Joe Mazzarella
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Global Health Risks of Non-state Transnational Terror
Grace Mazzarella
January, 2014
Most state efforts to combat
terrorism are motivated by a desire to prevent acts of terrorism and their
immediate impacts, namely the indiscriminate loss of life and injury to civilians
and noncombatant personnel. While acts
of terrorism catch worldwide media attention, terror groups can have
significantly greater far reaching and lasting effects through sustained low
intensity conflict. Terror in itself is
not the objective for terrorist groups inasmuch as it is to create conditions
of increasing civil instability to achieve various ends. These ends are often political, ethnic and/or
religious in nature. As a consequence,
civilian populations are often targeted based upon on their ethnic and
religious composition and political alignments.
For the ideological modern terrorist, the objective is to inflict not
only death, but to instigate mass displacement and removal of objectionable
segments of the civil population. This,
in turn, creates enclaves of control to stage, assemble and support larger
operations with the intent of further challenging incumbent government forces,
disrupting national systems of civilian and military support, such as commerce
and transportation routes and utility infrastructure, and creating successively
greater instability within the state.
These strategies and mass displacement effects have been observed in a variety
of conflicts including Iraq, Syria and the Sudan.
Focusing on Syria, one needs to
only consider the scale of humanitarian tragedy occurring in Syria to understand
the scope and nature of this problem. As of
the writing of this Article, the United Nations High Commissioner Refugees (UNHCR),
reports that over 2.3 Million refugees have been displaced from their Syrian
homes as a result of ongoing civil war, and it is predicated that the refugee
population could reach 4 Million if the conflict continues along it present
course.[2]
Despite its political characterization, the
greater reality is that the Syrian civil war is being fueled by an influx of
multinational Islamic fighters, many of which are aligned with known terror
groups such as Al-Qaeda and external state sponsors of terrorism like Iran.[3]
Beyond the effects of conventional fighting between insurgents and government
forces, civilian populations have been brutalized by numerous reported attacks
of barbarity designed to terrorize and incite mass civilian departure. In one of many similar reported incidents, on
January 17, 2014, Al-Qaeda insurgents reportedly overran the western-backed
Free Syrian Army held town of Jarabulus located in Northern Syria. Al-Qaeda fighters then initiated an
indiscriminate killing spree, murdering men, woman and children. Among their heinous acts, over hundred men
were rounded up and Al-Qaeda fighters began slaughtering them, including beheading
their victims and posting heads on spikes.
As a result of this terror, nearly 1,000 civilians fled for the safety
in Turkey.[4] Syria’s
civilians, much like in other recent modern terror infused conflicts, are
suffering extreme and indiscriminate brutality which is driving mass population
displacement.
But Syria is not unique. In many of today’s conflicts around the
globe, terrorist organizations operate to destabilize government institutions by
sowing fear and insecurity among the populace, and eroding the will and capacity
of government institutions to carry-out the delivery of basic services.[5] Whether one begets the other is open for
debate, however it is generally recognized that terror groups tend to coalesce
and root themselves in places where governments are politically weak and have
failing civil institutions. Cases on
point include Iraq, Afghanistan, Pakistan, South Sudan, Somalia, Libya,
Algeria, Nigeria, the Palestinian Territories, Lebanon, Indonesia and Yemen, among
others.[6] In fact, the number of displaced person has
risen year over year and reached its highest since 1994 with an estimated 45
Million refugees, and the UNHCR reports that vast percentage of refugees are
arising within the aforementioned countries.[7]
As non-state actors foment civil unrest and spread terror, large civilian
displacement becomes a major pandemic disease vector that has broad regional
and global implications.
By way of example, the Syrian war
has given rise to an outbreak of polio, a disease that has been effectively
eradicated from most of the global community, save a few, through decades of
vaccination efforts. Prior to the
conflict, the last reported case of polio in Syria was reported in 1995. In November of 2013, the WHO raised an alarm
with an outbreak of up to 37 confirmed cases of polio. [8] As
result, a massive immunization effort has been launched to stem the
outbreak. Nonetheless, this in turn has raised
fears that there is high risk of a polio outbreak in Europe given that large
numbers of Syrian refuges may begin to migrate from temporary camps in
neighboring countries to Europe as they search for better living conditions.[9]
Other places where polio has
gained a foothold through disease importation include the African horn nation
of Somalia, which is home to a nominally functioning government and numerous
terror camps. Other countries of polio importation,
as reported by the WHO, include several African countries with terror based
insurgencies such as Niger, Mali and the Congo.[10] Meanwhile, the countries of Afghanistan,
Pakistan and Nigeria remain polio endemic.
All of these locations share another common thread besides polio. They are each suffering from ongoing conflict
spurred by endemic terror groups operating within their borders are main
drivers of forcible displacement.
