Pandemics and Open Borders

By William R. Hawkins l June 10, 2009


Mexico confirmed the first deaths related to the outbreak of H1N1 swine flu on April 24, 2009. Five days later, the World Health Organization (WHO) raised its pandemic alert to 5, the second-highest level, warning of widespread risk to human health. Dr. Margaret Chan, the U.N. agency’s director-general, advised all countries to “immediately” activate pandemic preparedness plans. “This change to a higher phase of alert is a signal to governments, to ministries of health and other ministries, to the pharm[aceutical] industry and the business community that certain actions now should be taken with increased urgency and at an accelerated pace,” Chan said.

The same day, President Barack Obama downplayed the possibility of closing the U.S. border with Mexico, where the deadly influenza virus originated. “It would be akin to closing the barn door after the horses are out,” he said during a news conference. The flu had already crossed into the United States, with the first cases being discovered in Texas and California. But the more infected people who cross the border, the wider would be the contamination and the faster the virus could spread. So the president’s claim that it was too late to take action was not logical. It was, however, in keeping with the policy priorities shared by Obama and his predecessor President George W. Bush in placing the NAFTA “free trade” agreement ahead of public health. The political imperative is to keep the southern U.S. border open to business interests who have outsourced production to Mexico or who are importing goods through Mexican ports and transit routes.

The WHO has kept the alert level at 5, meaning that there is a risk of a pandemic, but that a pandemic has not yet broken out. There has been criticism of a media overreaction to the spread of the Mexican swine flu. A Gallup Poll conducted May 5, however, found Americans evenly split on how the media covered the story, with 45% saying the media had exaggerated the dangers while 46% said the media had about right in its coverage. It is only in retrospect that anyone can be sure how a new virus will spread and how lethal it will prove to be. The global influenza pandemic of 1918 killed 40 million people; costing more lives than World War One. The pandemics in 1957 and 1968 killed approximately two million and one million people worldwide. The WHO and other health agencies have been predicting that another major pandemic is likely.

In the event of a pandemic, the early days and first reactions of governments to contain the spread of the virus will be crucial. Waiting to see if an outbreak proves to be massive and lethal before taking action means policy has failed to protect the public. Yet, it is a “business as usual” attitude that has guided the U.S. government in its negotiations with Mexico and Canada over how to respond to a health crisis.

President George W. Bush signed the Security and Prosperity Partnership (SPP) of North America on March 23, 2005 at a summit in Waco, Texas, along with Mexican President Vicente Fox and Canadian Prime Minister Paul Martin. In March 2006, the leaders of the three countries met again, this time in Cancun, Mexico, where they agreed to address the pandemic threat as part of the SPP, a successor agreement to NAFTA being implemented by the NAFTA office at the Department of Commerce.

The result was the North American Plan for Avian & Pandemic Influenza released in August, 2007. The introduction warns: “Although the timing of an influenza pandemic cannot be predicted, history and science suggest that the world will face at least one influenza pandemic this century. A worldwide outbreak of a new influenza virus could result in hundreds of thousands of deaths, millions of hospitalizations, and hundreds of billions of dollars in direct and indirect costs to North American economies.” As the document lays out how the three countries should deal with this threat, it is clear that the economic costs far outweigh health considerations and were much more on the minds of the diplomats than the lives of those who may be struck down. And within the economic concern, business tied to cross-border trade is to be given special protection.

In the SPP’s North American Plan, the section on Principles: for Cooperation talks in general terms about sharing information, coordinating actions, giving advice to each other to form decisions, and providing the public with information. But then the list hits the real area of concern:

• Agree that the imposition and removal of veterinary or public health measures on the movement of people, animals and goods, under our national laws and international obligations, will not be more restrictive or maintained for a longer period than necessary to achieve the veterinary or public health objective, so as to avoid unnecessary interference with the movement of people and goods within North America;
• Ensure that the business continuity plans of our respective governments consider the highly interconnected nature of our economies.

The Chapter 3 section on Border Control Measures Associated With Notifiable Avian Influenza states that “Each country should apply proper and proportional import health measures when NAI [avian flu] is confirmed and reported. These measures are intended to maintain the animal health status of the importing country while minimizing the impact on the trade of poultry, poultry products and other products from avian species among Canada, Mexico and the United States.” It also advises that “To enable a common approach that is both consistent and uniform among the countries; Canada, Mexico and the United States recognize that conditions for regional trade should be established to minimize unnecessary trade disruptions among the three countries.”

Chapter 4, Pandemic Influenza, “assumes that a focus on preventing or delaying the spread of a novel strain of human influenza or mitigating the impacts of pandemic influenza must serve public health, social and economic goals.” Chapter 5: Border Monitoring & Control Measures Associated with Pandemic Influenza states: “Emphasizing a North American approach, rather than individualized approaches among Canada, Mexico and the United States, may be the best way to slow the spread of a novel strain of human influenza into our respective countries. Strong disease surveillance systems coupled with appropriate screening at all North American airports, seaports and regional perimeters may further delay the entry of a novel strain of human influenza.” The focus on preventing avian flu from reaching the continent is fine, but once the disease is inside North America, it is assumed little can be done to keep it from infecting all three countries because borders will remain open.

