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From the ‘Cold War’ to the ‘Hot War’: Microbes change – Can We?

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1997 Congressional Testimony more relevant today.

April 24, 1997

Testimony by

Chuck Woolery, Issues Director

National Council for International Health

Submitted to

Congressman Sonny Callahan, Chairman of the

Foreign Operations Subcommittee of Appropriations

U.S. House of Representatives

From the ‘Cold War’ to the ‘Hot War’:  Microbes change – Can We?

 “No matter how selfish our motives, we can no longer be indifferent to the suffering of others. The microbe that felled one child in a distant country yesterday can reach yours today, and seed a global pandemic tomorrow.”   —Nobel Laureate Dr. Joshua Lederberg, 1996

Thank you for allowing the National Council for International Health (NCIH) to give public testimony regarding the prioritization of US foreign aid appropriations.  NCIH represents over 100 member organizations including the American Medical Association, the American Public Health Association, American Dental Association, the American College of Preventive Medicine, the American Nurses Association, the American Association of Critical Care Nurses, 6 Schools of Public Health and dozens of other international health and development organizations.  Most of these organizations and thousands of individual health professionals are in support of this Subcommittee re-examining its fundamental priorities in light of both human needs around the world and the growing threat to our nation’s security from new and re-emerging infectious diseases.

New threats to US Security:  For decades stopping the spread of Communism dictated most US foreign policy actions.   In the post Cold War era, a very strong case can be made for waging a serious ‘hot war’ against the spread of infectious diseases.  Overwhelming evidence already exists to support the launching of such an initiative as one of the primary directives of US foreign policy.

In some ways, infectious diseases pose a far greater threat to US security than any invading army.   We have the technological power to defend against armed aggressors.   We have few defenses against a growing number of new microbial threats.   We can easily detect the launch of an ICBM.  We didn’t detect the emergence of new strains of HIV/AIDS.  Even after we have identified a new virus, we may have nothing to stop it with.  Prevention, in the coming ‘Hot War’ may be our smartest and cheapest defense.    The old approach of ‘peace-through-strength’ must now be tempered with containment by prevention and compassion.   Given the potential for human devastation from the natural, accidental or intentional release of an infectious agent, we must reorient ourselves to achieving a broader security and lasting peace.

The best selling non-fiction book “The Hot Zone” awoke public interest with the details of an ‘air born’ strain of Ebola accidentally released at a research facility in Reston VA several years ago.  This particular Ebola strain only affected monkeys — this time.  It struck again at a facility last year in Alice, Texas.  Only a few months ago there was fire in a building at Fort Deitrick, the high security site in Maryland where our military houses some of the most lethal biological agents known to man.   A white supremacist was earlier arrested at his house with vials of Bubonic Plague not yet removed from the glove box of his car.  They were mail ordered from a federally supported lab in Rockville, Maryland.   A high school girl in California had part of her lung surgically removed because her strain of TB was not responding to our best antibiotics.  The incidence of children with whooping cough, a serious and sometimes fatal disease that’s preventable with a vaccination – has shot up 83% so far this year.  Tainted strawberries, a new strain of HIV/AIDS from Africa, a mysterious infection jumping the species barrier from fish to man off the shore of North Carolina – these are just a few examples of an increasing trend. Congressman Ganske returned from Peru last fall and was hospitalized for two weeks with a double infection of ‘post-viral encephalitis’ (inflammation of the brain) and an intestinal bacterium called campylobacter.  He still feels some of the effects.   A tuberculosis outbreak at Bancroft elementary school less than a mile from this Capital last week.  This week there was a measles outbreak in another part of town.  There is a trend here.

Laurie Garrett’s 750 page book “The Coming Plague” (recently made into a 4 hour documentary with the same name) details the many times in our past when humanity was both lucky in victory and not so lucky in defeat against microbial adversaries.   The best scientists, doctors, and experts from both the public and private sector and from nearly every branch of the USgovernment, in 4 separate reports over the last 6 years, say this is a dangerous trend.  The National Academy of Sciences Institute of Medicine, The Centers for Disease Control, the Department of Defense, The National Security Council and others has well documented these growing risks.

They have also made recommendations for action which can be classified into four basic areas; Surveillance, Response, Research and Prevention.   There has been little progress on any of these levels.

The most recent report, “America’s Vital Interest in Global Health”, was announced in a March 17 press release issued by the National Academy of Sciences, Institute of Medicine.  It stated:

“The expansion of global trade has ushered in an era of unprecedented opportunity and risk.  As the number of goods, services, and people crossing national borders each day increases, so does the chance that they may spread infectious diseases…  In order to capitalize on the opportunities of this new era while protecting Americans, the United States must broaden its commitment to global health…  The United States now devotes a lower percentage of its gross domestic product (GDP) to global health than it has at any time since 1950… More than just a humanitarian concern, the report says, it is in America’s’  ‘enlightened self interest’ to more fully engage in global health.”  (Copies of the report are available from the Institute of Medicine’s Board on International Health;  202-334-2427)

All of the evidence overwhelmingly points to a future of certain catastrophe if we fail to adequately respond to this growing ‘real world’ threat.

With a focus on prevention, this Subcommittee can do more to protect the security of Americans than any other government agency, including the Department of Defense.   Secretary of State Madeline Albright recently said that foreign aid represents only 1% of our federal budget but it will determine 50% of our history.   In the context of infectious diseases, 50% could be an underestimate.   Given the severity of the situation, it is time to radically alter the US priorities regarding the appropriation of foreign aid dollars.

No debate:

While opposing sides debate other threats like chemical weapons, rogue missiles, global warming, NAFTA, or trade with China, there is no debate regarding the reality of this certain and most serious health risk.  The body count is just too high with the numbers climbing higher each year.  The numbers are already so high that they make death counts from all previous wars pale in comparison.   Well over 150,000 Americans now die each year from infectious diseases and that number is growing.  In fact, infectious diseases have risen from the 5th largest killer of Americans to the 3rd largest killer in just the last 12 years.  Over 60,000 Americans died last year from hospital acquired infections.  That’s almost 10 times the US annual casualty rate during the Vietnam War.  There were an additional 24,000 deaths from ‘unknown’ causes that same year but were attributed to a possible infection.   Infectious diseases now account for over 50% of all doctor visits in the US and the cost to our economy is well over $120 billion a year.

Globally, infectious diseases remain the single greatest killer taking the lives of over 50,000 people, mostly innocent children, every day.  They cause needless suffering and disability in far greater numbers.  Most of these deaths and disabilities are affordably preventable.

The most alarming fact is that while the growing threat is clearly documented, the response of this nation’s government has been minimal.  In some cases, this inaction could be labeled detestable.  The Clinton Administration itself, while well aware of the threat, has suggested a $30 million cut to ‘international health’ efforts while requesting a billion dollar increase in the overall foreign aid budget.  The increase is acceptable; however, the mere $60 million increase designated for Development Assistance and $30 million reduction in USAID child survival and health efforts is not!

While this subcommittee has been quite heroic in its protection of child survival and disease prevention efforts, it, too, has fallen short of the humanitarian and national security needs.  The opportunity for bold leadership still remains unfulfilled.   To twist a phrase, ‘for lack of vision, the people will perish’.

Warnings Unheeded:

Nearly two decades ago, Congress was given a clear warning by no less than a Presidential Commission after an exhaustive study of the issue of world hunger.  At the end of the Carter Administration, this prestigious group of experts concluded:

“In the final analysis, unless Americans — as citizens of an increasingly interdependent world — place far higher priority on overcoming world hunger, its effects will no longer remain remote or unfamiliar.  Nor can we wait until we reach the brink of the precipice; the major actions required do not lend themselves to crisis planning, patchwork management, or emergency financing… The hour is late.  Age-old forces of poverty, disease, inequity, and hunger continue to challenge the world.  Our humanity demands

that we act upon these challenges now…”

Presidential Commission on World Hunger, 1980.

Congress failed to act but the microbes were already in the process of fulfilling on the Commission’s prophecy.   Less than 2 years after the release of the Commission’s report, our nation began to feel the sting of the HIV/AIDS pandemic.   The lethal virus had been spreading through the human population for over a decade moving slowly from the Kinshasa Highway of Zaire to the main streets of the United States.  The fact is, if America had been more interested in the health and well being of poor people beyond our shores much earlier, we would have had at least a 10 year head start in slowing (or stopping) the spread of this rapidly mutating pathogen.   Our failure to detect early that single disease will cost the US hundreds of thousands of lives.  It is now also costing us an estimated $30 billion a year.   Some have called the AIDS epidemic an “act of God” as punishment for those who violate the “laws of God”.   A stronger case could be made that HIV/AIDS is God’s ‘wake-up call’ to humanity, gently telling us, “Take better care of one another or you will all suffer,”.  God’s next message could be ‘air-borne”.   Whatever belief system one might have, the reality is that microbes don’t care.   In the words of Nobel Laureate, Joshua Ledderberg, “They’re just looking for a piece of warm meat.”

HIV/AIDS was not the first disease in modern times to be brought into America and it will not be the last.  With over 27 million North Americans traveling to the less-developed nations each year and returning home virtually unscreened, it is guaranteed there will be more pandemics to come.  They could be new strains of HIV, Polio, or Tuberculosis, or an infectious disease we have never seen before.   In whatever form, they will come.

We could follow current policy and wait until each disease gets here before we respond.   We could even try endlessly to stop them from crossing our borders or entering via airports.  The cheapest and most effective alternative, however, remains a pre-emptive strike on their home turf, amid the conditions of poverty, hunger, illiteracy, squalor and chaos.   This subcommittee has jurisdiction over this key area of interdiction.

“…the emergence of the most harmful diseases can be countered not only for pathogens that are recognized as threats but also for those posing threats that are not yet recognized.  Providing pure water supplies, reducing attendant-borne transmission, reducing vector-borne transmission preferentially from ill people (e.g., by providing mosquito-proof houses) should guard against the emergence of virulent pathogens, whether the pathogens are unidentified or are highly virulent variants of identified human pathogens.”

Paul W. Ewald, Dept. of Biology, Amherst College. “Guarding Against the most Dangerous Emerging Pathogens:  Insights from Evolutionary Biology”, Emerging Infectious Diseases, CDC, Vol. 2, No. 4, Oct-Dec 1996.

Wide spread poverty and chaos, and the associated lack of basic health services, clean water, sanitation, nutrition, and education, are perhaps the greatest contributors to the vitality and virulence of pathogens.   These fertile microbial breeding grounds, combined with the modern air travel of over a million people a day across all national borders, creates a truly ‘global village’ where political, economic, or social boundaries become nothing more than a figment of the human imagination.   Microbes are indiscriminate predators of the human family.   Until we become as indiscriminate in caring for one another, we will continue to give advantage to their numbers and their virulence.

Funding our Nation’s Defense:

For almost 5 decades, we have spent hundreds of billions of dollars each year protecting our nation from the spread of communism.  The time has come to invest the cost equivalent of at least a single B-2 bomber in what may be the best security investment this nation has ever made — investing in the security of life, liberty (from fear of disease) and justice for all.

Would our nation’s military really notice one less B-2 bomber?  Yes, a few jobs might be lost, but how much could the US gain from the early global eradication of polio and measles and the significant global reduction of hunger, illiteracy, tuberculosis, HIV/AIDS, unwanted births, abortions, blindness, cholera, malaria, Hepatitis A, and dozens of other lethal and disabling diseases?    Imagine the increased US economic benefits from increased trade alone if half of the world’s people weren’t fatigued by some variety of pathogen every day of the week.

“There are risks and costs to a program of action.  But they are far less than the long-range risks and costs of comfortable inaction.”  – John F. Kennedy

Thousands of adventurous Americans return daily from their travels abroad, and increasingly they are returning from exotic and chaotic regions of the world.  Those that I know personally, often return with a sniffle or intestinal illness.   With the exception of AIDS, the US has been epidemiologically lucky.  But that luck is running out.   If a strain of the flu as lethal as the 1918 “Spanish flu” was present today, somewhere between 1 to 3 million Americans would die in matter of months.   These deaths would not be limited to the young and old.  Compare these numbers to the 400,000 American soldiers killed during our 4-year-long involvement in World War II; it would be the most horrific event in American history.   There is virtually nothing preventing the comeback of this virulent strain or some other pathogen with a similar or higher kill rate.   Surveillance, response, research and prevention efforts should now be a top national security priority.    This Subcommittee’s funding levels for development assistance are inadequate in this new context.  There has never been such a profound rationale for increasing US foreign aid.

If sufficient money is not added to the foreign aid appropriations budget to meet this need, this Subcommittee will have to make the tough decisions on where it will be found within the existing aid budget.  A shift of 20% of the current foreign aid appropriations could accomplish significant health and development objectives–objectives with which the Preamble of our Constitution aligns with:

“We the people of the United States in order to form a more perfect Union, establish justice, insure domestic tranquillity, provide for the common defense, promote the general welfare, and secure the blessings of liberty to ourselves and our posterity, do ordain and establish this Constitution for the United States of America.”

Some aid constituencies will not be happy with such a shift; but they can make their case to the American people if their needs are indeed more urgent or important than this.

In addition to National security interests…

There are several other superb reasons why we, the US, should be paying our fair share in achieving measurable progress in health and humanitarian goals before the turn of this millennium.  Doing so is the right thing to do, we said we would do it, and the American people want it done.

