Natural and unnatural infectious disease threats
Threats from infectious disease can be broadly divided into two categories, the known threats from established naturally occurring infectious diseases and the unknown threats from emerging diseases, laboratory accidents, disasters, and deliberate acts. In addition to managing the daily disease burden, animal health and human health systems must be prepared against the unknown threats. Often we are only aware of the importance of having strong health systems when it is too late, once the Health Services are struggling to cope with consequences of an unlikely and unpredictable event.
Recent examples of emerging and re-emerging infectious diseases highlight how ineffective we have been at predicting when and where new diseases will emerge or where existing ones will resurface. Some of these examples also highlight how quickly weak health systems can become overwhelmed. Although we are only just beginning to understand the complex interaction of factors that lead to disease emergence, it is becoming clear that climate change and man’s disturbance of ecosystems will facilitate the emergence of more and more infectious disease threats.
Animal and human Health Services also need to be prepared against existential threats. Physical disasters are constantly reminding us how natural (tsunamis, extreme weather, earthquakes) and unnatural (conflicts, industrial accidents) events disrupt or destroy the infrastructure that we rely on every day to keep infectious diseases under control.
Naturally occurring day to day infections are by far the most common cause of disease outbreaks and have the greatest impact world-wide. However, history has shown us that the less likely and potentially devastating threats from bioterrorism and laboratory accidents are real and should not be ignored. As long as there is political instability in the world or a threat from non-state actors, including terrorists, there is a risk that naturally occurring or engineered pathogens will be used as bioweapons agents. Most pathogens that have been used, or considered for use, as bioweapons agents have been animal pathogens due to their severe impacts on health, economies, social stability and trade, and their ready availability. Poor compliance with laboratory biosecurity increases the likelihood that dangerous animal pathogens and zoonotic agents will fall into the wrong hands, as well as creating the very real possibility that dangerous infectious agents will be accidentally released.
Over the last century, technology has helped us to get a better understanding of disease evolution; it has also provided us with better tools to detect and control disease. However, technological advances, including developments in synthetic biology, have created further scope for the misuse of science.
International standards for strong health systems
At the international level, the World Health Organization (WHO) and the World Organisation for Animal Health (the OIE) have longstanding and robust frameworks (WHO’s International Health Regulations and OIE’s International Standards) under which their Member Countries are obliged to report disease outbreaks, to control them, and to build resilience against biological threats. These internationally adopted standards are the basis for global infectious disease prevention and control, including early detection and rapid response to biological events, and for strong animal health and human health systems. Compliance with these international standards ensures resilience against all infectious disease threats because the tools and systems used to detect diseases early and to control them quickly are the same whether the cause is natural, accidental or deliberate.
Unfortunately many parts of the world suffer from weak health systems (which do not comply with WHO and OIE standards) and several recent examples have demonstrated how quickly disease outbreaks can overwhelm health systems that have poor governance and are lacking infrastructure. To counter biological threats in a sustainable way, the security community has engaged with the health community to support their efforts to strengthen health systems and bolster scientific networks.
Synergies between health and security
The relationship between health and security is of course a two-way street. Lapses in security or social unrest may increase the chance of a potentially devastating bioterrorist attack or a laboratory accident. On the other hand, infectious disease outbreaks may lead to social unrest or instability, particularly if they disrupt social infrastructure or reduce food availability, or if they create fear and panic.
Whilst security risks and health concerns may overlap, the two are not always perfectly aligned. Therefore, it is vital that the human and animal health sectors work together with the security sector to assess priorities and maximise the efficient use of resources, so that the burden of infectious animal diseases and zoonoses from natural or unnatural origins, can be reduced and, at the same time, biological security is strengthened.