Overall, the Syrian conflict serves as a
powerful example of the role that non-sate terror organizations play in
breeding conditions for global health emergencies and potential pandemics. While the twentieth century was occasioned by
state conflicts, the twenty-first century has given rise to a new form of
non-state entity conflict that is transnational in nature. Hallmarked by internal destabilization, these
forces operate to sow political instability and fear among the populace and
ignite civil strife. Unlike traditional
sovereign conflicts, the ability for world organizations to reach into and
operate in these conflict areas to stem global health emergencies is often
hampered due to non-existent diplomatic functions and no reliable or formal
command and control leadership capable of brokering necessary conditions of
security and safety for non-combatant relief workers. In Syria, the effort to provide humanitarian
relief has been thwarted in many cases and nation-states have been unable to
provide consistent meaningful humanitarian aid.[11]
In the emerging reality of
geopolitical conflicts characterized by non-state terror groups, it is possible
that global health emergencies may be exploited as another tactic to create
large scale destabilization and fear. In
this vein, while seemingly remote, it is not unreasonable to assume that terror
groups could seek to spread highly contagious diseases in target populations through
one or more terrorist cells. In essence,
the dynamics of population displacement, nonfunctional health delivery systems,
and access to contagious diseases becomes a vehicle for biological warfare, or
coined another way its own weapon of mass destruction (WMD). While polio would be an unlikely candidate
due to mass vaccination, infectious diseases such as the hemorrhagic Ebola or
Marburg viruses could be used to create a large scale pandemic with a small
team of sickly volunteers. Further, proximate access to and vectors for movement
by a multinational terror organization are present because they are coincident with
terror endemic areas, notably the Sudan, Uganda (bordering South Sudan) and
Democratic Republic of Congo.[12] These viruses can be opportunistically
identified in the population and then intentionally passed from a host to
willing conspirators. Placing “ground zero” patients inside of highly dense
refugee camps along and infecting several disparate international targets has
the potential to create global impacts that could overwhelm response systems
and resources. This tactic, albeit crude
by today’s standards, has a historical precedent within North America when
British forces used infected blankets of small pox to eradicate Native Indians during
the French Indian Wars.[13]
More generally, non-state
controlled areas with largely collapsed or inoperative healthcare systems and
large refugee populations present conditions for pandemic outbreaks that can
impact local, regional and global security.
This risk requires collaboration and attention among not only world
health authorities but political and policy leaders, security experts and
institutions of research and higher learning in order to create the necessary
programs to monitor, identify, respond to and mitigate these hazards. As
the world community makes progress towards its MDGs, it is important that it
recognize emerging changes in geopolitical dynamics and be prepared to adapt
its programs and strategies to counter their associated risks.
[1] United
Nations, The Millennium Development Goals
Report 2013, 1 July 2013, ISBN 978-92-1-101284-2, available at:
http://www.refworld.org/docid/51f8fff34.html.
[2] Syria
Regional Refugee Response, UNHCR Interagency Information Sharing Portal –Regional
Overview, Web. 20 Jan. 2014 (http://data.unhcr.org/syrianrefugees/regional.php)
[3] Laub, Zachary, and Masters. "Al-Qaeda in
Iraq (a.k.a. Islamic State in Iraq and Greater Syria)." Council on Foreign
Relations, March 2013.
[4]
Hunter, Isabel, Al-Qaeda slaughters on Syria's killing fields, AL Jazeera
Online (January 21, 2014) (http://www.aljazeera.com/indepth/features/2014/01/al-qaeda-slaughters-syria-killing-fields-2014121112119453512.html)
[5]
Audrey Cronin, Ending Terrorism – Lessons
for Defeating Al Qaeda, International Institute for Strategic Studies
(Adelphi Paper 393, 2008), Ch. 1.
[6] National
Counter Terrorism Center, Counterterrorism Calendar 2014 – Interactive Map,
Web, accessed January 22, 2014 (http://www.nctc.gov/site/map/index.html)
[7]
UNHCR-Global Trends Report 2012, Displacement-The
New 21st Century Challenge, June 19, 2013 (http://unhcr.org/globaltrendsjune2013/UNHCR%20GLOBAL%20TRENDS%202012_V08_web.pdf)
[8]
Global Alert and Response, World Disease News, Polio in the Syrian Arab Republic – update, World Health
Organization (November 23, 2013), Web (http://www.who.int/csr/don/2013_11_26polio/en/index.html?utm_medium=twitter&utm_source=twitterfeed)
[9]
Eichner &Brockmann, Polio emergence
in Syria and Israel endangers Europe, The Lancet, Volume 382, Issue 9907, Page 1777, 30
November 2013 (Elsevier Ltd, pub. online November 8, 2013, http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)62220-5/fulltext)
[10] Polio
Global Eradication Initiative Annual Report 2012, World Health Organization (WHO,
Geneva, March 2013). (http://www.polioeradication.org/Portals/0/Document/AnnualReport/AR2012/GPEI_AR2012_A4_EN.pdf).
[11]
Blanchard, Humud & Nikitin, Armed
Conflict in Syria: Overview and US Response, Congressional Research
Service, Rel. RL33487, January 14, 2014 (avail. http://www.fas.org/sgp/crs/mideast/RL33487.pdf),
10. “As with humanitarian assistance, U.S. efforts to support local security
and service delivery efforts to date have been hindered by a lack of regular
access to areas in need. According to Administration officials, border
closures, ongoing fighting, and risks from extremist groups have presented
unique challenges.”
[12]
CDC, Known Cases and Outbreaks of Ebola
Hemorrhagic Fever in Chronological Order, Web, accessed January 23, 2014,
and CDC, Known Cases and Outbreaks of
Marburg Hemorrhagic Fever, in Chronological Order, Web, accessed January
23, 2014. (http://www.cdc.gov/ncidod/dvrd/spb/mnpages/dispages/marburg/marburgtable.htm).
[13]
F.
Fenner et al., The History of Small Pox and its Spread Around the World, (Geneva,
WHO, 1988): 239.] See, also, Sheldon
J. Watts, Epidemics and History: Disease,
Power and Imperialism (Yale University Press, 1999) for a comprehensive
exposition on the geopolitical impacts and epidemics in the Western world.
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