Disease burden
Countermeasure development
Estimated 1.7 million people died from tuberculosis in 2009 [15]
“Funding for [tuberculosis] control continues to increase and will reach almost US$5 billion in 2011. … Compared with the funding requirements estimated in the Global Plan [to Stop TB], the funding gap is approximately US$ 1 billion in 2011. Given the scale-up of interventions set out in the plan, this could increase to US$3 billion by 2015 without intensified efforts to mobilize more resources” [15]
Estimated 781,000 people died from malaria in 2009 [16]
“International funding for malaria control has risen steeply in the past decade. Disbursements reached their highest ever levels in 2009 at US$ 1.5 billion, but new commitments for malaria control appear to have stagnated in 2010, at US$ 1.8 billion.… The amounts committed to malaria, while substantial, still fall short of the resources required for malaria control, estimated at more than US$ 6 billion for the year 2010” [16]
Estimated 1.8 million people died from AIDS-related illnesses in 2009 [12]
“A total of US$ 15.9 billion was available for the AIDS response in 2009, US$10 billion short of what is needed in 2010” [12]
Biodefence spending in the United States has grown from USD 0.6 billion in 2001 to USD 8.1 billion in 2005. USD 6.5 billion were budgeted for 2011 [3]
While the impact of naturally occurring infectious diseases is to a certain degree foreseeable and a lot of experience with preventing, limiting, countering, responding to, and recovering from natural disease outbreaks exists, bioterrorism events have been so rare that knowledge is largely hypothetical. Undoubtedly, bioterrorist attacks have the potential to be unexpected mass casualty events. How likely such events are, how exactly they would look like, and how best to respond remains very much debated. The uncertainty associated with the bioterrorism threat makes public health preparedness planning for such events practically and politically very difficult.
1.3 Aim and Structure of This Book
In a world of limited financial resources states can ill afford to create parallel structures for preventing and preparing for natural disease events and for human-made, deliberately caused disease outbreaks. While there are obviously a number of differences between natural and deliberate outbreaks of disease – e.g. the types of diseases involved, the extent of decontamination necessary, or the legal follow-up – there also are large areas where differences are likely to be small, in particular in the areas of detection (e.g. through disease surveillance) and non-disease-specific public health responses. After all, in both cases one deals with a disease outbreak.
At the moment, preparedness for natural disease outbreaks and bioterrorism preparedness are all too often dealt with by different actors with different approaches under different funding arrangements. Describing and comparing the existing relationships between measures to protect public health in general and measures to prepare for the unlikely but potentially catastrophic event of a bioterrorism attack, and drawing lessons for optimizing this relationship is the aim of this book.
The book focuses on countries in southeastern Europe, a region where some of the diseases caused by agents of bioterrorism concern are endemic, such as tularemia or Crimean Congo hemorrhagic fever. This region suffers regularly from natural outbreaks of bioweapons-relevant diseases. To allow a broader comparative analysis, case studies on a number of countries from outside this region are also included.
The book is divided in two parts. In the first part, the scene is set. Jonathan Tucker, a policy analyst on chemical and biological security issues, Washington, DC (USA), assesses the current bioweapons threat. Vladan Radosavljevic from the Military Academy, University of Defence, Belgrade (Serbia), offers a framework for differentiating between a biological attack and other epidemics. The differences in responding to natural and unnatural disease outbreaks are analysed by Amesh Adalja from the Center for Biosecurity, University of Pittsburgh Medical Center, Baltimore (USA).
The following three chapters address selected public health issues from a supranational perspective. Catherine Smallwood and colleagues from Health Security and Environment, World Health Organization, Geneva (Switzerland) offer WHO’s perspective on managing acute public health events. Dorit Nitzan Kaluski, WHO Country Office Serbia, Belgrade (Serbia), and Maria Ruseva, WHO Regional Office for Europe, Copenhagen (Denmark), describe the recent reforms of public health systems in countries in the South-eastern Europe Health Network. And Massimo Ciotti, European Centre for Disease Prevention and Control, Stockholm (Sweden), portrays health security and disease detection efforts in the European Union.
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