Philosophical/ethical/religious Interests:  Only those who value money more than human life would argue that funding the most basic of human needs is a poor choice of priorities.

Political Credibility Interests:   In 1990, President Bush attended the UN World Summit for Children.  At the conclusion of that summit his Administration pledged that the US was willing to, “make available the resources,”  to meet a set of measurable, affordable and achievable goals for the year 2000.  Other global summits and US Administrations aligned on these goals as well. We urge Congress to help keep the US commitments made by both the Republican and Democratic Administrations in the first half of this decade. The 27 specific goals agreed to at the 1990 World Summit for Children include:

  1.  A one-third reduction in 1990 under-five death rates (or to 70 per 1,000 live births, whichever is less).
  2.  A halving of 1990 maternal mortality rates.
  3.  A halving of 1990 rates of malnutrition among the world’s under-fives (to include the elimination of micronutrient deficiencies, support for breastfeeding by all maternity units, and a reduction in the incidence of low birth weight to less than 10 %).
  4. The achievement of the 90 % immunization among under-ones, the eradication of polio, the elimination of neonatal tetanus, a 90% reduction in measles cases, and a 95% reduction in measles deaths.
  5. A halving of child deaths caused by diarrhoeal diseases.
  6. A one-third reduction in child deaths from acute respiratory infections.
  7. Basic education for all children and completion of primary education by at least 80 % girls as well as boys.
  8. Safe water and sanitation for all communities.
  9. Acceptance by all countries of the Convention on the Rights of the child, including improved protection for children in especially difficult circumstances.
  10. Universal access to high-quality family planning information and services in order to prevent pregnancies that are too early, too closely spaced, too late or too many.

Political interests:

This subcommittee could continue the leadership it started when it created the Child Survival and Disease account by significantly increasing the funding for child survival, disease prevention and the other development efforts that are needed to sustain the lives of children and the health of the world’s population.  We believe with a high degree of confidence that this could be done without any political liability.  In fact, it is not hard to imagine the political liabilities of not continuing such leadership.

We all know the reputation of past politicians who appeased Hitler’s spread across Europe.  And we are all aware of the stigma attached to those who stood idly by as millions of innocent lives were lost in Hitler’s concentration camps.   Future generations may judge today’s policy makers and this generation with similar distaste regarding our failure to stop the spread of infectious diseases and our lack of response to the massive loss of innocent life when so much could have been done at so little cost.   Toward the end of the movie Schindler’s List, the gutsy and wealthy businessman /hero is left crying and grasping a piece of jewelry with the realization that he literally could have bought the survival of a few more innocent Jews with the measly trappings of his lavish lifestyle.  He made the cold calculation of how many lives he could have saved with his gold ring.

The choices this subcommittee and ultimately this Congress must make are not much different.   Antibiotics costing less than two dollars per child could greatly reduce the acute respiratory infections now taking about 3 million lives a year.    A six cent measles vaccine per child, could be saving another 1.5 million.  A two cent dose of Vitamin A or iodized salt could save the lives and proper development of millions more.   The questions we should ask ourselves include:  What programs are merely for political gain?   Which programs mean the difference between life and death?  How will each of us feel at the end of this millennium?  Will we know we did our best, or, when we look back on history, will we be left with the same haunting feeling as Schindler?   I think there is a powerful message here for us all as we approach the year 2000.

Popular Interests:

While polls indicate American’s want foreign aid cut, everyone on this subcommittee is aware that the same polls indicate the majority of Americans really don’t know how little we actually spend on foreign aid.  Most Americans feel we should be spending at least 5% of our budget on aid, which would actually be a 4-fold increase.   Other polls indicate that the most popular role for US aid is in addressing unmet human needs.    The dislike of foreign aid by the majority of Americans may stem from the fact that US aid fails to meet this popular criteria.

Well over half of the US Congress was not in office in 1990 when the Bush Administration committed this nation to, ‘making available the resources,’ to meet the year 2000 goals.   Not keeping our nation’s promises is one thing; not keeping promises when they were made to the world’s children is quite another.  Especially when failing to meet those promises means millions of children will die or be permanently disabled.   I guarantee you the vast majority of Americans are against such a tragedy.

It is rather awkward to imagine starting the new millennium with hunger still significantly effecting nearly one out of every five people on this wealthy and abundant planet.   It is hard to imagine that 350 of the world’s billionaires control more of the world’s resources than the poorest billion people.  It is even harder to imagine that Americans spent over $450 billion dollars last year on gambling but would be upset with this Congress if it made a $2 billion investment to eradicate the worst aspects of wide spread disease, hunger and poverty.

Personal Interests:

Wealth, power and technology are no fortress against the world’s ills.  To microbes, people are all created equal — at about 98.6 degrees Fahrenheit.  President Roosevelt was crippled by polio.  Less than four months ago Congressman Tajeda (D-TX) lost his life to a virulent case of pneumonia which took advantage of his immune system weakened by cancer treatment.  Congressman Ganske’s episodes with  ‘post-viral encephalitis’ and campylobacter demonstrate no one is really safe.

Economic interests:

Minor global expenditures yield enormous domestic savings.   The US investment of just $32 million dollars in the global eradication of Small Pox 20 years ago has already saved the USover $3 billion! [a GAO Report in 1997 updated this figure to over $17 Billion.]  And, we continue to save approximately $300 million a year in today’s dollars.

This year, protecting US children against polio will cost Americans $231 million, plus an additional $14.3 million for a second vaccine to prevent “7 to 8” Americans from getting polio as a rare reaction to the first vaccine.   None of these expenditures will be necessary when polio is eradicated.  The US share of that global eradication effort is only a minute fraction of our current domestic costs.   Targeted cuts to Child Survival efforts by the Clinton Administration, however, are unlikely to accelerate the eradication effort.  Each year of delay will cost the US hundreds of millions more.   Measles and Tuberculosis (TB) are other examples where small international health investments will bring great domestic savings.   Eradication of measles will save Americans over $250 million a year while reduction of TB could be saving us up to $500 million annually.  Deficient TB treatment practices anywhere in the world can cause the TB bacteria to become multi-drug resistant.  Strains then imported into the US will cost as much as $250,000 per patient to cure.  In the developing world TB can be prevented for well under $100 per patient.  Treatment of TB in the US now costs hundreds of millions of dollars per year while our international efforts at TB control are virtually non -existent.

There is a second US economic benefit that will be realized by improving world health.  Healthy people contribute more to a healthy economy.  People in poor health anywhere cause economic implications for both the rich and the poor in the form of lost work or reduced productivity.   With less income, people buy less.   In a global economy poverty anywhere translates into fewer US jobs as a direct result of lost foreign purchasing power or US companies moved to cheaper labor markets.    With less income people may also go without healthcare.  Undiagnosed conditions would be more likely to emerge putting other people at risk.  Good health reduces health care costs and health education promotes the usage of annual physical, dental and eye exams.  Preventative campaigns which promote healthy lifestyles reduce the chances of illness.  This saves both consumer and public money which can then be spent on other things.

“The total economic loss to India due to the plague epidemic in 1994 was in the order of $1.7 billion.  Over 45,000 travelers to India canceled their travel plans, leading to a 20-60% decrease in hotel occupancy rates.  While Air India lost $66,000 per day, Indian Airlines lost $1 million every week. There was a 50% decrease in ships docking at the port of Mumbai. The country lost $460 million in exports, of which $23 million was in diamond exports alone.”

THE HINDU ON-LINE, “WHO sounds alert on new diseases” April 7, 1997

By Our Special Correspondent, NEW DELHI, April 6.

For economic reasons alone, global disease prevention efforts should remain a top priority.  There will be no enduring economic prosperity for our country without economic growth in the Third World. There will not be security and peace for our citizens without stability and peace in developing countries.

George P. Shultz

Military interests:

US troops are regularly exposed to harsh conditions and foreign populations.   Protecting them from accidental or intentional infections is a major emphasis of US defense strategy.  Few people realize that 75% of all US military hospitalizations during World War II, the Korean War and the Vietnam War were a result of infectious diseases.

One of the most dangerous activities for US troops outside of waging war is trying to stop a war or quell civil unrest.  Given the escalating cost and risk of peace keeping, prevention of war and the breakdown of nation states are receiving increased attention.  A recent CIA report studied the breakdown of nation states in order to predict and possibly prevent future hot spots.    After looking at hundreds of variables, the CIA identified the infant mortality rate as the number one indicator for predicting the breakdown of a nation state.  While it is obvious that child survival programs alone are insufficient to keep nations from imploding, the value of reducing child deaths should not be underestimated as a critical factor in keeping populations more docile.

Those who believe the cost of ‘peace keeping’ is too high have not fully examined the human and economic costs of chaos.   Exposing US troops to chaos anywhere does expose them to higher rates of infectious disease as well as other dangers.  However, not sending US troops to quell conflicts could result in even greater chaos and increased advantage to our microbial adversaries in a host of other ways.  For example:  Wars always increase the spread of disease.  Refugees which are created by war are usually the most affected by loss of health infrastructure.  They are also most likely to migrate to areas of safety, taking whatever health problems they have acquired with them.

The intentional use of biological infectious agents by our human adversaries is perhaps the most frightening future prospect.   There is really no way to defend against such an attack if an agitated force is committed to delivering pathogens to US citizens.   While the threat of retaliation by a powerful US military force might prevent some adversaries from using biological weapons, the same US military force of unconfrontable power will force other aggressors into covert actions to achieve their objectives. The smaller the force, the more likely it could immunize its members against the infectious agent and then deliver that agent, undetected, to its target population.    The bottom line is that the US should be very hesitant in making enemies of anyone except the microbes.   It is not possible to overstate our vulnerability to the use of biological weapons.   Even trying to defend against biologicals may carry serious health side effects as now possibly manifested by the Gulf War Syndrome.   Adequately supporting the four basic recommendations of the CISET report would help neutralize the effects of an intentional biological attack. Just as important, this Subcommittee should not overlook the degree to which US leadership in helping the world meet the most basic of human needs globally will reduce the likely hood of future conflicts and aggression.

History has taught us that wars produce hunger,  but we are less aware that mass poverty can lead to war or end in chaos.  While hunger rules, peace cannot prevail.

–Willie Brandt, Chairperson of the Brandt Commission.  1981

Standing by in a land of great abundance while millions are dying each year from malnutrition and infection does not build good will or stability.  Almost any American child is uncomfortable with this injustice.

Justice is the great interest of man on earth.  Wherever her temple stands, there is a foundation for social security, general happiness and the improvement and progress of our race.  (Inscribed above the entrance to the US Dept. of Justice, Washington DC.)

The Basic Needs of Woman and Children:

While great progress has been made in saving and protecting the lives of children, it appears progress is waning.  The US response to the conditions that continue to kill 35,000 children each day must not.  The majority of these deaths are still caused by easily and affordably preventable malnutrition and infection.  Funding for traditional Child Survival and micronutrient efforts should be increased and a portion of that increase given to not-for-profit organizations doing direct services to those most in need.   More emphasis should also be put on getting resources where they are most needed.   The two regions of the world where child deaths are still highest receive the least amounts of US aid – Africa and Asia.    Vaccines, ORT, antibiotics and Vitamin A are essential but not enough to sustain child survival and development.  Other health and development programs are also essential.

Maternal survival and health, which are vital in and of themselves and also vital for child survival, are not currently a fiscal priority of our international aid package.  Tuberculosis alone kills over 1.5 million women each year.  Little of US aid is spent addressing this rapidly mutating killer. There is food distribution, but where does it go?  There is micronutrient work, but the worldwide blight of anemia and the resulting intellectual dullness and lack of energy for work continues on a massive scale.   There is essential obstetric care, but due to fiscal constraints, it is limited to small pockets of intervention.  As many as 580,000 women will die this year as a result of complications in pregnancy or child birth.

Increased funding for the promotion of breastfeeding alone may be as productive in saving lives as ORT, immunization or antibiotics and may prevent as many births as family planning programs. It is estimated that breastfeeding ALONE has THE POTENTIAL TO SAVE 1-2 MILLION MORE children each year.

In general, about 55% of child mortality is attributed to poor nutrition.  These nutritional deficiencies cannot be filled by micronutrients alone.  There must be at least a 10 fold increase in breastfeeding support programming and a 20 fold increase in micronutrient and non-micronutrient programs targeted specifically to the needs of women and children if we wish to make the desired strides in addressing maternal and infant mortality.

HIV/AIDS is increasingly taking the lives of women and children and dramatically affecting the lives of even those who are not even infected.  Clean water, sanitation and antibiotics are of great benefit in reducing the complications of opportunistic infections, and microenterprise credit efforts can reduce the number of females trading sex for money.  Basic education is as important to reducing HIV/AIDS in the Third World as the availability of condoms.   A comprehensive approach to all infectious agents will be the most effective, and few approaches will be as effective as the training of basic health providers (nurses, nurse midwives, primary care doctors).  Investments in training people to safely deliver immunizations and antibiotics, quality family planning services and family health information, would be some of the most effective money we could spend.   The strengthening of the public health sector in areas such as education, nutrition, and child survival prevents the diffusion of infections and, thus, averts potential costs of treatment.  Adequately supplied health clinics staffed by adequately trained health workers affordably accessible to all the world’s people would provide us with our first line of defense and our  ‘first alert’ system to protecting us from any new or re-emerging diseases.

