The Highly Pathogenic Avian Influenza A(H5N1) Virus: a twenty-year journey of narratives and (in)secure landscapes Philip Rolly Egert Dissertation submitted to the faculty of the Virginia Polytechnic Institute and State University in partial fulfillment of the requirements for the degree of Doctor of Philosophy In Science, Technology, and Society Barbara L. Allen (Chair) Daniel Breslau Bernice L. Hausman David C. Tomblin March 18, 2016 Falls Church, Virginia Keywords: H5N1, HPAI, highly pathogenic avian influenza virus, pandemic, social justice, bioterrorism, bioethics, biopower, tacit knowledge, dual-use dilemma, dual-use research of concern, emerging infectious disease Copyright Philip R. Egert The Highly Pathogenic Avian Influenza A(H5N1) Virus: a twenty-year journey of narratives and (in)secure landscapes Philip Rolly Egert ABSTRACT This dissertation is comprised of two manuscripts that explore various contestations and representations of knowledge about the highly pathogenic avian influenza H5N1virus. In the first manuscript, I explore three narratives that have been produced to describe the 20-year journey of the virus. The journey begins in 1996 when the virus was a singular localized animal virus but then over the next 20 years multiplied its ontological status through a (de)stabilized global network of science and politics that promoted both fears of contagion and politics of otherness. Written by and for powerful actors and institutions in the global North, the narratives focused on technical solutions and outbreak fears. In doing so, the narratives produced policies and practices of biopower that obscured alternative considerations for equity, social justice, and wellbeing for the marginalized groups most directly affected by the H5N1 virus. The second manuscript explores a unique aspect of the H5N1 virus’s journey as an emerging infectious disease – its representation as a potential weapon for bioterrorists. The US government’s recent attempt to secure what constitutes H5N1 knowledge produced a global debate between scientists and policy makers over how to balance the nation-state’s desire for security with the life science’s tradition of openly shared research. Known as the dual-use dilemma, this debate set up binaries of impossible reconciliation between the two groups. This dissertation argues that the dual-use dilemma obscures larger questions of justice. I propose a new concept of justice, knowledge justice, as an alternate more globally inclusive framework for exploring ways out of the dilemma. The concept is premised on the assertion that if knowledge is framed to obscure justice issues, then the justice questions of owning that knowledge can be used as a way out of the dual-use dilemma. Thus, knowledge becomes a question of justice that should be as important to policy makers as more traditional justice considerations of inequities in distribution, recognition, representation, and fairness. ACKNOWLEDGEMENTS I owe a large debt of gratitude to numerous teachers, fellow students, and research colleagues whom I have been fortunate enough to meet as I pursued this research project. Their generous collegial support, encouragement, and advice was always carefully considered and a welcome source of continuous motivation. In particular, I must give thanks to my committee – David Tomblin, Bernice Hausman, Daniel Breslau, and in particular Barbara Allen – for their excellent guidance and insights throughout the development of this dissertation. They pushed me to think differently and harder about my research, which produced a better result than I would have otherwise achieved. Thank you. Additionally, I was blessed to have the support of many friends whose conversations were constant sources of varying perspectives that kept my research firmly grounded in reality. Notably, I wish to acknowledge Roger Butts for his longstanding friendship and keen interests in my academic endeavors. At an age when most people are comfortably retired, Roger took his newly conferred doctorate degree and went off to Siberia to teach. His resultant life altering experiences inspired me to believe that it was never too late to return to school and pursue my own similarly long-held education dreams. Lastly, I cannot give enough thanks and gratitude to Mary Tanner. Throughout this project’s five-year journey she always went far above and beyond the role of supportive partner in helping me keep all my stars aligned. But more importantly, she never wavered in her belief in me and in the value of what I was trying to accomplish. Without her, this dissertation would not have happened. It is as much hers as it is mine. iii TABLE OF CONTENTS Title Page Abstract Acknowledgements ........................................................................................................................ iii Table of Contents ........................................................................................................................... iv Introduction ....................................................................................................................................1 Introduction ..........................................................................................................................1 References ..........................................................................................................................12 Narratives of Disease: following the H5N1 virus from birds to (de)stabilized networks ......13 Title Page and Table of Contents .......................................................................................13 Acronyms and Abbreviations ............................................................................................14 Abstract ..............................................................................................................................16 Introduction ........................................................................................................................17 Foucault on Power & Latour on Semiotics ........................................................................28 Bird Flu Narrative (virus to disease) ..................................................................................35 Public Health Narrative (disease to crisis) .........................................................................53 Outbreak Narrative (crisis to [de]stabilized networks) ......................................................70 Conclusion .........................................................................................................................77 References ..........................................................................................................................80 Knowledge Justice: an alternative approach to resolving the H5N1 dual-use dilemma ...105 Title Page and Table of Contents .....................................................................................105 Acronyms and Abbreviations ..........................................................................................106 Abstract ............................................................................................................................107 Introduction ......................................................................................................................108 H5N1 Debates and the Myth of Easy Replication ...........................................................115 Bioethics of Silence .........................................................................................................136 Thorny Problems of Justice and Securitized Knowledge ................................................152 Conclusion .......................................................................................................................174 References ........................................................................................................................175 Appendix A: Timeline of Selected Major Events ............................................................197 Appendix B: Literature Review .......................................................................................198 Appendix C: Sources and Methods ..................................................................................207 Conclusion ..................................................................................................................................210 Conclusion .......................................................................................................................210 References ........................................................................................................................214 iv 6',''##$#+&$$&'+"(#!'("# # - "$# ( -$#'' #&!""#(#" -(#!" )((#! ($&# &(/(#&( *"!((&/(#) (!#"'(&/" ) (!( -/(#) *&)''((""#(#"(&# "((& )"*&' -'(&)(*2'#&! ,("'#"# #$#+&3+ $)((-#" )!"'#*&"(-27 :#)) (A??B/ADC; INTRODUCTION In the first two weeks of 2016, three disconnected events occurred that illustrate the arguments of this dissertation. On January 7 and 8, I attended the National Science Advisory Board for Biosecurity (NSABB) meetings to hear presentations and discussions on the board’s preliminary risk and benefit assessments for “gain-of-function studies of concern” – or research with the potential to generate pathogens with enhanced pathogenicity, transmissibility, and ability to evade public health control measures.1 The meeting was part of a deliberative policy making process set in motion in late 2014 when the