Change in Public Health Perceptions

In the 1990s, the collapse of the Soviet Union left many Soviet-era biological weapons facilities vulnerable to theft while globalization provided new linkages to transport materials and sell technology across borders to non-state actors searching for unconventional means of intimidating governments. Simultaneously, a string of bioterrorism attempts internationally in the 1980-90s redefined bioterrorism not as a deterrent or a last-resort, but a powerful threat to the authority of the world powers that created these weapons in the first place. Response to a biological threat became both a health, military, political, and economic issue that the United States responded to by putting the military in charge of much public health response funding.

Case Study: 1990s US Response Policy Reforms

U.S. National Guard practicing a response to a bioweapons attack.

Responding to the new threat of bioterrorism, Presidential Decision Directive 39 (PDD-39, June 1995) defined responsibilities for federal agencies in the event of a biological attack.

The Federal Bureau of Investigation (FBI) was assigned lead responsibility for resolving immediate emergencies and crime scene investigation to gather evidence to prosecution perpetrators. The Federal Emergency Management Agency (FEMA) and the Office of Emergency Management Preparedness (OEP) were to coordinate health and medical services in the event of an attack. However, the Defense Against Weapons of Mass Destruction Act (1997) allocated the majority of health and medical response funding to the Department of Defense (DOD), tasked with developing domestic preparedness training programs for local, state and federal agencies on how to cope with chemical, biological, radiological, and nuclear (CBRN) threats. Finally, military responsibility for response falls on the site’s corresponding regional National Guard Rapid Assessment and Initial Detection Teams (10 in total) and the Marine Corps Chemical and Biological Incident Response Force.

Future Direction for Bioterrorism Response?

This demonstrates how fear of an unknown attack motivates more funding for the defense budget, which can at time become a black box. An alternative could be funding transparent public health and medical programs or addressing systemic public health inequalities that a biological weapon attack would exacerbate.