By Melaka Jude

Decades have passed since the world was taken by storm by the explosion of international trade. Through rapid advancements in transportation and communication, what once took weeks or months to be transported, could now be shipped across the world in a matter of hours. This allowed nations who were once considered to belong to the furthest reaches of the world, to now influence and shape the very fabric of our society. What one very rarely realises, however, is that goods, services, and people were not the only elements that could suddenly find themselves in a vastly new location. In fact, in a much more sinister and unfortunate way, so could infectious diseases. The recent COVID-19 pandemic is a very fresh example of this truth and serves as a reminder of just how connected we all are. But all hope is not lost, as you will soon see. As with anything, there are two sides of this coin, which brings two almost completely separate worlds together. A world defined by commercial value, and a world defined by health. Two worlds, colliding where it matters most. 

Trade Routes: An Infectious Diseases’ Best Friend

Infectious diseases have a tendency to spread. That is, by definition, their nature. So much so that, the more people connect physically with each other, the greater likelihood that such diseases would infect possible hosts and in turn increase the reach of such diseases. Keeping aside the expansion in trade in modern times, history shows us a multitude of instances where the main, if not the only, route of spread of infectious disease in ancient civilisation was through trade routes. This cannot be seen better than in the case of smallpox. While the origins of this deadly disease are unknown, there is evidence to suggest that traders from Egypt, carried the disease across to the Indian sub-continent as early as the first millennium BCE. The Silk Road, arguably the most important trade route of the ancient world, has played a vital role, multiple times, in the spreading of this disease. The spread of smallpox from China to the Korean peninsula and Japan leading to the devastating break out of the mid 700s which resulted in the death of over a third of its population, the Indian subcontinent’s smallpox incidence reaching endemic level, and its spread into the Northern and Central European region during the 13th century are all examples of just how devastating the Silk Road was in this aspect. Portuguese expeditions to the West coast of Africa seeking new trade routes, European voyages to the American continent in search of an alternate way into China, and the influence of Muslim traders into North Africa leading to the spread of smallpox into these new locations and the devastation that followed, are all evidence for just how tangled, trade and infectious disease has always been. And while this article has only expounded upon smallpox, diseases such as the bubonic plague, anthrax and leprosy have also found their home along major trade routes.

The modern boom in trade has not made things easier. From the Spanish flu in the 1910s, to HIV/AIDS pandemic that began in the late 20th century, to the Ebola virus of the 2010s, and more recently the COVID-19 pandemic, trade has made it such that there are very little places left in the world that do not get alarmed by the news of the discovery or spread of a new infectious disease. With about a multitude of ways that a disease-causing agent can get from point A to point B, this has made the control of such infectious diseases effectively impossible, unless a country completely shuts down its borders, a very popular tactic used during the COVID-19 pandemic. 

Trade Also Influences Zoonotic Transmission

Infectious diseases are not limited to human contact. In fact, the nature of infectious diseases is such that one of the main modes of transmission is through livestock and animal products. In this respect the trade in these commodities also plays a crucial role in controlling infectious diseases. The trade in poultry products has been linked to the spread of bird flu (avian flu), and with suspicion still present around the zoonotic origin of COVID-19, there maintains an ever present need to ensure that proper biosafety and biosecurity mechanisms are in place to circumvent this risk. Numerous nations have already implemented such measures, with a good example being the biosecurity measures in Australia, a fact that Sri Lankan mothers trying to send local food to their children down under often complain about. 

But – Trade is Not All Bad in the Medical World 

One could argue that international trade is the only thing that allowed us to get the CPR test-kits, gloves, medical supplies, and personal protective equipment that helped us to overcome the COVID-19 epidemic in our own country. While the expansion in trade in modern times has indeed led to an increase in the rate of spread and the frequency of infectious diseases, it has also ensured that countries facing new threats are allowed the opportunity to request and obtain the tools needed to contain them. 

Coming back to the ancient world, we see how the Silk Road was vital for practices such as variolation, a process of intentional inoculation of an individual with smallpox material, to spread and later form the basis of the science of vaccination, a key part of disease management and control. Testing for Ebola in impoverished African nations would have been next to impossible if it was not for PCR and antigen test kits obtained via international trade, with the added aid of diplomacy and negotiation. It is important to understand that International trade agreements, most of which have specific clauses for health related commodities, play a crucial role in averting and controlling crises through the improvement of access to medical products. It is however equally important to note that these agreements can be improved as there are many weaknesses and loopholes in them. These were made apparent by the recent pandemic as countries were often seen to secure supplies for their own needs, which while understandable, could have negative impacts as well.  

In addition, trade has led to the increase in collaboration between nations in many fields but most importantly, in health. Research collaborations with regards to MERS, SARS and Ebola have led to positive developments in both treatment and containment methods. This was very prominently seen during the COVID-19 pandemic, as countries raced to sequence new strains found in various parts of the world, develop vaccines such as the COVAX initiative and also enhance the understanding of the virus, ensuring a global response to the global emergency and proper containment and control measures were enacted. 

Protectionist Policies as a Hindrance to International Trade

It seems miraculous that international trade can lead to beneficial partnerships between countries, although that is also essentially where the problem lies. International trade promises so much but often falls short. Limitations especially due to countries looking after their own interests, political agendas, trade embargos, and inherent weaknesses in supply chains, led to a majority of the world scrambling for vital resources, such as PPE and other medical supplies, during the pandemic. In addition, certain trade agreements may act as unnecessary barriers or red tape that hinders the free movement of ideas and essential commodities. All these issues have led to increased calls to increase domestic production, a tactic Sri Lanka seems to be wanting to commit to, to reduce dependence on, at times limited, international sources and trade for essential commodities that can aid in the controlling of infectious diseases from spreading worldwide. It is important to recognise these shortcomings and address them, striving to ensure that the promises trade makes, can be fulfilled. 

Trade and Infectious Diseases: A Complicated Relationship 

While infectious disease and trade might seem at first, worlds apart, they in fact have probably the world’s longest love story. From the ancient times when traders spread disease from the far reaches of China, across oceans, to the isolated landmasses of the Americas, to more modern times when a pandemic can sprout within the course of a few weeks, these two have always had their bad times in their relationship. However, when we see the effects of variolation, the precursor to modern vaccination, collaborations that have given the world miraculous initiatives such as COVAX, knowledge sharing or “trading” platforms, and the trade of medicinal supplies, one might think that maybe, just maybe, their relationship isn’t so bad after all. 

These two worlds that have always been a part of the human journey, are inextricably linked in society, and even more so in today’s interconnected one. It has always been up to us on how we chose to use and manipulate these two worlds. Whether we choose to foster the good sides, increase collaboration and promote the trade and sharing of essential medical commodities and knowledge, or instead, allow the toxic side of this relationship to run rampant, will ultimately decide our fate as a species. But one thing is for certain, wherever trade happens, wherever man goes, and wherever humans interact on a physical level, infectious disease will always follow close behind, watching and waiting. 

The views and opinions expressed in articles submitted to the Comparative Advantage Blog are those of the author and do not necessarily reflect the views of The Moot Court Bench.


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