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Professor C Kameswara Rao
Foundation for Biotechnology Awareness and Education
Bangalore 560 004, India

In the developing countries, the level of scientific/technical expertise, infrastructure and preparedness to face sudden and unforeseen threats to health security even from periodical outbreaks of diseases is alarmingly low.   Anticipating health risk, its assessment and mitigation leave much to be desired.  Awareness of dual use life science research concern (DURC), its preparative and remedial action is lacking even among the professional and administrative circles, who should know better. 

The Governments and health personnel are often unprepared, helpless and lost in times of crisis from even routine incidents.  Vast numbers of the population are extremely vulnerable to conventional disease outbreaks, resulting in an enormous human tragedy.

It would take a decade for advancements in life sciences/biotechnology that would make significant difference to pathogen diagnostics, preventive and management protocols in the form of vaccines, antibodies, etc., to reach the developing countries.   By that time new developments would have replaced them in the west, leaving the developing countries chasing technological innovation forever.

The inadequacy of awareness and preparedness to face biological disasters was acutely reflected by several events such as the repeated bird flu outbreaks in several developing countries in the recent past. 

In India, the Surat plague epidemic, outbreak of epidemics following earthquake in Gujarat, and several other disasters, have reiterated the need for concerted action. The confusion and panic on epidemic outbreaks at the periodical and/or annual religious events at auspicious rivers where millions congregate have repeatedly shown the inadequacy of preparedness of public health authorities, and not enough lessons seem to have been learnt from the past nightmares.  

In order to prepare the developing countries, even marginally,

a) to foresee and face unexpected events,

b) to avoid wasteful duplication of technical and financial resources,

c) to enable them to adopt new technology sooner than later, and

d) to minimize, if not totally avoid, the confusion and panic that prevails in times of biological disasters that pose a serious risk to health security, the following international organizations need be set up:

1. An International Organization with units in different countries to

a) share and provide state of the art technical know-how, and

b) to co-ordinate and monitor diagnostic, preventive and remedial action, and

2. An International Funding Body to provide financial support to prevent human tragedy for want of technical know-how and financial resources.

The mandate of these organizations would be to facilitate

a) Improvements in state and local surveillance infrastructure, such as establishment of Biodisaster Control Centres, to perceive and handle bioterrorism and biowarfare threats from conventional or modern technologies;

b) Survey major hospitals for supplies of antidotes, drugs, ventilators, personal protective equipment, decontamination capacity, mass-casualty planning and training, isolation rooms for infectious disease, and familiarity of staff with the effects and treatment of biological threats;

c) Encourage governmental and private agencies engaged in health and medical R&D to share their information on

i) diseases, ii) diagnostics iii) drugs, iv) personnel, v) resources, and vi) on the sources of threats to health security and protocols to mitigate threats;

d) Convene discussions among the appropriate agencies making them aware of current developments and on the use of investigational products in mass-casualty situation and on acceptable proof of efficacy for products where clinical trials are not ethical or are otherwise impossible;

e) Develop incentives for both public and private hospitals, to be receiving hospitals, to stockpile antidotes and selected antitoxins and make them available to the first responders, by changing laws if needed;

f) To purchase appropriate personal protective equipment and expandable decontamination facilities and train emergency department personnel in their use;

g) Provide for state and central training initiatives with a programme to incorporate existing information on threats to health security and their preventive and treatment methods into the manuals and reference libraries of first responders, emergency departments and biotoxin control centres; and

h) Intensify Public Health Service efforts to organize and equip Urban Medical Response Teams and Community Response Teams, in high-risk cities and other locations, throughout a country.

These measures would enhance the general ability of governments, public health authorities and the communities, to cope with mass-casualty events.

In view of its expertise, influence and reach, the WHO is best suited to recommend and oversee the implementation of the suggested measures.

*The Foundation for Biotechnology Awareness and Education is a Registered non-profit organization working since January 2001, to enhance levels of awareness, and standards of education, of modern biotechnology.