Health Security Volume 13, Number 1, 2015 ª Mary Ann Liebert, Inc. DOI: 10.1089/hs.2015.1112
Editorial
Health Security for the Time Ahead Tom Inglesby
W
elcome to the inaugural issue of Health Security. Over the past 12 years, this Journal has been called Biosecurity and Bioterrorism: Biodefense Strategy, Practice, and Science. It was established at the start with a focus on diminishing the public health consequences of biological threats. The title served the journal well as it developed readership and scholarship. It has been a major forum for research and the exchange of ideas related to medical and public health preparedness, medicine and vaccine development, community resilience, dual-use research, risk communication, disease surveillance, countermeasure development, and a wide range of topics in the field. Over time, the field has broadened to include the threats posed by pandemics and emerging infectious diseases, natural disasters, outbreaks of foodborne illness, health emergencies caused by the many forms of terrorism, and the potential for biological, chemical, and nuclear accidents. This larger domain of related issues and the deepening interest in expanding scholarship led us to a decision to change the title of this journal. From this issue forward, the journal will be called Health Security. Here is why . In recent years, health security has come to represent a set of goals, principles, policies, and programs related to protecting and ensuring health from epidemics, disasters, and other shocks. In the US, the federal government has defined national health security as ‘‘a state in which the Nation and its people are prepared for, protected from, and resilient in the face of health threats or incidents with potentially negative health consequences.’’1 At the international level, the World Health Organization has said that ‘‘all countries and the global community have, and actively contribute to, the information, policies, capacities, practices, and access to the resources, expertise and networks needed to keep
populations informed and safe from the important health security [my italics] related risks, hazards and emergencies.’’2 And the vision of the Global Health Security Agenda, an initiative established in 2014 and signed on to by more than 40 countries, is a world safe and secure from global health threats posed by infectious diseases—where we can prevent or mitigate the impact of naturally occurring outbreaks and intentional or accidental releases of dangerous pathogens, rapidly detect and transparently report outbreaks when they occur, and employ an interconnected global network that can respond effectively to limit the spread of infectious disease outbreaks in humans and animals, mitigate human suffering and the loss of human life, and reduce economic impact.3
Examples of the range of serious threats to the public’s health in just the past 2 years, as well as the potential for new health interventions and controversies, make clear the importance of our preparedness and response efforts.
The world’s largest outbreak to date of Ebola virus in West Africa has implications for health infrastructure, infection control, and drug and vaccine development worldwide. Ebola cases in the US had enormous societal and political consequences beyond what could have been anticipated by the limited number of cases. Analysis of how we communicated, the policies we pursued, and the impact of our efforts is critical. The new enterovirus D68 strain in the US surprised medical and public health experts with its intensity and serious clinical impact. MERS-CoV continues to spread in the Middle East, with persistent low levels of transmission.
Tom Inglesby, MD, is Editor-in-Chief of Health Security, and CEO and Director of the UPMC Center for Health Security. 1
HEALTH SECURITY FOR THE TIME AHEAD
The cases of H7N9 in Asia continue despite major efforts to eliminate it from its probable sources in live markets. The spreading Chikungunya outbreak in the Western Hemisphere shows what can happen when a new mosquitoborne virus is introduced into a population with no preexisting immunity. The growing problem of antibiotic resistance led the White House to release its strategy for combating antibiotic-resistant bacteria this past summer. The May/June 2015 issue of the Journal will devote special attention to this topic. The discovery of smallpox virus in a storage room at NIH, the accidental exposure of CDC employees to anthrax, the accidental shipment by CDC of a highly pathogenic H5N1 strain, and the accidental potential laboratory exposure to Ebola all highlight the ongoing importance of biosecurity and biosafety in the laboratory. The US government’s announcement of a moratorium on funding scientific experiments intended to create novel highly transmissible, highly pathogenic viruses has led to an important debate among scientists. The persistent challenges to developing an effective annual flu vaccine are evident again, with most circulating H3N2 viruses genetically different from the vaccine virus. The effort to develop a universal flu vaccine must continue to be a top priority. Continued weather- and flood-related changes in the world that have been linked to climate change must be anticipated and prepared for.
And of course, major health consequences are also at stake during hurricanes, earthquakes, tornadoes, and nuclear accidents in the US and abroad.
2
It is more important than ever to continue to examine scientific and technological innovations that help us pursue disaster risk reduction strategies, to strengthen our ability to prepare for and respond to emergencies, and to establish national policies and international collaborations that produce greatest benefit. Health Security is the only peer-reviewed journal dedicated to this set of issues. We will continue to encourage original contributions on issues where this journal has traditionally placed emphasis. And we will also welcome articles that examine new components of health security that have received relatively less attention and focus to date. As always, we deeply appreciate the contributions of our authors, our readers, and our reviewers and hope they will continue to turn to this journal to publish new research, new ideas, and new approaches to the way we study, prepare for, and respond to these challenges.
References 1. Frequently asked questions: health security. US Department of Health & Human Services website. Last reviewed August 26, 2014. http://www.phe.gov/Preparedness/planning/ authority/nhss/Pages/faqs.aspx. Accessed January 12, 2015. 2. About WHO: health security (HSE). World Health Organization website. http://www.who.int/about/structure/organigram/ hse/en/. Accessed January 12, 2015. 3. Global health security—vision and overarching target. http:// www.globalhealth.gov/global-health-topics/global-healthsecurity/Overarching%20Target.pdf. Accessed January 12, 2015.
