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Chuck W.

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

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

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

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

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

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

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

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

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

 

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

 

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

 

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

 

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

 

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

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

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

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

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

 

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

 

More Might! More Fright! More Plight!

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

 

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

 

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

 

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

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

 

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

 

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

 

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

 

CISET Report:

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

 

“…any city in the world is only a plane ride away from any other. Infectious microbes can easily travel across borders with their human or animal hosts. In fact, diseases that arise in other parts of the world are repeatedly introduced into the United States, where they may threaten our national health and security. Thus, controlling disease outbreaks in other countries is important not only for humanitarian reasons. It also prevents those diseases from entering the United States, at great savings of US lives and dollars.”

 

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

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

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

 

Other Sources:

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

 

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

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

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

 

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

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

 

Cost effectiveness of Development dollars:

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

 

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

 

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

 

The latest in infectious diseases:

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

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

 

Last year:

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

 

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

 

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

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

Economic Support Fund (ESF) increased by $42 million

OPIC increased by $35 million

 

TOTAL non development aid increases: $103.5 million

 

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

 

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

 

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

 

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

 

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

 

 

 

 

 

 

April 25, 1996

 

Testimony by

Chuck Woolery, Director

Communication for Health Campaign

 

Before

Congressman Sonny Callahan

Chairman of the

Foreign Operations Subcommittee of Appropriations

U.S. House of Representatives

 

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

 

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

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

 

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

 

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

 

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

 

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

 

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

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

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

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

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

 

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

 

More Might! More Fright! More Plight!

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

 

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

 

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

 

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

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

 

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

 

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

 

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

 

CISET Report:

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

 

“…any city in the world is only a plane ride away from any other. Infectious microbes can easily travel across borders with their human or animal hosts. In fact, diseases that arise in other parts of the world are repeatedly introduced into the United States, where they may threaten our national health and security. Thus, controlling disease outbreaks in other countries is important not only for humanitarian reasons. It also prevents those diseases from entering the United States, at great savings of US lives and dollars.”

 

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

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

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

 

Other Sources:

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

 

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

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

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

 

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

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

 

Cost effectiveness of Development dollars:

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

 

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

 

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

 

The latest in infectious diseases:

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

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

 

Last year:

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

 

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

 

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

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

Economic Support Fund (ESF) increased by $42 million

OPIC increased by $35 million

 

TOTAL non development aid increases: $103.5 million

 

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

 

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

 

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

 

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

 

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

 

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

 

 

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The United Nations system: What’s Gone Wrong? What’s Gone Right?

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To better understand the inner workings and problems with the U.N. system, we asked a few poignant questions of “The Other” Chuck Woolery. The one who was elected by his peers to Chair the United Nation’s Association Council of Organizations (over 110 US based NGOs representing a collective membership of over 25 million Americans) and the Action Board of the American Public Health Association (membership of 120,000 US Health Professionals).  He had spent three decades working with non-profits and other NGO’s advocating for a stronger United Nations for addressing global issues.
 

Many people have put hope on the U.N. systems to solve our ongoing crises. Why is this not a good idea, and how and why is the U.N. platform ineffective?

Ideas can be hopeful. The U.N. was a good idea. The prevention of problems is something everyone knows needs to happen. But that requires long-term thinking and effective action. Unfortunately, the U.N. was never given any power other than providing a peaceful gathering of nationals to work on problems they agreed on.  Any UN solution depended on the voluntary action and funding of those nations. The UN can help coordinate practical efforts but then takes the blame when things go wrong.

 

The UN lead the global campaign that eradicated Smallpox. It succeeded because of truly universal cooperation, coordination, and adequate volunteer funding.  I believe the most recent UN success story was in 2015.  Back then stakeholders on many issues at every government level from every nation came together and worked out a plan to maximize preventive efforts that could get humanity to the year 2030 with minimum difficulties/crisis. The bad news on these 17 Sustainable Development Goals is that few people in the U.S. have ever heard of them. If they have, they fall into four basic categories.

  1. Those who favor their particular goal believing it is the most important of the 17.  Unfortunately, each of these 17 goals requires equal, sustained, and urgent efforts.  And each is underfunded.
  2. Those who don’t believe they are sufficient.
  3. Those who don’t believe they will ever happen.
  4. And some who are suggesting the only rational means of achieving them.  These rapidly hit mental constructs in other’s minds that make effective action unlikely if not impossible.

