How War and Crisis Help Spread Diseases Like Zika

Woodland mosquito (does not carry Zika virus). Flickr/Katja Schulz

Is the Middle East ground zero for the next deadly epidemic?

In 2009, President Barack Obama together with Secretary of State Hillary Clinton launched the U.S. Science Envoy Program following a landmark “new beginnings” speech in Cairo. I sat down with the White House and State Department U.S. Science Envoy, Dr. Peter J. Hotez, to highlight how links between disease and conflict could affect U.S. Middle East policy in the coming years.

In 2014, West Africa experienced the world’s largest Ebola virus outbreak. For two years, the poverty-stricken countries of Guinea, Sierra Leone, Liberia and Côte d’Ivoire were ravaged by the disease, leading to over eleven thousand deaths and cementing the 2014 outbreak’s deadly place in history. During the epidemic, global attention was largely focused on preventing the spread of the Ebola virus. Less reported was how an entire subregion of Africa became so susceptible to the rapid spread of a catastrophic disease. While poverty is a well-known driver of disease, its links with another potent driver are often ignored by the foreign-policy community— conflict.

West Africa’s decades-long history of intertwined conflicts and its devastating effects—weak government institutions, faltering health services, forced human migration, environmental degradation and failed development—created the perfect storm of conditions for an outbreak of a catastrophic infectious disease. Unfortunately, new information from the U.S. Science Envoy of the White House and State Department, Dr. Peter J. Hotez, indicates that the same cycle of conflict and political and economic instability is now taking place in the Middle East and North Africa (MENA) and with it a similar breakdown in health infrastructure, creating the breeding grounds for another potential epidemic of infectious disease.

Infectious diseases have emerged as one of many nontraditional security challenges facing the world in the twenty-first century. The Ebola outbreak illustrated the frightening efficiency of a transnational threat that cannot be deterred, coerced or compelled by a nation-state or the international community. It also illustrated how unprepared the international community was to counter the outbreak because no viable vaccines and medications existed at the time. A mere year after Ebola, the outbreak of the Zika virus in the Americas—a disease that also has no vaccine—has demonstrated that developed countries around the world remain unprepared.

While most infectious diseases, particularly tropical diseases, habitually affect disadvantaged populations in underdeveloped and conflict riddled regions, modern-day air travel and human migration can facilitate the spread of infectious diseases to developed regions and beyond, creating an international health crisis and making it an issue the developed world should no longer ignore. An unstable MENA region could serve as ground zero for such an impending health crisis.

Therefore, alongside a vigorous implementation of conflict-resolution measures, the United States and other major powers should invest in a foreign policy that incorporates preemptive and preventative health measures when addressing unstable regions vulnerable to infectious disease. Advances have recently been made in the nonprofit sector to develop countermeasures (i.e. vaccines) outside of the profit-driven pharmaceutical market; however, a government-centric approach should also be considered.

Conflict and Disease in Sub-Saharan Africa

Towards the end of the twentieth century and the beginning of the twenty-first century, scientists began noting links between conflict and the emergence of infectious disease epidemics in sub-Saharan Africa. Particularly dominant were a group of diseases that prevail in tropical and subtropical conditions in regions with high levels of poverty, known as neglected tropical diseases (NTDs). These diseases are considered neglected because impoverished populations are generally afflicted with these diseases, many of which are preventable, but fail to reach a global level that would, therefore, concern developed societies where the bulk of the world’s pharmaceutical companies reside. Consequently, NTDs remain virtually unknown to the average citizen and appropriate vaccines remain undeveloped. Examples of neglected tropical diseases listed by the World Health Organization include, but are not limited to: Chagas disease, Dengue and chikungunya fevers, leishmaniasis, schistosomiasis and Human African trypanosomiasis, colloquially known as “sleeping sickness.”