Visiting scholar on avian influenza and post-9/11 biosecurity

When outbreaks of the H5N1 avian influenza virus struck in Indonesia and other Asian countries in the mid-2000s, the United States intervened quickly, contributing millions of dollars to bird flu initiatives in the hopes of preventing a global pandemic. In her talk on Monday, University of Washington Professor of Anthropology Celia Lowe will discuss why the H5N1 virus's appearance in Southeast Asia was treated as a major medical issue, how U.S. approaches to its treatment relate to post-9/11 anxieties about international biosecurity and why those approaches, although well-intentioned, proved somewhat problematic. Lowe specializes in science and technology, sociocultural anthropology and Southeast Asia.

Why was the United States so insistent on a large-scale interventional approach to treating the Indonesian H5N1 outbreaks during the 2000s?

The H5N1 avian influenza outbreak emerged in East and Southeast Asia in the wake of the attacks of Sept. 11, 2001. You might recall from that time that Dick Cheney and the new Department of Homeland Security were advising Americans to buy duct tape and plastic sheeting to seal their windows in the event of a biological attack. We also had an attack of anthrax on U.S. postal workers right after Sept. 11. The new strain of H5N1 influenza developed within this milieu, where a narrative of emergent vulnerability to microbes had become a robust element of American national security and public policy. These narratives drove a particular type of neoliberal approach to the outbreak. Indonesia, where the outbreak was most severe, has many health needs. Dengue fever is on the rise in response to climate change and urbanization. New strains of drug resistant malaria are emerging. Road deaths are of huge consequence to human health. All of these familiar public health issues require intensive investment in public health infrastructure, training and health policy. The approach to the H5N1 outbreak was different in Indonesia in that it did not invest broadly in this public health infrastructure that is of great use to the Indonesian people. Instead, the focus was on preventing a pandemic outbreak through surveillance and stamping out measures. There is nothing wrong with wanting to halt a virus before it begins to spread, though exceedingly difficult in the case of avian influenza in Southeast Asia. Nevertheless, pandemic preparedness efforts in Indonesia took resources away from Indonesian healthcare, medical research, lab time and drug production. In emphasizing surveillance over public health infrastructure, the global health community was focusing on its own biosecurity priorities at the expense of Southeast Asian interests in national health.

What were some of the issues with the approaches to halt H5N1?

It is not at all clear that the methods promoted by the global health community in the pandemic preparedness response to H5N1 were directly related to stopping the outbreak. Small-scale and backyard poultry farmers across Southeast Asia were asked to cage their birds and wash their hands. Government officials participated in military style tabletop and community simulations where they enacted disease outbreak scenarios. While this was the focus of the international effort, giant poultry conglomerates were left to enact their own professional biosecurity measures with limited oversight. It turns out that transformations to the influenza virus emerge out of the conditions of industrial production, not out of the backyard. When animals live in dense populations, a microbe can afford to be virulent. It can kill off its host and jump to another host. This, and the stress of living cheek by jowl with thousands of other birds, creates the conditions for the evolution toward virulence of pathogens. And yet, the questions at hand concerned traditional practices of Southeast Asian cockfighting or children playing with poultry in the backyard. There was racism in the pandemic preparedness effort, and there was also the desire to protect large agribusiness. The perceived urgency of intervening in the outbreak made it hard to question the motivations and methods of interventions made in the name of global health. Fear is easily mobilized to distract us from more fundamental causes and common needs.

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