through the Geneva Protocols and the Biological and Toxin Weapons Convention (BTWC), advisors to the Reagan administration, including Nobel Laureate Joshua Lederberg, began to warn in the late 1980s that rising states hostile to the United States might acquire biological or chemical weapons (Wright, 2007). Several years after the U.S. Defense Science Board (DSB) cautioned about state biological weapons ending up in the wrong hands, Soviet defectors offered eye-popping tales of extensive U.S.S.R. bioweapons infrastructure (Alibek & Handelman, 1999). Meanwhile, security concerns abounded when terrorist organizations and criminals, such as Aum Shinrikyo in Tokyo and the Rajneeshes in Antelope, Oregon, attempted to use biological and chemical weapons to seek political ends in the mid-1990s (Tucker, 2000) and when concerns about Saddam Hussein clandestinely producing chemical and biological weapons stores surged in the post-Gulf War period (Miller et al., 2001). U.S. decision makers poured new energy into imagining and countering potential germ threats from state or rogue actors.
Think tanks brimming with military and government risk planners pushed to ensure growing awareness of “catastrophic bioterrorism” (Danzig, 2003), which leached into the public sphere via a bevy of “epidemic entertainments” (Tomes, 2002). Both official and entertainment media reinforced a primary apocalyptic vision (Schoch-Spana, 2004; Keränen, 2011a) of global collapse via pandemic. Richard Preston’s 1994 Hot Zone, later turned into the blockbuster film Outbreak, and Laurie Garret’s The Coming Plague were among the cultural touchstones of the period that introduced readers to the dangers of bioterrorism, newly emerging viruses, and pandemic. Ayotte (2011) has examined how Preston’s Hot Zone “play[ed] a significant role in shaping the premises of public arguments about biological threats” (p. 3), framing Ebola and emerging infectious disease for a widespread set of political and citizen readers. Here, racialized and colonialist representations of a “primitive” and “predatory” viral hemorrhagic fever that moved “out of Africa” transfixed American audiences and promoted racist stereotypes (Haynes, 2002). Virus discourse pervaded popular culture at this time, particularly since HIV/AIDS had already cued publics to the limitations of modern science’s ability to address newly emergent viral threats. In short, in contrast to the celebrated successes of early twentieth-century biomedical and public health measures, publics and officials were becoming increasingly aware of our inability to effectively counter new viral threats due to growing antibiotic resistance and the emergence of never-before-seen viruses.
Former public health workers led the charge in raising awareness of the threats of bioweapons agents. In 1998, “D. A.” (Donald Ainslie) Henderson, former Director of the CDC’s Virus Disease Surveillance program for the Epidemic Intelligence Service, who was by then already famous for leading the World Health Organization’s (WHO’s) decade-long global smallpox eradication campaign, founded the Center for Civilian Biodefense Strategies at the Bloomberg School of Public Health at Johns Hopkins University. This group was the precursor to the Center that created the Clade X simulation discussed in the opening of this essay. Having declared smallpox eradicated, Henderson turned his attention to the concern that biological warfare posed risks to civilian populations. In 1999, he published an essay in Science Magazine, “The Looming Threat of Bioterrorism,” which maintained that “during the 1970s and 1980s, there was a mood of complacency [in the United States] about bioterrorism; funds for defensive activities all but evaporated, and a highly-regarded research program and team were partially dismantled” (p. 1280). That same year, his colleague animated the concern, growing among policymakers, that the once-vanquished smallpox might exist in frozen storage in a politically failing state that could become the property of a rogue state, terrorist group, or criminal. Henderson’s colleague Tara O’Toole (1999) published “Smallpox: An Attack Scenario” in Emerging Infectious Disease. “An attack using the virus would involve relatively sophisticated strategies and would deliberately seek to sow public panic, disrupt and discredit official institutions, and shake public confidence in government,” she opined before narrativizing a fictional attack in order to “provoke thought and dialogue that might illuminate the uncertainties and challenges of bioterrorism” (p. 540). In addition to increased attention from military analysts, bioweapons attained heightened currency in political discourse. Within this context of growing alarm for a “catastrophic biological event,” the anthrax mailings of 2001 supplied a powerful exigence for moving concerns about biological security into the public and official spheres. Thus, Koblentz, writing in 2003, declared that “biological weapons have become one of the key security issues of the twenty-first century” (p. 84). The varied seeds of biosecurity had sprouted.
In the decade after 9/11, numerous divergent definitions of biosecurity circulated in public and official texts. Some of these framed biosecurity as:
Notably, the definitions above move from the WHO’s conceiving of biosecurity as a laboratory practice akin to what has been called biosafety, to concern that inappropriate actors might acquire biological agents for malevolent use, as seen in the definition developed by the Institute of Medicine and the National Research Council. In Fidler and Gostin’s (2008) conception, we see a wider societal responsibility to protect against biological threats including diseases that evolve pathogenically without human intervention. Finally, Lakoff and Collier (2008) offer a Foucauldian-critical historical perspective that locates biosecurity at the nexus of a range of material and symbolic efforts to ensure the health of individuals and the population. Given this small sample of a much wider swath of competing definitions, this chapter pursues what I have introduced above as “biosecurities”—or multiple, overlapping senses of a contested discourse and practice concerned with governing life (Lakoff & Collier, 2008). Although my intellectual sensibility most closely aligns with Lakoff and Collier, I do not seek here to resolve the objective level of biological threats themselves. Instead, my attention in this chapter concerns biosecurities as a set of discourses and practices that have gained increasing currency during the past two decades and focuses on the need for communication scholars to more intensively engage with biosecurity texts, contexts, assemblages, and ecologies.
Most realist discourses of biosecurity derive from a particular set of assumptions about the nature of disease threats and the modern world. First, they tend to regard climate change and globalization as twin engines propelling a resurgence of emerging infectious disease and invasive species. Second, they regard this risk as inherently unpredictable and humans as inherently vulnerable to this unknowable risk. Third, they view risk management in terms of technological solutions to counter and contain emerging threats. These assumptions resonate with the theory of risk society—the idea that humans have produced technoscientific wonders like plastics and nuclear energy, which carry with them unforeseeable future risks that exceed the insurable limit. Anticipating and preparing for such risks becomes part and parcel of late modernity (Beck, 1992), such that society is increasingly oriented toward imagining, managing, and recovering from such risks. Preparedness thus becomes not only a buzzword but a way of being in the world, especially at the institutional level. In short, biosecurity discourses and practices are often thematized in terms of risk and vulnerability (Dobson, Barker, & Taylor, 2013).
