Iris Hunger, Vladan Radosavljevic, Goran Belojevic and Lisa D. Rotz (eds.)NATO Science for Peace and Security Series A: Chemistry and BiologyBiopreparedness and Public Health2013Exploring Synergies10.1007/978-94-007-5273-3_19© Springer Science+Business Media Dordrecht 2013
19. Concluding Remarks
(1)
Research Group for Biological Arms Control, Carl Friedrich von Weizsäcker Centre for Science and Peace Research, University of Hamburg, Hamburg, Germany
(2)
Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
(3)
Institute of Hygiene and Medical Ecology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
(4)
Military Academy, University of Defence, Belgrade, Serbia
(5)
Medical Corps Headquarters, Army of Serbia, Belgrade, Serbia
Abstract
The case studies collected in this book illustrate the considerable differences in bioterrorism threat perception, levels of biopreparedness, and views on how to balance general public health efforts and biopreparedness measures. While investing too little in biopreparedness leaves countries ill-equipped for a potential disaster, spending too much might create a threat in itself, for example, by redirecting resources away from dealing with everyday health threats. Countries, regardless of perceived threat or economic capacity, should aim to develop and maintain a public health system capable of a well-planned, well-rehearsed, and rapidly executed response to natural health emergencies. Such a system will diminish the consequences of both a naturally occurring health emergency and a bioterrorist attack, should it occur.
The findings and conclusions in this chapter are those of the author and no not necessarily represent the views of the Centers for Disease Control and Prevention.
How to balance efforts to improve public health in general with efforts to counter bioterrorism has been a concern of experts at least since the anthrax letter attacks in the USA in 2001. Finding this balance is particularly difficult, because – as the case studies in this book illustrate – the agents of public health concern match agents of bioterrorism concern only to a very limited degree. Even regarding just the agents of bioterrorism concern, there is little agreement about which agent is of high, low, or no concern. An impressive number of agent lists exist in both the public health and counterterrorism areas, sometimes several lists in one country.
Bioterrorism events (excluding hoaxes) are a subset of health emergency events. They are part of the group of unexpected, rare disease events that challenge public health systems globally and continuously. Examples of such unusual disease events are imported cases of dangerous infectious diseases such as a Lassa fever case in Germany in 2000 [3], cases of rare diseases such as anthrax in intravenous drug users in 2009–2010 across Europe [1, 2], the appearance of dangerous new diseases such as SARS in 2003 [4], or cases of known diseases with unfamiliar characteristics such as enterohaemorrhagic Escherichia coliO104:H4 infections in Germany in 2011 [5]. None of these were known to be intentionally inflicted. Nevertheless, they were unusual because they concern known diseases that normally do not occur in a country, emerging diseases, or diseases exhibiting new characteristics. Such disease events challenge prevention, detection, diagnostic, and treatment capabilities of public health systems.
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