opinionWar

A Bitter Pill: Fake Drugs and Global Health Security

There is an emerging discourse in the security field regarding health security and how issues within the realm of defense intersect with public health. In my own career, having focused on biological warfare, the overlap between weaponizing of viruses and bacteria and the effects and response of health authorities to disease outbreaks is apparent. In the era of swine and bird flu, SARS, and Ebola pandemics and the deployment of civilian and military personnel in response, it is clear that the threat to public health these afflictions represent is also a threat to national security. These international health threats receive much media attention. However, there is another threat to health security (and therefore national security) that receives less attention despite possibly having even more dangerous international repercussions: Fake drugs.

Not Just Ebola

Those of us working in the counter-terrorism and chemical, biological, radiological, and nuclear (CBRN) defense fields are awfully worried about things like Sarin, Anthrax, and Ebola. In truth, these are not going to kill us all and, even in worse case scenarios, they are not even likely to have a major effect on the vast majority of us, especially in the developed world. However, something like super-resistant tuberculosis spreading across North American and Europe or the return of drug-resistant malaria to areas where it had been eradicated should scare the hell out of us all.

It is important to keep threats like Ebola in proper perspective. Make no mistake: Ebola is a scary and lethal disease. But it has a basic reproductive number (the mathematical calculation of its ability to spread) that is quite low and Ebola outbreaks are most often stopped quickly if basic body substance isolation and infection control procedures are used.  Ebola, a disease found solely on the African continent, kills many. But it is illustrative to look at other causes of death in Africa which are responsible for many more casualties each year.  People in Africa die from many other infectious diseases every year: HIV (1M+), diarrheal diseases (600K+), Malaria (500K+), Meningitis (240K+), Tuberculosis (200K+), and neonatal sepsis and infection (170K+), to name only the primary offenders on the list.

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