Health Security最新文献

For over half of its lifespan, the Biological Weapons Convention (BWC) operated without any dedicated continuous institutional support. This shortcoming was finally remedied at the Sixth Review Conference in 2006, not long after the convention's 30th anniversary. The Implementation Support Unit (ISU) created by that Review Conference has now been in existence for almost 2 decades. This year also marks the 50th anniversary of the convention-an appropriate moment to make some observations on the contribution of the ISU to the overall development of the BWC. In this commentary, we examine the efforts made over the years to equip the BWC with stronger institutional support and provide a description of the establishment of the ISU in 2006. We also summarize some key achievements of the ISU alongside some of the challenges that it has faced. Finally, we conclude with reference to the ongoing discussions within the Working Group on the Strengthening of the Convention to endow it with a more robust institution.

This study evaluates South Korea's legislative amendments related to infectious disease after the 2015 Middle East respiratory syndrome (MERS) outbreak and how they were applied during the COVID-19 pandemic. A significant legal case after the 2015 MERS outbreak highlighted the government's liability due to inadequate response, which led to amendments in the Infectious Disease Control and Prevention Act. Key revisions included changes to epidemiological investigations, information disclosure, and requests to provide information. This study reviews the application of these amendments during COVID-19, focusing on related litigation and Korean courts' decisions. Additionally, it examines South Korea's efforts after COVID-19, which aim to balance effective infectious disease responses with personal information protection, incorporating lessons from past outbreaks. The study concludes that continuous legal and systemic improvements focused on the specific circumstances are crucial for managing future infectious disease crises, highlighting the need for a legal framework that maximizes the beneficial aspects of being able to curb the spread of infectious disease while minimizing the problematic issue of personal information infringement.

The COVID-19 pandemic exposed vulnerabilities in health systems' abilities to detect, report, and respond to threats. Inadequate preparedness led to healthcare worker infections, essential service disruptions, and impacts on communities. Primary healthcare (PHC) is often overlooked in health security initiatives. Epidemic Ready Primary Health Care (ERPHC) is an initiative that strengthens PHC facilities to prevent, detect, and respond to outbreaks, while maintaining essential services. ICAP at Columbia University, the Sierra Leone Ministry of Health, and Resolve to Save Lives is implementing a multiyear ERPHC project in Sierra Leone. We conducted a retrospective data review of 52 confirmed measles cases across 4 PHC facilities from January to March 2024. Data are presented using an adapted 7-1-7 quality improvement approach for detection and notification to evaluate the key tenants of ERPHC: speed, safety, and surge. Out of the 52 confirmed cases, 98% and 100% met the first "7" and "1" for detection and notification. Immediate case management and safety actions were completed for all 52 cases. None of the facilities were able to implement 2 readiness parameters for surge: sufficient supplies and referral pathways. Key bottlenecks included patient late presentation to health facilities, delayed notification via the electronic case-based surveillance system, inadequate personal protective equipment availability, and no updated referral pathways. These results underscore the need to scale and implement ERPHC in PHC facilities using adapted 7-1-7 metrics. Healthcare worker safety, increased community engagement, national supply chain mechanism strengthening, and established patient referral pathways need to be the foci of further health security investment in Sierra Leone.

The Biological and Toxin Weapons Convention (BWC) celebrates its 50th anniversary in 2025, a historical milestone for the first treaty to ban an entire class of weapons. Despite major shortcomings and barriers, the BWC remains a stalwart bulwark against the deliberate misuse of biology. In this special feature, experts from around the world highlight critical challenges and opportunities for the BWC, honoring the treaty's first half-century and drawing lessons from past experiences, but more importantly, looking ahead to envision the next 50 years of biological weapons disarmament and nonproliferation.

Biological weapons can take many forms and have been designed for a variety of purposes, including-but not limited to-attacks on human populations. The 1972 Biological Weapons Convention has played a key role in the comprehensive prohibition and prevention of such weapons over the past 50 years. To sustain this prohibition into the future, states parties to the treaty must carefully monitor advances in science and technology, while also remaining vigilant against the risks posed by older, outdated forms of biological weapons.

In the absence of formal inspection protocols, states parties of the Biological Weapons Convention (BWC) continue to trade unsubstantiated accusations undermining confidence in the BWC and fueling geopolitical distrust. This commentary argues that open-source intelligence (OSINT) offers a vital, albeit imperfect, solution to enhance BWC compliance in this environment. It also discusses 2 primary ways OSINT can contribute. First, by providing transparent, verifiable evidence to support or refute compliance allegations, OSINT can mitigate credibility challenges associated with state-issued intelligence. This is made possible by ever-expanding publicly available data streams from high-resolution satellite imagery to publication and patent databases and publication records. Second, OSINT empowers civil society organizations to monitor bioscience activities, expose suspected violations, and exert public pressure for accountability. Although OSINT cannot fully substitute for onsite inspections or confirm intent, embracing OSINT as both a technical resource and an advocacy tool offers a practical pathway to strengthen BWC compliance and reinforce the norm against biological weapons.

