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Can You Catch It From a Caliph? Ebola, ISIS, and the Politics of Contagion

Two potent forces power the Ebola and ISIS epidemics that the media are ignoring. They're (1) breakdown of governing authority, and (2) dissolution of "social capital" -- ties of trust and cooperation that empower individuals, families, and others to forge coalitions and tackle common problems at the community level.
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I'm close to panicking about the politics of panic.

We've entered a fall season of frisson with catastrophe of the medieval kind. Infected, dying souls who can't kiss their loved ones goodbye. Townspeople put to siege, then told to convert to Islam or prepare to die. And butchery up close and personal -- the beheadings that moved Americans to back a new military campaign.

Fear of contagion is the common theme. The specter of terror spread by Twitter -- and by Americans who contract the jihadi virus on battlefields 6,000 miles away -- swung the polls hard toward war on ISIS. Meanwhile, mainstream news outlets are upping the ante on Ebola. It's "biological war," the BBC warned earlier this month. It "has the potential to alter history as much as any plague has ever done," a New York Times op-ed announced a day later. The op-ed's author, a former Bush administration official best known for a 13-year-old book subtitled, "What America Needs to Know to Survive the Coming Bioterrorist Catastrophe" (each chapter opens with an imagined account of a germ attack), warns that Ebola could spread to "megacities" and soon infect us through the air.

Those who rushed us to war in Iraq now cast President Obama as a ditherer for counting to 10 and collecting an international coalition before acting against ISIS. And those who hyped bioterror after 9/11 are staging a reprise, talking of quarantines, troop movements, and other martial measures against Ebola.

ISIS is barbaric. Ebola is scary. I don't want to live in a world that accedes to genocide, and there's something to be said for the contention that a great power signals weakness by allowing madmen to behead its citizens without consequence. Nor can we ignore nightmarish scenes of dying people being shunned, or fleeing space-suited health workers, or being turned away from overwhelmed hospitals.

But ISIS has leveraged our loathing to the point that we've lost a grasp of proportion (which, of course, is its snuff videos' purpose). It's killed perhaps several thousand, orders of magnitude fewer than the nearly 200,000 lost in Syria's civil war and the more than five million dead since the late 1990s in Congo's Hobbesian chaos. ISIS may be the richest jihadist group ever, but it's not a proven global menace: It's focused on winning believers and seizing territory for its "Caliphate."

As of September 18, Ebola had killed nearly 3,000 and infected almost 6,000, according to the World Health Organization. WHO projected last month that total cases could reach 20,000 before the outbreak abates in nine months; recently, a WHO team warned that without robust containment, there could be more than 20,000 cases by early November. Other computer models posit that total cases could exceed 100,000 under low-probability, worst-case assumptions. (A Centers for Disease Control report released Tuesday projected a virtual end to the epidemic by January 20 under best-case assumptions but an explosion in the number of cases, to 1.4 million by January 20, if governments and private groups don't deliver on aid commitments they've made.)

A crisis, worthy of global response? Yes, and after unfortunate delay, President Obama has acted by mobilizing American logistical capabilities to deliver medical aid. But "one of the great humanitarian tragedies of our time," as Larry Gostin (a prominent public-health law commentator who urges laws that would make it much easier to detain and forcibly treat people during epidemics) put it?

Well, compare the WHO's 20,000 projected cases (half of whom will die, if current survival rates don't improve) to the 50,000 Somalian children now "at death's door" from drought and war, according to Oxfam and other relief agencies. Or consider that malaria (preventable and curable) killed an estimated 627,000 people -- mostly African children -- in 2012. That year, tuberculosis killed 1.3 million worldwide. And 2.2 million people -- mostly children in poor countries -- die preventable deaths each year from waterborne illness.

The Ebola outbreak's greatest threat may be its potential to divert resources from more dire public health needs. And warnings of Ebola's becoming airborne (an implausible proposition, to put it politely) are better-calculated to win cable TV face time for their issuers than to contribute to prudent policy. Ditto for declarations that ISIS is poised to commit mass terror attacks in America, a prospect more speculative than Saddam's chemical weapons.

So let's move ahead with the medical support needed to hold the Ebola outbreak to the low end of the range of projections of viral spread. And let's not shy from using armed force to keep ISIS from committing genocide, stop its advance, and push it from territory it's taken. But let's also staunch our own viral panic. Let's leverage current fear to turn citizens' and policy-makers' attention to contagion's causes.

Two potent forces power the Ebola and ISIS epidemics -- and the much larger humanitarian tragedies, like malaria -- that the media are ignoring. They're (1) breakdown of governing authority, and (2) dissolution of "social capital" -- ties of trust and cooperation that empower individuals, families, fraternal groups, and others to forge coalitions and tackle common problems at the community level. It's hardly coincidence that Ebola and ISIS have swept across regions rent by war between faiths and clans and by regimes that deliver terror more dependably than public services.

Ebola in America will prompt fear (and sensationalist press), but it won't spread. Public health authorities will mobilize. People will cooperate with contact tracing and hygienic procedures, and they'd seek treatment instead of hiding. There will be some bureaucratic hiccups, heavy-handedness, and panic, to be sure. But public governance will be mostly effective (Katrina was the exception that underscored the rule), private groups will rush to meet need, and citizens will cooperate, even sacrifice.

This social immune system safeguards us against Ebola -- and against malaria, cholera, and other poxes of social breakdown. When, in 2003, Secretary of State Colin Powell warned that HIV posed a national security threat to America because of its potential to destabilize Africa, he reversed cause and effect: Collapse of public authority and mutual trust are the tinder for contagion.

Were an Ebola vaccine to be approved tomorrow, social trust would be critical. People from Monrovia to remote villages would need to be persuaded that the vaccine wasn't someone's murderous scheme. Likewise for lockdowns and other limits on movement of infected people. Coercion can't substitute for community cooperation; force can't be scaled up to control the private acts of millions. The same is so for assaults on ISIS from the air, or "boots on the ground." The Obama administration has wisely prioritized winning over Iraq's Sunnis for this reason.

So as we scale up against contagion, let's mobilize against the social breakdowns that enable it. The development strategies that have created economic possibility and catalyzed public trust in East Asia and parts of Africa have made these places resistant to poxes, both political and microbial. Education that builds human capabilities; safe water, good nutrition, basic medical care, and other health essentials; political participation; and protection for personal rights and the agency of women are no less urgent than isolation wards and air power where Ebola and ISIS now flourish.

Human development along these lines vaccinates against contagion. This approach demands large-scale effort and unflagging commitment. There will be setbacks along the way. Fear and distrust, hostility from vested elites, and violent disorder will at times put progress on hold. But America at its best can be a vector for its viral spread.

I write regularly on subjects at the interface between law, culture, politics and your health. Follow me on Twitter: @greggbloche

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