On the way to pandemic preparedness in united Germany. A new citizenship project during the 1990s?

"When the Hollywood thriller 'Outbreak' will start in our cinemas soon, you may ask yourself or be asked what Lower Saxony would do in that case," the head of the Medical Examination Office in Braunschweig warned Gerhard Schröder, then prime minister of Lower Saxony. The film "Outbreak - Silent Killers," which was released in German cinemas in March 1995, was about killer viruses that first appeared in Africa and from there spread to the USA. The head of the Medical Examination Office in Braunschweig was sure that even if the plot was fiction, a threat to society by new viruses was real. Epidemic outbreaks in the 1990s seemed to prove him right. Disease protection and pandemic preparednes were on the political agenda, but how was the public health service to be structured on a national level under the conditions of the unification of East and West Germany under the premises of efficiency, optimization and savings to fulfill these needs? The head of the medical examination office in Braunschweig used the fictitious threat of viruses staged by Hollywood to back up his protest against the closure of the medical examination offices in Lower Saxony. In his eyes, the existing decentralized offices were a proven "fire department for the rapid detection of epidemics" that kept an eye on local health events. The planned centralized state health office could hardly react quickly enough to local developments, he argued. While centralization was urged at the state level, decentralization of public health service agencies was taking place at the federal level. In 1994, Federal Health Minister Horst Seehofer dissolved the Federal Health Office in the hope that the new decentralized structure would be more flexible, efficient and cost-effective. The Robert Koch Institute, former one of the departments of the Federal Health Office and now based at the Federal Ministry of Health as an independent institute, advanced to become the central institution for combating infectious diseases. At the same time medical health experts around the world became more and more aware that epidemics, and especially viruses, were a major threat to increasingly globalized societies and a question of security. The WHO called for worldwide pandemic plans in the late 1990s. The pandemic plans were intended to prepare as best as possible for a future yet unknown pandemic event. How the restructured Public Health Service institutions in unified Germany were involved into pandemic planning and setting up pandemic preparedness? The paper explores the restructuring of the Public Health Service and setting up pandemic preparedness in Germany during the 1990s and early 2000s. The state assumingly was not the sole driving force here. Rather, in view of the increasingly pluralizing health care system since the 1980s, various actors will have been involved. How e.g. the German public and NGOs discussed restructuring the public health care system and how the need for pandemic preparedness? Can the process of reorganization of the public health service and pandemic planning be understood as citizenship projects in the sense of empowering and inclusion and on the other hand of ensuring the protection of citizens?