Surveying biosecurities discourses in 2008, science policy analyst Kathleen
M. Vogel identified two competing discursive frames. The dominant framing,
she maintained, focuses on the “material and informational” aspects of
biosecurity with a future orientation (2008a, p. 50). This view is evident
in the first three definitions above, wherein technological solutions for
biosecurity are posited or implied. For Vogel, the dominant view assumes
that threats increase alongside technological developments. Moreover, the
focus on technology has “structur[ed] policy attention and resources to
address primarily the ‘technological’ aspects of the problem” (p. 51).
Consider, for instance, the words of the former President of the American
Institute of Biological Science (AIBS): In these early years of the 21st century, scientific discovery and
understanding are playing an important and growing role in meeting the
challenges—environmental, human health, economic—facing societies
everywhere. At the forefront are advances in biology. Indeed, it is
reasonable to say we are entering the Age of Biology, paralleling in
many ways the Age of Physics in the first half of the 20th century.
(Cracraft, 2004, p.
In these early years of the 21st century, scientific discovery and understanding are playing an important and growing role in meeting the challenges—environmental, human health, economic—facing societies everywhere. At the forefront are advances in biology. Indeed, it is reasonable to say we are entering the Age of Biology, paralleling in many ways the Age of Physics in the first half of the 20th century. (Cracraft, 2004, p. 979)
Here, technoscientific solutions in the life sciences are heralded as solving the world’s most pressing challenges and cast as ushering in an era of revolutionary scientific advancement, a progress narrative featuring heroic science.
If the dominant view of biosecurity presupposes that technology is the means
through which to secure biological safety, then the alternative and
comparably more muted frame focuses on the sociocultural aspects of biosecurity. This view assumes that
understandings of the nature of the threat are modulated by culture and by
the cultural and technical aspects of biotechnology. Lakoff and Collier’s
above-quoted definition, which is sensitive to the roles that society and
power play in defining what counts as a risk, threat,
security, or even health itself, resonates with
this alternative view. Surveying the expanding realm of biodefense and its
connections to health security, Lakoff
and Collier (2008) maintain that what they call vital
systems security is a “significant mutation in biopolitical
modernity” (p. 21). Vital systems security: arose at a later conjuncture in the evolution of biopolitical
government, beginning in the early 20th century. With the
intensification of modernization and industrialization processes,
planners and policy-makers recognized that collective life had become
dependent upon interlinked systems such as transportation,
electricity, and water [. . .] Vital systems security does not rely on
statistical analysis of past events to generate knowledge about
security threats, but rather on the simulation or enactment of
potential future events. Indeed, the very instruments of biopolitical
government, which aimed to foster the health and wellbeing of the
population, came to be seen as potential sources of vulnerability. (p.
arose at a later conjuncture in the evolution of biopolitical government, beginning in the early 20th century. With the intensification of modernization and industrialization processes, planners and policy-makers recognized that collective life had become dependent upon interlinked systems such as transportation, electricity, and water [. . .] Vital systems security does not rely on statistical analysis of past events to generate knowledge about security threats, but rather on the simulation or enactment of potential future events. Indeed, the very instruments of biopolitical government, which aimed to foster the health and wellbeing of the population, came to be seen as potential sources of vulnerability. (p. 21)
In its staging of potential future threats, Clade X and simulations like it are examples of vital systems security. Elsewhere I have argued (Keränen, 2011a) that these wargame and tabletop simulations played a key role in animating the threat of bioterrorism and emerging infectious disease for U.S. officials in the period just before and after 9/11, paving the way for increasing funding for biodefense in the years after 9/11, while Lakoff (2008) has maintained such exercises help establish a “generic biothreat” that works to both generate “an affect of emergency” and “generate knowledge” to “guide intervention” (p. 401; see also Schoch-Spana, 2004).
Looking back over the late 1980s through the early years of the twenty-first century, we can trace four trajectories that began to intersect to keep the germ threat lodged in official and public imaginaries and political activities: animal and crop security, biological weapons, war gaming, and public health/epidemiology. This observation is not to say that these four threads did not have intersection points at earlier times in history, but only to suggest that they began to converge after 9/11 with marked significance—particularly following the fall 2001 anthrax mailings—as the U.S. spent “billions for biodefense” (Franco, 2008, p. 131). That these domains coalesced into a powerful new vision of public health can be seen in the WHO’s 2007 report, A Safer Future: Global Public Health Security in the 21st Century, which articulated this evolving paradigm for responding to infection: global public health security. Central to the idea of global health security are the interconnected ideas of risk, vulnerability, and the extension: resilience. The final section of this chapter explores the rhetorical and material entailments of this paradigm as outlined in the WHO report, but first, it is useful to examine the linkages between biopolitics and biosecurity before addressing how scholars have approached biosecurity across empirical, interpretive, normative, and critical contexts.
Attention paid to biosecurity in official and public realms after 9/11 coincided with an intensifying focus on the intersection between biology and politics in academia. Here, the concept of biopolitics gained significant traction in the humanities and social sciences in the last decades of the twentieth century. Biopolitics, most broadly, refers to “the merger of life [bios] and politics” (Lemke, 2011, p. 3), but the term encompasses a disparate transdisciplinary set of meanings that can be roughly sorted into several primary conceptions. While a full examination of biopolitical theory is beyond the scope of this chapter, three conceptions relate well to our discussion of how biosecurity has been studied. The first, extending the work of French philosopher Michel Foucault, Rose (2006) regards biopolitics as involved in the administration (or governing) of life, while a second, advanced by Italian political theorist Giorgio Agamben (1988), focuses on the power of the sovereign state to exclude or kill certain members of society. A third perspective, developed by Italian philosophers Michael Hardt and Antonio Negri (2009), postulates that biopolitics represents a new stage of development in which labor, bodies, material, and affect are subsumed under a global capitalist regime.
