“Today, diseases as common as the cold and as rare as Ebola
are circling the globe with near telephonic speed, making long-distance
connections and intercontinental infections almost as if by satellite. You
needn’t even bother to reach out and touch someone. If you live, if you’re
homoeothermic biomass, you will be reached and touched” (Angier, 2001).
Introduction
In his TED talk, Goldin (2009) mentions that globalisation
has caused the world to become more complex and functionally integrated. This suggests
that local events may have global consequences. Globalisation, the increase of
“flows and influences of capital and goods, information and ideas, and people
and forces, as well as environmentally and biologically relevant substances”
across multi-continental distances, has facilitated the spread of emerging
infectious diseases around the world (Keohane & Nye, 2000). Using the
Severe Acute Respiratory Syndrome (SARS) outbreak in 2003 as a case study, this
essay demonstrates that contemporary globalisation has resulted in greater
human mobility, which may contribute to the rapid spread of the virus around
the world. This essay will also evaluate the measures taken to tackle this
global health threat.
Human mobility
Armelagos and Harper (2010) assert that we are witnessing a
re-emergence of infectious diseases due to anthropogenic factors. As a result
of globalisation and technological advances, more people are becoming mobile
with the ability to travel more frequently as well as visit areas that used to
be remote and inaccessible (Wilson, 2007). According to the World Tourism
Organization (2014), more than a billion tourists travelled outside their
countries in 2013. This does not include the undocumented travellers, internal
migrants and the millions more who crossed national borders for other reasons.
With a highly efficient transportation system, it is now
possible to reach most places in the world within two days, which corresponds with
the incubation period of most infectious diseases (Wilson, 2007). ‘Incubation
period’ is defined as the “time between catching an infection and symptoms
appearing” (National Health Service, 2014). Furthermore, travel often involves
multiple shared spaces such as airplanes and hotels, where people from
different origins congregate together before moving to different destinations.
These networks of global travel become conduits for pathogen transmissions,
allowing infectious diseases to spread quickly and extensively.
The rapid dispersal of SARS in 2003 is a good example of how
the world’s interconnectedness has facilitated the spread of the virus. SARS
first appeared in Guangdong province of China in November 2002 and was subsequently
reported outside of the country in March 2003. The outbreak was traced back to
a Chinese doctor who had been treating patients with ‘atypical pneumonia’ in
Guangdong and then stayed on the ninth floor of Hong Kong’s Metropole Hotel.
Other international guests who stayed on the same floor soon became infected
with the virus. Many of them felt well enough to travel out of Hong Kong,
carrying the virus into Canada, Vietnam and Singapore. In the next few months,
SARS was spread to other countries in the Asia-Pacific region, Europe, North
and South America. By the time the outbreak was contained, there were a total
of 8,437 known cases with 813 fatalities (Mwambi & Zuma, 2007).
Responding to SARS
In response to the outbreak, the World Health Organization
(WHO) (2003b) issued an international health warning on SARS and travel
advisories to regions affected by the virus on March 2003. The agency also
recommended screening of air passengers departing from certain affected areas
in an attempt to prevent travel-related spread of SARS (World Health
Organization, 2003c).
The SARS outbreak highlighted the limitations that the WHO
encountered in identifying and controlling its spread. Based on international
health regulations in 2003, countries were only required to notify the agency
of yellow fever, cholera and plague outbreaks (Federation of American
Scientists, 2003). The WHO will then have the authority to intervene and
restrict trans-boundary movements. However, with other diseases such as SARS, the
WHO can only take on an advisory role. The global health threat was exacerbated
when the Chinese government failed to report promptly and openly about SARS (Huang,
2004). Moreover, not everyone is willing to cooperate with WHO’s guidelines.
For instance, despite being suspected of having SARS, a man still managed to
board his plane (Federation of American Scientists, 2003). While some people
view freedom of movement as a human right (Paquin, 2007), others question the
ethics in issuing SARS related travel advisories or compulsory quarantines
(Teo, Yeoh & Ong, 2005).
Since 2003, the WHO (2003a) has taken a stronger role in
coordinating and leading the fight against any infectious disease that
threatens global health. This can be seen in a case from 2013, when a new
SARS-like virus was promptly reported to the WHO, which later issued an
international alert (Sutton, 2013). I believe that with global cooperation and
mobilisation, global health security can be enhanced when “global solidarity is
placed above national sovereignty” (Heymann, 2006). As individuals, we can all play
a part by being responsible global citizens who prioritise societal rights over
individual liberties in the event of an outbreak.
Conclusion
Diseases transcend boundaries. As the world becomes more
complex coupled with the unprecedented volume, reach and speed of human
mobility, the risk of emerging infectious diseases being transmitted around the
world is set to rise. However, the very interconnectedness that allows pathogens
to spread globally offers mechanisms to address global health threats. With the
WHO spearheading medical responses around the world, countries’ governments
have to do their part by making disease surveillance and response a priority.
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