Funding Levels:

Too small a portion of US foreign aid is directed at improving health conditions where they are most lacking.    To make matters worse, development programs have received deeper and more disproportionate cuts than any other sector in the foreign aid budget.  This subcommittee has done much to restore funding to international health programs but these programs are still about $200 million short of what they were in FY’95 and are still far short of meeting the year 2000 goals.

We support the President’s request for a $1.4 billion increase in the foreign aid budget.  We strongly disagree, however, with how and where this money will be spent.  In the President’s FY’98 budget for USAID, funds for population, health and nutrition have been targeted for a reduction of approximately $25-30 million dollars.  The USAID Budget office has told us that this cut will come from Health and Child Survival programs, and most of the  “$20-25 million” from “Child Survival”.   This is unacceptable.  While other categories in the USAID budget, such as agriculture and environment or aid to the former Soviet states, certainly deserve increases, these increases should not come at the expense of health and child survival programs.  We strongly urge any budget increase to be applied in a fair and proportional manner.

More US aid is needed to address global poverty.   According to Church World Service/Lutheran World Relief, “Only 34% of bilateral assistance (including development assistance, ESF, military assistance, NIS/SEED, international narcotics control, and debt restructuring) requested for FY98 is designated for low-income countries (GNP per capita $695 and below in 1993).  Two thirds of that aid goes to Egypt ($2.1 billion), leaving just over $1 billion (of the total $9.2 billion) for the more than forty low-income aid recipient countries.  Israel, with a per capita income of $13,920, receives three times the amount allocated to these poor countries.”

While it is obvious for political reasons why only two nations receive over $5 billion in US aid, from all the reasons listed above, it is indefensible that development efforts focused on the poorest half of the world would receive so little.  As the senior Members of this subcommittee know, the central mission of USAID is to alleviate poverty.  For the newer Members of this Subcommittee, I would like to point out that the Foreign Assistance Act of 1961 states that USAID’s principal purpose is “to help the poor majority in developing countries,” with the goal of “increasing their incomes and access to public services which will enable them to satisfy their basic needs…”.     We believe that the USAID budget should reflect this.    We urge this subcommittee to continue its leadership in supporting the “Child Survival and Disease Account,” and believe the US should be spending at least $800 million in FY’98 on these specific efforts without reducing aid to other vital development programs.

Debt Relief:   Debt Relief to countries like Uganda will assist political leaders to better meet the health and education needs of their own people.

Multilateral Programs:   NCIH supports $1.035 billion for the International Development Association (IDA) of the World Bank to cover both FY’98 contributions and past arrears.   We are also hopeful you will press the World Bank to promote popular participation in its operations, especially by consulting local communities prior to approving loans.  NCIH will work with Bread for the World and others in direct advocacy through Congress at both the World Bank and the US Treasury to achieve the participation goal.

There is really only one reason not to increase funding for international health and development efforts:   the immediate economic gains of not spending the money now.    This logic roughly falls into the same category as not changing the oil in your car or buying new tires to ‘save’ money.   The reality is, we can pay a little now, or we will pay a lot more down the road.   Prevention pays for itself.   In the case of development assistance and disease prevention it will be saving lives as well as dollars.  As my Junior High daughter would say,  This is a “no-brainer”.

“Public health is purchasable.

Within natural limitations, any community can determine its own death rate.”

Herman M. Biggs, MD, Msc, LLD (1859-1923).

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Chuck W.

We have a failure to communicate: Why this could have been prevented

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Twenty four years before the words “Corona Virus” entered the public consciousness, we were warned.

Yes, we have been here before. Many times before. For years and years, decades and even for centuries, we have been educated and warned, informed and indoctrinated with the truth that, in the words of Albert Einstein, “We cannot solve our problems with the same level of consciousness that created them. Mankind is going to need an entirely new way of thinking if it is to survive.”

About 24 years ago, on April 25, 1996 infact, Mobilized contributor, Chuck Woolery of Rockville, Maryland gave his Testimony on behalf of Communication for Health Campaign before Congressman Sonny Callahan, Chairman of the Foreign Operations Subcommittee of Appropriations , U.S. House of Representatives.

The result of his testimony? His words would fall on deaf ears. Over and over again, those of us in-the-know, have advised, counseled and warned leaders and the public-at-large of the failure to honour Natures Law of systems, structures and principles.

The result of failing to listen? Just open you eyes, you will see it everywhere.

Thank you for allowing me as the Director of the Communication for Health Campaign to testify today regarding the prioritization of US foreign aid appropriations.

The World is in great change. Within the context of this change, the appropriations made by this Subcommittee now constitute the basis for maintaining the security of the American people. In the past, this Constitutional mandate was carried out by military strength. Today, military strength alone can no longer protect Americans from the foreign threats now approaching and breaching our shores.

 

The disturbing trend of new and re-emerging infectious diseases puts public and global health squarely in the realm of national security interests. Numerous reports document the threat infectious diseases pose to American lives and prosperity, and identify them as a threat that will only grow in the coming years. The rate and magnitude of that growth has been determined by our past neglect of poverty, environment and public health concerns. Our continuing failure to address a host of critical international problems within this specific context promises us almost certain catastrophe.

 

For some, the catastrophe is already here in the form of HIV/AIDS or multidrug-resistant Tuberculosis. These two diseases already consume a large portion of our nation’s health expenses.

 

AIDS was first recognized as a US problem in the early 1980s. If we had been more interested in international health threats earlier, we could have started research to combat the AIDS virus as early as 1962 when it was first recognized by African physicians as the “slims” disease.

 

After three decades of decline, TB in the US re-emerged as a major public health problem in the late 1980s. Targeted federal funding brought it back under control but still, in 1995, TB outbreaks were investigated in churches, schools, dental offices, court rooms, trains, subways, neighborhood bars, racetracks and even on a river boat casino. Until we control TB globally, we will continue to pay the expensive price for outbreaks here. One outbreak in New York City in 1993-1994 cost the city over $90 million. The world devotes less than half of that annually for the global control of TB.

 

Infectious diseases spreading in US hospitals kill more Americans each year than all the American troops lost throughout the entire Vietnam conflict. A significant number of these ‘domestic’ infectious diseases were imported from the harsh conditions of poverty abroad. As these conditions worsen, the number and variations of microbes will continue to grow and move with the aid of modern transportation. The actions of this Subcommittee, in regard to development and humanitarian assistance will have the greatest impact on the future security of the American people and control of these impending threats.

 

The cost of stopping microbial threats at the gates of our cities or at our water’s edge is no longer a practical option. A handful of microbes can be stopped at the border but the vast majority cannot. It would be prohibitively expensive to stop, test and quarantine every human or foreign product that crosses our borders or air space every day. Reducing infectious diseases, terrorism, pollution, or even unemployment in America now requires our pro-active efforts to extend beyond US boarders. Prevention there is far cheaper than dealing with these problems at our borders or in our cities. That is the new profound opportunity of this Subcommittee – to impact the conditions of global poverty and chaos, that are the primary fuel feeding the health, economic, environmental and security threats now facing this nation.

 

The Communication for Health Campaign and NCIH represent over 120 member organizations including the American Medical Association, the American Public Health Association, American Dental Association, the American College of Preventive Medicine, the American Nurses Association, the American Association of Critical Care Nurses, 9 Schools of Public Health and dozens of other international medical and health related organizations. These organizations and thousands of individual health care professionals urge this Subcommittee to re-examine its fundamental priorities in this new ‘national security’ context.

 

This Subcommittee took two steps forward last year by establishing the “Child Survival and Disease Account”. Unfortunately, it took a large step backward when it failed to appropriate sufficient funds to achieve its own recommendations. The ‘Child Survival and Disease’ earmark of $484 million falls $127 million short of the levels it recommended for Child Survival ($254 million), UNICEF ($100 million), Polio ($25 million), AIDS ($129 million), and Basic Education ($108 million). If we consider the absence of other expenditures needed to cure or prevent tuberculosis, provide clean water and sanitation, slow the spread of malaria and other tropical diseases, and support other vital health related programs, the total appropriated will be stretched even further. USAID could divert other aid resources to meet these specific health needs but cannot do so without taking away from other vital programs; that in the long run, bring health, security and stability in the Third World, and ultimately to our shores. Family planning and microenterprise programs are also important contributors to the health of individuals and communities. Support for democracy and human rights also have an impact in reducing the chance of conflict that so often halts and even destroys health services.

 

The 52 words of the Preamble to our own Constitution now provide the perfect and most urgent rationale to solve this dilemma.

 

“We the people of the United States in order to form a more perfect Union, establish justice, insure domestic tranquillity, provide for the common defense, promote the general welfare, and secure the blessings of liberty to ourselves and our posterity, do ordain and establish this Constitution for the United States of America.”

 

Nearly every American would agree that the primary role of any legitimate government is to provide for the defense of its citizens. Reductions in development assistance over the last few years however, have reduced our health defenses, and dramatically increased our risks.

 

Article 1. Section 8. of the Constitution says that “The Congress shall have Power to lay and collect taxes, duties, imposts and excises, to pay the debts and provide for the common defense and general welfare of the United States…”

 

It does not suggest that the common defense and general welfare of the American people should be sacrificed to balance the budget. That is indeed the scenario now being played out.

 

It is not hard to imagine a health crisis in this country where even Article 1. Section 9 of the Constitution “…The privilege of the Writ of Habeas Corpus” would need to be “suspended”, when “the public safety may require it.”

 

Article IV. Section 4 of our Constitution states that “The United States shall guarantee to every State

in this Union a Republic Form of Government, and shall protect each of them against Invasion; …” The Constitution does not specify invasion from what. I believe it is not a stretch of the imagination to claim that the framers of our Constitution had the protection of American citizens in mind when they agreed to this wording. This Article has now been violated by the entry of AIDS, malaria, dengue fever, ebola, tuberculosis, cholera and perhaps a dozen other pathogens; and unfortunately, this is only the beginning. Legal and illegal immigration certainly plays a role in the transportation of disease, but the greatest source of cross-border transport of pathogens is the result of legal domestic travelers dressed in business suits, army uniforms, and tourist or holiday attire. More than 50 million people cross the US border each year. Nearly half of the food we purchase and place on our kitchen table each evening has been imported from nations where the cheapest labor is hired for harvesting and processing the crops.

 

Stopping the flow of people and goods would be prohibitively expensive if not impossible. Yet at any given time approximately one-half of the world’s population is ill. The heaviest concentration of pathogens is found in the developing world where fewer than half the world’s people try to make a living on less than $400 a year. It is in these parts of the globe that we must implement comprehensive, preventive measures if we want to provide the greatest safety for American citizens.

 

Article VI says “…This Constitution and the laws of the United States…shall be the supreme law of the land.” We are hopeful that the next law this body passes will reflect its solemn duty to provide for the defense and welfare of the American people.

 

Over the last 50 years, the US Government has devoted trillions of dollars to a cold war to protect us from the possible threat of a communist aggressor. While that threat remains a remote possibility today, we are guaranteed an onslaught of infectious diseases in the near and not too distant future. This is not my opinion. It is the findings of a National Academy of Sciences Institute of Medicine report published 3 years ago. Since then the world has suffered an outbreak of bubonic plague in India, Ebola virus in Africa and new variations of tuberculosis within the US that are resistant to every antibiotic we now have in our health arsenal. Perhaps this Subcommittee could provide the bold leadership needed to commit the US to a “hot war” to ensure our freedom from fever. How easily we forget that the largest killer and disabler of men, women, children and even the unborn in the world is simple malnutrition and infection. Our reliance on the progress of science to protect us has betrayed us. The progress of pathogens to adapt to our arsenal of medicines promises to be the fight of our species. It is truly an “us against them” war that needs to be waged. We can destroy the majority of them at their base camp by ridding the world of the poverty related conditions in which they multiply, thrive, and strengthen.

 

For the cost of a pair of B-2 bombers (bombers the Pentagon says it doesn’t want or need) we could launch such an offensive. This minor investment could eradicate many diseases and greatly reduce our risk to a host of others. No number of additional B-2 bombers can do that.

 

In the closing paragraphs of The Coming Plague, aptly entitled “Searching for Solutions”, Laurie Garrett writes:

“The human world was a very optimistic place on September 12, 1978, when the nations’ representatives signed the Declaration of Alma Ata. By the year 2000 all of humanity was supposed to be immunized against most infectious diseases, basic health care was to be available to every man, woman, and child regardless of their economic class, race, religion, or place of birth.

But as the world approaches the millennium, it seems, from the microbes’ point of view, as if the entire planet, occupied by nearly 6 billion mostly impoverished Homo sapiens, is like the city of Rome in 5 B.C. “The world really is just one village. Our tolerance of disease in any place in the world is at our own peril,” Lederberg [Nobel laureate for discovery of DNA] said. “Are we better off today than we were a century ago? In most respects, we’re worse off. We have been neglectful of the microbes, and that is a recurring theme that is coming back to haunt us.”

In the end, it seems that American Journalist I.F. Stone was right when he said, “Either we will learn to live together or we will die together.”

