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Communicating BiosecurityCharles L. Briggs aa Department of Anthropology , University ofCalifornia , BerkeleyPublished online: 07 Jan 2011.

To cite this article: Charles L. Briggs (2011) Communicating Biosecurity, MedicalAnthropology: Cross-Cultural Studies in Health and Illness, 30:1, 6-29, DOI:10.1080/01459740.2010.531066

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ARTICLES

Communicating Biosecurity

Charles L. Briggs

Shifting from risk-calculation orientations focusing on populations topreparedness perspectives that model uncertainty through scenario-basedprojections, biosecurity debates redefined notions of ‘‘health’’ and ‘‘security.’’Nevertheless, a key focus of biosecurity discussions—the domain labeled‘‘communication’’—has not been fundamentally rethought, even as it hasexpanded and professionalized. Bracketing preconceived ideas about theterm’s content, the article traces debates about biosecurity ‘‘communication’’from the 1990s to the present, drawing on ethnography and textual analysis.Using a notion of biocommunicability, the cultural modeling of how discourseis produced, circulates, and is received, the article analyzes assumptionsregarding subjects, subject-positions, objects, spatializing and temporalizingpractices, scales, economies of affect, and regimes of ethics that are built intodiscourse about ‘‘communication.’’ Ironically, the conviction that ‘‘communi-cation’’ is of marginal importance as a focus of critical inquiry, seeminglyshared by most medical anthropologists, enables these assumptions tofundamentally shape discussions of biosecurity and emergency management.

Key Words: biocommunicability; biosecurity; emergency management; mediatization; risk and

crisis communication

CHARLES L. BRIGGS, PhD, is the Alan Dundes Distinguished Professor in the Department of

Anthropology of the University of California, Berkeley. He is the author of eight books, includ-

ing Stories in the Time of Cholera (with Clara Mantini-Briggs). He is currently researching

health news in Cuba, Ecuador, the United States, and Venezuela and writing a book and

making a documentary film on mediatization and biosecuritization in an outbreak of

bat-transmitted rabies in Venezuela. Correspondence may be directed to him at University of

California, Berkeley, Department of Anthropology, 232 Kroeber Hall, Berkeley, CA 94720,

USA. E-mail: clbriggs@berkeley.edu

MEDICAL ANTHROPOLOGY, 30(1): 6–29

Copyright # 2011 Taylor & Francis Group, LLC

ISSN: 0145-9740 print=1545-5882 online

DOI: 10.1080/01459740.2010.531066

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Following 9=11 and 10=4—the anthrax letters that became public onOctober 4, 2001—experts anxiously sounded the alarm: a bioterroristattack was inevitable, and we were not prepared. Congress allocated morethan $40 billion for biosecurity research, developing and stocking vaccines,and training health professionals; emergency preparedness and securityissues became central concerns from local public health offices to theCenters for Disease Control and Prevention (CDC) to the World HealthOrganization.

This origin story is complicated by earlier shifts in thinking and planningabout health and security. Collier and Lakoff (2008) suggested that empha-sis on ‘‘preparedness,’’ planning for potentially catastrophic events thatcannot be prevented or predicted, is rooted in Cold War civil defense.Schoch-Spana (2004) traced changes during the 1990s from stories of the‘‘natural’’ evolution of disease to apocalyptic tales of the subversion ofscientific, biological knowledge. Lakoff (2008) argued that repositioningemerging infectious diseases from medical=public health to national securityinvolved a shift from specific threats against national populations to imagin-ing a ‘‘catastrophic disease threat’’ by modeling uncertainty throughscenario-based projections. Collier, Lakoff, and Rabinow suggested that‘‘problematizing’’ biosecurity transformed health infrastructures intobiosecurity apparatuses and rationalized claims that resources are insuf-ficient to counter possible attacks, even if bioterrorist rationalities face alack of consensus among experts (2004:3).

What particularly interests me, however, is a dimension whose terms haveseldom been critically scrutinized or fundamentally redefined—but on whicha fair amount of consensus exists. Portrayed as marginal, it is largely absentin evaluation measures that demonstrate yet again that ‘‘we are notprepared.’’ It crosses disciplinary and institutional boundaries. It is highlyproductive in shaping the subjects, objects, subject-positions, spatializingand temporalizing practices, scales, economies of affect, and regimes ofethics that constitute the domain of biosecurity. This element helps enablebiosecurity-based constructions of health to coexist with humanitarianand market-oriented varieties. I am speaking of ‘‘communication.’’

Most readers share assumptions that make communication seemmarginal. Some may object that communication has often appeared in biose-curity debates. Indeed, crisis, risk, disaster, and emergency communicationgained considerable importance and funding after 9=11 and 10=4. Manyofficials have taken courses to become ‘‘more effective communicators.’’Politicians, spokespersons, and officials worry that they are not adequately‘‘reaching the public,’’ that people usually don’t take biosecurity seriouslybut then panic—deviate from official expectations—when emergencies occur.How to get your ‘‘messages’’ into the social media is a current concern.

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Biosecurity policies and legislation have addressed—and funded—infrastruc-tures and networks for mining information about infectious diseases andshaping its further dissemination.

These discussions hold basic assumptions about ‘‘communication’’ inplace, even as notions of health and disease have been rethought andredefined as they are linked to security issues, as discussions of infectiousdiseases morph with those of bioterrorism and ‘‘natural’’ disasters. Noparallel critical process is apparent for notions of communication, whichcontinue to be culturally modeled as a transport mechanism for conveyingknowledge produced by experts to policymakers, bureaucrats, politicians,reporters, and ‘‘the public.’’ Such models obscure how sites and processesassociated with ‘‘communication’’ are highly productive, formative increating biosecurity objects, subjects, and publics.