New verification approaches are needed to strengthen compliance and build transparency under the Biological Weapons Convention (BWC). This study considers how blockchain technology could support laboratory oversight by addressing issues like data integrity, traceability, and secure data sharing in facilities handling sensitive biological materials. Low submission rates of confidence building measures currently limit the impact of the BWC. Blockchain's decentralized, tamper-resistant ledger brings security and openness critical for international collaboration in biosecurity. Using blockchain, laboratories can establish unalterable records that build accountability and trust among stakeholders while lowering the risk of data manipulation. This system also supports cooperative investigations under Article V of the BWC by providing a secure platform for sharing sensitive biological data between states. Key benefits include more substantial information reliability, better control over access, and the ability to trace biological materials' origins and uses, helping distinguish lawful activities from illicit ones. These improvements support BWC compliance by allowing for selective and privacy-conscious data sharing. Challenges such as scalability, technical training, balancing data security with transparency, and securing long-term funding must be addressed through thoughtful planning and cooperation. As BWC member states seek stronger compliance measures, integrating blockchain provides a solution that could significantly support global biosecurity over the next 50 years.

Over the past 5 decades, the Biological Weapons Convention (BWC) and the broader biosecurity agenda have evolved significantly, shaped by the widespread and rapid development of emerging science and biotechnologies. This evolving landscape demands more inclusive governance mechanisms and has driven scientific communities and networks of nonstate actors to play a crucial role in shaping biosecurity governance, thereby paving the way for a new approach for the BWC in the coming decades. In this commentary, we explore innovative approaches to strengthening global biosecurity governance by emphasizing the role of scientific communities and networks of new actors in enhancing the BWC's framework. We identify 5 key approaches for advancing biosecurity by analyzing cases we observed: (1) exploring governance strategies and providing early warning for emerging technology risks, (2) promoting biosecurity by design and responsible innovation, (3) capacity building through grassroots networks of new actors, (4) building action networks based on knowledge sharing and collaboration for rapid response to biosecurity risks, and (5) engaging in science diplomacy and bridging governance gaps. Building on the analysis of the linkages between these innovative approaches and the BWC, we seek to offer a forward-looking vision for revitalizing the BWC by incorporating efforts through a well-designed bottom-up mechanism, ensuring a more inclusive, collaborative, and proactive biosecurity governance framework in the coming decades.

The Biological Weapons Convention (BWC) was the first international disarmament treaty to eliminate an entire class of weapons. As it celebrates its semicentennial, the BWC is recognized for enshrining norms against the misuse of biology, even during the height of the Cold War: norms that encapsulated humanity's repugnance of bioweapons. Nevertheless, the BWC faces unique challenges compared to other disarmament treaties, such as the Nuclear Non-Proliferation Treaty or the Chemical Weapons Convention. These include debates around verification, sociopolitical friction across the states parties, and even accusations that states parties have maintained biological weapons programs despite their treaty obligations. Many experts note difficulties in strengthening the BWC, particularly in a multipolar, competitive geopolitical environment. One potential pathway to support the BWC is using open-source information collection, analysis, and methods applied toward a "layered approach to verification [which] could help build confidence in compliance and potentially verify the BWC." Colloquially known as open-source intelligence (OSINT), this intelligence-gathering discipline uses publicly available information and signals sources for fact-checking, investigating suspicious occurrences, and examining items of interest. This approach has shown promise in other weapons of mass destruction applications, from tracking and tracing Syrian and Russian use of chemical weapons to uncovering nuclear weapons arsenals. Further, as stakeholders generate and retain more biological data from multisource samples, now is an opportune time to examine how open-source information and methods might mitigate bioweapons risks. This is particularly germane to the present, as people explore OSINT information and methods as 1 tool to both help strengthen the BWC architecture and support transparency and norm-setting efforts outside of the treaty.

Health quarantine officials play a critical role in safeguarding public health and preventing infectious diseases at Vietnam's air, land, and sea points of entry. While previous evidence suggests that knowledge, attitudes, practices, and experiences are interrelated, many interventions in Vietnam have focused solely on improving infection control knowledge. This study aimed to assess the correlations between knowledge, attitudes, practices, and experiences and identify variables associated with higher levels of these domains to inform more effective interventions for strengthening infection control capacity. We conducted a cross-sectional survey of 618 health quarantine officials across 163 points of entry using a self-reported web-based questionnaire. To ensure reliability and validity of the questionnaire, we used Cronbach α, McDonald ω, and confirmatory factor analyses. Path analysis and a generalized linear model with a gamma distribution were used to establish relationships between knowledge, attitude, practice, and experience, and identify associated sociodemographic factors with higher levels of these domains. The final analysis included 378 valid responses, representing 61.2% of Vietnamese health quarantine officials. Our instrument demonstrated good reliability and validity. Path analysis revealed a significant positive effect of attitude on practice (direct coefficient 0.82; 95% CI, 0.64 to 1.01; total coefficient 0.86; 95% CI, 0.68 to 1.04). Attitude also showed a significant positive association with experience (coefficient 0.62; 95% CI, 0.36 to 0.89). A positive attitude emerged as a key factor in enhancing experience and practice of infection control, highlighting the need for targeted interventions that foster positive attitudes while considering certain socioeconomic factors affecting willingness to change.