“Either we work together to rise to the challenges or we condemn ourselves to irrelevance”

José Manuel Barroso, President of the European Commission

The history of human civilization and the development of the modern world is inextricably linked to various types of emergencies and disasters: epidemics, earthquakes, floods, hurricanes, extreme heat and cold, fires etc.; societies have continuously been subjected to natural and man-man disasters. This preface begins with a few examples of the historic and prehistoric natural disasters known to us which can teach us important lessons about disaster preparedness and mitigation.

The Italian volcano Mt. Vesuvius erupted on August 24, 79 AD, killing thousands of people and smothering the towns of Pompeii, Stabiae, and Herculaneum with ash. The volcano is still a threat and the area is much more densely populated today than it was two thousand years ago.

The plague of Athens, which occurred in the fifth century BC, is the best known of the ancient plagues and another important example of a historical disaster. Two more devastating ancient plagues were the Athenian of 430 BC (to which Pericles succumbed during the Peloponesian War) and the Justinian of AD 542.

Malaria is a disease that has threatened humankind with frequent outbreaks throughout the last several thousand years, another is shistisomiasis, a disease caused by parasitic blood flukes. Cholera may have been the reason for the Assyrian forces suddenly abandoning their siege of Jerusalem in 700 BC and polio was present in isolated cases in ancient Egypt.

Biological weapons have been in use since at least the seventh century BC, when Scythian archers dipped their arrows in blood, dung or decomposing bodies to stop the invading Assyrians.

We have some information on the development of inoculation and vaccination: pock sowing is recorded in a sanskrit text of the second or third century AD. Scientists argue that most diseases have presented a more serious threat as civilization has advanced.

Nowadays, disasters disrupt hundreds of thousands of lives and leave thousands more homeless every year. Statistics of injuries suffered due to disasters are rarely taken into account, but for earthquakes, the rate is about 30 people injured for every death; for hurricanes it is closer to 50 to 1. The impact of a disaster is felt far beyond the immediate area affected. More than 95 percent of all deaths caused by disasters occur in developing countries.

Industrialized countries, on the other hand, tend to suffer more from economic damage: the financial impact of natural and man-made disasters totals hundreds of billons of US dollars. GNP (Gross National Product) lost due to disasters tends to be 20 times greater in developing countries than in their developed neighbors, however, hurricane Katrina in the US entailed the highest total damage by far, at $135 billion.

Here are a few examples of natural and man-made disasters that took place in 2009.

Man-made disaster: more than 70 people perished in the accident of August 17 which destroyed three out of 10 turbines at RusHydro’s Sayano-Shushenskaya plant in southern Siberia, Russian Federation, and limited electricity supply to manufacturers. It has not been made clear whether it was due to human error or a technical failure. The repairs will cost 40 billion roubles ($1.28 billion) over four to five years.

Natural disasters: in the early morning (01:32) of Monday, April 6, central Italy was struck by an earthquake of 6.3 magnitude. The L’Aquila earthquake caused serious damage to several medieval hill towns in the region, killing over 260 residents, injuring over 1,000 and leaving 28,000 homeless.

The 2009 flu pandemic is a global outbreak of a new strain of an influenza: a virus subtype H1N1, first identified in April 2009, in Mexico. In early June, as the virus spread worldwide, the World Health Organization (WHO) declared the outbreak to be a pandemic. It has not been established where the virus originated.

Threats to mankind are constantly evolving, and national and international experts are examining and reviewing new plans and priorities applicable to today’s threats. The chemical, biological, radiological, nuclear, and explosives (CBRNE) threats have recently come to the forefront of international discussions. Traditionally, natural disasters and industrial accidents have posed the greatest threat to people worldwide, but CBRNE emergencies present new challenges, with the potential to become global threats affecting the developing and developed world alike.

Srgjan Kerim, president of the U.N. General Assembly, called on the international community in Sept, 2008 to implement a “new way of thinking” to enable greater cooperation around the world to better counter global terrorism. The U.S./Russia Working Group on Counterterrorism (CTWG) met for its 16th session in June, 2008 in Moscow to update current plans and initiate new areas of cooperation in countering terrorist threats. But governments alone cannot protect people from terrorism. A complete counter-terrorism strategy requires cooperation between governments, businesses, scientists, communities, and civil society in general.

For centuries, the field of international peace and security was the province of politicians only, but times have changed, with academics, scientists, business, industry and the arts becoming more educated, knowledgeable, sophisticated, penetrative, and democratic in their diversity than ever before.

Because disasters are a global issue, the study of how to counter them is also a global issue. Counter-terrorism requires the cooperation and collaboration of multi-dimensional groups such as academics; representing the theoretical and research areas, policymakers; representing coordination and authorization aspects and professionals; representing practical and real life experiences.

