Safe Food_ Bacteria, Biotechnology, and Bioterrorism - Marion Nestle [162]
Restrict access to computer systems.
Protect the perimeter; secure doors.
Notify authorities of evidence of unusual behavior, tampering, or sabotage.
SOURCE: FDA. Food Security Preventive Measures Guidance, January 9, 2002. Online: www.fda.gov.
Food Security as a Public Health Issue
Soon after the September 2001 terrorist attacks, commentators identified at least one cause of the nation’s inability to respond adequately to such crises: years of neglecting the public health “infrastructure”—the oversight systems and personnel needed to track and prevent disease. The focus on “homeland security,” they said, although perhaps politically necessary to allay public anxiety, diverted attention and resources away from basic public health needs. International actions also focused on matters other than public health, even when providing food aid. No responses to the crisis—domestic or international—were addressing “root causes”—the underlying social, cultural, economic, or environmental factors that might encourage terrorist activities. From the perspective of public health, bioterrorism may never entirely disappear, but it seems less likely to be used as a political weapon by people who have access to education, health care, and food, and who trust their governments to help improve their lot in life. If, as many believe, terrorism reflects frustration resulting from political and social inequities, it is most likely to thrive in countries that fail to provide access to basic needs, or that give lesser rights to ethnic, religious, or other minority groups. In such situations, public health can be a useful means to strengthen society as well as to avert terrorism.
The recent history of Afghanistan illustrates these points. Its health care system is poor by any standard, and its high infant mortality rate is approached by only one other country (Pakistan) outside of sub-Saharan Africa. As noted earlier, malnutrition is widespread, in part because only slightly more than one-tenth of the population has access to clean water supplies (contaminated water induces diarrheal and other infectious diseases that, in turn, contribute to malnutrition). In this situation, advised Richard Horton, editor of the Lancet, “Attacking hunger, disease, poverty, and social exclusion might do more good than air marshals, asylum restrictions, and identity cards. Global security will be achieved only by building stable and strong societies.”67
Because a healthy population is an essential factor in economic development, the health effects of globalization—positive and negative—become important concerns. Globalization has improved the social, dietary, and material resources of many populations, but it has also heightened economic and health inequities. Globalization brings safe drinking water and antibiotics, but it also brings pressures to reduce food safety standards, protect intellectual property rights, and accept the marketing of high-profit “junk” foods. Food shortages are of particular concern for at least three reasons: their harm to health, their destabilizing effects on civil order and economic development, and, not least, their breach of the social contract in which food security—in every sense of the term—is a basic human right.68
With these ideas in mind, the American Public Health Association suggests short- and long-term strategies to prevent terrorism and its adverse health consequences: address poverty, social injustice, and disparities; provide humanitarian assistance; strengthen the ability of the public health system to respond to terrorism; protect the environment and food and water supplies; and advocate for control and eventual elimination of biological, chemical, and nuclear weapons.69 Writer Laurie Garrett explains, “Public health is a bond—a trust—between a government and its people. . . . In return, individuals agree to cooperate by providing tax monies, accepting vaccines, and abiding by the rules and guidelines laid out by government public health leaders. If either side betrays that trust the system