Here I extend a project that I launched in these pages in an editorialco-authored by Mark Nichter, focusing on H1N1 (Briggs and Nichter2008). I am interested in restarting dialogues between medical anthropologyand linguistic anthropology, not to create a specialized subfield but toadvance core issues of concern to medical anthropologists by scrutinizinghow cultural models of communication, language, and narrative are builtinto phenomena that we study and the frameworks we use to explore them.The H1N1 pandemic contrasts usefully with broader biosecurity discus-sions. Issues of communication were often focal in H1N1 debates in claimsthat the pandemic was simply a communicative artifact—pure ‘‘mediahype’’ created by reporters and=or public health officials. How GoogleFlu Alert and other search-engines mined ‘‘chatter’’ for epidemiologicallyrelevant data became news. I read H1N1, however, as the exception thatreveals the rule—‘‘biosecurity,’’ I argue, is also mediated as notions ofgerms, bioterrorists, vaccines, and national stockpiles are co-produced withcultural models of communicative infrastructures, crisis communicationtraining, and public gullibility. Biosecurity debates thus reveal how thepower of representations of communication for shaping subjects and objectsemerge precisely from their self-projected epistemological and politicalsubordination.

I take an initial point of departure from media theorist Jesus MartınBarbero, who argued with reference to ‘‘media’’ and ‘‘communication’’ that‘‘(w)e have found it necessary to lose ‘the object’ in order to gain new under-standings’’ (2003[1987]:280, translation mine). I examine how notions of‘‘communication’’ appear in biosecurity discussions, trying to bracket thesense that they refer to preexisting objects. After describing their appearancein diverse contexts, I develop a framework for understanding how theyoperate as cultural models through the notion of communicability,explicated next. This leads me to explore how models of communication

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performatively create—obviously in dialogue with other cultural models,practices, and materialities—basic features of subjects, objects, times,spaces, affects, and ethics that structure how health and security areco-produced.

Where to look proved to be as important here as how to look. Thisarticle emerged from a larger collective project. Since 2003, I have beenworking with medical anthropologists, media scholars, and public healthscholars in the United States and five Latin American countries on thegrowing role of the media, including print, radio and television news,advertising, social media, and the Internet, in shaping understandings ofhealth and disease. I became interested in how ‘‘health’’ and ‘‘security’’domains were intersecting, both in disease-specific contexts (includingSARS and H1N1) and biosecurity in general. This article draws on myanalyses of print and electronic media, legislation, research articles, plan-ning documents, websites, social media, and other materials. I conductedinterviews with journalists, researchers, officials in public health and secur-ity sectors, laypersons, policymakers, and others, including interviews withpolicymakers and public information officers in local, state, and nationaljurisdictions in the United States and officials in international organiza-tions, and undertook ethnographic observations of ‘‘response scenarios,’’both in vivo and via the Internet.1 I suggest next that eschewing purelytextual analyses and pursuing ethnography has crucially shaped the viewof biosecurity I develop here.

D. A. HENDERSON: COMMUNICATING THE BIOTERRORISTTHREAT PRE-9=11

Biosecurity narratives often focus on origins—turning points that seem tohave inexorably thrust the world into particular trajectories. Just as 9=11,10=4, and Hurricane Katrina seem to provide fixed, transparent, naturalanchors for national accounts of biosecurity, interviewees in state and localinstitutions often pointed to ‘‘events,’’ such as Columbine for Colorado orthe Alfred P. Murrah Federal Building bombing for Oklahoma, thattook place in their jurisdictions. In national biosecurity origin stories,D. A. Henderson looms large. His fame springs from public health’s mostimpressive accomplishment—WHO’s 1966–1977 eradication of smallpox,which embodies constructions of public health as benevolent andtriumphant. Nevertheless, Henderson’s biosecurity role revolves aroundreintroducing the spector of small pox—in the guise of a potential bioterror-ist weapon. Founder of the Center for Civilian Biodefense Studies at Johns

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Hopkins, Henderson narrated in ‘‘Bioterrorism as a Public Health Threat,’’published in Emerging Infectious Diseases, the birth of public discussions ofbiosecurity:

Until recently, biological terrorism had been little discussed or written about.Until recently, I had doubts about publicizing the subject because of concernthat it might entice some to undertake dangerous, perhaps catastrophic experi-ments. However, events of the past 12 to 18 months have made it clear thatlikely perpetrators already envisage every possible scenario. (1998:488)

Henderson projected a time when a small cabal of experts producedbioterrorism knowledge but paternalistically kept this from ‘‘the public.’’However, when individuals with sinister, nonscientific motives secretlybecame cabal members, Henderson was forced to create a biosecuritypublic—a public sphere constituted through awareness of bioterrorism andother dangers.

Henderson becomes the harbinger of a Great Divide in the history ofbiomedicine, public health, and national security—the implosion of bound-aries that previously separated them. Since malevolent bioweaponeers hadfused military and medico-scientific domains, benevolent scientists mustrenounce the foundational boundary between science and politics (Latour1993) to create a humanistic medico-military regime and must accept newepistemologies, institutional structures, and funding priorities. The emerg-ence of biosecurity publics signals transformation not of the science butthe circulation of biosecurity discourse. His narrative projects competingcabalistic and public models of biosecurity communication and arrangesthem temporally—bioterrorists forced replacement of the former by thelatter. Even if scientists cannot control pathogens, they must regulate thelegitimate circulation of public information.

Around the turn of the millennium, the power of bioterrorist ‘‘events’’ torequire pronouncements, bureaucratic action, and increased funding wasgreatly extended by producing new ‘‘events’’ in the absence of an attack—‘‘response scenarios.’’ Designed to be read as texts, dramatized asrole-playing exercises or operational drills, or played as computer games,scenarios create ‘‘an artifice through which a person or group conjures apotential biological attack into their immediate experience’’ (Schoch-Spana2004:3). Borrowing from science fiction (recall The Andromeda Strain),Henderson imagined a bioterrorist attack on a US city—a biological agentgoes undetected until patients appear in emergency departments and physi-cians’ offices ‘‘with symptoms of a strange disease’’ (1999:1279). Hendersoncasts doctors, nurses, epidemiologists, and infectious disease specialists as‘‘the front line of defense’’ (1998:489). Complaining that military,

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diplomatic, law enforcement, and intelligence communities hadmonopolized power and resources, Henderson hybridized medical andmilitary discourses and medicalized national security in claiming bioterror-ism for health professionals (1999:1280): ‘‘the medical community musteducate both the public and policy makers about bioterrorism and build aglobal consensus condemning its use’’ (1999:1280). Such efforts to claimsome of the security pie for public health were widely echoed, if also criti-cized. In its Morbidity and Mortality Weekly Report, the CDC touted‘‘investment in the public health system’’ as ‘‘the best civil defense againstbioterrorism’’ (2000:13–14).

