Cooperation to Develop Health Security
SCOTT C. RATZAN
The means to safeguard the western way of living have
a significant impact in the beginning of this third millennium. The
world as we know it will be very different based upon decisions of some
key leaders.
Most of the research and academic inquiry in this Journal
is devoted to enhancing the quality and quantity of life through effective
health communication intervention. Our implicit Hippocratic oath to
‘‘do no harm’’ with our published research, while
exercising caution to beware of unintended consequences, is a central
tenet of our publication. Most of us understand the implications of
our research and the effects of our commission or omission of communication
to be amongst issues of greatest consequence.
Despite the focus on health communication, one of the
greatest risks that challenge the ‘‘world order’’
are the effects of war and the sequalae of human suffering and despair.
Nonetheless, there are those in the field of medical journal publishing
that profess medical journals have no right in discussing or meddling
in questions related to war in Iraq.1
As armed conflict is a risk factor of greatest consequence
to millions of people today, it would be unconscionable not at least
to contribute to the dialogue. Poverty, social inequality, education,
and a variety of other social/economic/political factors have an even
greater impact upon humankind than the microbes known to transmit disease.
We have lived for over half a century with the threat
of nuclear weapons. Proliferation abounds with uncertainty over the
development, ownership, and ability to deliver such weapons over long
distances. According to the United Nations report, the current threat
from Iraq does not appear to be based in possession of delivery systems
with nuclear capability.
Similarly, it is unclear if other potential ‘‘weapons
of mass destruction’’—biological or chemical weapons—are
harbored by terrorists who may have mechanisms to release them and threaten
innocent civilians. It has always been possible for terrorists to develop
microbes and chemicals from natural sources. Whether others might be
developed by rogue states or ‘‘stolen’’ from inadequately
protected foreign laboratories remains as uncertain as the evidence
on the risk of exposure to anyone. Nonetheless, decisions to protect
our ‘‘lives’’ have often been reduced to simple
slogans, fear of the consequences of exposure to such weapons (e.g.,
the smallpox scourge), and even simple personal
protective suggestions for harm reduction. (In February, 2003, residents
of the USA were urged to buy duct tape and plastic sheaths.)
If our principal goal is to combat biological terrorism
or the spread of chemical entities, developing an effective first line
global public health system of response with early detection, surveillance,
communication, and appropriate treatment interventions is critical.
The first step is in place as the World Health Organization has developed
international public health regulations and a reporting system for its
192 members. However, this could be bolstered with an international
network and system of national laboratories linked to medical and public
health interventions. This would need to be a
full-scale operation supplemented by contributions from and interaction
with the private sector as well as nongovernmental organizations such
as Doctors Without Borders.
In an era where microbes know no boundaries, we can embrace
the current focus on the threat of biological and chemical weapons as
a means to develop and strengthen a new Health Security. Detection,
surveillance, communication, and treatment response must reflect 21st
century science and execution. In addition to humanitarian values, global
Health Security capacity is in the interest of the developed world,
so that early warning systems can be in place and also serve as a type
of insurance that could hinder the creation of resistant strains. This
capacity could also enhance the fight to reduce the toll of HIV/AIDS
and other infectious diseases as well as prepare the world for future
non-communicable diseases of great proportion.
It of course, is idealistic to expect complex political
and economic conflicts will be reduced to an issue of security where
health of humankind would be of paramount interest. Regardless, we should
attempt to advance health as a common interest for positive political,
economic, and human impact, thereby contributing to stability and a
safer world. If the world were to invest in health security at only
a fraction of the cost of the military build up by the United States
alone, we would ensure a healthier world for future generations.
__________
1. Mark Graczynski, Editor, Medical Science Monitor in BMJ vol. 326. 23 Jan 2003.
Scott C. Ratzan MD, MPA, MA is Editor-in-Chief of the Journal
of Health Communication: International Perspectives. He holds academic
appointments at George Washington University School of Public Health,
Tufts University School of Medicine, Yale University School of Medicine,
The College of Europe, and the University of Cambridge.
