Medical Intelligence in the Multipolar World

21/01/25

In 2007, the book “Geopolitics of Chaos” by Carlo Jean, a general in the Italian Army and esteemed geopolitician, was published. It collected a series of speeches he had given in various forums between the end of the 90s and the beginning of the 2000s. He was obviously not the first to deal with chaos in international relations; the theme of complexity, of the influence of variables in human relationships, of the functioning of complex networks had already been addressed with multiple facets in fields such as sociology, economics, anthropology, political science. Yet that book by Jean, seen through today's eyes, represents something different from the simple analysis of chaos in international relations. It was actually more of an awareness, a moment of caesura between the world before (bipolar) and the one that would begin immediately after (multipolar), a state of mind of the Western world towards the one outside it.

After the end of the Cold War and the collapse of the Soviet Union, the belief quickly emerged that, with the “peer competitor” – the USSR – disappearing, the historical and idealistic mission of the United States would be to export democracy and promote the free market, conditions that would make the world less and less conflictual and increasingly projected towards the end of history. But at the beginning of the 2000s, when Jean was writing, the world was not going at all in the direction hoped for by the American “neocons”, and not only because of the proliferation of conflicts in the world. Rather, there was the first awareness that the Western model was not at all accepted in many parts of the world and, as Dario Fabbri rightly observed in his “Human Geopolitics”, not because there was a bad autocrat of the moment who prevented the spread of democracy, or because certain societies were so immature as not to understand the depth of Western thought, but simply because the Western model is not, by history, tradition, culture, the reference model for other peoples. And so, it is not certain that it will work and that it will lead to a better world. This is where the Western dismay lies, which sees in the advance of the hegemony of other States, hostile to the West, a threat to its own existence. And this is where the sense of chaos identified by Jean lies: Today we know that it was not confusion and complexity, or rather not only that, but it was the bitterness of the defeat of idealism due to the re-emergence of pragmatic realism in the geopolitical world.

Today a satisfactory geopolitical analysis must necessarily go back to what was the realism of the classics (Mahan, Mackinder, Spykman) but also the neorealism of Mearsheimer, which would explain in a clear and, perhaps, equally dramatic way, the direction in which the political actions of Russia, China, USA, Europe tend. The perceived chaos therefore becomes awareness that the design of great powers adverse to the West is anything but chaotic, but motivated by logics that belong at the same time both to the power and to the intimate awareness of their role assigned by history.

The “world-island” constituted by the Eurasian continent, the so-called “Heartland”, remains the place whose control allows for the domination of the world, and its edges, from Europe to the Middle East, to India and the Pacific, the so-called “Rimland”, constitute an essential element of theHeartland.

Today the powers of theHeartland, Russia and China, are chasing control of the rimland to defeat the West, one looking to the West and dreaming of restoring the Iron Curtain, or perhaps even further, the other looking both to the East (Formosa and the islands of the South China Sea) and to the West (Silk Roads – Belt and Road Initiative). The US can counter this drive only by maintaining control of both the Pacific and the Atlantic, and thus of Europe, a onerous task that has recently forced them to push Europe itself to assume more responsibility in ensuring control of that part of the rimland on behalf of the United States.

The competition will be tough, costly and in all fields, from which Europe and we Italians will not be allowed to avoid.. The need for defensive, protective and deterrent actions will be vital for the protection of the economy, social stability, employment levels, the protection of industrial sectors, the integrity of political institutions and democratic values, the safeguarding of the territory, artistic heritage, correct information; we must also add the protection of physical well-being, health, health security, which can be compressed by external threats, direct and indirect, unconventional, transnational and asymmetric such as CBRN which include chemical, biological, radioactive, nuclear threats, inflicted both by tangible actors, state and non-state, and by intangible actors, with apocalyptic implications for the economy and health that represent dangers equal in dignity to global phenomena such as a world war.

Within NATO, biological threats have long been classified according to their origin: natural emergence of unknown or re-emerging agents, accidental release, and finally intentional release by political choice, sabotage, or theft, in contexts of biological warfare, bioterrorism, and biocrime.

The development of digital technology in the medical/health sector subjects the data collection system to a greater awareness of the risks in the processing of information that may have implications for national security, thus requiring a high level of defense of strategic information, but also a more proactive role in the acquisition of sensitive data in this sector.