Let’s consider these approaches more closely. In the first view of biopolitics as the administration of life, we find an extension of Foucault’s notion of biopower as a technique of power that coincided with the emergence of the modern nation state in the late eighteenth century. Biopower, in the Foucauldian lexicon, includes an array of techniques that seek to “make (subjects) live” (fairer vivre, for Foucault) and “let die,” operating both on the anatomical body and the body politic to secure the health of individuals and the population. Whereas the sovereign had the power to take life in the premodern period to protect from external threats, in the modern period, a new technique of power emerged that had the power to “make live,” working to ensure the health and wellbeing of the general populace. Through “the emergence of a specific political knowledge and new disciplines such as statistics, demography, epidemiology, and biology,” it became possible to examine “processes of life on the level of populations and to ‘govern’ individuals and collectives by practices of correction, exclusion, normalization, disciplining, therapeutics, and optimization” (Lemke, 2011, p. 5). The now ubiquitous workplace wellness campaigns are an example of biopower aimed at both the individual and population levels. In promoting weight loss through regimens of diet and exercise, which seek to normalize, correct, and regulate individual employee body mass indices, workplace wellness programs aim to produce healthy workers as an overall population. Biosecurity in this view is seen as an array of techniques, widely dispersed through society, for ensuring healthy populations in order to make them fit for the capitalist workplace.
By contrast to a view of biopolitics as a productive power of making live, a second view of biopolitics most associated with Giorgio Agamben locates biopolitics as the ability to take life, similar to what Murray (2008) has called thanatopolitics. In a revision of Foucault detailed in his book Homo Sacer, Agamben (1988) positions biopolitics not as a break from past forms of sovereign power, but as its logical extension. Biopolitics works through the “rule of exception.” Here Agamben traces a political lineage from the Roman legal concept of homo sacer, a person who could be killed with impunity because they are seen as existing outside the political community and exist in a state of “bare life” or sheer physicality. Agamben focuses on such states of exception from political rights. Refugees unprotected by law, concentration camp victims, and even the prisoners at Guantanamo Bay are cogent examples. For Agamben, this state of exclusion has become integral to contemporary political rationality. Biosecurity in this view is bound up in securing particular kinds of lives and determining which lives are outside the bounds of political participation and the apparatus of state security.
Yet a third view of biopolitics emerges in the work of political theorists Michael Hardt and Antonio Negri in Empire (2000) and Multitude: War and Democracy in the Age of Empire (2009). Biopolitics here appears as a new stage of capitalism that erases the borders between economics, politics, production, and reproduction. In the communication discipline, Hardt and Negri’s views of biopolitics have received comparatively more attention, although studies of Agamben and states of exception, particularly in the case of immigration and terrorist detention sites, are common as well. Rhetoricians of health and medicine have tended toward the Foucauldian version of biopolitics with its accompanying attention to genetics, wellness, and the prospects of “making live,” but this literature is comparatively smaller than works drawing from Agamben and Hardt and Negri. Finally, it is worth noting that the concept of immunity (Esposito, 2013) figures largely in the biopolitics literature, referencing how modern subjects seek to secure immunity for the contagion of the community.
Surveying communication scholarship that includes the keywords biosecurity, biological security, bioterrorism, pandemic, biological weapons, and bioweapons reveals roughly 200 works that attempt to bolster biosecurity, describe biosecurity, or critique biosecurity, that roughly sort into (1) analyses of the stories and frames of emerging infectious disease and bioterrorism discourse, with significant attention paid to news framing of pandemic or emerging infectious disease; (2) studies of public response or perception to messages about biological threats; (3) best practice and public relations recommendations; and (4) critical commentaries on biosecurity discourses, policies, or artifacts. Because scholarly literature on HIV/AIDS discourses predates biosecurity but later aligns with it and because the HIV/AIDS literature vastly outnumbers works devoted explicitly to biosecurity, works addressing HIV/AIDS are considered outside of the scope of this chapter, although they are certainly relevant to realist, interpretivist, and critical conceptions of biosecurity. It is also important to note that in choosing to focus on large thematic areas, this review cuts across several subfields of communication studies, ranging from health communication to rhetorical criticism. While some of these topical areas reveal an affinity for a particular subfield, others contain work that cuts across many subfields and methodological paradigms.
Humanities and social science scholarship have tracked the close coupling of discourses of disease with those of national security, reinforcing that how we talk about infection is often laden with a sense of national belonging. Resulting discourses draw borders between a mythical, healthy ingroup, an “us,” and a contaminated “Other”—much like dehumanizing contemporary discourses about immigration (Cisneros, 2008; Joffe, 2011; Wald, 2008). Such discourses can both assist and hamper health authorities’ and citizens’ ability to contain new illnesses. Sociologist Sheldon Ungar (1998, 2008) contributed some of the earliest and most enduring work in this area. Ungar analyzed news reports of emerging infectious diseases (EIDs) like Ebola Zaire (1998) and bird flu (2008) to identify a “mutation-contagion” discursive package. Drawing from the concept of moral panic, Ungar found that news frames switch from alarming and speculative messages that position EIDs as unwieldy threats to reassuring containment messages when outbreaks that potentially could produce panic occur. First, he charted how media create a sense of hot crisis, by framing the emerging infection as novel, mutating (and therefore unpredictable), and potentially threatening to readers. But when an outbreak occurs, media attempt to quell potential panic by reassuring publics that the disease is not as contagious as feared, that it is not airborne, and by stressing how mainstream health systems have the disease under control. Ungar (1998) also found efforts to blame disease on “primitive” others.