While the human race battles itself… the advantage moves to the microbes’ court. They are our predators and they will be victorious if we, Homo sapiens, do not learn to live in a rational global village that affords the microbes few opportunities. It’s either that or we brace ourselves for the coming plague.”

 

This new reality requires a radical shift in the way Americans relate to each other and to the rest of the world. More weapons will not bring us more security. In fact just the opposite may now be true.

 

More Might! More Fright! More Plight!

In the modern world of disorder and dissolving nation states, the more US Military superiority we have, the less US national security we actually gain. Maintaining or increasing US military strength has at least 4 negative consequences on the health of US citizens. First, military spending usually distracts scarce financial resources from meeting basic human needs. Every billion dollars spent today beefing up our military against a possible human aggressor means a billion dollars less for the programs essential to protecting Americans from the aggression of infectious diseases. It is true that a small portion of military spending is spent in combating infectious diseases and more spent here could certainly be helpful. However, more B-2 bombers or a new space based anti-missile defense system is just plain wasteful, in the face of this new threat.

 

Second, military units stationed abroad always return home bringing whatever health problems they have with them. There may be as many as a quarter million troops stationed overseas at any given time. Their interactions with foreign populations, combined with their rapid and regular travel habits contribute to globalizing health problems. Sexually Transmitted Diseases, AIDS, anti-biotic resistance and a host of other communicable diseases are now in the pipeline.

 

Another increasingly important effect of ‘military might’ affecting public health falls in the category of terrorism. As our military gains an undisputed level of superiority, we squelch the possibility of any overt enemy attack on our shores. This squelching of overt aggression however, only increases our risks to covert aggression by any hostile individual, group or nation. The bad news: The ultimate weapon of affordability, ease of delivery, and effective human destruction is microbial in nature. In the Conference report on the Anti-Terrorism bill passed last week, a Senator suggested that if this bill passed, it would help protect the American people. This is a dangerous myth. We are all entirely vulnerable to the misuse of lethal or crippling pathogens in nearly every aspect of our lives. Any moderately intelligent person can find at least a dozen ways to infect hundreds if not thousands of people. A 98 cent plastic misting bottle from any drug store, a dose of salmonella from any blend of raw eggs and a 20 second pass around any popular salad bar is just one example. The Tokyo subway nerve gas attack last year killing 12 and injuring over 5,000 wasn’t particularly creative (nerve gas in a paper bag). The fact that members from this same sect went to Zaire posing as relief workers responding to the 1995 outbreak of ebola is, however, truly terrorizing. Imagine the consequences in America if the unibomber, the Oklahoma City bomber or the Trade tower bombers had any training in basic microbiology.

 

Senator Hatch reminds us that the “possession of dangerous human pathogens, such as bubonic plague, anthrax…are…readily available to just about anyone…” The December 30, 1995, Washington Post has a story with a headline that leaps off the page: `Man Gets Hands on Bubonic Plague Germ, but That’s No Crime.’ The story is more chilling than the headline. In Ohio, a white supremacist purchased three vials of

the bubonic plague pathogen through the mail. This was the same pathogen that wiped out about one-third of Europe in the Middle Ages. When the purchaser called the seller to complain about slow delivery, the sales representative got concerned about whether the caller was someone who really should have the bubonic plague in his possession. According to the story, the Ohio authorities were contacted. When police, public health officials, the FBI, and emergency workers in space suits scoured the purchaser’s house, they found nearly a dozen M-1 rifles, smoke grenades, blasting caps, and white separatist literature, but no bubonic plague. The deadly microorganisms were found in the glove compartment of his automobile, still packed as shipped…”

 

Investments in research on pathogens and the development of targeted treatments is a viable responsibility of government involvement. We cannot wait for the market place to catch up with the mortality rate of Americans.

 

With the current level of global poverty, rapid means of global transportation and general lack of resources directed at improving the human condition, terrorists really don’t have to do much of anything. Our own lack of basic human services here for the US homeless and below-poverty populations means the spread of disease by normal factors is already a disaster waiting to happen.

 

The fourth military factor is related to ‘peace keeping’ and ‘nation building’. These traditionally non-military roles carry a certain element of risk by increasing American troop exposure to foreign populations. Keeping peace and increasing a nation’s capacity to meet the immediate needs of its people is however, the best way to prevent or eliminate the chaotic conditions that give favor to pathogens in the first place. International involvement carries a risk but it is a far greater risk to allow war and chaos to disrupt the health and well-being of any population. US military capacity is still needed to protect us from an array of the traditional military threats but they can no longer alone protect American lives. Even the Military recognizes this fact.

 

CISET Report:

Perhaps the most alarming, comprehensive and credible warning related to this issue, came last summer from the Committee on International Science, Engineering, and Technology (CISET) Working Group. A report, co-authored by the Department of Defense, the National Security Council and the Center for Disease Control and Prevention, and a dozen other federal agencies, documented the emergence since 1973 of at least 30 new pathogen types and the re-emergence of dozens of previously controlled infectious diseases. The report places infectious disease issues in the realm of national security.

 

“…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 in other parts of the world are repeatedly introduced into the United States, where they may threaten our national health and security. Thus, controlling disease outbreaks in other countries is important not only for humanitarian reasons. It also prevents those diseases from entering the United States, at great savings of US lives and dollars.”

 

(CISET report is available: http://www2.whitehouse.gov/WH/EOP/OSTP/html/cisetsum.html

For a copy of the report call CDC, 404-639-2603 or fax your request to 404-639-3039.)

[Updated 10-10-14 http://clinton1.nara.gov/White_House/EOP/OSTP/CISET/html/toc-plain.html]

 

Other Sources:

A Washington Post article last June also pointed out that among all the infectious threats, the problem of increasing drug resistance may be the most serious, and America is no safe haven.

 

Antibiotic resistance is on the rise…A few pay in illness and death. The bill is going up every year… Once emerged, resistant bacteria spread quickly, sometimes via a single infected person traveling between countries. Similarly rapid diffusion occurs in the microbial world [when] resistance…can pass from bacterium to bacterium, evolving in one enterprise, such as agriculture, and soon showing up in an unrelated one, such as medicine. In the United States, resistance is everywhere – in childhood ear

infections, in venereal diseases, in TB, in surgical wounds and among the 60,000 deaths each year from hospital acquired infections. In the developing world, antibiotics are the most common pharmaceuticals, and they often can be bought without a prescription. Many people take them when they’re not needed or don’t take them long enough to cure an infectious completely. Such practices, combined with high rates of infectious disease, make developing countries especially fertile breeding grounds for drug resistance.

 

In one high-profile example, the outbreak of dysentery that killed up to 15,000 Rwanda refugees last summer might have been less deadly if the strain of Shigella dysenteriae hadn’t been resistant to five common antibiotics…

 

Epidemics, however, are not what experts fear from drug resistance. Instead, they fear the slow erosion of history’s most useful medicines…They fear that treating simple illnesses will become onerous and expensive, and that the number of mild illnesses taking complicated turns will rise.

 

“The old people in the nursing homes are going to die, and the young kids with ear infections are going to progress to mastoiditis, sinusitis, meningitis,” said Calvin M. Kunin, a professor at Ohio State University School of Medicine and past president of the Infectious Disease Society of America. “I think there ought to be a new organization called MAMA, Mothers Against the Misuse of Antibiotics. Because it’s the mothers’ children who are going to die.”

 

…About 150 million courses of oral antibiotics are prescribed each year in the US. Childhood ear infections are the single leading reason…Some experts estimate that as many as half the prescriptions written for antibiotics in the US are not needed or warranted on diagnostic grounds…

 

Whatever their source, drug-resistant germs are now such an unavoidable part of the environment that children get them as birthright. In a study published five years ago, researchers analyzed the intestinal bacteria of infants and toddlers in three separated locales. They found that 42% of sample from children in Qin Pu, China, were resistant to three or more antibiotics. Multiple-drug resistance was found in 30% of children sampled in Caracas, Venezuela, and in 6% of children in Boston. None of the children had recent exposure to antibiotics.

 

…For reasons that are quite mysterious, some microbes develop resistance to many antibiotics simultaneously…

 

One of the more important disease-causing bacteria in human beings is called Streptococcus pneumoniae. Its resistance to penicillin is a huge problem in Europe and a growing one in the US. Penicillin-resistant S. pneumoniae, however, was originally found in Papua New Guinea. In the late 1960s, the Australian army gave New Guinean villagers monthly penicillin shots in order to prevent yaws, an infection resembling syphilis that is spread by casual, not sexual, contact. Over time, the campaign created a large human population in which penicillin-resistant S. pneumoniae could flourish. …

 

… The best documented example involves the spread of penicillin-resistant S. pneumoniae in Iceland. The bug surfaced in Iceland in December 1988, at a hospital in Reykjavik. DNA fingerprinting revealed that it was similar to a strain found in Spain, a popular winter vacation spot. Within 3 years, 20% of the S. pneumoniae in Iceland was resistant…apparently all descended from the single Spanish import…

 

As a threat to public health, S. pneumoniae is currently the greatest object of concern. The bacterium is the leading cause of illness and death from infection in the US. It is responsible for roughly 7 million cases of ear infection, 500,000 cases of pneumonia; 50,000 cases of bloodstream infection; and 3,000 cases of meningitis each year…Inevitably, though, a greater number of cases will become “complicated”…

 

Each year in this country, about 2 million cases of infection are contracted by people while they are in the hospital. The problem is far more common than in the past, as critically ill patients are kept alive, many connected to tubes and ventilators that give microbes easy portals of entry.

 

A common cause of these infections is a family of bacteria known as the enterococci, which infect surgical wounds, the urinary tract, the heart and bloodstream. …these germs have developed resistance to a half-dozen antibiotics. However, they remain susceptible to vancomycin, an expensive and occasionally toxic intravenous antibiotic…

 

The biggest cause of hospital acquired infections – the family of Staphylococcus bacteria — is currently resistant to everything but vancomycin in 40% of cases in large teaching hospitals. Experts fear the day that drug becomes useless in staph infections — though few doubt it will arrive.

 

Nearly every multidrug-resistant TB organism evolved in patients who stopped taking their medications early or took them sporadically. Changing both patients and doctors habits would slow the emergence of resistant strains and might even turn back the clock in some cases…

“The Abuse of Antibiotic: Bacterial resistance evolves”. Washington Post, June 26, 1995

 

Last year, about 25,000 people between the ages of 3 and 49 died of unexplained causes in the US — but with symptoms that suggested microbial infections…

“Budget Cuts Slow Agencies Fighting New Bacteria Strains” Washington Post, June 27, 1995

 

Cost effectiveness of Development dollars:

Development is far cheaper than defense. Even the strategic planners in the military now figure that preventing and resolving conflict is far cheaper, in both lives and dollars, than waging war. Healthy populations also tend to be better consumers of American goods and services. Thus the importance of public health and prevention of disease. Global disease eradication efforts also have a significant domestic return on international investments. For each of these reasons, increases for development assistance can be justified on economic grounds alone. But the security rational is far more important. Cuts to development assistance have troubling side effects. One of our members, upon return from the refugee camps in Bosnia noticed a decrease in cooperation among private voluntary organizations. She made me aware of the fact that cuts to development assistance decrease the overall effectiveness of our relief efforts. Shrinking moral is one small factor. Another consequence is the increased competition between PVOs and NGO’s for scarce donor dollars. Competition may be increasing the effectiveness of individual PVOs, but it is detrimental to the larger scale cooperative efforts needed to effectively deal with development and relief problems. Making sufficient government money available, and strengthening the mechanism for delivering US aid abroad could reduce this competitive problem.

 

USAID plays an important role here and continues to work closely in collaboration with WHO, PAHO, PHS/CDC, NIH and others in a number of areas, and is producing cost-effective health improvements. CDC, WHO and USAID bring collaborative partners to the table, thus sharing the benefits of worldwide and local expertise and reducing the cost borne by any one partner.

 

It is vital to keep overall funding for development activities at a level that will allow AID to continue to support internationally-coordinated efforts. Since 1993, such funds, though a relatively small amount of the AID budget, have been in decline. Cooperative funding activities, including work on HIV/AIDS through WHO, the Global Program on AIDS, and the new independent UNAIDS program, is estimated to decline by one-third between FY94 and FY96, from a level of $40 million to about $27 million, of which HIV/AIDS funding still accounts for at least two-thirds of the total.

 

The latest in infectious diseases:

Last month the British beef industry was crippled (almost eliminated) because of a pathogen ‘scare’. The economic cost alone could be as high as $2 billion dollars. Last week, Ebola related primate deaths in Alice, Texas resulted in the need to kill hundreds of other primates. Aside from this loss of life, this incident cost both business and government, a few hundred thousand dollars. The media will probably spend more than that covering this particular isolated and relatively insignificant health threat, yet the real story is not being told. These are not ‘isolated’ incidents. They are an increasing trend in the global spread of infectious diseases that requires our utmost attention and response. It is a trend that holds the capacity to bring life as we know it to a grinding halt.

 

The bright side: If we respond to the trend appropriately and adequately it could propel all of humanity into a long, healthy and prosperous future.

 

Benjamin Franklin long ago reminded all of us that preservation of our form of government depended on our constant vigilance. The trend of new and re-emerging diseases is a threat to our people, and our way of life. These global warning signs require more than constant vigilance.

