The Politicization of Disease

By Cailin Hong

Senator and 2016 presidential hopeful Ted Cruz (R-TX) made media waves this October when he criticized the Obama Administration’s response to Ebola cases reported in the US.

“I remain concerned we don’t see sufficient seriousness on the part of the federal government about protecting the American public and doing everything possible to ensure that people infected with Ebola do not come to the Unites States,” he said, advocating for an air travel ban for those coming to the United States from regions afflicted with the virus.

“The administration is not treating [the outbreak] with the gravity it deserves.”

Cruz was just one of many Republicans – including Senator Rand Paul (R-KY) and Governor Rick Perry (R-TX) – denouncing the current administration’s ineffectiveness at the height of what was a highly competitive, highly partisan midterm campaign season.

The debate has now become progressively polarized, with Republicans blaming the president for being unauthoritative and Democrats arguing that the GOP-pushed NIH and CDC budget cuts were the true causes of U.S.’s unorganized response to the outbreak. Analysts from Politico, CNBC, and local news sources suggested that Ebola could play a decisive role in the weeks leading up to the midterm election, which was exactly what happened as Ebola became the highlight of many divisive debates.

Political polarity surrounding disease is nothing new, particularly in the partisan U.S. With the global outbreak of avian flu in 2006, a whopping 76 percent of Republicans were confident in the Bush Administration’s response to the crisis, compared to just 52 percent of Democrats. In 2009, however, Democrats were nearly twice as likely as to support the vaccine for the influenza strain H1N1 (“swine flu”) proposed by the Obama Administration as compared to Republicans. The trend continued in 2014, with 76 percent of Democrats confident in Obama’s Ebola response compared to 54 percent of Republicans.

This pattern suggests an informational gap, or even misinformation, on half of the American public, and a tendency to defer to the authority of ideologically-aligned political leadership. This trend also extends into non-health related issues, with Republicans and Democrats tending to support the policies of their respective administration. Thus, contrary to the suggestions of Ebola-focused political commentators, although elections may raise the stakes and drive politicians to increasingly partisan rhetoric to differentiate themselves from the opposing side, the partisan history of public health perception suggests that, at least for the American public, political allegiance trumps support for specific disease policies.

When the public gets their views on disease outbreaks from the rhetoric put forth by politicians, the claims made by politicians and their incentives for making those claims become more important than ever. The real danger, therefore, lies not in the polarization of disease, but in its politicization.

The archetypical case comes from the 1976 fiasco, in which President Gerald Ford hastily ordered a massive nationwide vaccination campaign against swine flu, the largest vaccination campaign in US history. Rushed and haphazardly organized, the vaccine was prematurely approved and linked to over fifty cases of Guillain-Barre syndrome, a paralyzing neurological disease associated with vaccination. Although studies by the CDC only found that the vaccine increased occurrences of the syndrome by one case per 100,000 individuals, the fiasco caused a long-lasting distrust of federal public health initiatives.

Arthur M. Silverstein, professor of ophthalmic immunology at Johns Hopkins, argues that the poor planning and unprecedented, even uncalled for, sense of urgency was a failed attempt by Ford to shed his pusillanimous image and secure his re-election by taking swift, authoritative action. Contrarily, Ford’s political opportunism compounded by the financial and medical blunder of the H1N1 campaign provoked large public criticism, which gave him a reputation for incompetence that cost him the election.

Ukraine provides a more modern example when, in 2009, Prime Minister Yulia Tymoshenko led a series of quarantines, school closures, and bans on mass gatherings in response to what she touted to be the plague of the century (again, swine flu), despite statements to contrary by the World Health Organization. Tymoshenko was concurrently running for president, and the crisis gave her an opportunity to demonstrate her competence and decisiveness. Conversations with her campaign advisors later revealed Tymoshenko deliberately exaggerated and politicized fears of the strain to portray the presidential hopeful as a “white knight” and distract the public from the government’s failure to improve Ukraine’s dismal economy. During a chaotic period in which citizens were forced out of the public sphere and paralyzed by fear on an impending pandemic, even international media defaulted to the politician’s hysterical campaigning over the word of the WHO.

The political ramifications of disease and pandemics’ utility as a political tool are undeniable. A deep scare can create a sense of urgency that forces the public to put faith in their central leadership and divert attention from other government failures. The consequences could range from long-lasting damage to the legitimacy of public health concerns, as was the case with Ford, to political manipulations that undermine democracy, as seen with Tymoshenko.

This is not to suggest that all disease outbreaks are securitized threats constructed by ruthless politicians; rather, the severity and sensitivity of political rhetoric surrounding disease should underlie the importance of a transparent, informative public health policy that transcends popular sound bites and media frenzy.  Striving to understand the political stakes a party may have in presenting epidemic in a certain light should help the public cast a critical lens over the extent to which popular rhetoric may be trusted.

So where does Ebola lie in all this? Recently, Media Matters reported that news coverage of Ebola dropped from nearly 1,000 segments in the month leading up to the election to 49 in the two weeks that followed. While Ted Cruz is right to warn the public of the political handling of Ebola, exactly which of these two we should be more concerned about—the politics or the disease—remains to be seen.

Endnotes:

[1] http://dallasmorningviewsblog.dallasnews.com/2014/10/rick-perry-vs-ted-cruz-on-ebola-whos-exhibiting-stronger-leadership.html/

[2] Shephard, Steve. “Democrats in danger over Ebola.” Politico. Web. 20 Oct 2014. http://www.politico.com/story/2014/10/politico-poll-ebola-democrats-112017.html

[3] Myrow, Stephen. “Will Ebola affect the outcome of the election?” CNBC. Web. 17 Oct 2014. http://www.cnbc.com/id/102098189#.

[4] Memoli, Michael. “Ebola scare is the latest issue to cloud midterm election debate.” LA Times. Web. 17 Oct 2014. http://www.latimes.com/nation/politics/politicsnow/la-pn-ebola-politics-20141017-story.html

[5] Nyhan, Brendan. “The Partisan Divide on Ebola Preparedness.” The New York Times. 16 Oct 2014. http://www.nytimes.com/2014/10/17/upshot/the-partisan-divide-on-ebola-preparedness.html?abt=0002&abg=1

[6] Baum, Matthew. “Red State, Blue State, Flu State.” Web. http://www.hks.harvard.edu/fs/mbaum/documents/RedStateBlueStateFluState_JHPPL.pdf

[7] Nyhan

[8] Sencer, David and Donald Miller. “Reflections on the 1976 Swine Flu Vaccination Program.” National Institute of Health. Web. Jan 2006. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3291400/

[9] Sencer and Miller

[10] “Guillain-Barre Syndrome.” CDC. Web. 22 Oct 2014. http://www.cdc.gov/flu/protect/vaccine/guillainbarre.htm#what3

[11] Spitzer, Robert. “Review: Pure Politics and Impure Science” Adminstrativ Science Quarterly, Vol. 29, No. 2. Web. Jun 1984. http://www.jstor.org/stable/2393193

[12] Ioffe, Julia. “Ukraine’s Phantom Flu.” Foreign Policy. http://www.foreignpolicy.com/articles/2009/11/25/ukraines_phantom_flu

[13] Ioffe.

[14] Gertz, Matt and Rob Savillo. “Ebola Coverage on TV News Plummeted After Midterms.” Media Matters. Web. 19 Nov 2014. http://mediamatters.org/research/2014/11/19/report-ebola-coverage-on-tv-news-plummeted-afte/201619

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