Helen Joffe (2011)
complicates and extends Ungar’s work when she posits three moves in media
coverage of EIDs: “distancing the disease from the self/one’s in-groups;
blame of particular entities for the disease’s origin and/or spread; and
stigmatization of those who have contracted it and/or who are represented
as having intensified its spread” (p. 446). Joffe’s analysis further
suggested that “EID fatigue”
might be setting in among Western publics (p. 456), along with wider
skepticism about health authority and government response in addition to
more reflexivity about disease discourses. MacPhail (2009) extends this line of thinking
further when she tracks how avian influenza is becoming a mounting
political issue wherein nation states jockey for global recognition. She
finds that: Highly-publicized and politically-charged battles over samples of
the H5N1 virus, transparency, timely case reporting, and China’s
contribution to and cooperation with global institutions like the
World Health Organization (WHO), have all emphasized the mounting
political positioning of public health prevention measures. (p.
Highly-publicized and politically-charged battles over samples of the H5N1 virus, transparency, timely case reporting, and China’s contribution to and cooperation with global institutions like the World Health Organization (WHO), have all emphasized the mounting political positioning of public health prevention measures. (p. 456)
Here, discourses of outbreak and contagion intersect with broader cultural narratives and practices.
Another important concept that illuminates this tight coupling comes from
English professor Priscilla Wald
(2008), who maintains that stock cultural discourses across a
range of artifacts comprise a standard outbreak
narrative. She explains: the outbreak narrative—in its scientific, journalistic, and
fictional incarnations—follows a formulaic plot that begins with
the identification of an emerging infection, includes a discussion
of the global networks throughout which it travels, and chronicles
the epidemiological work that ends with its containment. (p. 2)
the outbreak narrative—in its scientific, journalistic, and fictional incarnations—follows a formulaic plot that begins with the identification of an emerging infection, includes a discussion of the global networks throughout which it travels, and chronicles the epidemiological work that ends with its containment. (p. 2)
Central characters include patient zero, heroic doctors, unwitting carriers, primitive locals, and sinister, agentic, anthropomorphized viruses, which Wald tracks across Typhoid Mary discourses, public health films, and novels and even how the science of sociology borrowed language from virology. Here, the discourses of contagion and society co-evolve in consequential ways. Ultimately, across her case studies, Wald demonstrates “how the outbreak narrative articulates community on a national scale, as it identifies the health and well-being of those legally within the borders of the state and its worthy representatives” (p. 33). In other words, discourses of contagion are always already about national identity and security. While larger societal discourses comprise one means to access cultural narratives about disease and security, news frames supply another. Because the largest share, by far, of the literature derived from my search terms concerned pandemic and bioterrorism news frames, I devote a larger portion of space to works in this area before delving into other areas of inquiry within communication studies.
A large body of literature identifies and analyzes international news frame about pandemic, foodborne illness, and emerging infectious disease, a full review of which exceeds the scope of this essay. Similarly, for each outbreak, SARS, H1N1, H7N9, e-coli, salmonella, anthrax, Hantavirus, Ebola, and so on, there are separate literatures, which are too voluminous for comprehensive coverage in this handbook.
Much of the literature on media frames stresses the inaccuracy and sensationalism of news frames of outbreaks and bioterrorism. Hefferen, Misturelli, and Thompson (2011) observe that “Disease panic and the news media form their own generative circle. The more panic, the more rumors, the more demand for information to be supplied by the newspapers (and, later, CNN)” (p. 615). Goodall, Sabo, Cline, and Egbert (2012) examined H1N1 coverage of print and electronic news across six major U.S. sources for the five months following an outbreak. They found that most stories over-emphasized the severity of the threat and that 95 percent of stories used the inaccurate term swine flu instead of the scientifically preferred term H1N1. They also found that the stories over-reported H1N1 deaths and hospitalizations. Compared with the severity of the threat, information about actions individuals could take to protect themselves from infection (self-efficacy) was sparser and occurred later in the stories. Similarly, Swain (2007) tracked the use of “outrage rhetoric” in 2001 across 833 stories from 272 U.S. newspapers, the Associated Press, National Public Radio, and four national television networks (CBS, NBC, CNN, ABC) following the anthrax attacks. She coded this coverage for displays of outrage rhetoric, including speculation, conflicting reports, coverage of hoaxes/false alarms, vague advice, and off-record attribution. She concluded that “Overall anthrax coverage was both frightening and functional. Most was characterized by fear rhetoric, speculation, and confusing incidents, which in turn may have contributed to outrage. Surprisingly, the use of unnamed sources was common” (p. 347).
Several authors have tracked evolving pandemic coverage over time,
finding differences in language framing across several major pandemics.
Blakely (2003) analyzed
835 New York Times articles on influenza across three
historical pandemics: 1917–1920, 1957–1960, and 1968–1970. Of these,
Blakely found that coverage of the earliest pandemic was more
fear-inducing and panicked than in that of later pandemics. This early
coverage painted a portrait of a medical profession overwhelmed by the
virus and blamed the disease on “foreigners,” as a “German sickness,” or
a “Spanish sickness.” All three pandemics invoked war metaphors in the
Times, but coverage in 1958 placed more optimism in
science (until vaccine supplies ran low) and initially framed the disease
as mild. Coverage was more medical in 1968 and focused on presenting
scientific information, tracking the epidemic, and trying to calm public
unease about vaccine availability. The CDC became the arbiter of
expertise above the Surgeon General, who had featured prominently in 1958
pandemic coverage. Blakely found that themes in the coverage tended to
map onto the popularization of science within the broader culture.
