The last chapter of Jason Brennan’s book Against Democracy has the title 'Civic Enemies'. “Politics tends to make us hate each other, even when it shouldn’t. We tend to divide the world into good and bad guys. We tend to view political debate not as reasonable disputes about how best to achieve our shared aims but rather as a battle between the forces of light and darkness (Princeton: Princeton University Press, 2016, pp 231-232).”
Even in a peaceful democracy – invariably held up as a model for the world, ‘the city on the hill’ – democracy creates civic or situational enemies. Even before the election of Donald Trump, more than half of Democrats told pollsters that they were afraid of Republicans and almost half of Republicans said the same about Democrats.
Today, democratic civic enmity has cost the lives of American citizens. In The New Statesman story How America built the best pandemic response system in history – and threw it away: The Trump administration destroyed an infrastructure, built over two decades, that may have been humanity’s most powerful weapon against new diseases is the story as told by Laurie Garrett, who had been at the Council on Foreign Relations for less than a year when, in 2005, she was told that a “mutational event” had occurred on Qinghai Lake in north-western China. A type of avian influenza was infecting bar-headed geese, a species that migrates thousands of kilometres, crossing the Himalayas from the Tibetan plateau to reach as far as southern India. It was the H5N1 influenza virus.
She immediately went to George W. Bush’s security council and was heard eagerly by officialdom. Bush ordered the creation of a pandemic preparedness plan, the first to be formulated by the US government.
In 2009, less than three months after Barack Obama’s inauguration, the H1N9 influenza – or swine flu - began to spread around the world. In the event, the CDC estimate that it killed somewhere between 152,000 and 575,000. “Swine flu really shook him up.”
By 2013, the US had a health security proposal that Garrett describes as “a scheme to train governments in poor countries in how to do surveillance and response to new diseases”. Disease-monitoring in other countries was to be shared by the CDC and the US aid agency, USAID. Domestically, “thinking exercises… training exercises… outbreak training exercises, [were] in almost every hospital in America”. And still, the US was not prepared.
In 2014, Ebola emerged in West Africa. The Obama administration “watched in shock… we’d never before seen Ebola in more than one country at a time, we’d never before seen it at international airports, and we’d never run the risk that it would get to some huge hub.” When a case did appear at a hospital in Dallas, Texas, a co-ordinated domestic response meant that “it went no further than that, largely because they mobilised swiftly and responded correctly”.
The Ebola outbreak alerted the administration to the need for a health security infrastructure that extended far beyond its own borders. By 2016, America had coordinated “an all-of-government response” to the next epidemic, in the knowledge that “if it hit America, every agency would be taxed, from US Treasury Department to Commerce to USDA. It wouldn’t just be the health agencies”.
Garrett describes this response as a “special elite corps inside of the National Security Council, the Department of Homeland Security, Health and Human Services and CDC, amongst others… an emergency capacity for surge drug approval at FDA… a lot of coordination with the states… a whole division that was doing nothing but training hospitals in infection control and appropriate epidemic responses… and a lot of study on how to surge hospital beds, how to surge physicians out of retirement, and so on.”
On 8 May 2018, Donald Trump signed Rescission Proposal R18-1, asking the US government to take back $15bn in spending.The cuts covered the Children’s Health Insurance Program ($7b), for International Disaster Assistance that had been committed in 2015 as part of the Ebola response ($252m) and the State Department’s $30m Complex Crises Fund. On that very day, the WHO announced a new outbreak of Ebola in the Democratic Republic of Congo.
Two days later, newly appointed National Security Advisor, John Bolton, dissolved the Global Health Security team within the NSC. Timothy Ziemer, the most senior White House official in charge of responses to pandemics or bioterrorism, left that day and was not replaced.
It wasn’t that these programs were expensive: the $282m saved on pandemic preparedness by R18-1 represents less than 0.007 percent of US government spending in 2018. The nub was that they were connected to the health security agenda, which had been an Obama project.
“Whether this is based on a real personal animosity, or the knowledge that it appeals to his base, the removal of America’s ability to protect itself and the wider world from pandemics of infectious disease appears to have been driven by this impulse.”
“It was really,” says Garrett, “just about getting rid of things that had Obama’s name on them.”
Cass Sunstein observes that in 1960, only about 4 to 5 percent of Republicans and Democrats would be ‘displeased’ if their children married members of the opposite party; now, about 43% of Republicans and 33% of Democrats admit they would be displeased (Brennan, p 234). We can see why, and with what consequences.