Moving from text to performance, Henderson, Randall Larsen, and otherleading biosecurity preparedness figures staged the scenario Dark Winterless than 3 months before 9=11; it included 12 former senior officials andTimes reporter Judith Miller. Replayed in Congressional hearings, briefingsof high officials, and White House planning for a national smallpoxvaccination program, Dark Winter retains a central role in biosecurity dis-cussions, becoming an origin story trope. Incorporating features of popularentertainments (King 2002), the scenario included simulated television newsbroadcasts projecting a smallpox attack on Oklahoma City. A leading figurein biosecurity debates who played a central role in designing Dark Wintertold me that ‘‘those phony newscasts brought in all the drama we needed,and put the pressure’’ on former Senator Sam Nunn, playing the president.The videos, my interviewee suggested, were the key to convincing politiciansthat they were ignorant of and unprepared for bioterrorism—and thusneeded to create infrastructural and discursive strategies for use in a realevent.

Prominent journalists helped turn biosecurity into a policy issue andpopular preoccupation. Laurie Garrett’s (1994) best-seller The ComingPlague featured a 1989 tabletop scenario at a tropical disease conferencethat simulated an Ebola outbreak. In the first nationally televised bioterror-ism scenario Biowar, a five-part Nightline broadcast, Ted Koppel andofficials simulated the release of anthrax in a subway. In Germs, Pulitzerprize-winning journalists detailed how they assisted Henderson, JoshuaLederberg, military officials, politicians, and popular writers in publicizingbioterrorism (Miller, Engelberg, and Broad 2001:224). Richard Danzig,Clinton’s Navy Undersecretary, encouraged Richard Preston, author ofgerm thriller The Hot Zone (1994), to write The Cobra Event, a bioterrorismnovel (1997); Lederberg contributed a plot line (Miller et al. 2001:225). Inhis acknowledgments, Preston cited more than 100 experts, merging sciencefiction and science. Genome scientist J. Craig Venter convinced Clinton toread Cobra. ‘‘Clinton began asking his friends, cabinet members, evenHouse Speaker Newt Gingrich whether they had read the book and what

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they thought about it’’ (Miller et al.:158), clearing space in Clinton’sschedule for biosecurity advocates. Clinton gave a major biosecurity addressin 1998 and started embedding references in speeches.

Henderson’s narrative was framed as purely locutionary or referential, inAustin’s (1962) terms, merely describing what exists in the world of biologyand terrorism; by prescribing a communicative shift, however, he performa-tively created a new category, biosecurity publics, thereby producing newsubjects. Scenarios, models that are made to feel real, complexly hybridizerepresentations of biomedicine, militarism, nature, and communication.Their basic components are mediated events more than viruses and bacteria,which remain virtual; acts of communication dominate their plot structure(X has just told Y that Z; Y has relayed this information to A; etc.). Com-mercial firms that organize scenarios encourage their clients to produce fauxradio broadcasts, press releases, video footage, faxes, electronic messages,and newspaper articles in advance. Projections of communication are ascarefully crafted as epidemiological ones, which have been criticized asbased on problematic assumptions (Barrett 2006). Scenarios are fabricatedto have extended communicative half-lives, to be replayed in the media,Congressional hearings, White House briefings, and mundane agency plan-ning sessions. Henderson, Lederberg, and other advocates thus placed com-municative models deep within the domain of biosecurity even as theyreproduced cultural models of communication as a defective but necessarymeans of transporting expert knowledge to politicians, policymakers, andpublics.

COMMUNICATING BIOSECURITY AFTER 9=11

Since 9=11, my efforts have focused on attempting to shape the thinking ofsenior administration and congressional leaders, in addition to the army ofpolicy wonks here in the nation’s capital. After four and a half years on thispath, I decided it was time for a change . . . . I want to take this discussiondirectly the American people, because elected officials here in Washingtonare interested in public opinion. (Larsen 2007:ix–x)

Exhortations seemingly became reality on 10=4 through deliberate anthraxinfections, spreading discourse farther than bacteria and creating anotherGreat Divide for biosecurity narratives. Donald Rumsfeld, Tom Ridge,and Dick Chaney reported to Congress in May 2002 that bioterrorismaccordingly shifted from the subjunctive to the future—not ‘‘if ’’ but ‘‘when’’(Schoch-Spana 2004). Lederberg (2004:17) recounted: ‘‘We used to seeksome comfort in the historical datum that there had been no significant

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bioweapons attack in recent history. Some had then argued that we neednot make any fuss at all about the problem. That illusion was shatteredby the anthrax attacks.’’ The fuzzy line between science and sciencefiction again imploded. Anthrax ironically suggested how communicativepractices and bioterrorism had merged—the first to die was an AmericanMedia, Inc. photo editor, and letters were mailed to the New York Postand NBC News.

This real-live bioterrorist event, whose epidemiological parameters weremuch more modest than those projected in scenarios, purportedly confirmedthe need for biosecurity publics. Constructing the real as a simulacrum ofthe scenario, Maryland health secretary and later American Public HealthAssociation (APHA) Executive Director Georges Benjamin declared inSenate testimony (2002:9) that pre-10=4 skeptical beliefs ‘‘were challengedin our real world scenario and found to be untrue.’’ Senate witnesses repeat-edly argued that the boundary-making practices that sustain autonomousscientific, professional, and bureaucratic domains thwart prevention effortsand would prove fatal in a bioterrorist ‘‘event.’’ Existing structures forproducing and circulating biosecurity information were thwarted by ‘‘dupli-cation’’ and ‘‘silos,’’ self-interested spheres of knowledge and institutionalpower, compromising national security. The solution required an ‘‘overallsystem of coordination’’ (Senate 2002:16, 25), ‘‘a team effort’’ consistingof corporate entrepreneurs, academics, medical professionals, military plan-ners and researchers, local, state, and federal officials (p. 6), environmental-ists, disaster-preparedness experts, fire and police officials, and‘‘bioweaponeers’’ (p. 10) under the central command of the Departmentof Homeland Security (DHS).