Similarly, Angeli (2012)
analyzes electronic news framing of H1N1 and “Swine flu” from 665 online
sources in 2009 and finds both configured in terms of battle, war, and
natural disaster, but also that H1N1 was framed in terms of being a
scientific/medical concern and a “visitor,” while swine flu was discussed
in terms of being a victimizer: Names intended to invoke emotion, such as swine flu, often include
metaphors that blame and instill fear. Names intended to refer to
the technical nature of the flu, such as H1N1, often include
metaphors that show officials have no control over the flu, as flu
is “just a scientific force of nature,” so to speak. (p. 218)
Names intended to invoke emotion, such as swine flu, often include metaphors that blame and instill fear. Names intended to refer to the technical nature of the flu, such as H1N1, often include metaphors that show officials have no control over the flu, as flu is “just a scientific force of nature,” so to speak. (p. 218)
Beyond U.S. English-language news reports, scholars have investigated the
contours of international coverage of pandemic and EIDs in Canada (Gerlach, 2016), China (Ding, 2013, 2016; Hefferen et al., 2011; Keränen, Lindholm, & Woolly, 2017),
including Taiwan (Ying,
2010) and Hong Kong (Chan,
2016; Fung, Namkoong,
& Brossard, 2001; Keränen et al., 2017), England (Gerlach, 2016), India (Krishnatray & Gadekar, 2014), the
Netherlands (Vasterman &
Ruigrok, 2013), Norway (Bjørkdahl & Carlsen, 2017), Singapore (Lee & Basnyat, 2013), South
Korea (Lee & Paik, 2017),
and beyond. Bjørkdahl and Carlsen
(2017) analyzed Norwegian news coverage of the H1N1 pandemic in
2009 with a focus on how various actors made “fear” a central theme of
the coverage. They found that a wide array of social actors were quoted
as claiming the media was creating fear or panic but that they did so
without evidence: “The drama that emerged on the mediated stage revolved
not so much around a genuine fear of the flu, as around a fear of the
fear of the flu” (p. 366). Their work identified the work of the “third
person effect”; that is, “the phenomenon that people tend to believe that
other people are more severely influenced by the mass media than what
they believe themselves to be” (p. 358). Gerlach (2016) tracked coverage of Ebola news in
2014 across 485 news articles from British, Canadian, and U.S. leading
news outlets to argue that Wald’s outbreak narrative was not strictly
followed in the coverage.
Lee and Basnyat’s (2013, p.
119) content analysis of Singaporean government press releases included
in news coverage shows that the evolution of information from press release to news
is marked by significant changes in media frames, including the
expansion and diversification in dominant frames and emotion
appeals, stronger thematic framing, more sources of information,
conversion of loss frames into gain frames, and amplification of
positive tone favoring the public health agency’s position.
shows that the evolution of information from press release to news is marked by significant changes in media frames, including the expansion and diversification in dominant frames and emotion appeals, stronger thematic framing, more sources of information, conversion of loss frames into gain frames, and amplification of positive tone favoring the public health agency’s position.
Krishnatray and Gadekar (2014) analyzed 2009 coverage in the English-language Times of India, finding four dominant frames across sixty-two news articles: fear/panic, attributions of responsibility, action, and human interest, concluding the newspaper’s focus on death had the potential to be fear-inducing. Together, these studies bolster claims that news coverage tends to reinforce the idea of fear of contagion.
News reports of avian influenza in post-SARS mainland China tended to present an image of a strong national response in the wake of SARS (Hefferen et al., 2011), while Hong Kong news reports of pandemic often re-narrated the lessons of SARS, much as Chan (2016) and Keränen, Lindholm, and Woolly (2017) found in their respective analyses of news coverage of pandemic in 2009 and 2013. Chan (2016) identified a three-step template for narrativizing the 2009 swine flu in Chinese coverage: narrativizing lessons learned from SARS, focusing on presenting a “detached neutrality of news objectivity” (p. 1031) by appealing to health authorities, and offering a narrative of repair that diverts blame away from health authorities.
A growing body of literature also larger than the purview of this essay but worth mentioning concerns the use of the internet and social media in societal responses to pandemic and biological threats. Ding (2013, 2016; Ding & Zhang, 2010) has notably focused on how citizens use social media for participatory risk communication in China and the United States in the wake of SARS. Work that examines the use of social media to respond to outbreak represents an important future site for investigation of and productive communication intervention.
Well-intentioned analyses of official and media discourses concerning biosecurity may minimize or ignore important issues of knowledge, perception, and agency among general publics. Related studies of citizens and audiences provide an important supplement—and potentially, correction—to those other genres. In one example, Ho’s (2012) nationally representative telephone survey of more than 1,000 Singaporeans revealed that newspaper reading was not associated with a widened knowledge gap about H1N1 between high- and low-income earners, although attention to television news and interpersonal conversations was association with a lowered knowledge gap between high and low socioeconomic status persons. She found that household income and risk perceptions correlated with knowledge of the flu. Wei and Zhou (2010) used CNN coverage in one experiment to examine how viewers perceived news stories about avian influenza. They found that the higher the message sensation value, the more audiences positively viewed the story in terms of clarity, credibility, understandability, enjoyability, and informativeness. Holland and Blood (2013) conducted interviews and focus group interviews with citizens deemed “at risk” of avian influenza in Australia. They found that while medical authorities and news media emphasized the “novel” and “deadly” nature of the flu, participants viewed it as “just another flu” (p. 523), revealing that the public’s lived realities did not match up with the news coverage.
One vein of scholarship concerns public perceptions of the threat of bioterrorism. Pollard (2003) conducted a national survey that found that local television, radio, and cable news and television were key sources of information for publics in the wake of the 2001 anthrax mailings. Lee and Rodriguez (2008) found that public information seeking about bioterrorism was linked to the perception of bioterrorism as an issue and delineated four types of publics based on media habits and trust dimensions. Aldoory and van Dyke (2006) used the situational theory of publics in focus group interviews with participants given news scenarios about a terrorist threat on a U.S. food item. Themes here included problem recognition, level of involvement, constraint recognition, fear, risk, and social connections. They found participants who felt the news source was in the same boat as them (shared involvement) were most likely to take the messages seriously. Elledge, Brand, Regens, and Boatright (2008) conducted twelve focus groups about avian influenza in Tulsa, Oklahoma, and identified five themes among the resulting conversations: terminological confusion, seriousness of avian influenza, disaster fatigue, appropriate precautions, and credibility of health information. They maintain each should be considered in developing effective risk communication messages.
In part because of a special issue focusing on CDC responses to the 2001 anthrax mailings, a disproportionate share of the literature addressing bioterrorism in communication studies focuses on CDC response processes. Robinson and Newstetter (2003) conducted interviews with communications officers at CDC offices in the wake of the anthrax mailings to determine how staff viewed CDC communicative responses. Although staff reported many challenges from too few phone lines to not having crucial information, they maintained that the anthrax mailings led to improved communications practice. Prue, Lackey, Swenarski, and Gantt (2003) examined how CDC had to step up its media monitoring and response processes in the wake of 9/11 and the anthrax mailings. Courtney, Cole, and Reynolds (2003) outlined how CDC was providing emergency health communication training to all personnel following the signal event.
