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Biological, Chemical and Radiological (BCR)
incidents in Latin America and the Caribbean

Introduction

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 need.

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 effort.

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

Introduction

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 on Bioterrorism.


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 organizations.

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 Act”
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.


Other Material from PAHO on BCR


Related Outside Links

Biological warfare, bioterrorism, biodefence and the biological and toxin weapons convention
www.ejbiotechnology.info/content/vol2/issue3/

Bioterrorism and Health System Preparedness: Series of Audio conferences for State, Local and Health Systems Policymakers, 2003
Agency for Healthcare Research and Quality
http://www.ahrq.gov/news/ulp/ulpdistn.htm

Latin America Workshop on Threats to Bioterrorism and other Threats to Public Health, September 29 October 3, 2003. Cuernavaca, México
http://www.onr.navy.mil/onr/conferences/bio_terror/ (Link to information on the workshop)

Center for the Study of Bioterrorism
http://www.bioterrorism.slu.edu/
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”
http://www.naccho.org/files/documents/Final_Effective_Bioterrism.pdf