Global Workforce and Access: Demand, Education, Quality.

There has long existed a substantial disparity in access to radiotherapy globally. This issue has only been exacerbated as the growing disparity of cancer incidence between high-income countries (HIC) and low and middle-income countries (LMICs) widens, with a pronounced increase in cancer cases in LMICs. Even within HICs, iniquities within local communities may lead to a lack of access to care.

Social media video analysis methodology for sarin exposure.

As social media becomes increasingly ubiquitous, many events are recorded and released on social media platforms, including chemical weapon attacks. We develop an objective tool in order to evaluate brief and unstructured social media videos for analysing sarin exposure from a civilian medical pathology perspective. We developed and validated this new questionnaire using a standardized procedure that includes content domain specification, item pool generation, content validity evaluation, a pilot study, and assessment of reliability and validity.

Local health department planning for a radiological emergency: an application of the AHP2 tool to emergency preparedness prioritization.

Objective: We tested the Analytical Hierarchy Process tool for its use in public health to identify potential gaps in emergency preparedness by local health departments (LHDs) in California and Hawaii during a radiological emergency.

Methods: We developed a dedicated tool called All-Hazards Preparedness Squared (AHP2) that can be used by those who are responsible for all-hazards preparedness planning and response to guide them while making strategic decisions both in preparing for and responding to a slow-moving incident while it is unfolding. The tool is an Internet-based survey that can be distributed among teams responsible for emergency preparedness and response.

The four faces of microbial forensics.

The emerging field of microbial forensics played a major role in the investigation of the 2001 anthrax mailings and has been closely associated with the process of attribution, or identifying the perpetrator of a biological attack for purposes of criminal prosecution or military retaliation. Nevertheless, microbial forensics has other potential applications in intelligence, nonproliferation, and verification. This article describes the relevance of microbial forensics for a variety of law enforcement and national security missions, examines the obstacles to its broader use, and concludes with some policy recommendations.

It is hard to predict the future: the evolving nature of threats and vulnerabilities.

This paper describes the evolving nature of threats and vulnerabilities associated with biological disasters with animal origins, and introduces some of the pitfalls and opportunities associated with anticipating future threats. Evolving threats and vulnerabilities include continued deforestation and encroachment on virgin habitats, the effects of globalisation on trade and transportation, the increased interdependence and social vulnerability of modern society, the commingling of intensive agriculture and traditional farming methods, the periodic appearance of pandemics and epizootics, and indications that numerous human actors are displaying an increasing interest in and capability of using biological agents as weapons. These developments must be viewed in the context of various impediments to accurately gauging future threats, such as the appearance of new elements that depart from current trends and the inherent difficulty in anticipating human, and especially terrorist, behaviour.

A history of biological disasters of animal origin in North America.

This paper examines past occurrences in North America relevant to the possibility of biological disasters with animal origins. With respect to naturally occurring animal disease outbreaks, North America, while not as adversely affected by epizootics as other regions, has had its fair share of such outbreaks of both 'traditional' and emerging animal diseases. The traditional category includes such diseases as anthrax, classical swine fever, bluetongue, brucellosis, foot and mouth disease, and the family of equine encephalomyelitis viruses.

What non-proliferation policy for the Soviet anti-plague system?

This article analyzes the proliferation challenges posed by the Soviet AP system and discusses possible nonproliferation strategies to prevent these threats.

The anti-plague system and the Soviet biological warfare program.

The USSR possessed a unique national public health system that included an agency named "anti-plague system." Its mission was to protect the country from highly dangerous diseases of either natural or laboratory etiology. During the 1960s, the anti-plague system became the lead agency of a program to defend against biological warfare, codenamed Project 5.

Growth of the anti-plague system during the Soviet period.

The Anti-plague system experienced a dramatic expansion in Soviet times. From the dozen facilities created in the Russian Empire, it grew during the Soviet period to include over 100 facilities engaged in public health activities as well as BW-related work. This article describes how this highly responsive public health system, created to respond to natural outbreaks of dangerous diseases, became a critical adjunct to the Soviet BW program.

Genesis of the anti-plague system: the Tsarist period.

Although the anti-plague system of the former Soviet Union developed fully during the Soviet era, its foundations were laid long before the Bolshevik Revolution of 1917. This article traces the evolution of the anti-plague measures from imposition of temporary quarantine in affected areas to the creation of the standard response system and the establishment of permanent anti-plague organizations. The purpose of this article is to demonstrate that by the end of the nineteenth century and the beginning of the twentieth century, despite numerous setbacks, the Russian imperial authorities succeeded in creating a nascent system of disease surveillance dedicated to protecting the population from especially dangerous infectious diseases such as plague.

The Soviet anti-plague system: an introduction.

This article describes the composition of the Soviet Anti-plague (AP) system and presents the methodology used by the authors in their study of the AP system.

Updating the International Health Regulations.

First adopted in 1951, the International Health Regulations (IHR) provide the international legal framework for efforts to prevent and control the cross-border spread of communicable diseases. In 1995, after outbreaks of emerging infections had rendered the IHR increasingly obsolete, the 192 member states of the World Health Organization (WHO) requested a major updating of the regulations to adapt them to the highly mobile, globalized world of the 21st century. After negotiations in 2004 and 2005, the revised IHR text was adopted unanimously by the World Health Assembly, WHO's highest policymaking body.

New considerations in infectious disease outbreaks: the threat of genetically modified microbes.

Genetically altered microbes are used widely in the conduct of scientific study and have facilitated the development of new medical therapies, preventive strategies, and diagnostic tools. Unfortunately, such organisms may also cause infectious disease outbreaks as a result of accidental or intentional transmission to humans. The unique microbial properties of genetically altered pathogens and the clinical symptoms exhibited by persons infected with them may impede the usual diagnostic and clinical evaluations or preventive strategies.

A discussion of findings and their possible implications from a workshop on bioterrorism threat assessment and risk management.

In November 2001, the Monterey Institute of International Studies convened a workshop on bioterrorism threat assessment and risk management. Risk assessment practitioners from various disciplines, but without specialized knowledge of terrorism, were brought together with security and intelligence threat analysts to stimulate an exchange that could be useful to both communities. This article, prepared by a subset of the participants, comments on the workshop's findings and their implications and makes three recommendations, two short term (use of threat assessment methodologies and vulnerability analysis) and one long term (application of quantitative risk assessment and modeling), regarding the practical application of risk assessment methods to bioterrorism issues.

Verifying compliance to the biological and toxin weapons convention.

There are difficult technical problems inherent in verifying compliance to the Biological Weapons and Toxin Convention (BWC) that are making it difficult to reach international agreement on a verification protocol. A compliance regime will most likely involve the formation of an Organization for the Prevention of Biological Warfare (OPBW). Based in part on the experience of UNSCOM in Iraq, this article considers the value of establishing an OPBW and the problems that would be faced by such an international organization.

National health and medical services response to incidents of chemical and biological terrorism.

In response to the growing threat of terrorism with chemical and biological weapons, the US government has developed a national concept of operations for emergency health and medical services response. This capability was developed and tested for the first time during the Atlanta Olympic Games in the summer of 1996. In the event of a chemical or biological terrorist incident that exceeded local and state-level response capabilities, federal agencies would provide specialized teams and equipment to help manage the consequences of the attack and treat, decontaminate, and evacuate casualties.