Others have examined organizational processes in response to pandemic and bioterrorism. Avery and Kim (2009) found that press releases from major health organizations like the CDC and WHO were sometimes lacking necessary information during outbreaks. Kim and Liu (2012) applied situational crisis communication theory to thirteen U.S. corporate and government organizations in the wake of the 2009 flu pandemic. They found that government organizations provided information and guidelines to publics, while corporations emphasized reputation management and at times used denial or diminishment as response strategy. Together, the literature on organizational responses to biothreats reveals how notions of biosecurities are driving organizational and infrastructural changes, particularly in the United States.
A number of studies from the field of communication that have examined biosecurity have adopted a realist position that assumes that the nature of a particular biological agent or hazard maps directly onto official perceptions of the risk of the biological threat (Fox, 1999). These works also mostly share the assumption that biosecurity is an end to which society should strive. Scott Ratzan’s (2003) editorial in the Journal of Health Communication evidences not only the realist position, but also articulates assumptions of the evolving global health security paradigm. “If our principal goal is to combat biological terrorism or the spread of chemical entities,” he writes, “developing an effective first line global public health system of response with early detection, surveillance, communication, and appropriate treatment interventions is critical” (p. 206). Works in this area tend toward producing recommendations that can help governments and disaster planners produce better communication about risks before, during, and after crises occur.
Several consistent arguments characterize this literature. First, authors stress the need for timely (Duhé, 2005; Golan, 2003; Venette, Veil, & Sellnow, 2005) and accurate (Duhé, 2005; Golan, 2003; Venette et al., 2005) information. Second, authors emphasize the role of trust and relationship building in responding to crisis or disaster (Meredith et al., 2007; Vaughan & Tinker, 2009). Third, authors establish the need for culturally appropriate, tailored messaging (Meredith et al., 2007; Vaughan & Tinker, 2009). Some work (see, e.g., Wray et al., 2008) maintains the importance of pre-event communication for establishing networks of trust and partnership to prepare for future events. In one representative essay, Abraham (2011) surveyed lessons learned from the 2009 influenza pandemic and identified four areas for further development: integrating epidemic communication with health communication, developing improved internet communications capacities for crisis response, creating trust in a “post-trust” society, and developing capacity to navigate the political and economic dimensions of pandemics and disease crises.
In addition, a subset of this line of scholarship offers best practices guidance for communicating with diverse and marginalized publics about biological threats, stressing the need for trusted information sources from within the marginalized community and for culturally sensitive messaging (Meredith et al., 2007; Quinn, 2008; Vaughan & Tinker, 2009). Noting that effective risk communication is essential for protecting vulnerable populations during pandemics, Vaughan and Tinker (2009) surveyed the scientific literature on effective health communication during pandemic situations. They note that communication plans should be based on the perspective of the affected population. Additionally, they offer a framework for developing communications that are phased and situation specific that incorporate multiple channels, community-first channels, community capacity and resources, and trusted and credible sources of information (p. S327). They maintain that “The quality of the societal response depends partly on meeting the specific communication needs of all populations—especially those most vulnerable to the risks and most likely to experience communication gaps” (p. S324). While communication scholars have contributed to the literature on biosecurities in empirical, interpretive, and critical veins, public health activities were shoring up a vision of biosecurity at the center of global public health initiatives in the form of an emerging health security paradigm.
Critical-cultural scholarship analyzes cultural artifacts and their interrelation with the societal structures and ideologies that produced them, with a particular focus on power and praxis. Within communication studies, a body of critical-cultural work has interrogated the production of a sense of “permanent emergency” in response to 9/11. With regard to biological threats, this work seeks to expose the powerful scientific and defense interests involved in promoting the threat of bioterrorism in the United States. In an early work in this area, Scott (2006) traced how pharmaceutical companies seized on 9/11 to recast themselves as “essential defense weapons” (p. 124) in fighting against what they configured as the serious and long-term threat of bioterrorism, wherein pharmaceutical companies cast themselves as patriotic partners to the U.S. government. I (Keränen, 2011b) chronicled how a self-styled group of biosecurity experts persuaded government officials to take more seriously the threat of bioterrorism, while making the nation more vulnerable to a magnifying set of biological risks. The same year Ayotte (2011) unpacked the pivotal role of novelist Richard Preston in creating a public vocabulary around bioterrorism that invoked military jargon and sedimented a gruesome and racialized image of Ebola into the public imaginary. Moving away from bioterrorism, Condit (2014) interrogated the deliberative processes by which twenty-two journal editors, publishers, and flu experts decided for the rest of humanity that it was okay to publish research detailing the creation of a virulent, airborne super-flu, which had been put on a publishing hold for Nature and Science. She faulted “sub-standard” decision-making processes that failed to account for the range of human risks from the publication of such sensitive information and pressed for global deliberative processes governing risky biosecurity research.
A 2008 forum in Communication and Critical/Cultural Studies, edited by Barbara Biesecker, addressed Giorgio Agamben’s 2004 essay “No to Biopolitical Tattooing,” detailing Agamben’s refusal to submit to a requirement to supply biometric data to gain entry into the United States, resulting in the cancellation of his course at New York University. Stuart Murray translated the essay (Agamben, 2008) and wrote a rejoinder, which argued for a more capacious understanding of biopolitics that included both life and death. Responses by Kelly Gates, Eric Doxtader, and Rajeswari Sunder Rajan complicated the notion of biopolitics further, while Rajan’s call to shift from First to Third World considerations of the right of refusal and biopolitics was an important and much-needed conclusion to the forum. Considered as a whole, the forum offers a snapshot of emerging critical-cultural responses to heightened biometric surveillance in the post-9/11 era, punctuating the connections among speech, consent, and citizenship.
