"Vulnerability is universal," wrote Margaret Chan, director-general of the World Health Organization (WHO), in The World Health Report 2007. The words ring even truer today. Heightened concern about the 2009 influenza pandemic, the rapid global spread of anti-microbial-resistant organisms and even the popularity of Contagion, a film featuring a lethal airborne virus, capture this sentiment.
Global public health has become a national-security and foreign-policy issue. Rapid transportation of people, diseases and information has increased public-health threats--from emerging influenza strains to bioterrorism--that cannot be managed solely through conventional practices such as isolation and quarantine. Effective global disease surveillance, timely detection of outbreaks and appropriate responses that help to control epidemics are the essential tools of public-health security.
Here, civilian organizations have much to gain by working with the military. While many public-health agencies struggle for funds, the militaries of various nations are investing in public-health security. Military scientific efforts towards characterization, prevention and vaccine development for emerging infectious diseases, for example, improve the lives of civilians as well as soldiers, in peace and war.
But tensions can arise from the different priorities of civilian and military groups. Our experience leading US military disease surveillance activities leaves us convinced that such vital collaborations can succeed if there is transparency and trust on all sides.
FROM SOLDIERS TO CITIZENS
Armies have long worked to prevent their personnel from contracting or spreading diseases, in the process making seminal contributions to public-health security that also benefit civilians. Ronald Ross, a British officer in the Indian Medical Service in the late nineteenth century, was the first to work out that Anopheles mosquitoes transmit malaria to humans. During the building of the Panama Canal at the start of the twentieth century, US Army researcher Walter Reed made discoveries about yellow fever that helped to control the disease and allow the completion of the construction, which opened new trade routes. US Army scientists developed vaccines for hepatitis A in the 1990s and hepatitis E in the 2000s (1). And in 2009, working with local Thai officials and others, US Army scientists developed the first vaccine to partially protect against HIV (2).
Indeed, the US Department of Defense (DOD) dedicates hundreds of millions of dollars every year to understanding infectious diseases and pathogens worldwide. Since 1997, the DOD Global Emerging...
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