This essay concerns the current intersection of national security and public health in the United States. It argues that over the course of the past three decades, a new way of thinking about and acting on the threat of infectious disease has coalesced: for public health and national security officials, the problem of infectious disease is no longer only one of prevention, but also—and perhaps even more—one of preparedness. The essay describes the process through which a norm of preparedness came to structure thought about threats to public health, and how a certain set of responses to these threats became possible. The story is a complex one, involving the migration of techniques initially developed in the military and civil defense to other areas of governmental intervention. The analysis is centered not on widespread public discussion of biological threats but, rather, on particular sites of expertise where a novel way of understanding and intervening in threats was developed and deployed. It focuses in particular on one technique, the scenario-based exercise, arguing that this technique served two important functions: first, to generate an affect of urgency in the absence of the event itself; and second, to generate knowledge about vulnerabilities in response capability that could then guide intervention. More broadly, the scenario-based exercise is exemplary of the rationality underlying the contemporary articulation of national security and public health.
Cultural Anthropology has published many essay on American politics and culture. See, for example, Heather Paxson’s “Post-Pasteurian Cultures: The Microbiopolitcs of Raw Milk Cheese in the United States” (2008), George Lipsitz’s “Learning from New Orleans: The Social Warrant of Hostile Privatism and Competitive Consumer Citizenship” (2006) and Steven Gregory’s “Race, Rubbish, and Resistance: Empowering Difference in Community Politics” (1993).
Cultural Anthropology has also published a number of essays on the ways security is conceived and pursued. See Joseph Masco’s essay “Survival Is Your Business: Engineering Ruins and Affect in Nuclear America” (2008), Hugh Gusterson’s “Nuclear Weapons and the Other in the Western Imagination” (1999) and John Devine’s “Can Metal Detectors Replace the Panopticon?” (1995).
About the Author
As of August 2008, Andrew Lakoff is an Associate Professor of Sociology and Science Studies at UC San Diego, and is a Program Officer at the Social Science Research Council. He is the author of Pharmaceutical Reason: Knowledge and Value in Global Psychiatry and co-editor of Global Pharmaceuticals: Ethics, Markets, Practices. His current research concerns the intersection of global health and national security expertise around the problem of biological preparedness. With Stephen Collier, he is investigating the genealogy of vital systems security in the 20th century U.S and they have co-edited "Biosecurity Interventions: Global Health and Security in Question" (Columbia, 2008).
Multimedia and Links
Set 1: In the article, Lakoff discusses the way in which the Dark Winter scenario set the stage for a new way to think about threats, and specifically the ways in which the state is considering itself as unprepared. The following videos were used in the Dark Winter Scenario as well as another scenario called Atlantic Storm.
The first clips (Video 1-5) are from Dark Winter and each is filmed as if it were the local or national news agency reporting from the initial US outbreak to the crash of the markets. Each is scripted to account for the various ways in which a small pox attack might effect specific sectors—or systems. In "Scripting Disaster" there are scripts for both Dark Winter and Atlantic Storm (another simulation exercise focused on smallpox threat).
Dark Winter Scenario 2001 (Simulated news stories)
Video #1: Setting the stage "we could have a serious health emergency on our hands"
Video #2: Limited vaccines available "....It means it could be a very dark winter"
Video #3: Day Six Report -- Military and Government receive vaccine "struggles to get vaccine lead to violence"
Video #4: Interstate conflicts "...starting to sound like a war zone"
Video #5: Day 12 -- Riots, market closes, vaccine blackmarket "...no other country is accepting flights in or transiting from the US"
Scripting Disaster: The following are examples of scripts available for two table top scenarios.
Questions for Classroom Discussion
1) What does preparedness mean in an era of vital systems security? Please explain both phrases in relationship to current national security and public health practices.
2) Lakoff describes Niklas Luhmann's work on expertise (401-402). Why does Luhmann argue that catastrophe cannot be accounted for within traditional risk assessment calculations; how does Lakoff mobilize this predicament by way of methodology?
3) Describe the three epochs of security offered in the article explain the difference between each and how there are potentially elements of each within our current era.
4) Using the examples from the text, how do state interventions shift depending on how disease is structured?
5) In the section about early health reform, what were key factors that were believed to effect one's health? What relationship did factors have to the interventions that were used?
6) How did late 19th and early 20th century notions of public health effect the rationality of public health experts; what the primary tool that they relied upon?
7) Explain the circumstance that surrounded the flu scare of 1976. How did it present a shift in practice by public health experts?
8) Explain Robert Kupperman's role in creating the foundation for preparedness and the common problems in a crisis and the actions he took to create a method to prepare for such crises.
9) What methodological contribution did Kupperman make to crisis management and what role did this have to larger interventions in the public health infrastructure?
10) Describe the circumstances in the 1990s that allowed for deep connectivity between infectious diseases, biothreats and national security.
11) What was Dark winter? How did dissemination of this event allow for influence far beyond the table-top?
12) Explain the following passage: "The scenario-based exercise thus functioned to authorize knowledge claims in the absence of actual events" (p. 419)
13) Explain the shift from a pandemic flu to a generic biological threat; what is significant about the change in threat?
Review the section "Scripting Disaster" chose two scripts. Read the scripts of each scenario then reflect on the following questions:
1) How is the situation described in each scenario; what are differences between the setup in each?
2) How are the participants expected to engage in the exercise?
3) Can you locate queues that serve to 'coach' specific responses from participants?
4) Why do you think these scenarios are also public events (covered by media, widely available on the internet etc)?
5) What "systems" are being measured and tested in the scenarios?
6) How is vulnerability accounted for in the planning of these scenarios?
7) Is there a certain level of vulnerability and risk that will always remain acceptable within these types of exercises?
8) What do you believe is the ultimate goal of each scenario?
9) Describe the methodology in each exercise, what tools are used to engage participants?
10) In what ways does the methodology of the scenario effect the exercise; can you think of other tools and strategies that could be used to produce other effects?
Aditional Work by Andrew Lakoff
Additional Projects Involving the Author
The collaboration on Vital Systems Security (VSS) examines the techniques, forms of reasoning, and political ontologies that comprise contemporary security assemblages. In the wake of the 9/11 attacks and Hurricane Katrina, and in the face of possible future catastrophes such as pandemic flu, the character of security has changed dramatically. Domains such as emergency response, public health preparedness, and system vulnerability have become central to security discussions in the United States and globally. The collaboration asks how, in this context, security is being reproblematized as an object of knowledge, intervention, and political reflection. It proposes that the security of “vital systems” – such as energy, transportation, communication and health – is one significant new norm of contemporary security in relationship to which existing elements are being configured. The collaboration focuses in particular on the knowledge forms, techniques, and modes of intervention associated with vital systems security and asks how these relate to the older forms of population security and sovereign state security. Click on the links below for more on Vital Systems Security.
How did a vocabulary of “preparedness” supplant one of “prevention,” re-structuring how U.S. agencies respond to threats to public health and national security? This question is at the center of an essay by Andrew Lakoff in the August 2008 issue of Cultural Anthropology that tracks the migration of scenario-based security planning exercises from their initial development in U.S. military and civil defense agencies to other agencies concerned with “vital systems security.” Lakoff describes two particularly important implications of this discursive shift from “prevention” to “preparedness.” Rather than statistically calculating probable risk based on historical evidence of disease, experts use the scenario-based methods of “imaginative enactment” to construct plausible singular events and potential disasters. Meanwhile, the ongoing living conditions of large populations -- poverty, limited access to health care, inadequate housing – fall increasingly farther outside the purview of a biopreparedness system in which prevention is no longer the main focus.