Biological, Chemical and Radiological (BCR)
incidents in Latin America and the Caribbean
The risk is slight that a country in Latin America or the Caribbean would
be the direct target of an international terrorist act. Nonetheless, Member
States in the Region identified the need to improve the capacity of their
health services to prepare for and respond to any potential emergencies
resulting from biological, chemical or radiological (BCR) terrorism. In
the case of biological terrorism, effective and timely detection and response
in any one country is of paramount importance for the entire region. The
threat is international.
It is important to place the threat in the context of the Americas. Each
year, diseases such as respiratory infections, diarrheal diseases or a
host of other preventable illnesses claim a far greater toll than is likely
to occur from a biological, chemical or radiological terrorist act in
a Latin American or Caribbean country. Therefore, developing the capacity
of the health sector to address any sudden occurrence of epidemic outbreaks
or the release of hazardous substances, regardless of the cause, is the
most effective public health investment to prepare for acts of terrorism.
The Role of PAHO/WHO in BCR Incidents
Frequently Asked questions
What is the role of PAHO/WHO in case of civil conflict or large-scale
acts of terrorism in a Member Country?
PAHO/WHO is the specialized health agency in the Americas. PAHO/WHO provides
support and guidance to national or international institutions to reduce
the suffering and loss of life of the public resulting from any cause:
disease, poverty or disasters. Civil conflict or acts of terrorism have
direct and indirect effects on public health.
Does PAHO/WHO provide direct relief to the victims?
Normally, PAHO/WHO does not provide direct medical or health care to
the victims, but rather assists and actively supports the local health
authorities, NGOs and international organizations who are responding to
the needs. PAHO/WHO’s assistance helps to improve the quality, effectiveness
and coordination of the health response.
How does PAHO/WHO contribute to improving the response?
Before the acute emergency, PAHO/WHO, as a development
agency, helps the health sector to reduce its vulnerability and prepare
to respond promptly and effectively. PAHO/WHO’s cooperation ranges
from advocacy and lobbying for resource allocation for health preparedness
to advice in preparing disaster plans, training responders (hospital personnel,
water providers, environmental health experts, epidemiologists, etc.),
conducting simulation exercises and drills and post-disaster evaluation.
During the acute emergency, PAHO/WHO mobilizes
its extensive network of experts (in-house experts, consultants or reference
centers) in any possible area of health expertise—from toxicology
to disease control—and provides health responders and especially
the local authorities with the guidance, advice or expertise they may
PAHO/WHO also coordinates the international health response with the country:
identifying unmet needs, preventing duplications or misguided and counterproductive
forms of assistance.
Finally, PAHO/WHO mobilizes financial resources to provide material
support to the local health or water institutions in their disaster relief
But does PAHO/WHO also provide technical advice to the general public
or concerned individuals?
PAHO/WHO has technical guidelines and recommendations on many health
topics, including the management of emergency response, which are available
to the public. They are published and/or posted on our web site.
These guidelines are based on the experience of many international experts.
They provide the scientific basis and policy framework for the practical
recommendations/instructions issued by the local authorities who best
know the local needs, culture and requirements.
PAHO/WHO, normally, is not equipped to provide a customized reply to
individual queries on preventive or curative measures to be taken in a
specific terrorist act or conflict.
PAHO Guiding Principles for Prevention and
Response to BCR Incidents
The prevention and response to bioterrorist acts is one of the most important
concerns in the world. The role of PAHO is to guide the countries of Latin
America and the Caribbean in preparedness and response to an eventual
terrorist attack, by providing them with technical support and making
recommendations, PAHO wants to strengthen the capacity of the countries
to face biological terrorism. To maintain a technical credibility and
leadership without taking part of the spread of paranoia, it is essential
to clarify the position and the role of PAHO.
Prevention of terrorist acts is a security matter for
national governments either individually or collectively. PAHO can contribute
through, for instance, its current efforts to improve the security in
biological laboratories or the safety of the transport of hazardous substances.
Preparedness of the health sector to respond to biological/chemical/radiological
terrorism is best done by strengthening the everyday local health capacity.
An improved capacity to detect and respond to all types of epidemics,
and chemical or radiological emergencies should be the prime objective.
Specific considerations resulting from the purposeful cause of the event
should be considered by and included in the disaster plan and training,
but not justify a distinct separate organizational approach by the health
authorities and PAHO.
Response to terrorist acts, especially occurring outside
North America, will pose a definite challenge to PAHO who most likely
will be called to provide technical support and coordination. From a management
point of view, the challenge to and demands on PAHO can best met by using
similar channels, mechanisms, and responses used for major chemical, biological
and radiological accidents. Unfamiliar technical requirements and security
considerations will only add an additional layer of complexity to the
“normal” chaotic and emotional scene of a disaster.
Documents and Studies
Events and Meeting
Conclusion of Advisory Meeting on Bioterrorism
Oct. 24, 2001
PAHO began a broad process of consultation with its Member Countries
to respond to requests for assistance to help prepare for and respond
to BCR terrorism. On 24 October 2001, PAHO convened an Advisory Meeting
on Bioterrorism. Experts discussed potential scenarios and developed recommendations
to strengthen the capacity of the countries to face biological terrorism.
Read the Conclusions of the Advisory Meeting
Workshop: “Health Sector Preparedness for Biological, Chemical
and Radio Threats”
Costa Rica, December 7, 2001
After this important workshop, PAHO prepared a CD-ROM to facilitate collaboration
in strengthening the health sector’s ability to respond to and prepare
for the possible impacts of biological, chemical or radiological/nuclear
terrorist attack All the information was compiled until the month of December
of the 2001, utilizing as sources specialized international and national
The contenst of the CD-ROM
can be viewed here. The expressed opinions, formulated recommendations,
and utilized denominations do not reflect necessarily the criteria of
the policy of PAHO/WHO and of its Member States.
Workshop: “Management of the Health Consequences of a Terrorist
Panama, June, 2003
The Southern Command of the United States of America with technical cooperation
of the Pan American Health Organization sponsored the implementation of
the Workshop: "Management of Consequences in Health by Terrorist
Acts", it was developed in City of Panama from 10 to 13 June 2003.
This workshop was directed to the staff members responsible for this subject
in the Ministries of Health, Ministries of Defense, and National Organizations
of the Management of Disasters of the Central American countries. The
principal objective of the workshop was to strengthen the coordination
among the different components of the alert, identification and control
of the results of terrorism over the health of the population.
For additional information on the workshop, there is a CD-ROM
that compiled attached sampling of research, resources materials related
to BCR terrorist acts. We hope that these materials will prove useful
to policy-makers, researchers, and, more generally, people throughout
the region that seek to promote the capacity of the health sector to address
any sudden occurrence in this matter.
Ministers at PAHO Meeting Discuss Bioterrorism Preparedness
Washington, D.C April 25, 2003
Deliberate contamination of food with chemical or biological agents can
occur at any point in the food chain, from the farm to the table, with
dramatic potential impact for the public health of the populations. More
information about the meeting.
Related Outside Links
Biological warfare, bioterrorism, biodefence and the biological and
toxin weapons convention
Bioterrorism and Health System Preparedness: Series of Audio conferences
for State, Local and Health Systems Policymakers, 2003
Agency for Healthcare Research and Quality
Latin America Workshop on Threats to Bioterrorism and other Threats to
Public Health, September 29 October 3, 2003. Cuernavaca, México
(Link to information on the workshop)
Center for the Study of Bioterrorism
They have been producing educational material designed to assist in the
mitigation of and recovery from bioterrorist events.
National Association of County and City Health Officials: “Elements
of Effective Bioterrorism Preparedness”