Detecting biological weapon use
A red light comes on in the epidemiological surveillance system alarms. An abnormal increase in diarrhoea cases is reported by the Bundeswehr naval unit physician in Djibouti: 13 cases out of 70 staff in under 48 hours. The NATO Deployment Health Surveillance Capability (DHSC) confirms this information and sounds the alarm. This early warning system, patented by the Health Service of the French Army, could be added to the equipment of NATO's armed forces and detect the use of a biological weapon. Code name: ASTER.
Lieutenant Colonel Benjamin Queyriaux is the deputy head of service and epidemiologist of the Deployment Health Surveillance Capability (DHSC) based in Munich, Germany. He currently has a four-person team. His role is to develop for NATO an epidemiological surveillance system for tracking the state of health of Allied troops in operations. Recent experiences in the African and Balkan theatres, as well as in Afghanistan, have demonstrated the critical importance of real-time tracking of health and of the threats to soldiers in their mission.
In Afghanistan, for example, NATO does not always have a way of knowing the exact number of malaria cases among Allied forces and whether that is affecting the Alliance's operational capabilities in the field.
"The requirement for developing a real-time epidemiological surveillance and alert system, which is crucial particularly in the event of a biological attack, dates back to the 2002 Prague Summit" explains Benjamin Queyriaux. "A stocktaking of NATO's capabilities for countering NBC threats shed light on our inability to detect a biological attack for several days."
For that reason, in 2010 the DHSC – a branch of the NATO Centre of Excellence for Military Medicine (NATO MILMED COE) based in Budapest, Hungary – was created on a French and German initiative aimed at overcoming the difficulty of identifying the state of health of forces in the field, detecting an epidemic, and assessing the effectiveness of preventive measures. The DHSC's mission is to contribute to enhanced protection of NATO's deployed forces against the threats of infectious diseases and bioterrorist attacks.
"The aim is not only to identify the epidemics caused by infectious agents released intentionally, but also to detect and manage natural events, such as epidemics of influenza or malaria that occurred in the past", continues Benjamin Queyriaux.
In an operation, should an influenza epidemic occur, for example, it is certain that if the forces of one nation are infected, NATO's embedded forces will all quickly be contaminated. It is therefore crucial for the Alliance to have real-time surveillance data to detect and consequently manage any health problem, and not just to rely on the Allies' national capabilities.
Some difficulties still remain to be addressed before NATO will have a real-time health surveillance system that is multinational. A single system will have to combine medical practices and information security rules that differ from one country to another. The retrieval of national information supplied by physicians and nurses which is not standardized and is subject to medical confidentiality may also prove problematic, as may turning that information into epidemiological analyses that are useful for NATO.
But the system is promising. "ASTER is an important part of NATO's future epidemiological surveillance and alert system," adds DHSC Commander Hans-Ulrich Holtherm. "It is a good example of smart defence applied to public health: rather than try to gather fragmentary data from a few Allied nations, NATO is building a single system that will offer a complete overview of the health situation of deployed troops."
Today, the new ASTER system is being used for the French and German forces in Djibouti. Once the interoperability problems have been solved, NATO will be able to use this system routinely. Other nations are also interested in development of the DHSC, including the United States, Poland and Canada. And the United Kingdom is even physically taking part in the project, since a British officer will be joining the DHSC in Munich this autumn.
The DHSC is hoping to be fully operational in 2013.