 

The choice is yours and the time is now. We urge this Subcommittee to recognize this growing threat for what it is; a threat worthy of top priority concern. Any less would be a form of negligence in protecting the national security of this nation and the lives of the American people.

 

For this Subcommittee to protect the American people, there are at least four basic areas requiring adequate and immediate action.

 

  1. The need for surveillance is quite clear. A global network of adequately supplied, staffed and trained health posts capable of monitoring and reporting health conditions of even remote populations.

 

  1. The capacity to response quickly and adequately to any and every outbreak of infectious disease.

 

  1. Research and development to ensure our capacity to respond to any outbreak be it accidental or intentional.

 

  1. Elimination and prevention of the conditions that breed and foster infectious diseases. Poverty is perhaps the greatest culprit. Unlike other attempts to address poverty from a humanitarian perspective, any new effort must be comprehensive and eternally supported.

 

Because this subcommittee determines appropriations that will impact each of these areas, you have the greatest capacity to defend this nation’s security. You can advance our most basic values and provide for our most basic security by focusing your fullest attention on last area mentioned. Ensuring that every man, woman and child on earth has at least the basic necessities (nutrition, clean water, sanitation,

education and basic health services) for a healthy existence will not ensure total safety from infectious diseases. It would, however, greatly reduce this growing threat.

 

Last year:

Despite the most restrictive budget limitations, last year this Subcommittee found the resources to increase funding for at least 3 foreign aid programs, in the context of ‘national security’.

 

This House Subcommittee on Appropriations passed its FY’96 bill with increases for:

 

Foreign Military Financing Program (FMF) increased by $13 million.

Int’l Military Education & Training (IMET) increased by $13.5 million.

Economic Support Fund (ESF) increased by $42 million

OPIC increased by $35 million

 

TOTAL non development aid increases: $103.5 million

 

Last years cuts to development assistance programs averaged over 25%. A 25% reduction to FY’95 levels of the favored programs listed above could yield $1.408 billion — more than enough to meet the development goals that most of this nation’s citizens are aligned on; nutrition, primary health care, water and sanitation, family planning, basic education, microenterprise lending…

 

Last year the Senate Foreign Operations Subcommittee attempted to shift Department of Defense dollars into the foreign aid budget to increase funding for IMET. The time for this funding source to be considered in the context of infectious national security threats has arrived.

 

The economic benefits alone that will result from improving the quality of life for people internationally cannot be overemphasized. The cost savings to this government and the American people from the global eradication of smallpox has been well documented. Our cost savings from the global eradication of polio and measles will be even more bountiful. Combine this with the increase in US jobs as result of increased US exports to a healthier, more prosperous international markets and we could balance our federal budget well within a safe time line.

 

These decisions are always difficult, and we have a history of ignoring warning signs prior to crisis. An example was the reduction of defense appropriations prior to the sneak attack on Pearl Harbor in 1941. But I can tell you that the cost of that negligence will be insignificant compared to the cost if these microbial trends are also ignored.

 

In conclusion, the effectiveness of pathogens can be attributed to one simple trait. They are basically non-discriminatory. Most pathogens are blind to their victim’s nationality, income level, political party, skin color, age or sex. Until we Americans, as humans reach the same level of indiscrimination regarding who benefits from our foreign assistance, we may soon find ourselves on the bottom of the food chain. As Nobel Laureate, Dr. Joshua Lederberg says, to pathogens we’re all just “another piece of meat”. This Subcommittee is our best defense.

 

 

 

 

 

 

April 25, 1996

 

Testimony by

Chuck Woolery, Director

Communication for Health Campaign

 

Before

Congressman Sonny Callahan

Chairman of the

Foreign Operations Subcommittee of Appropriations

U.S. House of Representatives

 

Regarding Funding for International Health and Development Programs for Preventing the Spread of Infectious Diseases.

 

 

Thank you for allowing me as the Director of the Communication for Health Campaign to testify today regarding the prioritization of US foreign aid appropriations.

 

The World is in great change. Within the context of this change, the appropriations made by this Subcommittee now constitute the basis for maintaining the security of the American people. In the past, this Constitutional mandate was carried out by military strength. Today, military strength alone can no longer protect Americans from the foreign threats now approaching and breaching our shores.

 

The disturbing trend of new and re-emerging infectious diseases puts public and global health squarely in the realm of national security interests. Numerous reports document the threat infectious diseases pose to American lives and prosperity, and identify them as a threat that will only grow in the coming years. The rate and magnitude of that growth has been determined by our past neglect of poverty, environment and public health concerns. Our continuing failure to address a host of critical international problems within this specific context promises us almost certain catastrophe.

 

For some, the catastrophe is already here in the form of HIV/AIDS or multidrug-resistant Tuberculosis. These two diseases already consume a large portion of our nation’s health expenses.

 

AIDS was first recognized as a US problem in the early 1980s. If we had been more interested in international health threats earlier, we could have started research to combat the AIDS virus as early as 1962 when it was first recognized by African physicians as the “slims” disease.

 

After three decades of decline, TB in the US re-emerged as a major public health problem in the late 1980s. Targeted federal funding brought it back under control but still, in 1995, TB outbreaks were investigated in churches, schools, dental offices, court rooms, trains, subways, neighborhood bars, racetracks and even on a river boat casino. Until we control TB globally, we will continue to pay the expensive price for outbreaks here. One outbreak in New York City in 1993-1994 cost the city over $90 million. The world devotes less than half of that annually for the global control of TB.

 

Infectious diseases spreading in US hospitals kill more Americans each year than all the American troops lost throughout the entire Vietnam conflict. A significant number of these ‘domestic’ infectious diseases were imported from the harsh conditions of poverty abroad. As these conditions worsen, the number and variations of microbes will continue to grow and move with the aid of modern transportation. The actions of this Subcommittee, in regard to development and humanitarian assistance will have the greatest impact on the future security of the American people and control of these impending threats.

 

The cost of stopping microbial threats at the gates of our cities or at our water’s edge is no longer a practical option. A handful of microbes can be stopped at the border but the vast majority cannot. It would be prohibitively expensive to stop, test and quarantine every human or foreign product that crosses our borders or air space every day. Reducing infectious diseases, terrorism, pollution, or even unemployment in America now requires our pro-active efforts to extend beyond US boarders. Prevention there is far cheaper than dealing with these problems at our borders or in our cities. That is the new profound opportunity of this Subcommittee – to impact the conditions of global poverty and chaos, that are the primary fuel feeding the health, economic, environmental and security threats now facing this nation.

 

The Communication for Health Campaign and NCIH represent over 120 member organizations including the American Medical Association, the American Public Health Association, American Dental Association, the American College of Preventive Medicine, the American Nurses Association, the American Association of Critical Care Nurses, 9 Schools of Public Health and dozens of other international medical and health related organizations. These organizations and thousands of individual health care professionals urge this Subcommittee to re-examine its fundamental priorities in this new ‘national security’ context.

 

This Subcommittee took two steps forward last year by establishing the “Child Survival and Disease Account”. Unfortunately, it took a large step backward when it failed to appropriate sufficient funds to achieve its own recommendations. The ‘Child Survival and Disease’ earmark of $484 million falls $127 million short of the levels it recommended for Child Survival ($254 million), UNICEF ($100 million), Polio ($25 million), AIDS ($129 million), and Basic Education ($108 million). If we consider the absence of other expenditures needed to cure or prevent tuberculosis, provide clean water and sanitation, slow the spread of malaria and other tropical diseases, and support other vital health related programs, the total appropriated will be stretched even further. USAID could divert other aid resources to meet these specific health needs but cannot do so without taking away from other vital programs; that in the long run, bring health, security and stability in the Third World, and ultimately to our shores. Family planning and microenterprise programs are also important contributors to the health of individuals and communities. Support for democracy and human rights also have an impact in reducing the chance of conflict that so often halts and even destroys health services.

 

The 52 words of the Preamble to our own Constitution now provide the perfect and most urgent rationale to solve this dilemma.

 

“We the people of the United States in order to form a more perfect Union, establish justice, insure domestic tranquillity, provide for the common defense, promote the general welfare, and secure the blessings of liberty to ourselves and our posterity, do ordain and establish this Constitution for the United States of America.”

 

Nearly every American would agree that the primary role of any legitimate government is to provide for the defense of its citizens. Reductions in development assistance over the last few years however, have reduced our health defenses, and dramatically increased our risks.

 

Article 1. Section 8. of the Constitution says that “The Congress shall have Power to lay and collect taxes, duties, imposts and excises, to pay the debts and provide for the common defense and general welfare of the United States…”

 

It does not suggest that the common defense and general welfare of the American people should be sacrificed to balance the budget. That is indeed the scenario now being played out.

 

It is not hard to imagine a health crisis in this country where even Article 1. Section 9 of the Constitution “…The privilege of the Writ of Habeas Corpus” would need to be “suspended”, when “the public safety may require it.”

 

Article IV. Section 4 of our Constitution states that “The United States shall guarantee to every State

in this Union a Republic Form of Government, and shall protect each of them against Invasion; …” The Constitution does not specify invasion from what. I believe it is not a stretch of the imagination to claim that the framers of our Constitution had the protection of American citizens in mind when they agreed to this wording. This Article has now been violated by the entry of AIDS, malaria, dengue fever, ebola, tuberculosis, cholera and perhaps a dozen other pathogens; and unfortunately, this is only the beginning. Legal and illegal immigration certainly plays a role in the transportation of disease, but the greatest source of cross-border transport of pathogens is the result of legal domestic travelers dressed in business suits, army uniforms, and tourist or holiday attire. More than 50 million people cross the US border each year. Nearly half of the food we purchase and place on our kitchen table each evening has been imported from nations where the cheapest labor is hired for harvesting and processing the crops.

 

Stopping the flow of people and goods would be prohibitively expensive if not impossible. Yet at any given time approximately one-half of the world’s population is ill. The heaviest concentration of pathogens is found in the developing world where fewer than half the world’s people try to make a living on less than $400 a year. It is in these parts of the globe that we must implement comprehensive, preventive measures if we want to provide the greatest safety for American citizens.

 

Article VI says “…This Constitution and the laws of the United States…shall be the supreme law of the land.” We are hopeful that the next law this body passes will reflect its solemn duty to provide for the defense and welfare of the American people.

 

Over the last 50 years, the US Government has devoted trillions of dollars to a cold war to protect us from the possible threat of a communist aggressor. While that threat remains a remote possibility today, we are guaranteed an onslaught of infectious diseases in the near and not too distant future. This is not my opinion. It is the findings of a National Academy of Sciences Institute of Medicine report published 3 years ago. Since then the world has suffered an outbreak of bubonic plague in India, Ebola virus in Africa and new variations of tuberculosis within the US that are resistant to every antibiotic we now have in our health arsenal. Perhaps this Subcommittee could provide the bold leadership needed to commit the US to a “hot war” to ensure our freedom from fever. How easily we forget that the largest killer and disabler of men, women, children and even the unborn in the world is simple malnutrition and infection. Our reliance on the progress of science to protect us has betrayed us. The progress of pathogens to adapt to our arsenal of medicines promises to be the fight of our species. It is truly an “us against them” war that needs to be waged. We can destroy the majority of them at their base camp by ridding the world of the poverty related conditions in which they multiply, thrive, and strengthen.

 

For the cost of a pair of B-2 bombers (bombers the Pentagon says it doesn’t want or need) we could launch such an offensive. This minor investment could eradicate many diseases and greatly reduce our risk to a host of others. No number of additional B-2 bombers can do that.

 

In the closing paragraphs of The Coming Plague, aptly entitled “Searching for Solutions”, Laurie Garrett writes:

“The human world was a very optimistic place on September 12, 1978, when the nations’ representatives signed the Declaration of Alma Ata. By the year 2000 all of humanity was supposed to be immunized against most infectious diseases, basic health care was to be available to every man, woman, and child regardless of their economic class, race, religion, or place of birth.

But as the world approaches the millennium, it seems, from the microbes’ point of view, as if the entire planet, occupied by nearly 6 billion mostly impoverished Homo sapiens, is like the city of Rome in 5 B.C. “The world really is just one village. Our tolerance of disease in any place in the world is at our own peril,” Lederberg [Nobel laureate for discovery of DNA] said. “Are we better off today than we were a century ago? In most respects, we’re worse off. We have been neglectful of the microbes, and that is a recurring theme that is coming back to haunt us.”

In the end, it seems that American Journalist I.F. Stone was right when he said, “Either we will learn to live together or we will die together.”

While the human race battles itself… the advantage moves to the microbes’ court. They are our predators and they will be victorious if we, Homo sapiens, do not learn to live in a rational global village that affords the microbes few opportunities. It’s either that or we brace ourselves for the coming plague.”

 

This new reality requires a radical shift in the way Americans relate to each other and to the rest of the world. More weapons will not bring us more security. In fact just the opposite may now be true.

 

More Might! More Fright! More Plight!

In the modern world of disorder and dissolving nation states, the more US Military superiority we have, the less US national security we actually gain. Maintaining or increasing US military strength has at least 4 negative consequences on the health of US citizens. First, military spending usually distracts scarce financial resources from meeting basic human needs. Every billion dollars spent today beefing up our military against a possible human aggressor means a billion dollars less for the programs essential to protecting Americans from the aggression of infectious diseases. It is true that a small portion of military spending is spent in combating infectious diseases and more spent here could certainly be helpful. However, more B-2 bombers or a new space based anti-missile defense system is just plain wasteful, in the face of this new threat.

