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Chuck W.

Nov 26: Nullification of National Sovereignty day?

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National Sovereignty may be the greatest conceptual evil that mankind (women were not in political or religious power then) has ever created.   Pope Innocent X (“the Tenth”) declared the Peace of Westphalia (which established this disastrous concept) null and void 370 years ago today. 

Unfortunately, nation-states ignored him.  They still do today.

By Chuck Woolery,  Social Activist, (not the TV Host)

The Pope’s concerns were unacceptable back then because the whole purpose of the Treaty of Westphalia was to stop the perpetual slaughter from 30 years of religious wars with zero regard for national borders, like ISIS, Al Qaeda and Christian White Supremacists today.

Before the Westphalia ‘peace treaty’ each religion essentially assumed the right to kill whomever they wanted, whenever they wanted, wherever they wanted.  The treaty essentially ended that chaos so mass murders were only allowed by governments within their own national boundaries.  Or, if another nation interfered with or annoyed another government for any reason, the treaty was null and void.  Mass murder could resume…but only against another nationality.

That government right still exists today.  The right to kill anyone, anytime, for whatever reason it wants, as long as they are within its own borders.  There is an exception to this “murder” rule.  If one nation has an extraordinary military and thinks it can safely murder or mass murder people in another nation, it’s OK to do so on any scale they believe they can get away with.

This national sovereignty “peace” concept has lasted 370 years.  Oddly, even after suffering two world wars, and the invention of weapons that could vaporize a hundred thousand people in seconds the world reinforced this ‘peace’ code of conduct with the UN Charter.  The Charter’s Preamble laughingly begins “We the peoples of the United Nations” but gave zero power to this international law system and its various structures to protect inalienable rights of ‘we the peoples’.



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Nothing represents this reality more than the recent murder and dismemberment of Jamal Khashoggi by Saudi Arabia’s henchmen in Turkey, done with the approval or acquiescence of the Saudi Prince.  Or consider the continued bombing of Yemen by Saudi Arabia and its acceleration of the starvation of up to 9 million innocent Yemeni men, women, and children.  This is in addition to the tens of thousands that have already been murdered with the assistance (weapons sales, bomber refueling, and precise targeting) funded by US tax payers.  And then there was the US shock and awe invasion of Iraq and it’s lengthy and bloody occupation just on a suspicion they might want to hurt us…in the land of the brave.

For nations that want to retain the supremacy of national sovereignty over the protection of human rights I wish they would really think through their worship of this insane concept.  They may want to consider a few of the things that have changed over the last three and a half centuries.  Border walls, rivers, oceans and castles that used to provide relatively good security don’t hold up well against a variety of new technologies.  Technologies that give far more advantage to the attacker.

For the life of me (literally) I’m trying to figure out how this 370 year old national sovereignty concept is going to protect me (and others) from bio-security threats (pandemics, bioterrorism…), a collapse of the global economy, WMD proliferation, terrorism, global warming, international cyber criminals, or space weapons.

Many things have changed since 1648.  Perhaps we should too.

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Chuck W.

The Interconnected structure of reality

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Post 9/11: Truth or Continued Consequences?

What did 9-11, Covid19, the Covid variants, the end of our 20-year war in Afghanistan, recent extreme weather events globally, and a decline in democracy in many nations all have in common?  First, they were all predictable, predicted, and preventable. Second, more costly blood and treasure consequences are yet to come – unless we understand the root cause and urgently act on it.

By “The Other” Chuck Woolery

Everyone who was conscious on September 11, 2001, recalls the events of that day. But understanding both the origins and the results of 9/11 is far more important than any acts of remembrance that we might perform. If we truly care to honor those who died and suffered on that unforgettable day, we must use our powers of understanding to develop sustainable strategies for preventing the next terrorizing event that might occur. Understanding must matter more than body counts.

The Post’s lead editorial of 9/11 cites Abraham Lincoln’s statement that, when combating danger “the best defense (against the dangers of his time) …lay in cultivating robust ‘reverence for the Constitution and laws,’ ” as well as his hopes that doing so “would inspire and sustain the people’s commitment to liberty and equality.”