The Land Borders section of Chapter 5 confirms this view, stating: “Once disease exists in one North American country, the others will likely experience outbreaks soon thereafter.” The reason is also clearly stated: “Canada, Mexico and the United States intend to share and coordinate common triggers, criteria and protocols for screening of travelers at land borders when certain conditions are met. These triggers, criteria and protocols should be balanced against the necessity to maintain the flow of persons, cargo and trade across North American borders….Once pandemic disease is common in all three North American countries, Canada, Mexico and the United States mutually understand that exit screening at our shared land borders may no longer be necessary.” So the countries will do little at the start of a pandemic to contain the disease at the border, and then stop doing anything at all as quickly as possible so as not to disturb business as usual – the flow of goods and people across U.S borders.

Indeed, in Chapter 6, the very existence of borders is considered a problem. “Borders represent a significant vulnerability to the countries’ interdependent critical infrastructure sectors because where cross-border movement is restricted, supply chain and personnel movements can be significantly disrupted. Thus, they may represent chokepoints that may negatively affect international commerce,” says the SPP Plan.

Dr. Henry I. Miller is a fellow at Stanford University’s Hoover Institution who had worked for the Food and Drug Administration during the George H. W. Bush administration. He tried to put a positive spin on open borders in a Washington Times op-ed of May 23. He argued, “Closing borders would deny access to many items made abroad that are needed during a pandemic, including masks and gloves, electrical circuits for ventilators and communications gear, and certain pharmaceuticals and their precursors.” But this only emphasized how vulnerable the NAFTA trade agreement has made the United States by the outsourcing of production of goods needed to fight a pandemic.

The SPP Plan cites the North American Free Trade Agreement and WHO documents as support for its open borders mindset. Drawing attention to NAFTA only confirms that commerce has first priority in the SPP Plan. Yet, a closer look at NAFTA reveals that even in the 1993 trade agreement there was more concern about public health than is evident today. NAFTA Chapter 7 contains a section on the Right to Take Sanitary and Phytosanitary Measures. The section states: “Each Party may, in accordance with this Section, adopt, maintain or apply any sanitary or phytosanitary measure necessary for the protection of human, animal or plant life or health in its territory, including a measure more stringent than an international standard, guideline or recommendation.” This statement confirms national sovereignty and the duty of public authorities to protect the lives of their citizens.

In 2006, the WHO released its Project on Addressing Ethical Issues in Pandemic Influenza Planning. It started with the acknowledgement that “Given the limitations of medical countermeasures, public health interventions will be vital for slowing the spread of an emerging pandemic.” On its list of interventions was International Travel and Border Control. These “measures are designed to check the global spread of infected individuals and goods. Techniques can include: entry or exit screening, reporting, health alert notices, collection and dissemination of passenger information, travel advisories or restrictions, and physical examination or management of sick or exposed individuals.”

The WHO paper notes that “Sovereign nations seek to safeguard their citizens’ health from external threats, even in a global world where people, animals, and goods rapidly diffuse across state boundaries. Although border protection is legitimate, it can severely disrupt travel, trade, and tourism. The World Trade Organization (WTO) defends free commerce, but permits science-based trade restrictions to protect the public’s health. As with trade restrictions, protection of the public’s health needs to be balanced against the global economic impact of any travel restrictions or border control policies.” But unlike in the SPP Plan, the WHO balance favors public health first.

Avian flu [NAI] is still thought to pose the greatest risk of a pandemic, but the threat from the Mexican swine flu [H1N1] is not over. The WHO’s Dr. Chan, speaking at the close of the 62nd World Health Assembly in Geneva, Switzerland, May 22, warned:

“For the first time in history, we are watching the conditions conducive for the start of a pandemic unfold before our eyes….this is a subtle, sneaky virus.…We need to watch the behavior of H1N1 very carefully as it encounters other influenza viruses circulating during the winter season in the Southern Hemisphere. The current winter season gives influenza viruses an opportunity to inter-mingle and possibly exchange their genetic material in unpredictable ways.”

Chan told her audience that “The world is alert and on guard as never before” but she was only partially correct. Within North America the guard is purposely down. America’s borders remain open and security against influenza is no more stringent than against illegal immigrants or drug smugglers. Thousands, perhaps millions, of lives are at risk because government has been corrupted by the pleadings of business interests to keep commerce flowing regardless of the impact on the general public. It has often been said that nothing will force Washington to take border security seriously until there is another major terrorist attack. The politicians have traded U.S. border security for a North American continental security perimeter. But since 9/11 did not make any substantial change in border policy, the country may have to suffer a pandemic far more devastating before public officials take their duty to the public more seriously.

William R. Hawkins, a former economics professor and Congressional staffer, is a consultant specializing in international economics and national security issues. He is a contributor to SFPPR News & Analysis.