October 4 was widely regarded as a media disaster. Tommy Thompson,Secretary of the US Department of Health and Human Services, stated thatthe Florida case was ‘‘isolated,’’ that ‘‘there is no evidence of bioterrorism,’’and that the photo editor might have contracted inhalation anthrax by drink-ing contaminated stream water, later compounded by HHS’s and CDC’sinability or reluctance to cope with a journalistic onslaught. Rather thanbeing a direct response to 10=4, however, biosecurity communication reformbegan before 9=11. The CDC’s 2000 Strategic Plan stressed the need for‘‘improved communication systems,’’ ‘‘communication programs to ensuredelivery of accurate information,’’ and ‘‘educational materials that willinform and reassure the public during and after a biological attack,’’ therebycountering ‘‘terrorists’ ability to induce public panic’’ (2000:4, 5, 11). The2002 Bioterrorism Act established infrastructures for exerting legal,institutional, and financial control over information circulation and tyingstate and local governments into ‘‘communications networks’’ (Sect.2801.b.2.f). It instituted the Office of the Assistant Secretary for Public

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Health Emergency Preparedness,2 charged with ‘‘improving communicationsfacilities and networks’’ and ‘‘improving capabilities for public health surveil-lance and reporting activities’’ (Sect. 2811) and an Emergency PublicInformation Communications Advisory Committee (Sect 104.b.3). DHS’sSecretary must devise ‘‘an integrated system or systems of public-health alertcommunications and surveillance networks.’’ The Act promoted a ‘‘corecurriculum [for health professionals] for the recognition and identificationof potential bioweapons and other agents.’’ The Secretary must create a‘‘strategy for effectively communicating information’’ (Sect. 105.g.1, Sect.104.c), including ‘‘strategies for Federal, State, and local agencies tocommunicate information to the public’’ (Sect. 108.a.H). The Act mandatedsuppressing unauthorized information and forbid federal agencies from dis-closing certain biosecurity information (Sect. 351A.h). The Department ofVeterans Affairs Emergency Preparedness Act of 2002 required DHS to cre-ate educational materials, including pocketcards (succinct summaries printedon small documents, made to fit in a pocket or emergency kit), teleconferencesand videoconferences, and websites. The American Medical Association,APHA, CDC, and state and local governments collaborated on thesepedagogical projects.

Risk communication saw ‘‘its fortunes rise precipitously post-9=11’’ (Glik2007:34). The CDC and other agencies instituted such organizationalchanges as enhanced media training, ‘‘emergency operations centers’’ inhealth departments, and mechanisms for monitoring news media (Prueet al. 2003; Ratzan and Meltzer 2005). Suggesting that ‘‘well-planned andwell-executed crisis and emergency risk communication’’ should be ‘‘fullyintegrated into every stage of the crisis response’’ (CDC 2002:1), theCDC, the Federal Emergency Management Agency (FEMA, part of theUS Department of Homeland Security), other agencies, non-governmentalorganizations, and consulting firms offer training programs, now availableonline.3 In planning for a generic crisis, the CDC teaches participants todevelop a ‘‘crisis communication plan,’’ designate spokespersons, and devisestrategies for influencing media coverage. Its manual delineatesinformation-regulation hierarchies, particularly who can talk to ‘‘themedia’’ and ‘‘the public’’ (CDC 2002:185). FEMA’s National IncidentManagement System Communication and Information Managementcourse teaches ‘‘flexible communications and information systems thatprovide a common operating picture,’’ thereby ‘‘ensuring accessibility andinteroperability.’’4

Laurie Garrett (2001) suggested that biosecurity planners view journalistsas uninformed, self-interested, and constituting threats during emergencies.Walsh, Norwood, and Hall (2004:234) argued that a past history of‘‘sensationalism, speculation, incorrect information, exploitation of

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vulnerable victims, repeating broadcasting of grotesque images, anddisclosure of classified information have contributed to a negativeimpression and mistrust of the media on the part of officials and the public.’’Blando, Robertson, and Brenitz (2008:57) argued that delivering infor-mation directly to ‘‘the general public’’ and emergency responders may bemore effective than going through the unreliable media. Public health pro-fessionals often lump the Internet and news media information as unreliable(Shuchman and Wilkes 1997), but enlist reporters to help counter Internet‘‘hoaxes’’ (Briggs and Hallin 2007), even as new training manuals discussways of using the Internet (CDC 2007[2006]).

Risk-communication experts suggest biosecurity professionals must learn‘‘how best to communicate using various journalistic modalities’’ (Walshet al. 2004:247)—that is, appropriating journalist practices. Reflectinglong-standing language ideologies of plain speaking (Silverstein 1996),specialists assert that ‘‘effective messages’’ must be accurate, clear, consist-ent, easily comprehensible, timely, frequently repeated, unambiguous, andsupplemented by visual materials. By listening to skeptics, anticipatingresistance, and incorporating opposing viewpoints, spokespersons can mini-mize criticism and circumvent competing interpretations (Covello 2003;Wallack et al. 1993). Kim Fortun (2004) suggested that the ‘‘informatingof environmentalism’’ pits risk communication models against those ofenvironmental information system designers. Whereas the former attemptto transmit simple, parsimonious, conclusive, and consistent messages, thelatter build ‘‘tools to help subjects of environmental risk visualize, spacia-lize, and prioritize risk’’ by embracing complexities and uncertainties(286). Biosecurity crises similarly confront epidemiologists’ efforts torepresent complex, rapidly emerging events with demands for ‘‘accurate,relevant, simple, fast, and consistent messages’’ (CDC 2007[2006]:5).

Training journalists requires ‘‘preparedness and response planning at alllevels’’ (Walsh et al. 2004:247). The CDC-sponsored Knight Public HealthJournalism Boot Camp and USC’s Annenberg School for Communicationteach biosecurity journalism. The Association of Health Care Journalistssponsors biosecurity-related sessions at its annual meeting, and theRadio-Television News Directors Association publishes on-line AJournalist’s Guide to Covering Bioterrorism. CDC manuals for journalistsgrant government agencies the power to define bioterrorism, determinewhen an ‘‘event’’ has occurred, privilege accounts by biosecurity experts,and restrict journalists to finding information, separating legitimate, scien-tifically based material from faux sources, translating it into clear anduncomplicated language, and conveying it accurately to ‘‘the public.’’

