East Asia is a pandemic epicentre. The last two pandemics, the 1957 ‘Asian flu’ and the 1968 ‘Hong Kong flu’ (and probably the 1918 ‘Spanish flu’ as well), originated there and the region is likely to remain a cradle of emerging infectious diseases in the future. Drawing on this book's over-arching theme of a regional–global nexus, this chapter analyses the security significance of an East Asian health problem that threatens to ignite a worldwide health crisis. Notwithstanding the possibility of biological warfare, microbial threats to human health come from within a state rather than from a state. And states have an innate inability to contain by themselves a highly contagious disease that transcends political borders. For the purpose of security analysis, therefore, the capacity of a state to project power is not the primary concern of this chapter. Rather, the focus for analysis is how the weakness of a state can threaten to weaken others. As regards the regional–global nexus, the path to security is overwhelmingly through state and non-state actors cooperating to reduce collective vulnerability rather than a competition for power in the international order.

In general, so-called ‘transnational’ security challenges defy any arbitrary delineation between regional and global security. Indeed, pandemic influenza as a security challenge is not region-specific; a pandemic is global by definition. However, for epidemiological reasons, any worthwhile analysis of the likely origins of a pandemic and the opportunities for preventing or delaying such an event requires an East Asian focus.