World Federation of Scientists, Erice, Italy, August 2012
Striving for Global Health and Water Security:
Achievable or Not?
Dr. Annette Sobel, M.D., M.S.
University of Missouri, USA
Departments of Community and Family Medicine, and
Electrical and Computer Engineering
BACKGROUND
Current events underscore the need for robust critical infrastructure to ensure
economic growth and regional stability in emerging nations. India’s recent
massive power failure (July 30-1 August 2012) spotlighted the challenges and
opportunities due to an asymmetry of infrastructure investment to population
growth, yet was a testament to the wonderfully peaceful culture of the Indian
people (The Economist, p.35-36, August 4, 2012). Power, water, food, and health
security policy enable the lifeblood flow of every economy.
All-source research performed for the U.S. Department of State (Multiple Sources,
Bureau of Intelligence and Research, DoS, October 2011) strongly supports the
conclusions that water policy is linked to long-term impacts in economic
development, regional stability and vulnerability to terrorist actions. Current
research typically selects 2040 as the endpoint for high confidence predictive
analysis. A longstanding medical truism adopts low (less than one per cent)
perinatal mortality as one of the most predictive indicators of a country’s
emergence and regional stability.
Global health security (the intersection of public health and biosecurity)
necessarily includes water, food and power security and the associated critical
infrastructure and virtual information security enablers. Similarly, human security
implies sufficient access to clean food, water, power, and infrastructure including
World Federation of Scientists, Erice, Italy, August 2012
shelter, health care, and other essential services necessary to sustain healthy
living. This paper concludes with a summary of recommendations for a roadmap
of globally and regionally interconnected infrastructure based on One Health-One
Science-One Security.
Assumptions in this paper include: (1) lack of significant technology deployment,
and implementation of research advances in emerging nations will occur in the
next three decades to significantly impact global health security; (2) investments
in critical infrastructure will be insufficient given population growth, human and
environmental factors, and other issues; (3) social networking and crowd sourcing
integrated with access to other information technologies will continue to impact
disaster mitigation due to natural and manmade events; 4) policy will continue to
be driven primarily by cultural norms, independent of regional instabilities. On a
more optimistic note, this author is highly confident that a science-based
response, if communicated efficiently and effectively to decision makers and the
public sector, is highly effective during complex, high uncertainty events such as
disasters. Most notable within the category of complex disasters are those
impacting infrastructure and resulting in second and third order effects to health,
security and confidence in government. These events are hybrid by their very
nature, and cause asymmetric threats to life, property, critical infrastructure (e.g.,
water, power, health, food, logistics, and information systems) and government
leadership/continuity. Ultimately, mitigation strategies may be impacted through
the perfect storm of inadequate critical infrastructure investment, security,
scientific knowledge, and public policy resulting in unconstrained health
catastrophes such as pandemic, (re-) emerging infectious disease outbreaks,
and/or biological attacks.
THE TRIAD OF ONE HEALTH-ONE SCIENCE-ONE SECURITY
The motivation for One Health (http://onehealthinitiative.com) stems from a
global virtual professional community dedicated to recognition that “…human
World Federation of Scientists, Erice, Italy, August 2012
health, animal health and ecosystem health are inextricably linked…”described in
Figure 1. Figure 1 represents the dynamic interrelationships of multiple entities
and also provides a framework for the insertion of One Science into this
paradigm. One Science provides a mechanism for understanding the complexity
of the relationships of these interdependent systems and a deeper understanding
of vulnerabilities and measurable impact(s) and limitations of interventions.
Emerging infectious diseases (EID) are now recognized as elements of adaptive,
dynamic systems. The mathematical modeling work of Kenkre et al. from the
University of New Mexico (BTR Proceedings 2005: Unified Science and Technology
for Reducing Biological Threats & Countering Terrorism, A.L. Sobel, Editor,
Albuquerque, NM, March 16-18, 2005) represents some of the earliest validated
work reflecting the re-emergence of a significant pathogen (Hantavirus) given the
optimal set of “boundary conditions” in humans, animals, plants, precipitation,
climate and the entire ecosystem. This work underscores the flaws in logic and
presumed high confidence associated with use of heuristic models in isolation to
predict disease outbreaks, and especially when hybrid (i.e., natural/manmade)
threats are to be considered. In addition, these models represent some of the
earliest field validated work supporting the use of combined linear analysis,
simulations and complexity, and suggest strategies for mitigation and
containment of a biological or hybrid threat. (V.M. Kenkre, “Modern Challenges in
Statistical Mechanics: Patterns, Noise, and the Interplay of Nonlinearity and
Complexity, AIP Proc. Vol. 658 (2003) 63.)
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Figure 1. P. Daszak et al., Science 287, 443-449 (2000).
This paper also posits that economic stability and emergence of nations are highly
interdependent, and recognizes the relationship to health and water security and
the naturally extrapolation to the broader strategic framework of One Health-One
Science-One Security.
METHODOLOGY: A SUGGESTED OPERATIONAL FRAMEWORK FOR ONE SCIENCEONE HEALTH-ONE SECURITY
Recent Haitian disasters (2010) have reinforced the value of technology and
shared information systems in complex emergencies. When well designed and
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mindful of security vulnerabilities, such platforms can assist with timely flow of
actionable information, vulnerability assessments of critical infrastructure,
prioritization of resource deployment, and capacity building. The over-whelming
human neediness is compounded by access and logistical challenges and may be
mitigated through use of real-time information and advanced imagery collection
techniques.