As Henderson’s comments suggest, constructions of ‘‘the public’’ havelong been part of biosecurity discourse. Controlling the circulation of

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information helps make ‘‘an informed and responsible public,’’ as formerWHO Director-General Brundtland put it (Williams 2004:80), but apanicked public might require military suppression (Schoch-Spana 2004).Tinker and Vaughan suggested that citizens become biosecurity risks byrefusing ‘‘to follow a recommended preventive or treatment regimen;inappropriate use of prophylaxis; decline in public confidence in experts’assessment of risk; social disruption; and an unforeseen increase in panicwithin affected communities’’; they argued that ‘‘bioterrorism requiresskilled communication that builds trust; informs; instructs; motivates appro-priate self-protective behaviors; minimizes panic, fear, or other negativepsychological responses and dispels rumors or misinformation’’(2004:309). ‘‘The public’’ is advised in a ‘‘biological attack’’ to seek only‘‘official news and information.’’ DHS warned that ‘‘public health officialsmay not immediately be able to provide information on what you should do.It will take time to determine exactly what the illness is, how it should betreated and who may have been exposed.’’5 DHS’s Citizen Corps modelsbiosecurity citizenship, according to former DHS Secretary Chertoff, by‘‘recognizing the need for personal responsibility in preparing for emerg-encies.’’6 In 2009, DHS claimed that ‘‘currently there are: 2,342 [CitizenCorps] Councils which serve 224,720,380 people or 78% of the total U.S.population.’’7 Biosecurity citizenship helps laypersons cope with bio(in)se-curity—by drawing them deeply within it, giving institutional life to thesubject-position that Henderson constructed.

FROM ‘‘COMMUNICATION’’ TO BIOCOMMUNICABILITY

Biosecurity discourses reproduce models of biomedical communication aslinear transmissions of knowledge from experts through journalists andother intermediaries to laypersons, including politicians and ‘‘the public,’’who nonetheless never quite get it—can never reproduce the desired referen-tial content or affective states. Disciplinary boundary work, bureaucraticstructures, ignorance, interest, indolence, and occasionally maliciousnessthwart this linear transfer, leading policymakers to fail to enact adequatemeasures and creating indifferent or panicky publics. These biosecuritycommunication debates create anxiety parallel to ‘‘we are not prepared’’and ‘‘not if but when’’ formulations. We thus constantly need more trainingprograms, citizen corps, scenarios, and new information technologies tomake biosecurity communication function properly.

This commonsense notion of biomedical communication is a culturalmodel that renders complex, shifting, heterogeneous communicativepractices legible through a simplifying construct. It implicitly separates

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communication into distinct processes of production, circulation, andreception and locates these phases in different sites and subjects—movingfrom expert producers to reporters, press officers, and other disseminatorsto policymakers, politicians, and ‘‘the public.’’ Building on the work ofMartın Barbero, I have suggested, however, that we should not take repre-sentations of ‘‘communication’’ on face value as referring to actually exist-ing processes of transporting ‘‘messages’’ from party to party but asperformatively constructing the social world. I have thus proposed the term‘‘communicability’’ to refer to how assertions about communication rely oncultural models that shape social life, and ‘‘biocommunicability’’ for modelsthat ostensibly refer to biomedical processes (Briggs and Hallin 2007).

This biocommunicable model crucially shapes biosecurity through itspowerful reliance on several sets of assumptions that are not explicitlydefined or questioned but are projected as facts about the world, seeminglyknown and accepted by interlocutors. One type consists of subject positionsand forms of subjectivity. Biosecurity communicability suggests that‘‘experts’’ inhabiting biosecurity-related branches of the Pentagon, CDC,DHS, FEMA, and think-tanks produce knowledge. Reporters, spokesper-sons, journalists, and health educators are defined by their distinctiveobligations in transmitting information; their roles in creating biosecurityobjects and subjects are thus obscured by their location as disseminators.Laypersons are cast in several subject positions depending on how theyreceive expert biosecurity knowledge by turning it into policies and fundingpriorities (policymakers and politicians) or into everyday states of awarenessand behaviors (‘‘the public’’).

Biosecurity citizenship is defined as complete, rapid internalization ofgovernment and expert discourse produced for ‘‘the public’’ and their repro-duction in utterances to family members and coworkers, bodily states, anddomestic environments. Although biosecurity citizens are supposed to be‘‘active,’’ this agency does not include subjecting official statements tocritical examination or producing biosecurity discourse—apart from report-ing any ‘‘unusual and suspicious substance nearby.’’8 Crisis and riskcommunication specialists ensure that players occupy their assigned subjectpositions and display appropriate forms of subjectivity.

Biosecurity allows room for debates about subject positions. Hendersonchanged communicable roles within a pre-established linear trajectory,complementing his role as producer of scientific discourse with that of dis-seminator of knowledge, and he created a space for ‘‘the public.’’ One of theleading biosecurity advocates I interviewed never accepted the latter expan-sion. At the same time that he began the exchange by asserting that if there’sa biodisaster, man-made or naturally occurring, public affairs would bemore important than public health, he asked rhetorically: ‘‘But whom do

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we want to communicate to? Do we want to go to the general public? I say,not a lot. I say senior leaders.’’ Broader ‘‘publics’’ should be reached by thedocumentary and fictional films on which he collaborates with scientists andHollywood producers.

Second, communicable models construct spatialization practices ofbiosecurity by producing, distinguishing, and connecting communicablesites, physical and virtual, including biosecurity research-and-developmentlaboratories, legislative bodies, government agencies, professional associa-tions, hospitals, clinics, doctors’ offices, media institutions, websites, andliving rooms. Defined vis-a-vis their projected roles in biosecurity com-munication, sites are ranked hierarchically in descending order as they enterinto discourse production, transmission, and translation to reception. Oneof my most poignant fieldwork experiences came at the conclusion of myinterview with a state Department of Homeland Security and EmergencyManagement (DHSEM) official, held within a military installation. Anunderground ‘‘Situation Room’’ featured rows of desks, each fitted with acomputer and telephone. Who could enter and where they would be posi-tioned represented which institutions count in emergency preparednessand how—even though the facility had never been used.

