Jeffrey LewisAvian Flu

Worse than Saddam.

The New England Journal of Medicine will report the findings of a group of Thai epidemiologists who conclude that H5N1 strain of influenza that killed an 11-year-old girl also killed her mother.

Documentation of person-to-person spread suggests a greater risk that the H5N1 strain could produce a global influenza pandemic.

The twentieth century suffered three influenza pandemics:

  • 1918 (Spanish influenza, H1N1)
  • 1957 (Asian influenza, H2N2)
  • 1968 (Hong Kong influenza, H3N2)

The 1918 outbreak probably killed between 50-100 M people. The Center for Disease Control (CDC) estimates that a new global influenza pandemic could kill between 2-8 million people worldwide. The World Health Organization (WHO) is using the CDC estimate, which assumes a relatively “mild” strain like 1968. Other researchers believe the total could be much, much higher—rivaling the 1918 pandemic.

What does this have to do with arms control? Arms control is one of many forms of international cooperation that grow out of the liberal institutionalist critique of state sovereignty.

Arms control is founded on the idea that the preoccupation with deliberate aggression leads goverments to jealously guard their soveriegnty, eschew cooperation and obssess about the balance of power, often at the expense of coordinating international responses to more dangerous threats to human security.

Deliberate aggression does occur. But other threats to human security, like deaths from natural disasters, too often get short shrift.

Nothing demonstrates the declining relevance of sovereignty and the need for greater international cooperation than the HN51 virus. As another blogger noted (via Bouphonia):

Somebody needs to tell President Bush that it’s not democracy and freedom that is likely to spread around the world under his “leadership.” Instead of cavorting at obscenely costly inaugural events he should be instructing his public health establishment to sound the alarm that we may soon come under attack by a Virus of Mass Destruction.

Are you lookin’ at me?

Consider the 1997 outbreak of H5N1 in Hong Kong.

The government, acting on the advice of outside experts, ordered all 1.4 million chickens and ducks slaughtered. “We believe we averted an incipient pandemic,” one advisor to the Hong Kong government told Time magazine. Had Hong Kong failed to heed international advice, millions of people around the globe might have died.

What can be said for sovereignty in a world where Hong Kong’s public health policies put millions of Americans and other people at risk?

One answer suggested by Deng et al is sovereignty as responsibility. As one reviewer explained:

In the new world order, should the community of nations continue to adhere to the old principle of nonintervention in the internal affairs of sovereign states so long as their domestic policies do not constitute a “threat to international peace”? Not if the world recognizes, as these authors argue it should, that sovereignty carries responsibility to fulfill a social contract in which the legitimacy of rulers derives from their efforts to promote the welfare and dignity of all their citizens.

For more information on Avian Flu, the WHO maintains an excellent website. See also, the National Academies of Science workshop, The Threat of Pandemic Influenza: Are We Ready?


  1. Rob Sprinkle (History)

    Of particular concern would be the exact H5N1 strain involved in any person-to-person transmission case. Either the people involved or the strain involved or the circumstances involved were sufficiently different from the usual to result in transmission, infection, and severe disease. The people were related (mother and daughter) and may have shared a familial vulnerability—a membrane receptor site, perhaps—but a better guess would be that a strain difference was explanatory. An infectious agent acquiring a new capability may not retain all its old capabilities; more antimicrobial resistance may be associated with slightly less virulence, for example. Here, though, we find lethality preserved, apparently.

    Nice blog, by the way, but “Beliberate” isn’t a word. [Typo fixed! _ACW_.]