A key obstacle to any human scientific, technical or social process is inefficient or non-existent information sharing mechanisms. It is not evident that everyone benefits by sharing information, but those who must act to counter global threats do. As information sharing implies education and training, these are necessary if we are to respond effectively to global threats.

The body of knowledge and experience being developed in these fields is so immense that a new information-sharing paradigm is required for the various disciplines in different societies to understand each other better.

New technologies have given the counter-emergency community an opportunity to build a collaborative, innovative, and knowledge sharing culture that will continue to engage in learning and research. The only impediment is the will to understand rather than to suppress each other. Everyone knows of outstanding scientific and academic initiatives such as the LHC (Large Hadron Collider, CERN) and the ISU (International Space University), famous for their incredible information sharing infrastructure. But countering global threats is not limited to science and education. The challenge of disaster preparedness and mitigation inevitably involves other sectors: politics, the military, medicine, law and law enforcement, industry, commerce, and grass roots approaches.

Key emergency countering forces should not be alone in their activity. They need help from other professionals. Moreover, the process requires social control and social interaction, as government structures are not always optimally positioned to effectively manage disasters.

The international project known as The Global Health Network Supercourse (University of Pittsburgh, Pittsburgh, PA, USA) is considering the use of media outlets for effective information sharing among societies around the world. The North Atlantic Treaty Organization (NATO) is one of the global actors which supports collaboration of world leaders in science, politics, technology, and other areas financially.

In his important paper, delivered at ‘Technology in Society’ 23(3), 2001, Prof. Fernando Carvalho-Rodrigues, director of the human and societal dynamics panel, Science for Peace and Security (SPS) program section of NATO, declared that the aim of NATO science programs is “putting scientists and politicians in the same loop”.The idea of holding a multidimensional cross-silo meeting (Prof. Carvallo-Rodrigues’ “loop”) has been the subject of discussion and design by a 4 member team: E. Gursky (USA), A. Rossodivita (Italy), E. Stikova (FYR Macedonia), and A. Trufanov (RF) since 2006.

As a rule, actions and instruments for countering global threats are multi or interdisciplinary, however, the meeting held in Milan, Italy, in 2008 was different. Its aim was to be cross-disciplinary (not only interdisciplinary and multidisciplinary but transdisciplinary as well), a term usually applied to the spheres of education and research. According to the definitions of Stokol and Rosenfield, transdisciplinary conceptual frameworks are characterized as reflecting a higher degree of integration than is achieved through interdisciplinary collaboration. The least-integrative forms of cross-disciplinary research or education activity, are multidisciplinary projects in which participating scholars remain conceptually and methodologically anchored in their respective fields

Moreover this meeting has been conceived as a cross-silo collaborative effort. That means cross-disciplinary, cross-national, cross-agency, cross-departmental, cross-level…, and cross- society concepts for diverse groups of pertinent actors.

The initiative was inspired by our distinguished colleagues, who developed the Supercourse effort, including Ronald LaPorte, Faina Linkov and Eugene Shubnikov, as well as by editors of the Journal Disaster Medicine and Public Health Preparedness, AMA (J. James, I. Subbarao).

Eventually, the project, entitled “Preparing regional leaders with the knowledge, training and instruments for information sharing and decision making against biological threats and pandemics” was selected by the NATO SPS program for financial and organizational support.

Developing the key NATO SPS events – ARW in Kaunas, Lithuania, 2005 and ASI in Skopje, FYR Macedonia, 2006, which focused of the ever-increasing frequency and severity of natural and man-made emergencies and disasters, the third pertinent meeting, ASI, was convened on Nov 29–Dec 10, 2008, in Milan. This initiative was aimed at further supplementing the efforts to transfer technology and knowledge and so help decrease the vulnerability of the population to natural, technogenic, and anthropogenic threats.

As foreseen by expert analysis, the follow-up ASI tried to unify the efforts of the scientific, academic and practical communities, creating a greater understanding and information sharing in the field of countering biological threats. The venue of the ASI was originally to be in Irkutsk, RF in early October, 2008, however the 2008 South Ossetia war, also known as the Russia–Georgia war, forced a change to the scheduling and venue of this event.

The conference was held in Milan in December 2008. Italy has a prominent history in the field. For example: the first world conference on health emergencies in technological disasters was organized by the Italian Department of Civil Protection in Rome, May, 1992. Continuing this tradition, the ASI Italian team; specifically A. Rossodivita, A. Caruso, M. Guidotti, and M. Ranghieri and their assistants, prepared to launch this as a prestigious event. We would like to thank the team for their organization skills, especially given the time pressures involved in planning this event. Their efforts to support the sessions, meetings and visits technically and spiritually were more than successful and in accord with the ideal of cross-silo cooperation.