 

Second, military units stationed abroad always return home bringing whatever health problems they have with them. There may be as many as a quarter million troops stationed overseas at any given time. Their interactions with foreign populations, combined with their rapid and regular travel habits contribute to globalizing health problems. Sexually Transmitted Diseases, AIDS, anti-biotic resistance and a host of other communicable diseases are now in the pipeline.

 

Another increasingly important effect of ‘military might’ affecting public health falls in the category of terrorism. As our military gains an undisputed level of superiority, we squelch the possibility of any overt enemy attack on our shores. This squelching of overt aggression however, only increases our risks to covert aggression by any hostile individual, group or nation. The bad news: The ultimate weapon of affordability, ease of delivery, and effective human destruction is microbial in nature. In the Conference report on the Anti-Terrorism bill passed last week, a Senator suggested that if this bill passed, it would help protect the American people. This is a dangerous myth. We are all entirely vulnerable to the misuse of lethal or crippling pathogens in nearly every aspect of our lives. Any moderately intelligent person can find at least a dozen ways to infect hundreds if not thousands of people. A 98 cent plastic misting bottle from any drug store, a dose of salmonella from any blend of raw eggs and a 20 second pass around any popular salad bar is just one example. The Tokyo subway nerve gas attack last year killing 12 and injuring over 5,000 wasn’t particularly creative (nerve gas in a paper bag). The fact that members from this same sect went to Zaire posing as relief workers responding to the 1995 outbreak of ebola is, however, truly terrorizing. Imagine the consequences in America if the unibomber, the Oklahoma City bomber or the Trade tower bombers had any training in basic microbiology.

 

Senator Hatch reminds us that the “possession of dangerous human pathogens, such as bubonic plague, anthrax…are…readily available to just about anyone…” The December 30, 1995, Washington Post has a story with a headline that leaps off the page: `Man Gets Hands on Bubonic Plague Germ, but That’s No Crime.’ The story is more chilling than the headline. In Ohio, a white supremacist purchased three vials of

the bubonic plague pathogen through the mail. This was the same pathogen that wiped out about one-third of Europe in the Middle Ages. When the purchaser called the seller to complain about slow delivery, the sales representative got concerned about whether the caller was someone who really should have the bubonic plague in his possession. According to the story, the Ohio authorities were contacted. When police, public health officials, the FBI, and emergency workers in space suits scoured the purchaser’s house, they found nearly a dozen M-1 rifles, smoke grenades, blasting caps, and white separatist literature, but no bubonic plague. The deadly microorganisms were found in the glove compartment of his automobile, still packed as shipped…”

 

Investments in research on pathogens and the development of targeted treatments is a viable responsibility of government involvement. We cannot wait for the market place to catch up with the mortality rate of Americans.

 

With the current level of global poverty, rapid means of global transportation and general lack of resources directed at improving the human condition, terrorists really don’t have to do much of anything. Our own lack of basic human services here for the US homeless and below-poverty populations means the spread of disease by normal factors is already a disaster waiting to happen.

 

The fourth military factor is related to ‘peace keeping’ and ‘nation building’. These traditionally non-military roles carry a certain element of risk by increasing American troop exposure to foreign populations. Keeping peace and increasing a nation’s capacity to meet the immediate needs of its people is however, the best way to prevent or eliminate the chaotic conditions that give favor to pathogens in the first place. International involvement carries a risk but it is a far greater risk to allow war and chaos to disrupt the health and well-being of any population. US military capacity is still needed to protect us from an array of the traditional military threats but they can no longer alone protect American lives. Even the Military recognizes this fact.

 

CISET Report:

Perhaps the most alarming, comprehensive and credible warning related to this issue, came last summer from the Committee on International Science, Engineering, and Technology (CISET) Working Group. A report, co-authored by the Department of Defense, the National Security Council and the Center for Disease Control and Prevention, and a dozen other federal agencies, documented the emergence since 1973 of at least 30 new pathogen types and the re-emergence of dozens of previously controlled infectious diseases. The report places infectious disease issues in the realm of national security.

 

“…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 in other parts of the world are repeatedly introduced into the United States, where they may threaten our national health and security. Thus, controlling disease outbreaks in other countries is important not only for humanitarian reasons. It also prevents those diseases from entering the United States, at great savings of US lives and dollars.”

 

(CISET report is available: http://www2.whitehouse.gov/WH/EOP/OSTP/html/cisetsum.html

For a copy of the report call CDC, 404-639-2603 or fax your request to 404-639-3039.)

[Updated 10-10-14 http://clinton1.nara.gov/White_House/EOP/OSTP/CISET/html/toc-plain.html]

 

Other Sources:

A Washington Post article last June also pointed out that among all the infectious threats, the problem of increasing drug resistance may be the most serious, and America is no safe haven.

 

Antibiotic resistance is on the rise…A few pay in illness and death. The bill is going up every year… Once emerged, resistant bacteria spread quickly, sometimes via a single infected person traveling between countries. Similarly rapid diffusion occurs in the microbial world [when] resistance…can pass from bacterium to bacterium, evolving in one enterprise, such as agriculture, and soon showing up in an unrelated one, such as medicine. In the United States, resistance is everywhere – in childhood ear

infections, in venereal diseases, in TB, in surgical wounds and among the 60,000 deaths each year from hospital acquired infections. In the developing world, antibiotics are the most common pharmaceuticals, and they often can be bought without a prescription. Many people take them when they’re not needed or don’t take them long enough to cure an infectious completely. Such practices, combined with high rates of infectious disease, make developing countries especially fertile breeding grounds for drug resistance.

 

In one high-profile example, the outbreak of dysentery that killed up to 15,000 Rwanda refugees last summer might have been less deadly if the strain of Shigella dysenteriae hadn’t been resistant to five common antibiotics…

 

Epidemics, however, are not what experts fear from drug resistance. Instead, they fear the slow erosion of history’s most useful medicines…They fear that treating simple illnesses will become onerous and expensive, and that the number of mild illnesses taking complicated turns will rise.

 

“The old people in the nursing homes are going to die, and the young kids with ear infections are going to progress to mastoiditis, sinusitis, meningitis,” said Calvin M. Kunin, a professor at Ohio State University School of Medicine and past president of the Infectious Disease Society of America. “I think there ought to be a new organization called MAMA, Mothers Against the Misuse of Antibiotics. Because it’s the mothers’ children who are going to die.”

 

…About 150 million courses of oral antibiotics are prescribed each year in the US. Childhood ear infections are the single leading reason…Some experts estimate that as many as half the prescriptions written for antibiotics in the US are not needed or warranted on diagnostic grounds…

 

Whatever their source, drug-resistant germs are now such an unavoidable part of the environment that children get them as birthright. In a study published five years ago, researchers analyzed the intestinal bacteria of infants and toddlers in three separated locales. They found that 42% of sample from children in Qin Pu, China, were resistant to three or more antibiotics. Multiple-drug resistance was found in 30% of children sampled in Caracas, Venezuela, and in 6% of children in Boston. None of the children had recent exposure to antibiotics.

 

…For reasons that are quite mysterious, some microbes develop resistance to many antibiotics simultaneously…

 

One of the more important disease-causing bacteria in human beings is called Streptococcus pneumoniae. Its resistance to penicillin is a huge problem in Europe and a growing one in the US. Penicillin-resistant S. pneumoniae, however, was originally found in Papua New Guinea. In the late 1960s, the Australian army gave New Guinean villagers monthly penicillin shots in order to prevent yaws, an infection resembling syphilis that is spread by casual, not sexual, contact. Over time, the campaign created a large human population in which penicillin-resistant S. pneumoniae could flourish. …

 

… The best documented example involves the spread of penicillin-resistant S. pneumoniae in Iceland. The bug surfaced in Iceland in December 1988, at a hospital in Reykjavik. DNA fingerprinting revealed that it was similar to a strain found in Spain, a popular winter vacation spot. Within 3 years, 20% of the S. pneumoniae in Iceland was resistant…apparently all descended from the single Spanish import…

 

As a threat to public health, S. pneumoniae is currently the greatest object of concern. The bacterium is the leading cause of illness and death from infection in the US. It is responsible for roughly 7 million cases of ear infection, 500,000 cases of pneumonia; 50,000 cases of bloodstream infection; and 3,000 cases of meningitis each year…Inevitably, though, a greater number of cases will become “complicated”…

 

Each year in this country, about 2 million cases of infection are contracted by people while they are in the hospital. The problem is far more common than in the past, as critically ill patients are kept alive, many connected to tubes and ventilators that give microbes easy portals of entry.

 

A common cause of these infections is a family of bacteria known as the enterococci, which infect surgical wounds, the urinary tract, the heart and bloodstream. …these germs have developed resistance to a half-dozen antibiotics. However, they remain susceptible to vancomycin, an expensive and occasionally toxic intravenous antibiotic…

 

The biggest cause of hospital acquired infections – the family of Staphylococcus bacteria — is currently resistant to everything but vancomycin in 40% of cases in large teaching hospitals. Experts fear the day that drug becomes useless in staph infections — though few doubt it will arrive.

 

Nearly every multidrug-resistant TB organism evolved in patients who stopped taking their medications early or took them sporadically. Changing both patients and doctors habits would slow the emergence of resistant strains and might even turn back the clock in some cases…

“The Abuse of Antibiotic: Bacterial resistance evolves”. Washington Post, June 26, 1995

 

Last year, about 25,000 people between the ages of 3 and 49 died of unexplained causes in the US — but with symptoms that suggested microbial infections…

“Budget Cuts Slow Agencies Fighting New Bacteria Strains” Washington Post, June 27, 1995

 

Cost effectiveness of Development dollars:

Development is far cheaper than defense. Even the strategic planners in the military now figure that preventing and resolving conflict is far cheaper, in both lives and dollars, than waging war. Healthy populations also tend to be better consumers of American goods and services. Thus the importance of public health and prevention of disease. Global disease eradication efforts also have a significant domestic return on international investments. For each of these reasons, increases for development assistance can be justified on economic grounds alone. But the security rational is far more important. Cuts to development assistance have troubling side effects. One of our members, upon return from the refugee camps in Bosnia noticed a decrease in cooperation among private voluntary organizations. She made me aware of the fact that cuts to development assistance decrease the overall effectiveness of our relief efforts. Shrinking moral is one small factor. Another consequence is the increased competition between PVOs and NGO’s for scarce donor dollars. Competition may be increasing the effectiveness of individual PVOs, but it is detrimental to the larger scale cooperative efforts needed to effectively deal with development and relief problems. Making sufficient government money available, and strengthening the mechanism for delivering US aid abroad could reduce this competitive problem.

 

USAID plays an important role here and continues to work closely in collaboration with WHO, PAHO, PHS/CDC, NIH and others in a number of areas, and is producing cost-effective health improvements. CDC, WHO and USAID bring collaborative partners to the table, thus sharing the benefits of worldwide and local expertise and reducing the cost borne by any one partner.

 

It is vital to keep overall funding for development activities at a level that will allow AID to continue to support internationally-coordinated efforts. Since 1993, such funds, though a relatively small amount of the AID budget, have been in decline. Cooperative funding activities, including work on HIV/AIDS through WHO, the Global Program on AIDS, and the new independent UNAIDS program, is estimated to decline by one-third between FY94 and FY96, from a level of $40 million to about $27 million, of which HIV/AIDS funding still accounts for at least two-thirds of the total.

 

The latest in infectious diseases:

Last month the British beef industry was crippled (almost eliminated) because of a pathogen ‘scare’. The economic cost alone could be as high as $2 billion dollars. Last week, Ebola related primate deaths in Alice, Texas resulted in the need to kill hundreds of other primates. Aside from this loss of life, this incident cost both business and government, a few hundred thousand dollars. The media will probably spend more than that covering this particular isolated and relatively insignificant health threat, yet the real story is not being told. These are not ‘isolated’ incidents. They are an increasing trend in the global spread of infectious diseases that requires our utmost attention and response. It is a trend that holds the capacity to bring life as we know it to a grinding halt.

 

The bright side: If we respond to the trend appropriately and adequately it could propel all of humanity into a long, healthy and prosperous future.

 

Benjamin Franklin long ago reminded all of us that preservation of our form of government depended on our constant vigilance. The trend of new and re-emerging diseases is a threat to our people, and our way of life. These global warning signs require more than constant vigilance.

 

The choice is yours and the time is now. We urge this Subcommittee to recognize this growing threat for what it is; a threat worthy of top priority concern. Any less would be a form of negligence in protecting the national security of this nation and the lives of the American people.

 

For this Subcommittee to protect the American people, there are at least four basic areas requiring adequate and immediate action.

 

  1. The need for surveillance is quite clear. A global network of adequately supplied, staffed and trained health posts capable of monitoring and reporting health conditions of even remote populations.

 

  1. The capacity to response quickly and adequately to any and every outbreak of infectious disease.

 

  1. Research and development to ensure our capacity to respond to any outbreak be it accidental or intentional.

 

  1. Elimination and prevention of the conditions that breed and foster infectious diseases. Poverty is perhaps the greatest culprit. Unlike other attempts to address poverty from a humanitarian perspective, any new effort must be comprehensive and eternally supported.

