Environmental Engineering Reference
In-Depth Information
1994, generate significant levels of fear, which then damages the material interests
of the state (primarily economic interests); and attrition epidemics, which include the
HIv/aIDS pandemic, malaria, and tuberculosis (tb), do not generate similar levels
of fear as there is relatively high certainty about morbidity, mortality, and pathways
of transmission regarding these pathogens. However, attrition epidemics do very
much threaten the material interests of the state through the inexorable debilitation
and destruction of its populace, weakening of military forces, depletion of human
capital, erosion of governance capacity, and general macroeconomic decline. States
will then seek to cooperate in order to limit transmission to prevent the erosion of
their material interests and this becomes the basis for regime formation. In both cases
a Pe model remains useful, although it is more applicable to the outbreak cases.
However, whereas realism and the state's concern for its material interests would
seem to be the principal motivating force impelling it to act, realism does not provide
a theoretical framework that is effective in containing pathogens, particularly in the
context of increasing international trade flows and migration. Sovereign states have
realised that strategies of self-help are doomed to failure as borders are increasingly
porous in this modern era of globalisation. effective surveillance and containment
of pathogenic threats must necessarily include high levels of cooperation with other
sovereign states, as moderated by international institutions and assisted by nGos. It is
ironic then that the basis of state concern is the prism of realism, yet realist strategies
of self-help will likely result in significant losses for all states, even a hegemon.
liberal strategies of cooperation among sovereign states, increased transparency,
and the dissemination of information through international organisations and nGos
permit pareto-optimal outcomes not possible under realist constraints.
History of an Epidemic
the epidemic of SarS began in Guangzhou in November 2002. A physician who
attended the ill, Dr. liu Jianlun, inadvertently became the index case for a global
chain of transmission when he travelled to Hong Kong and unknowingly infected
other travellers, who then spread the disease throughout the Pacific Rim countries
(vietnam, canada, Singapore, taiwan, and other regions of china). Despite attempts
to suppress dissemination of epidemiological information, in February 2003 the
chinese Ministry of Health notified the World Health Organization (wHo) that
305 cases of acute respiratory syndrome (of unknown cause) had occurred in
Guangdong province of southern china since november 2002. In that same month
a chinese traveller to Hanoi infected several healthcare providers there. later that
month a cluster of similar illness among healthcare workers occurred in Hong Kong.
on 12 March, the wHo issued a global outbreak alert and began international
surveillance efforts to track this syndrome. at that point the contagion had spread
throughout the states of the Pacific Rim, with the greatest incidence of cases in china
(5327), Hong Kong (1755), taiwan (665), canada (251), Singapore (238), vietnam
(63), and the U.S. (33) (wHo 2003d).