Third, biosecurity communicable models project temporalization prac-tices. Like spatialization, temporalization follows two tracks: lacking an‘‘event,’’ discourse moves slowly from laboratories and think-tanks toofficials and policymakers to journalists to ‘‘the public’’; crises involve arush from index cases to diagnosis to official deliberation to public disclos-ure. Interviews and scenarios suggest that communicable temporalities aredesigned to produce anxiety, not just by watching virtual viruses reproducebut, as you self-monitor, whether you are processing information andproviding responses within the allocated timeframe—being out-of-sync willelicit facilitator commentary and=or intervention. Commercial firms thatorganize scenarios advertise that in full-scale exercises, ‘‘real time’’ eventsfollow rigid schedules that are ‘‘highly stressful.’’ Several intervieweesemphasized ‘‘situational awareness’’—the requirement that temporalizationof communicative ‘‘inputs’’ must match that of timely decisions.

Fourth, Urry (2007) stressed that mobility is not immanent—phenomenonmust be constructed as possessing certain types and degrees of mobility.Communicable models project natural, one-to-one relationships betweenthemobility of biosecurity threats and communicative processes—since germsmight circulate sometime, information must circulate now. Biosecurity’scommunicative objects are projected both as immutable mobiles (Latour1988), able to travel without losing referential stability or truth value, andas circulating legitimately only in accordance with biocommunicable models.The uncontrolled hypermobility of representations in a crisis poses a serious

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threat and forms a focus of trainings and scenarios; discourse produced insites confined to reception or that follow undesignated routes are rumors,misinformation, or Internet hoaxes; they should be rendered immobile.

Fifth, practices of objectification and materiality transform dimensions ofbiosecurity communication into discrete objects—‘‘messages,’’ pressreleases, press conferences, training manuals, videos, photographs, e-maillistserves, posters, cards, and websites—that can be produced, circulated,and consumed. Nevertheless, their object(ive) status is deemed subordinateto that of ‘‘real’’ biosecurity objects—pathogens, terrorists, and vaccines—even, as in scenarios, when they are the only objects in circulation.Communicable models thus help keep the status of biosecurity objects asbiological-cum-communicative hybrids out of awareness; when itappears—as in claims that H1N1 was mainly media hype—it must be char-acterized as a betrayal of science, not a structural feature of biosecurityobjects.

Sixth, King argued that biosecurity relies on a complex politics of scalethat makes national security ‘‘ ‘pass through’ the laboratory and theepidemiological data-base’’ (2004:76). Biocommunicable models assumescale-making practices, shaping different scales (‘‘local,’’ ‘‘state,’’ and‘‘national’’) and institutionalizing their relations as communicativeinfrastructures and networks. Providing disaster, pandemic, and crisiscommunication training at all scales, often a funding requirement, helpsstandardize institutional practices and fashion biosecurity objects intoimmutable, if regulated, mobiles. Persons occupying distinct scalar positionsseldom interact face-to-face; communication systems thus link subjectswhen scalar differences engender discrepant subjectivities that threaten torender authorized objects immobile or unstable. Communicable scalarpolitics can invite resistance, as I suggest next.

Seventh, communicable models regulate economies of affect. Researchersargue that biosecurity ‘‘incidents’’ produce anger, fear, outrage, distrust,dread, uncertainty, and=or stress, thwarting information processing and cre-ating negativity and distrust of authority (Covello 2003; Lerner et al. 2003;Renn 1998). Crisis communication teaches spokespersons to providereassurance and restore rationality. Proper communication and desiredaffects go hand-in-hand; when ‘‘the public’’ or reporters become discourseproducers, rumors or media distortions create fear. The CDC suggests that‘‘effective communication with the public through the news media’’ isneeded to counteract terrorists’ efforts to produce panic. Risk and crisiscommunication pictures science ‘‘as a guarantor of truth and political con-sensus’’ (Fortun 2004:286). Nevertheless, biosecurity experts produceobjects and temporalities, especially for scenarios involving planners andofficials, that are meant to produce fear and uncertainty.

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Finally, communicability constructs ethical subjects of biosecurity.Laypersons who assimilate biomedical information and embody itcorporeally become biomedical citizens (Ong 1995; Shah 2001). Thosewho fail—through ignorance, non-compliance, resistance, or culturaldifference—become unsanitary subjects (Briggs and Mantini-Briggs 2003).Because communicable models require all participants to play their assignedduties for keeping biosecurity discourse moving, obstructing linear trans-mission constitutes an ethical violation; complicating or resisting officialcommunicable models threatens national security.

These assumptions are powerfully inscribed in scenarios. Stimuli aretailored to each player’s subject position, and responses must closely matchone’s location in the scenario’s communicable model. Temporal and spatialconstraints are inescapable. Production of objects is tightly constrained and,as the interviewee who discussed how Dark Winter was designed noted,affective responses were programmed via mediatized objects. Anydepartures from expectations inscribed in the communicable model—goingtoo fast or too slow, failing to respond or provide the right inputs—isimmediately signaled by the program or controller in computer-basedgames; facilitators monitor participants in live exercises. Gaps betweencommunicable models and outcomes become the focus of ‘‘hotwash’’evaluative discussions and subsequent debriefings. Scenarios are quintessen-tially communicable and yet define what is real in the virtual absence of bioter-rorist attacks or devastating pandemics, promoting conditioned responses thatshould shape how people react in crises. If, as Lakoff (2007:254) suggested, ‘‘therequirement of vigilant attention to the prospect of crisis is ongoing, perma-nent,’’ then the leakage of subject positions, subjectivities, objects, spatializingand temporalizing practices, scales, affects, and ethics into everyday imagin-aries and institutional practices is significant, if hardly automatic or irresistible.