 

Year after year progressive advocates focus on one sector or another.  Climate, water, peace, human rights, democracy, health, etc.

Why are these ineffective? What would you do to create an effective system that could detect problems before they start and invest in efforts that prevent it from occurring? 

From a U.S. perspective…Events are ineffective even if they are large. Ultimately, they are competing for limited resources with other movements for media attention, donations, access to policymakers or other influential people.

This strategy cannot effectively generate sufficient political within a majority of U.S. Congressional Districts and states.

 

Do egos get in the way of effective coordinated actions? I think it’s more a paycheck or cognitive dissonance issue. Leaders are hired to produce results in a particular arena. They can make a big splash.  But what is urgently needed is a movement that brings other movements together into one. A movement of all movements.  Otherwise singularly grand impacts by one movement (like Climate Change) will continue to distract from the importance and urgency of other vital movements.  Note how quickly the emergence of COVID19 muted every other movement (pro-democracy, regional wars, the evolution of weaponry, US debt…) or quickly exposed our failures in others (health care, infrastructure, pay gaps, supply chains).    Now the increasing urgency on vital action to address increasing climate emergencies are muting those.

We need a comprehensive, holistic, and global approach to human, environmental, economic, and political health. And sustainability.

 

What is the U.N. good at accomplishing?  Bringing together interested parties focused on global concerns/issues.

 

What is your greatest dissatisfaction through what you have experienced in organizing? Your biggest satisfactions?

The greatest dissatisfaction is knowing that all of the comprehensive studies that have been done by bi-partisan Presidential/congressional commissions, prestige entities like the National Academy of Sciences, and intellectual think tanks from multiple nations have always given us wise recommendations. Humanity knows what to do. But we don’t do it.  Short term thinking, national interests, political partisanship, and flawed political systems won’t allow it.

My personal awakening and satisfaction came from discovering how open our political system actually is.  Citizens simply don’t grasp the fact that a well-organized, informed, and lovingly persistent movement can create political will to achieve specific ends. My hopes are that Mobilized can spark such a movement.  That enough progressives, moderates, libertarians, and even conservatives will finally grasp the reality that things are going to get much worse…unless we unite under the realization that everything is interconnected!  Everything is interdependent!  And everything, including all of us, are vulnerable.

 

How would you title the editorial we are creating here with your words in a way that would lead people into concerted actions?

  • “Connecting the Dots. See the web of life. Doing what’s needed.  Or prepare for catastrophic consequences.”
  • Disobeying he Laws of Nature and Nature’s God will not end well.
  • We face a Trilemma:  Freedom, Security, and Independence. Which two do you want?
  • Human Rights and the environment vs national sovereignty.
  • Government openness and accountability. Or oblivion.

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“We hold” this truth “to be Self-evident.”

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Our U.S. Constitution has not formed a perfect union.

Instead, it has created an increasingly dysfunctional and stubbornly divided people within a collection of 50 unique and troubled states. With the continued contempt on Capitol Hill, it would be hard to find any U.S. citizen with the opinion that our government is doing what’s needed to “insure domestic tranquility.” Covid19 crushed the intent to “provide for the common defense.” And our cognitive divisions make it impossible to “promote” our “general welfare.” Our Constitution has allowed our military to enter into endless wars because we have valued the law of force instead of the force of law to end violent extremism. These efforts to preempt attacks instead of preventing them are at the core of our Constitution’s failure to secure the “Blessings of Liberty to ourselves and our Posterity.” The absence of justice in our laws combined with our 4th Amendment (our unyielding desire for privacy) makes our Constitution a virtual suicide pact.

By  “The Other” Chuck Woolery

How will we stop corruption from undermining our economic system, a white supremist engineering a bioweapon targeting Blacks or Jews, a cyberattack on our nation’s critical infrastructure, or a spy from exposing any other vulnerable aspects of any system vital to our nation’s security? Can we drone strike suspects? We do this in other countries.
Do we really believe that will make us sustainably safe?

Trust is the glue that holds any relationship, civilization, or democracy together. It depends on truths we can all agree on. Today, however, we believe firmly in different realities. Facts about our political party, religion, economic philosophy…that we are willing to kill and die for. And there appears to be no means of reversing this polarization. It may even be growing as gun sales have skyrocketed and bullets are now hard to find.