 

Because this subcommittee determines appropriations that will impact each of these areas, you have the greatest capacity to defend this nation’s security. You can advance our most basic values and provide for our most basic security by focusing your fullest attention on last area mentioned. Ensuring that every man, woman and child on earth has at least the basic necessities (nutrition, clean water, sanitation,

education and basic health services) for a healthy existence will not ensure total safety from infectious diseases. It would, however, greatly reduce this growing threat.

 

Last year:

Despite the most restrictive budget limitations, last year this Subcommittee found the resources to increase funding for at least 3 foreign aid programs, in the context of ‘national security’.

 

This House Subcommittee on Appropriations passed its FY’96 bill with increases for:

 

Foreign Military Financing Program (FMF) increased by $13 million.

Int’l Military Education & Training (IMET) increased by $13.5 million.

Economic Support Fund (ESF) increased by $42 million

OPIC increased by $35 million

 

TOTAL non development aid increases: $103.5 million

 

Last years cuts to development assistance programs averaged over 25%. A 25% reduction to FY’95 levels of the favored programs listed above could yield $1.408 billion — more than enough to meet the development goals that most of this nation’s citizens are aligned on; nutrition, primary health care, water and sanitation, family planning, basic education, microenterprise lending…

 

Last year the Senate Foreign Operations Subcommittee attempted to shift Department of Defense dollars into the foreign aid budget to increase funding for IMET. The time for this funding source to be considered in the context of infectious national security threats has arrived.

 

The economic benefits alone that will result from improving the quality of life for people internationally cannot be overemphasized. The cost savings to this government and the American people from the global eradication of smallpox has been well documented. Our cost savings from the global eradication of polio and measles will be even more bountiful. Combine this with the increase in US jobs as result of increased US exports to a healthier, more prosperous international markets and we could balance our federal budget well within a safe time line.

 

These decisions are always difficult, and we have a history of ignoring warning signs prior to crisis. An example was the reduction of defense appropriations prior to the sneak attack on Pearl Harbor in 1941. But I can tell you that the cost of that negligence will be insignificant compared to the cost if these microbial trends are also ignored.

 

In conclusion, the effectiveness of pathogens can be attributed to one simple trait. They are basically non-discriminatory. Most pathogens are blind to their victim’s nationality, income level, political party, skin color, age or sex. Until we Americans, as humans reach the same level of indiscrimination regarding who benefits from our foreign assistance, we may soon find ourselves on the bottom of the food chain. As Nobel Laureate, Dr. Joshua Lederberg says, to pathogens we’re all just “another piece of meat”. This Subcommittee is our best defense.

 

For more information contact Chuck Woolery, 301-738-7121, email: chuck@igc.org

 

 

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The EDUCATION and the 2020 elections: the missing links.

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Can we put Education at the top of the agenda as we head into another Election season?

We know education is vital to understanding the likely inevitability of our species of either threat, but appropriate and sufficient preventive action must follow.  And education for action should be the top topic in the 2020 elections.

Every democratic presidential candidate is missing a vital fact capable of motivating any voter to lean in their direction. It’s the link between the education and our national security.

By Chuck Woolery, Rockville, Md.

National security can be viewed in many non-military-centric ways, but most voters value the levels of defense dollars, investments in new weapons systems, the protection of U.S. troops, and those who have served and suffered the most.  While rational minds can question if these investments actually improve U.S. security, no well-informed mind can say with certainty that our nation is safer today than after 9-11.  Or, that we can actually spend enough to ensure our security as the evolution of war and weapons evolve beyond any existing controls.

Before the 2000 presidential election,  President Clinton foresaw that the acceleration of technology was having multiple unpredictable consequences in all aspects of our lives — especially in our nation’s security.  This wisdom led to his creation of a bipartisan “Presidential Commission on National Security in the 21st Century”.

Its final report (third over two years) released March 2001, just months after Bush defeated Gore and nine months before Sept. 11, 2001, we were warned to prepare for a catastrophic attack.  A history chancing attack came just six months later.  (Please note: the reports are found embedded at the bottom of this post.)

And it, in hindsight, resulted in the most flawed US foreign policy decision only two years later – the invasion, occupation and destabilization of Iraq with national security implications still accelerating today.

In truth, neither political party really abides by expert findings in most prestigious reports.  Such reports are called “dust collectors” inside the beltway if they are not shredded.  Read any Presidential Commission, National Academy of Sciences report, or think tank policy paper — on any issue over the last four  decades if you doubt this.

In truth both ‘we the people’ and the government are responsible.  We have always known what to do.  We just don’t do it.   Who among us doesn’t know the value of the Golden Rule?

From the pulpit of Detroit’s Second Baptist Church on Feb. 28, 1954 Martin Luther King Jr. never once mentioned racism.  Instead he talked about lost values and our need to recover them.He said then that the problem we face is not that “we aren’t good enough.” It’s just that our scientific genius has outpaced ‘our moral genius”.  He noted that the greater danger facing us then, wasn’t “the atomic bomb that was created by physical science” intended to kill millions, but “that atomic bomb which lies in the hearts and souls of men, capable of exploding into the vilest of hate and into the most damaging selfishness”.

We could still destroy ourselves in a nuclear war, but our selfishness is damaging the most important thing on God’s earth, our environmental life support system as a result of our worshiped economic system devoid of any value except profit.

We know education is vital to understanding the likely inevitability of our species of either threat, but appropriate and sufficient preventive action must follow.  And education for action should be the top topic in the 2020 elections.

The fundamental value of education in clear to all Americans. Especially those who home school their children. It’s safe to assume the motive of any true educator is honest and honorable. Even if all they teach from the Bible, Torah, or the Quran. But we/they must also learn that technology will continue to have an unpredictable outcome when the hearts and minds of anyone is contaminated by real or perceived injustices.  And profoundly, controlling how technology is used will be impossible without learning and acting on the fundamental principle that our cherished freedoms and security can never be sustained unless responsibility and accountable are codified into all of our policies and actions.

And ignoring the findings and recommendations of the seven Democrats and seven Republicans in Clinton’s unanimous bi-partisan Commission was enormously irresponsible.  In a press conference on the public release of the final report (March 2001) policy makers were clearly warned that Americans should prepare to die in large numbers on American soil from terrorism — the greatest national security threat according to the report.

But the second greatest threat was stunning.

The bipartisan recognition that it was a lack of education in US schools and institutions of higher learning was a serious nation security threat.

Republican Congressman Newt Gingrich, who a decade earlier had proposed the elimination of the US Department of Education, publicly apologized for this foolish ‘Contract for America’ priority he created.  After the apology he admitted, not only should we be “paying teachers more”, but we should also be “paying students to learn”!  

Why?

Because there was irrefutable evidence that we didn’t have the number of students coming out of our educational institutions that had the engineering, science, math, and language skills our nation needed to maintain, fund, evolve and manage our traditional national security defense systems. We still don’t.

According to the most recent the US National Science Board “The State of U.S. Science and Engineering 2020 report “U.S. national assessments of mathematics show little to no growth in scores over the past decade. At the same time, for higher education, the United States remains the destination for the largest number of internationally mobile students. Foreign-born non-citizens make up a considerable proportion of Science and Engineering doctorate recipients, including half or more of the doctorate recipients in engineering, mathematics and computer sciences, and economics. Many of these students stay in the United States after graduation. As such, foreign-born individuals account for a sizeable share of U.S. S&E employment, particularly among workers with graduate degrees.

The Superintend of Schools of Montgomery County Maryland gave a talk to county parents in the 1990’s that is even more relevant today. He said ‘when my father applied for a job, he competed with everyone in his community for it.  When I applied for a job, I competed with everyone in the US.  When your children applies for a job, they will be competing with everyone in the world.’    Today’s youth have it harder.  They will be competing with everyone and every robot in the world, not to mention every algorithm and Artificial intelligence — if the world’s debt burdened economy hasn’t collapsed before then.

Our cherished freedoms, security, and prosperity depend not just on the education of our youth, but the education of our nation’s policy makers and their courage to look beyond party purity and the next election.  Somehow we must get them to understand that everything vital to these cherished factors is dependent upon irreversibly globalized economic, communication, information, dual use technology, and environmental forces.  And without US policies being responsible and accountable with these irreversible interconnections and our local/global interdependence on them, our freedom, security and prosperity will NOT be sustainable.

Our reactionary form of government will continue to be dysfunctional and debt burdened. Without a more responsible domestic and foreign policies in every arena…not just education…things will not end well.  What sustainability requires for any system and structure is fact-based policies based on fundamental principles.  Not the political party principles that both political parties persistently ignore.

Our best chance of maximizing our nation’s security is with policies that are just and based on the “Laws of Nature and Nature’s God.”   Our best chance of maintaining our freedoms is with responsible policies based on the “Laws” of “Nature’s God”.  That would be “Liberty and Justice for all” for those who confuse their view of God as being separate from the “Golden Rule”.

Only a fool would expect all the world’s nations to make such a fundamental shift in thinking and action, and put the protection of human rights above the protection of their national sovereignty and ‘national interests’.  But only a fool would expect to keep their nation secure, prosperous and sustainable without somehow raising the protection of inalienable human rights above the protection of their own government.

Fortunately, there is a comprehensive approach available that is capable of preventing much of injustices driving the accelerating global chaos – government and corporate abuse of money, technology and political power.  This one option has been approved by most of the world’s people who know of it.  The 17 Sustainable Development Goals approved in 2015 for the year 2030.  You may not have heard of them. Our governments, foreign policy institutions and even many public non-profit organizations have failed in educating the public regarding their functional value in preventing more crisis. And new taxes are not needed. The money exists that should have gone to basic human needs and services for decades.  But nations have continued to protect the free flow of currency to offshore accounts as well as protecting the privacy of those who moved it there.  The enormous wealth of kleptocrats, oligarchs, drug cartels, real estate moguls, wealthy capitalists avoiding taxes, and even violent extremist groups funded by wealth attached to oil profits, put their money (approximately $32 trillion according to 2014 stats) where government controls refuse to go.

Another bipartisan Presidential Commission summarized 40 years ago warned that unless we put “ending world hunger” by the year 2000 ‘in the context of national security’ it probably wouldn’t happen.  And, if we failed, what we would see after that is more wars, terrorism, pandemics, environment degradation, refugees, and genocides.  We obviously didn’t listen. And they were right.

It’s hard to imagine what the world will be like in 2030 given the growing list of unsustainable national and global trends now before us.  But without sufficient and urgent investments in their prevention its rational to say that catastrophic outcomes will occur.  From debt, to global warming, to the evolution of weaponry, war and WMD proliferation, and the continued emergence of nature’s biosecurity threats — none can be prevented independently of the rest. MLK would say “no justice, no peace’.  If he were alive today he might say, “Liberty and justice for all- or freedom, security and prosperity for none.”

Phase I report – New World Coming: American Security in the 21st Century

New World Coming: American Security in the 21st Century was the first report completed by the Commission. Released on 15 September 1999, it attempts to provide a picture of the international security environment within the first quarter of the 21st century and the anticipated role of the US in that environment. The Commission anticipates an increasingly technologically, economically, and socially integrated world, i.e. increasing globalization amidst social and political fragmentation.The report provides twelve basic assumptions of that environment and fourteen conclusions based on those assumptions.

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Phase II report – Seeking a National Strategy: A Concert for Preserving Security and Promoting Freedom
Released on 15 April 2000, Seeking a National Strategy: A Concert for Preserving Security and Promoting Freedom proposes a new national security strategy based on the anticipated 21st century international security environment. The new strategy must consider how to minimize the potential destabilizing effects of the contradictory trends of globalization and political fragmentation while promoting US interests and values worldwide.

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Phase III report – Roadmap for National Security: Imperative for Change
Released on 31 January 2001, Roadmap for National Security: Imperative for Change suggests “significant changes must be made in the structures and processes of the US national security apparatus”[15]. The Commission believes that without these reforms, “American power and influence cannot be sustained”[16]. Five key areas are highlighted for reform, followed by the Commissions specific recommendations for each area.

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About the Author: Chuck Wooley (not the Game show host)

Chuck’s professional grassroots organizing and advocacy successes on global health issues led to his elected position on the respected Action Board of the American Public Health Association (membership of 120,000 US Health Professionals). Later he was then elected by his peers to Chair the United Nation’s Association Council of Organizations (over 110 US based NGOs representing a collective membership of over 25 million Americans). His focus has been connecting local and global issues to US national security interests and using non-partisan fundamental principles to advance public thinking and US policy on vital systems and structures essential to forming a more perfect union and sustainable environment.


Chuck credits much of his successes to his mother’s love, father’s violence, the study of Biology and wrestling (having qualified for the 1972 Olympic Trials only to find out he was seriously not qualified – but was honored to make it that far after a childhood of obesity and sloth.) “We are all”, he says “always wrestling with issues and concerns our entire life. Or we should be — given the persistent changes in our bodies and the world.” “Loving persistence” and “ruthless compassion” are two qualities his mentors offered him. Admittedly to his detriment he usually offers people what they need to know instead of what they want to hear. Chuck is an avid quote collector… one of his many favorites — “Science is my passion, politics my duty.” Thomas Jefferson

 

 

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Chuck W.