The development of interpretative models, the theft of sensitive information, the modification of health data, the manipulation of health and diagnostic devices, the manipulation of medical reports, interference during computerized and remote medical operations, are threats and cause alarmism that the national security system must face at a systemic level: active and passive security, research, awareness, culture and organic unity of the chains responsible for security and the protection of national interests.

A country system aware of the effects that a health emergency can generate, must necessarily develop a "Medical Intelligence" (MEDINT) that frames the pandemic risks in the context of national security to expand the sources of knowledge of the security apparatus by maximizing information and alarms quickly, with a tactical advantage in penetrating compromised environments, being able to act in advance with actions free from constraints and protocols, analyzing information based on atypical indicators relating to country risk, planning undercover monitoring of the technical-scientific capabilities outside the country, with the engagement of human sources in the scientific and academic world of foreign countries useful for generating technological leaps and strategic information increases.

MEDINT, therefore, contributes to the defense of the biological-health security perimeter of the country, through the collection, custody, analysis, use and security of health data for the protection and safeguarding of the integrity of the nation through the Intelligence services, especially with regard to the prevention of crimes or actions from which dangers for citizens and the State may arise, the monitoring, evaluation, management and communication of risks of a bio-scientific, bio-medical, epidemiological, environmental, human or veterinary health nature.

MEDINT is a tool of the Medical Policy of a government that obviously delegates its technical action to specific bodies such as ISS (national protection scheme), Universities (research), Drug Agencies (authorisation after verification of studies on health products), Industrial production (vaccines and drugs), while investigation or investigative activity The actual task is entrusted to the security bodies and the Armed Forces/Police with international tasks: AISI, AISE, DIS, ROS, specific sectors of the Armed Forces of the 4 Corps and related Study Centres.

It becomes useful and necessary to provide rapid and reliable indications to public decision makers on the emergence, expansion and contagion of known viruses, under control, but also of endemic ones and potentially capable of escaping from their environment, diseases of a natural or artificial nature, which could jeopardise the integrity of the defence system in the event of propagation across the territory.

MEDINT tools and purposes are to provide strategic information, such as the health needs and risks of a territory; the technologies of use, the provision of trained human resources, medicines; experimentation and related logistics; the predictive analysis of an epidemic scenario, the preventive actions to be undertaken, the coordinated actions in the different phases of the contagion, how to connect the chains of command, the hospital facilities and those of first access, both in the national territory and in foreign territory, the coordination of civilians and military personnel inside and outside the nation, how to collect sensitive data and how to keep them. But also what effects may arise in the medium and long term on the political, economic, social, military structure for the country affected by a known or potentially unknown epidemic outbreak.

It is therefore necessary to develop and broaden MEDINT awareness not only in the healthcare sector but in the country system, starting immediately a training following an innovative approach that goes beyond the useful psycho-pedagogical and historical-political approach, adding the proactive and operational aspect within the disciplines of analysis of an emerging and worrying strategic sector: medical and epidemiological information or investigation, with a specific capacity for analyzing critical issues and disseminating potential scenarios that necessarily involve important figures.PECS for the benefit of national security and CBNR warfare experts mostly Bacteriological/Virological, sector researchers and technicians assigned to such defense, defense economists and programmers, medical sector operators, civilian and military analysts in strategic sectors able to evaluate such new dangers that could be very powerful tools for both offense and defense.

There is therefore a need to create a structure, independent or functionally inserted within a Ministry, composed of specific figures qualified in the health and security analysis fields, figures specialized in epidemic intelligence, agents with specific technical, medical, biological, pharmacological, economic skills, used as subjects of investigation at national level and also in other places of the globe, in order to anticipate and understand threatening situations. Specialized figures capable of analyzing suspicious and dangerous news, promoting a capable countermeasure thanks to advance knowledge of the risks and dangers inherent in such threats.

How necessary steps in this direction are, we are reminded by the pandemic events of recent times and foreign interference towards Italy to exploit vulnerabilities in crisis situations. After all, Mackinder said: "He who controls the Heartland controls the world. But he who does not defend himself on all fronts risks losing his own Heartland as well."

Dr. Roberto Bevacqua

gen. d. (aus) Manlio Scopigno