“We the people” have never been more divided since our civil war. The consequences already include a drop in life expectancy approaching that of World War II. This was mainly due to an elected President that could have prevented it. And he still believes (along with millions of followers) that the election was rigged, and he should still be President.

But it’s worse than that. Even before Trump’s presidency, our nation’s top national security experts ranked our own government’s dysfunction as our nation’s second most significant security threat (terrorism was #1). And before Trump, the U.S. Surgeon General stated that our nation’s most significant health risk was “loneliness.” This suggests there is something even more dysfunctional than our Constitution.

Understanding the fundamental cause of each of these problems (and others) is now more valuable than winning any partisan debate, tweaking any budget lines, or changing any particular law among the thousands that our Constitutional process has codified in the last 70 years.

Something needs to change fast, given the escalation of domestic and international threats. We need systemic change. A comprehensive change. A transformational change in the very fundamental operating principles of our Constitution and what we believe in.

This question keeps coming to mind. How free, secure, or healthy can we be if we are well adjusted to a profoundly dysfunctional political system and nationalist culture?

No sane individual would now wager we will make the needed changes anytime soon. Buckle up, buttercup! Things are going to continue to get worse. Much worse before we fix it.

A catastrophic collapse of our economy or our 245-year-old political system is no longer unthinkable. It is as predictable as a pandemic had been. Both, inevitable. Given both the structural and systemic flaws in our Constitution and its persistent failure to abide by the “Laws of Nature and Nature’s God,” – another pandemic and our systems collapse are both inevitable.
How many people would ride on an airplane that they knew was engineered by a committee that understood the forces of gravity yet failed to abide by it during the aircraft’s construction? Our founding fathers understood the forces of nature and nature’s God. They all signed the document based on such self-evident truths found in the Declaration of Independence. Then they engineered a government that ignored them.

According to most former U.S. Presidents, Abraham Lincoln is the most popular U.S. President. This is because he presided over the correction of a fundamental flaw in our Constitution’s original design. A design flaw resulted in more dead Americans than all the wars our nation has fought in since then—Combined! Now a virus has killed even more than that in less than two years. Why? Because “we the people’ believed our powerful military, our economic system, our wealth would keep us safe. And we ignored history, science, the fundamentals of the faith (do unto others), and the flag pledge…” liberty and justice for all” that every American has said out loud hundreds of times with their hand over their heart.

Abraham Lincoln once wrote, our ‘Declaration of Independence is our “Apple of Gold.” Our Constitution is its “frame of Silver.”

Yet our elected officials, public servants, and military personal swear an oath to protect the Constitution. Not us. Not the environment on which we all depend. But on a fundamentally flawed document. A document that frames the codification of unjust laws and the protection of God-given inalienable rights. But only for U.S. citizens. And we wonder why tens of thousands if not millions of people in the world hate us enough to want to kill us. Murder us in large numbers.

Our only way forward as a united nation in this troubled world is to accept the pain and suffering our country has caused. We are asking forgiveness for our crimes against humanity. Slavery. We are not keeping our word “40 acres and a mule”. Stealing the land of ‘first Americans,’ breaking our treaties with them, then systematically destroying their cultures and heritage. Our interventionist wars are intended to protect our interests or preempt other nations without sufficient evidence, resulting in millions of civilian deaths in dozens of countries. Then, we re-engineered our Constitution to codify new laws. Laws and codes that effectively mirror those laws based on the “Truths” that ‘we hold to be self-evident.

Erase a few words from our political vocabulary. Words like independence, terrorism, and happiness. Replace them with “separation, mass murder, health. Imagine how different our culture and nation would be today if our Declaration of Independence had been called our Declaration of Separation. The concept of independence is so ingrained into our brains we believe it’s real. Yet, it exists nowhere in the known universe. Yet our Constitution considers our 50 states some level of ‘independence’ on some issues. And every nation in the world has a right to their ‘national sovereignty’ (independence) unless our Constitution is used to justify our nation violating it.

Then imagine what things would be like if Thomas Jefferson had listened to his friend Dr. Benjamin Rush (also a signer of the Declaration). Rush suggested that he change “life, liberty and the pursuit of happiness” to the pursuit of “Health.”
We have thoroughly abused the word ‘happiness’ as it was meant in previous times. Those alive at this nation’s creation believed ‘happiness’ to be ‘finding one’s purpose in serving the community as ‘finding one’s bliss.