Still another large body of research has focused on linkages (real and imagined) between biological threats and the War on Terror. A significant number of works that well exceed the space allotted have identified inaccuracies in framing the risk of weapons of mass destruction (WMD) in the build-up to the U.S. invasion of Iraq across news outlets, intelligence briefings, and presidential and administrative discourse (Arsenault & Castells, 2006; Benoit, 2006; Boudeau, 2012; Hartnett & Stengrim, 2006b; Taylor, 2007; Vogel, 2008b). Meanwhile, Cooper (2006) tracked “the biological turn” in the War on Terror, while Muntean (2009) exposed homologies between terrorism and avian influenza, and Scott (2006) has used rhetorical analysis to demonstrate how BigPharma seized the kairotic moment of 9/11 to bolster business using the threat of bioterrorism as cover. Overwhelmingly, this literature finds inaccuracies and overblown threat constructions, which promoted the Global War on Terror. Together, these works point to the ethical dimensions of information sharing among officials and publics and illuminate how biological and WMD threat assessments can be misused to serve corporate and national interests.
By way of concluding this section, is important to note the diversity of method, topic, and approach to biosecurity manifested in the communication studies discussed above. They testify to the field’s capacious scholarship that can be theoretical or practical, descriptive or normative, realist or constitutive, which, taken together, demonstrates the pivotal role communication plays in comprising the enterprise we call biosecurity. Having surveyed the landscape of communication studies addressing biosecurity, we can look to its manifestation in one artifact in particular: the WHO’s 2007 A Safer Future report.
The outcome of the heightened attention to biosecurity in the post-9/11 era was the emergence of a new paradigm, global health security, alternatively called the “securitization of public health” (Fidler & Gostin, 2008, p. 121) or public health security. This paradigm achieved clear expression in the WHO’s 2007 report, A Safer Future: Global Public Health Security in the 21st Century. A Safer Future is significant in its use of the term global public health emergency, a term that has evolved into the acronym—fully on display during Clade X—“public health incident of international concern” (PHIOIC; see Clade X simulation media releases). A PHIOIC represents a suturing of biosecurity concerns from different domains, including pandemic-prone diseases, bioterrorism, foodborne illnesses, accidental and deliberate contagion, and environmental disasters, including natural and human-induced disasters like accidents and terrorism. While many authors cite 9/11 as the galvanizing force leading to this paradigm, the key elements were aligning in the decades prior to 9/11, as outlined earlier in this chapter. Nonetheless, the concepts undergirding the new paradigm coalesced in A Safer Future’s seventy-four pages of blue, black, and white text and images, which unfold across eight parts: a preface, an overview, a history of the evolution of the concept of public health security, threats to public health security, new health threats in the twenty-first century, lessons learned and looking to the future, and toward a safer future with conclusions and recommendations.
Following on the heels of its 2000 report announcing the return of infectious disease (WHO, 2000), the central message of A Safer Future can be summarized as follows: The world is experiencing increased health threats from natural and human causes. To protect against these new threats, to which all humans are vulnerable, international collaboration, surveillance, preparedness and planning are needed. Addressing these concerns, a new set of International Health Regulations (IHR, 2005) requires nations to collaborate to monitor, detect, identify, and respond to emerging health threats. Let’s consider each of these assumptions in turn.
First, the WHO explicitly positions A Safer Future as a
response to a new and vexing set of health challenges and opportunities.
Margaret Chan, then WHO Director, framed “the disease situation” as
“anything but stable”: Population growth, incursion into previously uninhabited areas, rapid
urbanization, intensive farming practices, environmental degradation,
and the misuse of antimicrobials have disrupted the equilibrium of the
microbial world. New diseases are emerging at the historically
unprecedented rate of one per year. Airlines now carry more than 2
billion passengers annually, vastly increasing opportunities for the
rapid international spread of infectious agents and their vectors . .
. vulnerability is universal. (2007, p. vii)
Population growth, incursion into previously uninhabited areas, rapid urbanization, intensive farming practices, environmental degradation, and the misuse of antimicrobials have disrupted the equilibrium of the microbial world. New diseases are emerging at the historically unprecedented rate of one per year. Airlines now carry more than 2 billion passengers annually, vastly increasing opportunities for the rapid international spread of infectious agents and their vectors . . . vulnerability is universal. (2007, p. vii)
Note here the rhetorical work of “universal” vulnerability and increasing “opportunity.” In this passage, emerging threats to human health are positioned as unique to our present era, exacerbated by human activity, and accelerating. These threats are also cast as inescapable, necessitating an affirmative, productive biopolitics meant to safeguard from the unseen threats. The report is based on the assumption that epidemic, framed as the “antithesis” of health, “erodes prosperity, destabilizing the relations between state and society, renders institutions sclerotic, foments intra-state violence, and ultimately diminishes the power and cohesion of the state” (Price-Smith, 2009, p. 2).
Second, crucial to the rhetorical work of the report is its definition of
global public health security as “the activities
required, both proactive and reactive, to minimize vulnerability to acute
public health events that endanger the collective health of populations
living across geographical regions and international boundaries” (WHO, 2007, p. ix). This definition
noticeably expands the purview of public health, extending biosecurity
beyond biosafety into the broader concept of health
security, encompassing a widening array of domains, many of
which used to be seen as separate from, but potentially related to, health.
Moreover, this definition enlargens the terrain of public international
health beyond “airports and seaports” (p. xv) to any circumstance that could
potentially undermine health. A Safer Future even
explicitly acknowledges the work of this new definition: The broad definitions of “public health emergency of international
concern” and “disease” allow for the inclusion in IHR (2005) of
threats beyond infectious diseases, including those caused by the
accidental or intentional release of pathogens or chemical or
radionuclear materials. (p. 13)
The broad definitions of “public health emergency of international concern” and “disease” allow for the inclusion in IHR (2005) of threats beyond infectious diseases, including those caused by the accidental or intentional release of pathogens or chemical or radionuclear materials. (p. 13)
Here, terrorism and public health become explicitly and inextricably linked, suturing public health closer and national security.
This rhetorical move is not without consequences. Muntean (2009, p. 1999) has noted a similar
parallel in other discourses about terrorism and disease. He argues that:
By rhetorically constructing bird flu as a threat that is
ontologically homologous to that of terrorism, the nature of pandemic
disease—and the policies and programs designed to counter it—have been
fundamentally misconstructed, leaving us in some ways more vulnerable
to pandemic disease than before.