The recently forward-deployed system Medical and Public Health Information
Sharing Environment (MPHISE) used in Haiti met with limited operational success
and acceptance(http://haiti.mphise.net). Unfortunately, sustainability with
limited infrastructure investment remains an enormous challenge. This
information platform was modeled after a successful White House pilot project,
and subsequently adopted by the Pan American Health Organization (Data
submitted by Kathy Gilbeaux, www.new.paho.org , July 2011). The final pilot
project included 1300 representatives of organizations and social networks, all
with a common goal: to improve human and animal health, water and food
security in Haiti. The system’s mission included: situation awareness;
identification of mission critical gaps; employment of smart swarms for datamining, information retrieval and intelligent modeling. The system was built on a
task server solely purposed to converge smart swarms to resolve gaps in
actionable information and recommend courses of action (personal
communication, Dr. Jim Wilson, December 7, 2011).
Information fusion or integration using a set of pre-determined ‘rules’, i.e.,
parameters, is most helpful when the goal is to form a ‘common operational
picture’ or COP during complex emergencies. All-source surveillance data
(including epidemiologic and imagery, critical infrastructure data, logistics, and
other relevant operational data) will result in a translational pathway from data to
(actionable) information and knowledge. All-source information systems, such as
demonstrated in Haiti, include executable elements that assist with prioritization
and optimization of resource allocation and local/regional distribution networks,
and support favorable, measurable outcomes for all sectors of society involved:
government, public, and private. When combined with social network analysis, a
system for education, capacity building, and sustainability may be achieved using
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a ‘bottom-up’ approach to humanitarian assistance and disaster management
through actively engaging community leaders.
The American Association for the Advancement of Science (AAAS) and the
Association of Public and Land-Grant Universities (APLU) recently published a
sentinel report entitled ‘Bridging Science and Security for Biological Research: A
Dialogue between Universities and the Federal Bureau of Investigation’ (AAAS and
APLU, February 21-22, 2012, Washington, DC). In summary, this report stresses
the need for open communication between national security, government,
private, and scientific communities regarding mitigation of risks associated with
biological research and dual-use applications. Adequate biosecurity is defined
operationally by optimization of security for the given entity/situation,
understanding vulnerabilities to accidental and deliberate exposures, and use of
risk mitigation strategies across critical infrastructure research areas. This
systematic approach addresses the need to build collaborative global frameworks
for critical infrastructure public policy that ensures pursuit of peaceful,
collaborative, and yet potentially dual-use biological and life sciences research.
The scientific community is charged with educating policy makers and nonscientists to enable informed decision-making.
The decision to operationalize day-to-day seamless sharing of science and
technology resides with local, regional and national communities. During unstable
and rapidly evolving disasters, reciprocity of information sharing from the field
leads to a “tipping point” as rare events begin to repeatedly occur and attempts
are made at analysis and pattern recognition. This area of computational
dynamics and Big Data analysis offers many exciting opportunities for science and
technology to contribution to real-world problem-solving.
Traditionally, many academic institutions are driven by the search for
fundamental knowledge and applications-driven science is a new phenomenon
for many researchers. As applied science research becomes increasingly more
common, we must strive to streamline the processes, polices, and compliance
requirements to enable true scientific ‘breakthroughs’ and contributions. Over
the past 30-40 years, concerns about ethics, safety and security have begun to
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trump operational needs. Post 9/11, growth in regulatory requirements has
constrained the academic research and innovation milieu in the United States.
Despite protest from the academic community as a whole to these expanding
regulations and controls, (American Association of Universities, Association of
Public and Land Grant Universities, to name a few entities) regulatory
requirements have continued to escalate and approval processes have become
increasingly steeped in bureaucracy. Notably, research and development by
terrorist organizations, unilateral terrorists, and state-sponsored terrorist
organizations are not constrained in a similar manner. As a result, new
asymmetries have begun to emerge that favor terrorism, and are amplified and
accelerated by the unbridled science and technology investment being made in
proliferating nations.
CONCLUSION: A Suggested Roadmap Employing the Framework of One HealthOne Science-One Security
In a world in which security and stability are often the most fleeting, yet desirable,
end-states, the ability to create and sustain the seamless flow of validated
information takes on a new dimension of urgency. When faced with the
operational challenges of a hybrid threat, the ability to make efficient,
scientifically sound decisions and share information within an appropriate
security environment is paramount to mitigation, containment, and recovery.
Unconventional disasters are characterized by uncertainty and rarity and create
challenges and opportunities for decision making that may be enhanced through
use of science and technology, and innovative analytic techniques.
A political-social-financially sound roadmap intended to prevent and mitigate acts
of terrorism may be charted through information and knowledge integration in a
system empowered through continuous feedback from the operational
environment. In other words, connecting scientists to policy makers and the
operational community describes an ideal feedback loop in complex emergencies.
A notional, holistic One Science-One Health-One Security roadmap must include
input from the scientific, operational, private sector and policy communities.
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Only through these types of partnerships may the global community addressing
the most challenging issues of energy, water, food, and health security.
As governments and senior decision-makers begin to recognize the emerging
power of social networks, so must these leaders strive for balanced information
analysis that is science-based. Science cannot ‘de-risk’ decision making, rather,
careful analysis may suggest a compelling plan for risk mitigation.
This paper has attempted to extrapolate from the lessons-learned in a real-world
complex disaster and encourage the greatest scientific minds and innovators to
engage. In conclusion, I have attempted to re-emphasize the need for continuous
dialogue between the health, science, security and political leadership
communities as we traverse the continuing threats of terrorism and high
uncertainty of outcomes they pose.
ACKNOWLEDGEMENTS
I wish to thank Dr. Jim Wilson, colleague, and Dr. Gary Simpson, colleague and
mentor, for their unfaltering efforts in One Health and their selfless work to help
improve life for us all.