And what if the founders had followed Thomas Paine’s assertion that the only legitimate use of government is protecting human “freedom and security.” Our Constitution would have never allowed the slaughter of innocent people anywhere.

And the word we have worshipped yet butchered most is ‘freedom.’ We persist in ignoring the dozens of quotes that the founders and those before them they had thoroughly studied, that stress the importance of being responsible with one’s freedom – or it would be lost. Surprisingly, another word mentioned in their archived documents (over 120,000) said ‘virtue’ 6000 times. More times than freedom! Then, it implied that good men were needed to maintain God’s given freedoms.

Here’s another self-evident truth. We cannot stop the accelerating global forces that now penetrate our national borders effortlessly without breaking ourselves economically. No amount of money in the world can prevent the consequences of biological, cyber, environmental, criminal, or economic contagion from crossing our borders as if they were not there. In reality, our borders are political lines drawn on maps. But, unfortunately, the Laws of Nature and Nature’s God do not recognize map lines.
The exponential growth of technology – combined with its increasing affordability, availability, power, multi-use capacity, dependence building, norm busting, and unavoidable globally disrupting influences cannot be stopped militarily or with walls. And most are an inevitable and unstoppable assault on human privacy.

Our mind’s illusion that globalization on steroids can be stopped with hyper-nationalism will fail. And fail catastrophically. No nation can effectively address the escalating battery of globalized threats humanity now faces.

Our current global governance system ensures failure. And the costs in blood and treasure are nearly unimaginable. If we fail to reduce these risks, they will continue to relieve us. Instead, it will vastly increase us as refugees.

It is possible that our so-called ‘independent nations’ could rally and address the most popular environmental threat these days, global warming. But it’s not possible to stop pandemics, the evolution of weapons, and war – without every nation, village, and individual in the world being held accountable for any injustices or overt violations of inalienable human rights.

Since we have ignored or refused to codify the Universal Declaration of Human Rights, our only reliable path is to work as diligently as possible to fund and comprehensively achieve the United Nations 17 Sustainable Development Goals.

This is quite possible if most progressive groups in the U.S. and around joined into one single movement. For example, a movement of movements as Naomi Klein called for in 2014 during the Climate March in N.Y. city and hundreds of cities worldwide. Together such a movement could convince most of the world’s governments to freeze and then seize much of the illicit funds stashed in offshore accounts exposed by the Pandora papers.

 

A 2014 study estimated that as much as $32 trillion had been stashed there by kleptocrats, oligarchs, crime cartels, extremist groups, and ultra-rich capitalists avoiding taxes. Corruption and privacy in those – and now in cryptocurrencies – undermine every aspect of humanity’s freedom, security, prosperity, and sustainability.

Connect the dots. See the web of life. Work for justice for all. Or prepare for the consequences. Know that no matter how much we invest in resilience – it will not be enough.

It is past time we shed the 400-year-old dysfunctional global governance system of national sovereignty. And put in place an international rule of law where the protection of human rights (freedom and security) and the environment is above the rights of nations and corporations to do as they please.

Mission impossible…yes. What else are you going to do? Build a bunker?

“The Other” Chuck Woolery (not the Game show host)

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


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

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Chuck W.

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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Mobilized TV

Mobilized TV on Free Speech TV  takes a deep look at our world, the consequences of human activity on our planet, and how we can reverse and prevent existing and future crises from occurring. Mobilized reveals life on our planet as a system of systems which all work together for the optimal health of the whole. The show delves into deep conversations with change-makers so people can clearly take concerted actions.

Produced by Steven Jay and hosted by Jeff Van Treese.

Mobilized’s TV series Mobilized TV  premieres on Free Speech TV on Friday, October 15, 2021. All episodes appear:

Fridays 9:30 PM Eastern (USA/Canada)

Saturdays:  6:30 PM (Eastern USA/Canada)

Sundays:  8:30 AM Eastern (USA/Canada)

January 7, 8, 9, 2022

Leading Environmental Justice Attorney, Thomas Linzey of the Center for Democratic and Environmental Rights is a leading force helping communities implement successful rights of nature laws. Find out how your community could take on big business to serve the health of all.

 

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