By rhetorically constructing bird flu as a threat that is ontologically homologous to that of terrorism, the nature of pandemic disease—and the policies and programs designed to counter it—have been fundamentally misconstructed, leaving us in some ways more vulnerable to pandemic disease than before.
A Safer Future thus moves public health from a focus on “passive strategies” and prevention focused on a few diseases to a broader “defense” for any health-related issue, regardless of the source. The IHR calls for countries to develop a “set of ‘core capacity requirements’” to “detect, assess, notify, and report” on outbreaks and other threatening public health events. As an artifact of a neoliberal form of governance, the report seeks international cooperation to solve the complex challenges of globalization and advanced capitalism.
Third, the extension of this paradigm is a logic of preparedness or
resilience, codified in the new set of International Health Regulations. It
thus ushers in a new form of governance. Many authors have noted the
prominence of resilience thinking in contemporary global political culture
(Adey & Anderson, 2012;
Bean, Keränen, & Durfy,
2011; Walker & Cooper,
2011). Such preparedness discourse is shot through treatments of
health security, which focus on lessons learned from past outbreaks and
health emergencies for future ones. As Kruk et al. (2015) explain, Health system resilience can be defined as the capacity of health
actors, institutions, and populations to prepare for and effectively
respond to crises; maintain core functions when a crisis hits; and,
informed by lessons learned during the crisis, reorganise if
conditions require it. (p. 1910)
Health system resilience can be defined as the capacity of health actors, institutions, and populations to prepare for and effectively respond to crises; maintain core functions when a crisis hits; and, informed by lessons learned during the crisis, reorganise if conditions require it. (p. 1910)
Pandemic resilience similarly appears across all policy levels in the U.S., from Presidential Directives through hospital response policies. For instance, Homeland Security Presidential Directive (HSPD) 21 identified “community resilience” as among the “four most critical components of public health and medical preparedness.” Biological surveillance, medical countermeasure distribution, and mass casualty care were the others. Similarly, the U.S. Department of Health and Human Services Influenza Preparedness Plan seeks to enhance the “resilience of workers and their families” and the “resilience of the healthcare workforce,” while hospitals put in place policies for “resilient” responses to influenza. What is striking about present conceptions of resilience is how health resilience updates the twentieth century’s dominant public health prevention paradigm with a broader notion of preparation and recovery. More planning, more infrastructure, more vaccines, more BigPharma, more containment facilities, more bioweapons countermeasures, and more biosurveillance labs are the material outputs of health resilience and its implied sense of security.
As we move farther away in time from the publication of A Safer Future, the expanding reach of health security further crystallizes. To offer a mundane example, as this chapter was headed out for review, the journal Health Security (Sell, 2018) published a themed issue, “Communication and Health Security: Improving Public Health Communication in Response to Large-Scale Health Threats,” which included six essays:
In a journal that once raised alarm about the risk of bioterrorism to a group of government insiders and public health experts, we now see the full expression of the global health security paradigm that A Safer Future had articulated years before. The journal, produced by the Johns Hopkins Center for Health Security (formerly the Johns Hopkins Center for Civilian Biodefense—a name change that reflects the evolution of the paradigm of health security), subsumes a bevy of concerns from novel viruses to newspaper coverage under the umbrella of health security, showing how the global health security paradigm is generating its own forms of expertise (Lakoff, 2008) as it more tightly entwines public health, communication, and security.
While medicine, war, and security have always been connected and configured in relation to one another, the recent re-drawing of boundaries between domains of medicine and national security subsumes public health under the security state. Such a move marks a ratcheting up of biosurveillance at all levels of human activity from citizen at-home microbiota testing to large-scale global syndromic surveillance programs. Efforts to counter unknown future biological threats encourage the work of resilience with attention paid to envisioning, preparing for, and potentially recovering from anticipated biological threats and “public health emergencies of international concern” across ecological, foodborne, dietary and lifestyle, engineered forms of life, and bioweapons arenas, to name a few.
Communication scholars are well poised to conduct inquiry about biosecurities across empirical, interpretive, and critical projects that investigate the primary texts, artifacts, and assemblages of biosecurity, develop theory about contagious discourses and biological life and “threats,” map out appropriate responses, and suggest alternative frameworks for understanding emerging infectious disease and biological threats. In such analyses, biosecurities become at least as much about ethical, political, and discursive issues as they are material or technologically solvable ones, because the kinds of life to be protected, the ways they are protected, the distribution of vulnerability, and the requirements of resilient health system are profoundly ethical and political activities. As Lakoff and Collier (2008) have argued, neither health nor security has a limit, meaning the work of biosecurities is infinitely scalable and applicable to many domains of human life.
Rather than privileging one perspective on biosecurity, communication
scholars should intentionally interrogate a plurality of biosecurities,
asking about the broader ecologies in which various forms of life are
created, deployed, circulated, challenged, curtailed, and resisted. In so
doing, we should be mindful of King’s
(2002) caution that: the institutionalization of biodefense may encourage an exaggerated,
open-ended climate of crisis in which ethical deliberations are
hurried, obscure, or absent altogether. Such a climate would
perpetuate social choices that focus on highly-visible and visceral
threats whose actual contribution to the burden of disease is
negligible [. . .] Unless we are vigilant about critically
understanding their consequences, pragmatic compromises made in a
climate of crisis can fossilize into ethical choices about the
distribution of resources. (p. 445)
the institutionalization of biodefense may encourage an exaggerated, open-ended climate of crisis in which ethical deliberations are hurried, obscure, or absent altogether. Such a climate would perpetuate social choices that focus on highly-visible and visceral threats whose actual contribution to the burden of disease is negligible [. . .] Unless we are vigilant about critically understanding their consequences, pragmatic compromises made in a climate of crisis can fossilize into ethical choices about the distribution of resources. (p. 445)
As we both study and contribute to the literature on biosecurities, communication scholars should look both to the mundane and the exotic, and simultaneously to the local and the global, while exploring how biosecurities allow the emergence of new forms of global governance, surveillance and border control, and ultimately, ways of being.