CONCLUSION: BIOCOMMUNICABLE RESISTANCE ANDBIOSECURITY PUBLICS

Most persons engaged in biosecurity preparedness and emergencymanagement see communicative issues as less important; as an intervieweewho conducts DHS-funded biosecurity research in a US national laboratorynoted, our job ‘‘is just to understand the primary aspects of the problem—the communication is secondary.’’ Consultants who run crisis, emergency,and disaster communication training; public information officers; and jour-nalists accord greater importance to communication. I have suggested thatthey are no less dedicated to promoting biocommunicable models thatreproduce notions that we know what communication is and what it

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does—transporting information from sectors of production to those ofreception. Anthropologists who study biosecurity seem to place themselvesin alignment with the view that communication is less important and lessworthy of scrutiny than ‘‘primary aspects’’—thereby reproducing common-sense notions of communication. Rather than trying to convince readers tostudy ‘‘communication,’’ I have tried to trace how notions of communi-cation are produced in biosecurity and to show how they are less referentialthan pragmatic and performative, less a label used to refer to a shifting set ofheterogeneous objects than a means of positioning oneself in relation todiscursive and material practices that constitute biosecurity. Similarly, anumber of anthropologists have, to use Catherine Lutz’s (2002) valuabledistinction, focused on militarism, the broader dispersal of categories, per-spectives, and affects that make massive concentrations of capital, resources,people, and space that constitute militarization just seem natural (Gusterson1996, 2007; Lutz 2001; Masco 2006). The role of ‘‘embedded journalists’’ incurrent US wars and of embedded generals in mainstream news reports tothe proliferation of domestic surveillance to constant warnings in airportsof the ‘‘threat level’’ and requests to observe and report fellow passengerswho might be security ‘‘threats’’ suggest that communicability also needsto form an important part of this anthropological research agenda.

Ethnographic dimensions of my project—interviewing people in a widerange of scalar locations and types of institutions, observing scenarios,and participating in training courses—have led me to view biosecurity lessas a ‘‘worldview,’’ as King (2002:767) put it, a ‘‘consensus that has emergedduring the last decade.’’ I agree with Collier and Lakoff (2008:27) that thereare different kinds of biosecurity, tied to ‘‘different underlying values’’ aswell as divergent ‘‘technical understandings.’’ Statements from intervieweesin public health versus security and emergency preparedness agencies wereoften quite different. Nevertheless, I think that divergences in disciplinaryand institutional perspectives, a long-standing feature of modernity, mayinform us less about biosecurity and contemporary transformations ofhealth and disease than how issues of communicability constitute biosecur-ity as a pedagogical project. I think back to my interview with one of thefirst and foremost spokespersons for the importance of bioterrorismpreparedness. After asserting that national stockpiles of vaccines and infra-structures for rapid deployment had taken smallpox and anthrax, thediseases most likely to be used as bioweapons, ‘‘off the Weapons of MassDestruction list,’’ he warned me that politicians, planners, and ‘‘the public’’still ‘‘don’t get it.’’ We need, as a result, more biosecurity research, confer-ences, scenarios, briefings, policy statements, videos, and popular films.

What’s wrong? Why are we still ‘‘not prepared’’? The communicablemodels invoked in biosecurity discourse should ensure that things work

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smoothly. Less than instilling a worldview or effecting a vast epistemic trans-formation, these models project variegated sets of subject-positions, con-stantly reminding each of us which spaces, temporalities, and scales we arepermitted to occupy, what we should think, what forms of subjectivity weshould display, which objects we can access, how we should feel, and whatconstitutes ethical action for us. They specify how texts, images, videos, andbodies should move and our individual obligations for keeping them moving.Negative lessons also abound, warning what happens when we occupysubject-positions, spaces, temporalities, or scales that are not legitimatelyavailable to us or adopt dangerous forms of subjectivity and ethics—weendanger ourselves, our families, our communities, and national security.These models are not simply out there—their illocutionary (Austin 1962)forces are constantly recapitulated and the social, political, and biologicaleffects that should accrue to them are rearticulated each time they are embo-died in preparedness pronouncements, news stories, manuals, training pro-grams, scenarios, and websites. The CDC’s (2002) Crisis and EmergencyRisk Communication is a 256-page biocommunicable model available online.

It would be easy to ascribe biosecurity’s purported failure to practices ofresistance. In US debates about the H1N1 pandemic, health officialspointed to how healthy people showed up in emergency departments,demanding testing or Tamiflu, and they drew attention to the disappointingnumber of people who actually got the H1N1 vaccine as evidence of popularignorance and=or resistance, thereby justifying the familiar charge thatlaypersons do not fulfill their communicable roles. Officials also sometimesresist their biocommunicable positionalities. Challenging scalar hierarchies,a state health department public information officer noted that she hadtaken CDC’s and FEMA’s courses and found a few of their principles‘‘useful’’; nevertheless, they had ‘‘not really’’ changed how she does herjob. A former health reporter, she noted: ‘‘I suppose I have some biasesabout it, about some of the risk communication techniques that are taught.’’She then added with a mischievous smile, ‘‘is FEMA an expert in communi-cating? That’s who leads these classes. And think about Katrina, and thenyou think—these are the people who are advising on how to communicatewith the public!’’ With H1N1, her agency challenged the primacy ofemergency-preparedness communicable models: DHSEM’s public infor-mation officer told me, ‘‘any big thing, then we take over: we approve allthe messages and we coordinate the messages for the public. And we didthat for H1N1 . . . all the way through. It’s so that what goes out to the pub-lic, everybody’s on the same page.’’ But the Department of Health’s officertold me, ‘‘We felt like, ‘we’re the experts in dealing with this. We know this,we do this—we know how to survey for it, we know how to vaccinateagainst it, we know how to talk to people about preventing it.’’’ The

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governor, she reported, placed her agency in charge. These two officialsplayed crucial roles in their state’s H1N1 efforts, but they were certainlynot on the same biocommunicable page.

