Public health aspects of bioterrorism

While deliberate infliction of injury, other than in self-defence, runs contrary to almost all social norms, there is a special kind of abhorrence and dread associated with the use of biological agents. Many possible reasons for this can be suggested. The agents are ‘invisible’, they can cause injury indiscriminately and not only to those targeted and they can inflict disease and death in numbers quite out of proportion to the resources expended. Furthermore, their effects may only be experienced long after exposure and they may cause large outbreaks through person-to-person spread. Prior to the twentieth century, there were documented instances of crude attempts to use biological agents as weapons of war. For example, there are several reports of bodies of plague victims being hurled into the enemy ranks in order to infect their forces. There is also some evidence to suggest that European colonists in the Americas either actually used, or intended to use, ‘smallpox’ infected blankets to infect the native populations, who were previously unexposed (Patterson ＆ Runge 2002).

The public health approach to the prevention of bioterrorism includes identifying the causes of terrorism and evaluating appropriate preventive strategies at the most basic level. The causes are likely to be multi-factorial. Political elements frequently dominate and the distinction between terrorist and ‘freedom-fighter’ is often blurred. There is no generic cause of terrorism. Poverty and deprivation can provide fertile ground for recruiting members to a terrorist organization. In addition to reducing ethnic and religious tensions, an international goal should be to ensure that there are adequate processes for non-violent resolution of differences. At a government level, there needs to be a clear, universal condemnation of terrorism as a means of achieving change. Rather, emphasis should be placed on searching for common ground between groups.