The Politics of Global Public Health in Fragile States and Ungoverned Territories

Article In 2004 I was honored to be interviewed for the Lancet medical journal’s Lifeline Series.1 I had just come away from a disastrous short tenure as the Interim Minister of Health in Iraq following the 2003 war. I had support from former Secretary of State Colin Powell to rapidly mitigate and recover the war related destruction of essential public health infrastructure and protections required as Occupiers under Articles 55 and 56 of the Geneva Convention (GC) that follow every war. Predictably, the loss of essential public health protections in food, water, sanitation, shelter, health, and energy leads to excess and preventable mortality and morbidity, numbers that exceed those from war weaponry by 50-70% or more.2 This plan was immediately squelched by an unprecedented decision within the Bush Administration that moved these post-hostilities humanitarian responsibilities from the State Department to the Department of Defense under Donald Rumsfeld. This decision claimed that US forces were not ‘occupiers’ but ‘liberators’, promptly reversing any previously planned public health recovery and rehabilitation. The State Department’s coterie of seasoned nation-building experts, including myself, was summarily replaced. Before leaving Iraq I publicly declared Baghdad a public health emergency but this too fell on operational deaf ears.3 Many in Iraq see that decision as the most egregious of policies enacted after the invasion, in which the elderly, children, woma...
Source: PLOS Currents Disasters - Category: Global & Universal Authors: Source Type: research