Truth and Consequences

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“At the root cause of our problems is the failure to recognize that Independence is a man made concept. The truth of our reality is that everything is connected to everything and therefore, everything impacts everything.  Every action impacts the whole. Mobilized is firmly rooted in this natural law.”

Everyday a new story of systematic breakdown, of tragedy, a shooting, a broken system, the election of incompetent psychopaths, media companies at war with each other,  it’s a constant struggle to keep up with it all.

We can stand high atop a mountain and cream “What the F%&K is going on here?” or we can go down the rabbit hole and discover the root cause–the epicenter of all of our inherent, continual and on-going problems.

The Age of Consequences of Systematic Failure: Our existing situations are not problems. They are Consequences

By Chuck Woolery, Former Chair, United Nations Assn., Council of Organizations (not the TV host!) and Steven Jay, Creative Director, Mobilized

Summary:  After the Great Depression and the end of WWII the general sense of the common good generated by these crises gradually disappeared from public discussion (with the exception of the civil rights forces that yielded some important civil progress).

America’s success in the world and our fear of Communism helped fuel individualism, greed, and selfishness (the illusion of individual separation from the whole). This largely un-examined mind set eclipsed the ‘united we stand’ American character. It was an aberration of logic, compassion, and empathy that basically steamrolled American politics into the train wreck we have today. Recently, technology greatly accelerated this trend that had been well established by a largely unregulated capitalism system that had spread the dangerous meme of Independence globally for the past few decades.

The tragic and lethal consequences are now upon us. And instead of recognizing our collective mental flaw that got us here, and confronting it, many people have doubled down on it. They want to make American Great Again by going back to the comforts, conditions, and selfish mindset that tragically nurtured our disconnect from reality. The truth that “United We Stand” is still stands. Divided we will fall And, this time it will be a hard fall. One we may not recover from.

  • Trump is not the problem. He’s a consequence. And…
  • Climate change isn’t the problem. It’s a consequence.
  • Unprecedented obesity rates, opioid deaths, mass shootings, and suicides rates are not emergencies. They are consequences.
  • Flint, Michigan’s contaminated water, Honeybees’ Colony Collapse Disorder, Florida’s red tide are not environmental problems. They’re consequences.
  • The continuing wars in Afghanistan, Yemen and Syria are all consequences.
  • Radical extremism, nuclear proliferation, and Russian cyber hacks are not national security threats. Growing economic inequality, fake news, and loss of privacy are not dilemmas.

That’s right, they are consequences.

  • All of these, and most of the other problems that we are now encountering at breakneck pace in newspapers and in our lives are the inevitable consequences of our thinking and actions.

They are the result of our collective failure to do what we know is needed to prevent such problems.

All Americans have solemnly pledged dozens, if not hundreds of times, “Liberty and Justice for all”. But our desire for comfort, wealth, distractions, popularity, and freedom comes with all too real life and death consequences.

Americans love freedom. Some freedoms have arguably been worth the cost of hundreds of thousands of American lives and trillions of our tax dollars. But it has been our overindulgence in freedom without responsibility that is the fundamental cause of our (and the world’s) growing list of profoundly dangerous, destructive, unhealthy, and increasingly lethal consequences. Unforgiving consequences that were predictable and often warned about. Costly consequences that were, and remain, related to a simple conceptual flaw within our mental calculations.

We believe and act as if we are independent. As Americans, we reinforce that sentiment every 4th of July. And yet, as a concept, independence has no foundation … in sane thought or practical application in the known universe.

It is this unyielding faith in, allegiance to, and reflexive defense of this flawed principle that essentially disconnects us from much of our personal, civil, environmental, social, and economic responsibilities. Like Neo in the Matrix, we all sense something isn’t right… but can’t see the truth;

In reality every aspect of our lives is dependent on other people, the environment, our nation’s laws, and most importantly, the “Laws of Nature and Nature’s God” as expressed in the first paragraph of the Declaration of Independence.

The growing mass of undesirable consequences that threaten our freedom, security and prosperity were as inevitable as they were unintentional. But they are only self-evident if we are honest about reality.

Our Founding Fathers called reality “Self-Evident…Truths” based on the “Laws of Nature and Nature’s God”. Their catastrophic error was failing to codify this wisdom into their new government blueprint — the U.S. Constitution. The consequence was a civil war that killed more Americans than all the wars our nation has fought in since then, combined. And some of the consequences remain with us today.

Far more Americans will die from preventable causes in the years ahead related to global factors SUCH AS terrorism, pandemics, climate change, wars, and poverty because the the systems and structures that our Constitution protects today on both the national and international level still fail to codify the wisdom of “liberty and justice for all” in a world of irrefutable and irreversible interdependence.

Interdependence … is accelerating because exponential advances in technology are accelerating, while our government’s capacity for change (or adaptation to change) has virtually stopped, and in some arenas … actually reversing.

The illusion of Independence underlies most of our thinking, planning, policy making, and actions.

We assume without question our individual, budgetary, institutional, and national independence. The endless war against terrorism (a tactic that cannot be defeated) only accelerates our loss of freedom and security. Our modern world of unprecedented and increasingly powerful, affordable and ubiquitous technological capacity for WMD creation – and the increasing difficulty in accurately attributing the identity of the attacker, puts everything at risk.

Imagine the loss of lives, freedom, and prosperity from a bioterrorist attack or global pandemic as bad, or worse than the 1918 Flu epidemic. Unlike nuclear war, such a biosecurity threat is inevitable. And, we remain lethally unprepared for a catastrophe that will NEGATIVELY affect every system and structure in our bodies, our homes, our economies and THE world.
We have based our policies on the illusion of independence (a concept created by humans, not existing in nature) instead of obeying nature’s fundamental principles that are used in science and technology to engineer things that work to save and protect life, and make our lives more comfortable, profitable, and secure. … It is the flawed human principle of independence that leads to our abuse and misuse of the amazing science and technology that creates most of our problems. Often with catastrophic results, but still preventable … if we had followed the laws of nature and nature’s God.

Now imagine a government engineered on the fundamental principles offered in the Declaration of Independence. A government that … soundly embraces and promotes the responsibility of inclusion with ‘liberty and justice for all’.


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Some have asserted that the primary fundamental principle in both the laws of nature and nature’s God is justice. The basis of every major religion is the Golden Rule of do unto others as you would have them do to you. And anyone experiencing an injustice doesn’t need to be a religious believer to understand the supreme value of this. Our US Justice Department offers two quotes engraved in its exterior’s stone.

“Justice is found in the rights bestowed by nature upon man. Liberty is maintained in security of justice.”

And,

“Justice is the great interest of man on earth. Wherever her temple stands, there is a foundation for social security, general happiness and the improvement and progress of our race.”

Yet our federal (and lower) systems and structures of justice are profoundly unjust. In reality we have a legal system in which it is better to be guilty and rich than innocent and poor. Many of our laws are unjust. And unacceptable injustices can also be found in our national economic, electoral, education, healthcare, agriculture, military, foreign policy, and intelligence systems and structures. Is it really any wonder that things don’t work, Trump was elected, wars persist, the environment is trashed, and our society is ailing?
Every time I see or hear of another failing in our nation, a phrase I heard last year comes to mind; ;“How healthy can we be if we are well adjusted to a profoundly sick society?” We are afflicted with a mental illness; Our capacity to believe anything! Literally, anything. Fake news and conspiracy theory should make that stunningly clear…but so should our worship of the illusion of independence.

In reality, every system and structure in our body, our house, our environment, and our world is interconnected and interdependent on the health and sustainable functioning of a just world. Our … mind’s illusion of independence … disconnects us from our bodies’ vital needs; Love, peace, community, … and nature’s vital systems and structures that we have largely taken for granted. Natural systems that maintain our planet’s capacity for sustaining all life, human health, future prosperity, and ultimately our species survival.

There is … zero guarantee … our nation will last.

The Federalists worried that hostile nations could exploit any domestic divisions. George Washington warned in his farewell address that partisan “factions” could rip the country apart. James Madison feared that liberty could be lost by the “gradual and silent encroachments of those in power.” John Adams said, “There never was a democracy yet, that did not commit suicide”. But, many in our Republic praise democracy, and rightfully blame both parties that are dominating our flawed two-party system that’s giving us the consequences we are suffering today. Some are proposing the creation of “People’s Party”. They put too much promise in the will of the ,masses and offer a platform based on creative progressive ideas that are largely devoid of fundamental principles. In other words – they are engineering a political party that relies on creative and popular proposals that could win a majority – but completely incapable of transforming the profound flaws in our current system and structures, on both the national and international levels.

FYI: Earth itself has an expiration date. And we the American people (and probably most of the world) still reflect the opinion offered in the second paragraph of their Declaration of Independence which states “accordingly all Experience hath shewn, that Mankind are more disposed to suffer, while Evils are sufferable, than to right themselves by abolishing the Forms to which they are accustomed.”

The bad news however is that Unfortunately, the suffering that’s coming in our age of Consequences may be so great that our species may expire long, long before Earth. With the consequences of the acceleration of technology (WMD proliferation and AI) already knocking on our door, the majority of Americans or people in the world may not even get the chance to suffer the full effects of climate change. Because of multiple factors, time is NOT on our side.

If you are seeking the most practical action to take, a ‘justice for all’ system won’t be welcomed immediately by many policy makers or political parties. This would require the legal protection of all inalienable human rights …by the force.

What can be done is funding the provision of those rights by the force of political will. President Roosevelt offered the basics in his four freedoms speech; freedom of speech and worship, and freedom from want and … fear.”

Universal access to clean water, safe sanitation, adequate food, access to basic health services, basic education, and an equal opportunity to earn a living wage would be a great start. The fastest, most affordable, practical, and effective means of maximizing such ‘Liberty and Justice for all” here and abroad, thus laying the foundation for maximizing everyone’s freedom and security is the 17 Sustainable Development Goals (SDGs) agreed to by every nation in 2015 for achievement by 2030.

Seventy years ago (December 10, 1948) the world approval of the Universal Declaration of Human Rights. It was offered in the context of world security. Those who experienced World War II, the holocaust, and a new weapon that could vaporize 100,000 people in a second understood the essentials of ‘justice for all’ as a preventive measure. Unfortunately, they (and we) were … given an international system (and structures) committed to protecting national sovereignty (another human created concept). The system has failed to protect humanities God’s given inalienable human rights. This structural flaw in the UN resembles the original flaw in the US Constitution that led to our catastrophic Civil War.

It’s obvious that we will not get an enforceable Global Bill of Rights any time soon. But we could virtually enforce most essential human rights by funding the SDGs. The growing array of global threats to our freedom and security demand we to this as rapidly as possible.

A set of less ambitious but, measurable, achievable, and affordable goals were set for the year 2000 a the 1990 World Summit for Children. Even though all governments at the time signed a pledge to make the resources available, few of the goals were fully funded or achieved. Another more ambitious set of “Millennium Development Goals” were set in 2000 for the year 2015. These were also shorted and the wars, terrorism, climate change, refugees, starvation, revolutions, state failures, infectious diseases, international crime and genocides we see around the world today ARE largely a consequence. If we fail this time in achieving the SDG’s our deteriorating global conditions may overwhelm any chance of our children setting things right.
The depressing news is that achieving the SDG’s will cost trillions that governments cannot spare.

The exciting news is that they don’t need to.

Governments just need the political will to freeze and seize a good portion of the $32 trillion dollars that is now stashed in offshore bank accounts by kleptocrats (dictators and their cronies), drug cartels (illegal gains), and wealthy capitalist (legally and illegally avoiding taxes) that should be going to basic government services.

The political will could be generated if the general public is aware that their nation’s security and cherished freedoms depend more on meeting the SDGs than on more military spending or a new “Space Force” branch of the US military.

That level of political will in the US will require a movement of movements of informed and active citizens recognizing that voting is the least powerful civil action they can take. Petitioning our elected officials is infinitely better than protesting, resisting, or counter protesting. If the peace, environment, and economic/social justice movements combined in petitioning their elected Members of Congress (and those running for office) a dysfunctional congress could actually prove useful. And we would finally have a government of “We the people” …”with liberty and justice for all”.

Essentially, it truly doesn’t matter who is in office or what party they belong to if fundamental principles are codified into laws, budgets, and all government action.

Given the multiple threats we face as individuals, nations and a species it must be clear that few can be stopped with military power. And, many are exacerbated by its unprincipled use.
Our primary goal as voters and citizens must be to recognize our global interdependence and the profound value of “liberty and Justice for all”. Make it your personal goal to educate your policy makers on this fundamental reality.

Connect the dots (we are all connected). See the web of life (all systems and structures are connected). Work for justice (for all) …or prepare for the consequences (which will inevitably be catastrophic).

Chuck Woolery, Former Chair ,United Nations Association, Council of Organizations
Steven Jay, Founder and Creative Director, Mobilized.news
___________________________________________________________________
Mobilized is creating a collaborative constructive solutions network dedicated to our collective human potential, economic and ecologic justice, and human rights. We are a network of media producers, investigative journalists, deep-thinkers, scientists and pro-active organizers who believe that an enlightened and well-informed populous is important for a society to truly flourish and are committed to working towards bringing it about. Please join us as a collaborator in creation of a better world: It’s Free to sign up, your registration will never be compromised. Share the news of solutions and empower a brighter tomorrow, today. Click here to sign up!

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