In his writings, Lincoln also described the Declaration of Independence as “our apple of gold” and the Constitution as its “frame of silver.” To my mind, these analogies reflect our foundational goal of equality for all people, as invoked in the Declaration.   But our “rule of law, as detailed in the Constitution ignores both the concept of justice and humanities inalienable rights.  The Constitution’s reliance on the proposition of independence — a deeply flawed concept rooted deeply in our minds has not delivered justice or consistently protected human rights since its creation.  From the start it was engineered into every level of our nation’s government.

Many Americans today proclaim their allegiance to individual liberty at the freedom to infect others in their communities.  For a significant portion US citizens “independence” has come to denote the license to act irresponsibly without regard for the medical, environmental, or economic consequences their actions on others (rejecting masks, refusing vaccinations, or denying climate change).

This prevalent fusion of “freedom” with “self-gratification” has long consequences for rest of the world too. For many decades our foreign and military policies have disparaged other cultures as unworthy of the respect and privilege that we ourselves take for granted; we’ve dismissed foreign casualties as “collateral damage”, communist or terrorist sympathizers, or humans irrelevant to our nation’s interests.

My studies as a biologist and student of the natural world have made the fundamental flaws in our Constitution to be “self-evident”.  They consistently ignore the “Laws of Nature and Nature’s God” expressed in the first paragraph of our “Apple of Gold” the Declaration of Independence.   Interdependence is at the heart of nature’s laws. Chief Seattle (1780-1866), the head of the Duwamish and Suquamish nations, saw this clearly: “Humankind has not woven the web of life. We are but one thread within it. Whatever we do to the web, we do to ourselves. All things are bound together. All things connect.”   Yet most of us ignore our irreversible global interdependence environmentally, economically, militarily, and health wise.   Without being responsible with our freedoms abroad we cannot expect to sustainably preserve our freedom, security, or prosperity here.

Until we grasp the wisdom and survival value of putting the global protection of human rights and the environment above the protection of national sovereignty and corporate power, our vulnerability to the kind of dangers inflicted on 9/11 will grow.  Sustaining what quality of life that remains and improving it for ourselves and our children we must abandon the illusion of independence.

 

Our interdependence within this nation and on this planet is accelerating and irreversible. Nearly every troubling trend we are experiencing today is a symptom of our delusion of separation. There is a medical term for this mental condition – anosognosia.  It is when someone is unaware of their own mental health condition.  In a world with the accelerating evolution of weapons, pathogens, failing democracies, and civil strife It’s time for a wake-up call.

Our human-created construct of independence is responsible for our persistent failure to understand and respond effectively to nearly every danger we face (pandemics, pollution, terrorism, cyber security, economic stability, drug trade, refugee flows, food insecurity, extreme weather events…), each with lethal and unfavorable consequences for all — both here and abroad.

We can no longer simply react when disaster strikes. We can no longer build back to what we had before. It’s imperative now that we build forward in ways that prevent dangers and conserve limited resources.  It is our only means of maximizing any sustainable prospects of freedom, security, and prosperity for ourselves and our posterity.  Most nations have agreed to achieve the 17 Sustainable Development Goals by the year 2030.  It is the only comprehensive set of solutions we have, and humanity is not on track to meet them.  Time is not on our side…and e may not get another chance.

The truth of our interdependence can set us free.  Ignoring it will only have more unfavorable consequences.

 

Before you finish eating breakfast in the morning, you’ve depended on more than half of the world. This is the way our universe is structured, this is its interrelated quality. We aren’t going to have peace on earth until we recognize this basic fact of the interrelated structure of all reality.” Martin Luther King, Jr.

 

“A human being is part of the whole, called by us ‘Universe’; a part limited in time and space. He experiences himself, his thoughts and feelings, as something separated from the rest – a kind of optical delusion of his consciousness. This delusion is a kind of prison for us, restricting us to our personal desires and affection for a few persons nearest us. Our task must be to free ourselves from this prison by widening our circle of compassion to embrace all living creatures and the whole nature in its beauty. Nobody is able to achieve this completely, but striving for such achievement is, in itself, a part of the liberation, and a foundation for inner security.”   -Albert Einstein.  As quoted in Quantum Reality, Beyond the New Physics, p. 250.

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Chuck W.

Truth or 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
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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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