Health Security
Editorial
Health Security for the Time Ahead Tom Inglesby
W
elcome to the inaugural issue of Health Security. Over the past 12 years, this Journal has been called Biosecurity and Bioterrorism: Biodefense Strategy, Practice, and Science. It was established at the start with a focus on diminishing the public health consequences of biological threats. The title served the journal well as it developed readership and scholarship. It has been a major forum for research and the exchange of ideas related to medical and public health preparedness, medicine and vaccine development, community resilience, dual-use research, risk communication, disease surveillance, countermeasure development, and a wide range of topics in the field. Over time, the field has broadened to include the threats posed by pandemics and emerging infectious diseases, natural disasters, outbreaks of foodborne illness, health emergencies caused by the many forms of terrorism, and the potential for biological, chemical, and nuclear accidents. This larger domain of related issues and the deepening interest in expanding scholarship led us to a decision to change the title of this journal. From this issue forward, the journal will be called Health Security. Here is why . In recent years, health security has come to represent a set of goals, principles, policies, and programs related to protecting and ensuring health from epidemics, disasters, and other shocks. In the US, the federal government has defined national health security as ‘‘a state in which the Nation and its people are prepared for, protected from, and resilient in the face of health threats or incidents with potentially negative health consequences.’’1 At the international level, the World Health Organization has said that ‘‘all countries and the global community have, and actively contribute to, the information, policies, capacities, practices, and access to the resources, expertise and networks needed to keep
populations informed and safe from the important health security [my italics] related risks, hazards and emergencies.’’2 And the vision of the Global Health Security Agenda, an initiative established in 2014 and signed on to by more than 40 countries, is a world safe and secure from global health threats posed by infectious diseases—where we can prevent or mitigate the impact of naturally occurring outbreaks and intentional or accidental releases of dangerous pathogens, rapidly detect and transparently report outbreaks when they occur, and employ an interconnected global network that can respond effectively to limit the spread of infectious disease outbreaks in humans and animals, mitigate human suffering and the loss of human life, and reduce economic impact.3
Examples of the range of serious threats to the public’s health in just the past 2 years, as well as the potential for new health interventions and controversies, make clear the importance of our preparedness and response efforts.
The world’s largest outbreak to date of Ebola virus in West Africa has implications for health infrastructure, infection control, and drug and vaccine development worldwide. Ebola cases in the US had enormous societal and political consequences beyond what could have been anticipated by the limited number of cases. Analysis of how we communicated, the policies we pursued, and the impact of our efforts is critical. The new enterovirus D68 strain in the US surprised medical and public health experts with its intensity and serious clinical impact. MERS-CoV continues to spread in the Middle East, with persistent low levels of transmission.
Tom Inglesby, MD, is Editor-in-Chief of Health Security, and CEO and Director of the UPMC Center for Health Security. 1
HEALTH SECURITY FOR THE TIME AHEAD
The cases of H7N9 in Asia continue despite major efforts to eliminate it from its probable sources in live markets. The spreading Chikungunya outbreak in the Western Hemisphere shows what can happen when a new mosquitoborne virus is introduced into a population with no preexisting immunity. The growing problem of antibiotic resistance led the White House to release its strategy for combating antibiotic-resistant bacteria this past summer. The May/June 2015 issue of the Journal will devote special attention to this topic. The discovery of smallpox virus in a storage room at NIH, the accidental exposure of CDC employees to anthrax, the accidental shipment by CDC of a highly pathogenic H5N1 strain, and the accidental potential laboratory exposure to Ebola all highlight the ongoing importance of biosecurity and biosafety in the laboratory. The US government’s announcement of a moratorium on funding scientific experiments intended to create novel highly transmissible, highly pathogenic viruses has led to an important debate among scientists. The persistent challenges to developing an effective annual flu vaccine are evident again, with most circulating H3N2 viruses genetically different from the vaccine virus. The effort to develop a universal flu vaccine must continue to be a top priority. Continued weather- and flood-related changes in the world that have been linked to climate change must be anticipated and prepared for.
And of course, major health consequences are also at stake during hurricanes, earthquakes, tornadoes, and nuclear accidents in the US and abroad.
2
It is more important than ever to continue to examine scientific and technological innovations that help us pursue disaster risk reduction strategies, to strengthen our ability to prepare for and respond to emergencies, and to establish national policies and international collaborations that produce greatest benefit. Health Security is the only peer-reviewed journal dedicated to this set of issues. We will continue to encourage original contributions on issues where this journal has traditionally placed emphasis. And we will also welcome articles that examine new components of health security that have received relatively less attention and focus to date. As always, we deeply appreciate the contributions of our authors, our readers, and our reviewers and hope they will continue to turn to this journal to publish new research, new ideas, and new approaches to the way we study, prepare for, and respond to these challenges.
References 1. Frequently asked questions: health security. US Department of Health & Human Services website. Last reviewed August 26, 2014. http://www.phe.gov/Preparedness/planning/ authority/nhss/Pages/faqs.aspx. Accessed January 12, 2015. 2. About WHO: health security (HSE). World Health Organization website. http://www.who.int/about/structure/organigram/ hse/en/. Accessed January 12, 2015. 3. Global health security—vision and overarching target. http:// www.globalhealth.gov/global-health-topics/global-healthsecurity/Overarching%20Target.pdf. Accessed January 12, 2015.
Health Security
