Health Security最新文献

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.

Beginning in 2016, the Japanese Ministry of Health, Labour and Welfare (MHLW) began stationing liaisons within the US Department of Health and Human Services (HHS) Administration for Strategic Preparedness and Response to strengthen cooperation on bilateral health security engagement and collaboration. Notable accomplishments include the establishment of the US-Japan Health Security Committee and collaborations between the US-Japan Disaster Medical Assistance Team on mass event responses, such as the repatriation of American citizens from the Diamond Princess in February 2020 and the COVID-19 response. Japan has also embedded liaisons at the US Centers for Disease Control and Prevention to advance collaboration on public health. In 2021, with COVID-19 highlighting the importance of collaboration on pandemic preparedness, MHLW established a liaison program with the US National Institute of Allergy and Infectious Diseases. These liaisons with HHS agencies have paid dividends to health security collaboration, particularly by enabling greater connections between technical experts in MHLW and HHS.

Upon the commencement of their second term in 2025, the Trump Administration initiated significant policy shifts within health security, driven by an "America First" agenda. This marks a notable departure from the United States' long-standing role as a central and influential leader in global health security. Historically, the US has championed this domain through substantial financial contributions, the sharing of critical technical expertise, and the establishment and support of numerous international health initiatives. This leadership was underpinned by a bipartisan consensus that recognized global health as integral to American values, enhancing its soft power and global standing. Decades of this commitment yielded tangible progress in controlling infectious diseases, strengthening health systems in low- and middle-income countries (LMICs), and fostering essential international cooperation. However, this recent pivot in US policy carries profound implications for the established global health architecture. It is generating a cascade of both tangible and intangible consequences across various health security domains, including funding mechanisms, global health governance, preparedness and response capabilities, outcomes in LMICs, science diplomacy, US soft power, and ultimately, US national security. Given the inherent difficulty in predicting the next pandemic, global solidarity and collective international efforts are paramount. In this, effective prevention and management demand proactive, multidisciplinary preparations worldwide where continued US support and leadership through increased investment in surveillance networks, strengthened international collaboration, and data-driven decisionmaking are instrumental. There is an urgent need for prioritizing global health leadership and ensuring sensible health security policies that reverse the systematic dismantling of established public health infrastructure.

India bears a quarter of the world's tuberculosis (TB) burden. In 2018, the country set an ambitious goal to eliminate TB by 2025-5 years ahead of the global target. While India has launched several large-scale public health initiatives, including Pradhan Mantri TB Mukt Bharat Abhiyan and Ni-kshay Poshan Yojana, several challenges persist that threaten progress toward elimination. These include data transparency issues, overburdened healthcare systems, and an unrealistic timeline for achieving elimination. In this article, we highlight underaddressed health security challenges-including multidrug-resistant TB, weak biosafety infrastructure, relapse without posttreatment monitoring, environmental contributors like air pollution, and a lack of targeted strategies for tribal populations and undocumented immigrants-and call for a revised approach to TB elimination aligned with the global 2030 goal, emphasizing evidence-based policy, improved surveillance, workforce support, multisectoral coordination, and environmental and technological interventions.

Cross-border disease surveillance and response is critical for addressing the increasing burden of infectious disease outbreaks and heavy metal poisoning in West Africa, particularly between Niger and Nigeria. This study assesses the collaborative efforts of Niger and Nigeria in strengthening cross-border disease surveillance, addressing health security threats, and improving response strategies for heavy metal poisoning and infectious diseases. The West African Health Organization, in collaboration with regional partners, convened a cross-border meeting in June 2024, to bring together health experts and key stakeholders from both countries and from regional organizations. The meeting included technical sessions, working group meetings, and the development of a joint action plan. The discussions highlighted major challenges, including gaps in surveillance, delays in data sharing, and resource limitations. Key recommendations from the meeting included harmonizing surveillance tools, strengthening laboratory capacity, enhancing risk communication, and securing funding for sustainable cross-border health initiatives. Strengthened collaboration between Niger and Nigeria is essential to mitigate the public health risks associated with cross-border disease transmission. Policy actions, resource mobilization, and sustained engagement with regional and international partners are necessary for a robust and effective cross-border disease surveillance system.

Efforts to improve global health security should be a key international priority. In this commentary, I argue that while global health security is increasingly perceived as the domain of various professional and academic disciplines, ranging from global health to international relations, it is crucial to recognize it also as a value-based enterprise. Drawing on ethics literature, this commentary shows how a value-based approach is useful for analyzing ethical challenges in global health security in 4 key areas: analyzing the implicit values shaping global health security's problematic meaning, considering whether solidarity might be useful for grounding compensation for those facing an increased surveillance burden, examining how labelling outbreaks by origin can disguise questions of responsibility, and addressing how reasonable demands of nationalism are balanced. If global health security is not acknowledged as a value-based enterprise, there is a risk that those working in it will not develop the skills required to ask necessary moral questions or provide moral justifications that should be provided about their work, ultimately compromising global health security's potential to protect populations globally.

Following a nearly decade-long war in Eastern Ukraine, the conflict escalated in February 2022, and the World Health Organization swiftly began enhanced event-based surveillance (EBS) for the early detection of public health threats in Ukraine and refugee-hosting countries. The aim of this study was to assess the characteristics and trends of signals documented by WHO, especially examining how potential threats to human health in Ukraine and other affected countries were identified and presented during the first 4 months of the Ukraine crisis. The EBS process relied on the daily screening of information coming from different sources, and signals were categorized by public health risks. Between February 26 and June 30, 2022, a total of 208,484 articles were screened in the Epidemic Intelligence from Open Sources system and other sources, identifying 832 recorded signals. Most (94.1%) signals were reported within 2 days of publication of the relevant pieces of information. The most common categories of signals reported were "healthcare capacity" (n=283, 34.0%), followed by "technological hazards" (n=129, 15.5%), "population movement" (n=80, 9.6%), and "infectious diseases" (n=79, 9.5%). Among all signals, 85.5% were relevant to Ukraine. In Ukraine, the largest number of signals (20.4%) were reported from the city of Donetska. Although, resource intensiveness and appropriate balance for desired sensitivity and scope remains a challenge, EBS remains a vital surveillance method to rapidly identify potential health threats during public health events and humanitarian crises-when routine surveillance is weak or disrupted-and to contribute crucial data to guide health information management and planning.