All those attending felt welcome and were given the opportunity to work, network, attend site visits, and interact with colleagues.

We have been greatly impressed by and are grateful for the help that Italian organizations and their officials provided to the ASI. Specifically, we wish to thank:

- San Raffaele Hospital, in particular its President Don L. Verzè and the Supervisor for Health Policy: Dr. G. Zoppei

- The Sovereign Military Order of Malta in particular Col. M. Terrasi

- The Italian Association of Alpine (ANA) in particular Prof. P. Losapio

- The Italian Air Force Medical Service in particular Gen. O. Sarlo, Gen. N. Barale and Col. L. Oliva

- The Military Hospital of Milan in particular Gen. S. Valentino

- The Italian Association For Solidarity Among People (AISPO) in particular Dr. G. Zoppei and Dr. R. Corrado.

All the participants appreciated the attention of Italian civil and military circles. The audience was greatly inspired by a letter of greeting from the President of the Italian Republic, Giorgio Napoletano. We all appreciated Adm. Vincenzo Martines (Italy) for his speech at the opening ceremony of the conference, and the leader of the Russian delegation, Prof. S. Kolesnikov, Vice- Chairman of the Committee on Public Health, State Duma, Federal Assembly - Parliament of the Russian Federation, who posed key questions of international cooperation in the field of epidemics and pandemics; Dr. James, Director of the Center for Public Health Preparedness and Disaster Response, American Medical Association (AMA) for his interest in the ASI and Prof. Di Paolantonio, who presented on behalf of the Italian chapter of International Physicians for the Prevention of Nuclear War.

Throughout, the environment of the ASI was one of mutual support and of learning from one another, and genuinely cooperative. The organizers proposed, and attendees accepted, a wide range of activities focused on a creative a friendly atmosphere and plenty of networking opportunities. The choice of topic was timely and proactive as it occurred on the eve of the swine flu outbreak.

The agenda consisted of numerous lectures, seminars, and discussions, addressing a wide range of information sharing regimes and concomitant issues. The principal focus (preemptively, for infection diseases) was on how cooperation and the sharing of data in disasters can affect both the prevention and mitigation environments.

The conferences of Kaunas and Skopje were excellent in terms of multidisciplinary and international efforts. But the Milan meeting actually initiated cross-disciplinary and cross-border collaboration, bringing politicians, scientists, and the military closer to each other. ASI succeeded in expanding the information sharing territory with politicians, the military, doctors, scientists and the media. The main benefit for attendees was the creation of a bridge from science to application in the collaborative pursuit of better outcomes.

The list of 65 ASI contributors we would like to thank reflects the extensive experience in the participating countries (15 NATO + partners) in the field of combating natural and man-made disasters, as well as their secondary impact on democratic processes and the understanding between societies at different levels in and across the countries.

Undoubtedly this material, on the topic of information sharing while countering biohazards, will be of great value to a wider circle of readers.

The audience for publication includes specialists within various areas of research and teaching plus those working in the field who are responsible for mitigation, preparedness, response, or recovery actions.

This ASI served to put representatives of diverse circles “into the same loop” and the discussions that took place at the event covered some of the following: improving cooperation among different groups, actors, and organizations and using lessons learned to improve impact, and how to reduce communication barriers between diverse silo circles.

The mix of papers highlights strategic enablers that will allow countering communities to prevent disasters and emergencies, protect against global threats and recover should an event take place. These enablers are cross-disciplinary information sharing, international outreach and partner activities, public diplomacy and strategic communication. To be in line with the discussed approaches, all anti-emergency entities must foster cooperation with partners from other countries and international and regional organizations in order to develop a common understanding of global threats.

This collection of ASI papers serves as a showcase of disaster preparedness and mitigation work from various nations, and demonstrates how and to what extent experts form different countries and fields understand and collaborate with each other.

Collaboration between researchers and consumers of research in this translational approach is critical to reduce the threat burden for nations and consequential damage, the ultimate measure of benefit to all people. This concept of sharing information on the scope, content, and goals within threat countering is based on the work of those who have come to the ASI. The collection of papers recounts a volume of interaction between research, education and practice that has resulted in the current expertise in the field of global disasters and emergencies.

New synergy outputs and outcomes might be anticipated from such cross-silo scope. This concept had been central in the editing and realization of this book and we cannot help emphasizing the energetic and decisive cooperative contribution of the editorial board.

In our opinion, both the ASI and the book are modest but robust steps towards a new era of genuine cross-silo information sharing and cooperation in an atmosphere of trust. However, the next steps must be innovative and aggressive, and we hope the NATO SPS program will continue to regard its efforts in support of this direction as being of paramount value.

Alessandra Rossodivita and Andrey Trufanov, ASI co-directors