Failures at the Nexus of Health and Homeland Security: The 2007 Andrew Speaker Case February 6, 2009

Hosted by: The Project on National Security Reform (PNSR) and the Hudson Institute Center for Political-Military Analysis

Natural disease outbreaks, emerging infections, and deliberate acts of bioterrorism represent significant and looming U.S. national security issues given their ability to overwhelm the health care system, disrupt economic flows as a result of decreased workforce productivity, and incite fear among affected populations. Detecting, controlling, and mitigating these events requires integrated capabilities and timely decision-making across many sectors and levels, including local, state, and federal government agencies. In 2007, a case of Extensively Drug-Resistant Tuberculosis (XDR-TB) in one individual, Andrew Speaker, demonstrated faultiness in authority and communication among these bodies through their failure to deal effectively with a problem of public health importance on an international scale. This case study reviews the gaps in U.S. government strategies and processes that, if not addressed comprehensively within a national security context, will leave the country vulnerable as the world faces pandemics and a spectrum of biosecurity threats.

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