The prevalence of other biocommunicable models might contribute tobiosecurity’s purported communicable failure. News coverage of health iss-ues, health education that targets middle-class white populations, and phar-maceutical advertising are often modeled less as linear, vertical transfers ofknowledge from experts to ignorant laypersons than as centering on activeindividual patient-consumers who are governmentally obligated to seekinformation relevant to their ‘‘risk factors’’ from all sources, view them allskeptically (including statements by their doctors), and make self-interested,rational choices about which products and services to consume (Briggs andHallin 2007). A public citizen model casts laypersons, health professionals,and policymakers alike as possessing rights to debate health topics, whichare cast less as expert knowledge than policy issues for public discussion(Briggs and Hallin 2010). Although less prevalent, this model springs from1960s social movements and consumer-rights campaigns and a more recent‘‘inclusion-and-difference paradigm’’ for biomedical citizenship (Epstein2007). These models interpellate us vis-a-vis distinct subject positions, subjec-tivities, objects, spatialization and temporalization practices, scales, affects,and ethics. Despite the gaps and contradictions that emerge when peopleperversely use these other communicable models, biosecurity is criticallyimportant in shaping biomedical citizenship, in part, because it is a health-related arena in which linear, vertical biocommunicable models that picturelaypersons as ignorant recipients of expert knowledge still predominate.

If I were to accept these explanations of the ‘‘failure’’ of biosecuritycommunicability, however, I would leave these models’ power unchallengedby reinforcing the idea that it is their users who undermine them. Biocom-municable models are framed as designs that should generate appropriatediscourse and communicative practices—just add the right content.Nevertheless, biosecurity communicability is a pedagogical project that, likedevelopment projects (Ferguson 1990), is designed to fail. Linguistic anthro-pology would suggest that these models are metapragmatic, meaning thatthey consist of representations that purport to depict how discourse operatesand=or to regulate how it proceeds. By definition, metapragmatic represen-tations closely interact with the complex pragmatics of discourse withoutever determining or successfully mapping them (Silverstein 2004). In otherwords, there are always substantial gaps between cultural models ofdiscourse and how people talk, listen, write, read, and view. Such gaps inbiosecurity discourse are blamed on uninformed officials; silo-defendingor resource-hungry institutions; sensationalizing journalists; and, especially,ignorant, panicky, and downright recalcitrant citizens, not to mention

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bioterrorists. Claiming that biosecurity planning and scenarios can providecommunicative order, predictability, and reassurance inversely engendersthe projections of disorder, unpredictability, and panic that confirm howdifficult it is to be prepared. We may not be able to control the mutationof viruses or what happens in back-room bioterrorist laboratories, but withmore risk communication research, more media training, more cooperationby journalists and citizens, and more funding, a more biocommunicablysecure world is just around the corner. Or is it?

There is, I think, a lot at stake for medical anthropology and publichealth in this discussion. Biocommunicable models abound in clinicalmedicine and public health practice, and—surprise—they seem to be failingtoday more than ever! Researchers fabricate findings, pharmaceutical andmedical device corporations withhold results on dangerous or ineffectiveproducts, doctors will only tell you what marketers tell them to say, repor-ters are just trying to fill the 24-hour news cycle, the Internet is full ofhoaxes, and patients are as confused and non-complaint as ever, and, worse,they think they know more than their doctors. We move between a complexset of biocommunicable models, juggling their powerful and competingsubject-positions, temporalities, spatialities, objects, scales, affects, andethics; gaps between biocommunicable models and discursive practices arethen blamed on the users. Like those of biological and biomedical cit-izenship, models of global health are multiple and competing, and importantpolicy and practice implications emerge from competing definitions (Nichter2008). To a significant degree, global health is a communicable construct,projecting how knowledge as well as people and germs circulates globally;thinking critically about which communicable models we and others employis thus crucial for shaping global health policies that challenge global andlocal inequities rather than reproduce them. As lay discourse, includingpress coverage and Internet traffic, come to play an increasing role in diseasesurveillance (Brownstein, Freifield, and Madoff 2009), documenting care-fully how notions of communication are constructed and how they intersectwith digitally-mediated practices will be increasingly important.

I am not suggesting that communicable models and their assumptions areeither salutary or pernicious, only that they deserve careful ethnography andanalysis. Medical anthropology has been of little help in this process, largelycontinuing to regard ‘‘communication’’ as a surplus, something always com-ing after the facts of genetic mutations, index cases, and the like. Studying‘‘communication’’ must be akin to pursuing the kinds of ‘‘linguisticanalysis’’ to which many medical anthropologists were subjected in graduateschool, the ‘‘technical tools’’ to which some positivist anthropologistssuccumb. Thatmedical anthropologists seldom critically examine how notionsof ‘‘communication’’ are constructed in the social worlds they examine is not

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surprising, because they largely share the sorts of unexamined assumptionsabout ‘‘communication’’ that enable biocommunicable models to achieveparticular sorts of social, political, and medical effects. By revealing how theseassumptions operate within one domain of contemporary social life, I hopeto have pointed out what might be gained by critical disavowal of precon-ceived notions as to what ‘‘communication’’ might mean and inclusion of theirprocesses of construction as a part of broader research agendas.

ACKNOWLEDGMENTS

Thanks to researchers; clinicians; public information officers; administrators inlocal, state, national (US and Latin American), and international institutions;journalists; risk communication and other contractors; and others for speakingwith me and allowing me to observe them at work, including during scenarios.Laura McNamara and Monica Schoch-Spana provided valuable suggestionsand contacts. Thanks to Pheng Cheah, Andrew Lakoff, Mark Nichter, AihwaOng, Monica Schoch-Spana, and Candace Slater for comments on previousdrafts; suggestions by Medical Anthropology reviewers were also valuable.The final draft was written during my tenure as a Weatherhead Fellow atthe School for Advanced Research in Santa Fe, New Mexico.

NOTES

1. My commitment to interviewees and fellow scenario participants, including individuals who

work in security- and defense-related institutions and public figures whose

biosecurity-related statements are closely scrutinized, require not only anonymity but

framing their positions and sites of employment in very general terms.

2. This office is now called the Office of the Assistant Secretary for Preparedness and Response.

3. http://emergency.cdc.gov/cerc/CERConline/index.html, accessed September 25, 2009.

4. http://training.fema.gov/EMIWeb/IS/IS704.asp, accessed May 14, 2010.

5. http://www.ready.gov/america/npm07/tips/093007.html, accessed March 15, 2009.

6. http://www.ready.gov/america/npm07/releases.html, accessed March 15, 2009.

7. http://www.citizencorps.gov/, accessed March 15, 2009.

8. http://www.ready.gov/america/npm07/tips/093007.html; accessed March 15, 2009.

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