The announcement sent ripples throughout the international health community: On April 23, 2010, the World Health Organization (WHO) confirmed that seven children suffering from paralysis in the poor former Soviet country of Tajikistan were victims of poliomyelitis. Genetic sequencing showed that the virus had probably arrived with a traveler from India. It was the first importation of polio into Europe since 2002, when the region was certified as polio-free. The outbreak rapidly spilled over into neighboring Kazakhstan, Russia, and Turkmenistan, causing 476 laboratory-confirmed cases, including 29 that were fatal. WHO warned that there was a high risk of further cross-border spread of the crippling and extremely contagious illness.
High rates of immunization -- 90 percent or more -- are required to stop the spread of polio, for which there is no cure. WHO partnered with the United Nations Children's Fund (UNICEF) and the US Centers for Disease Control and Prevention (CDC) to contain the outbreak. Together these organizations provided oral polio vaccine for more than 25 million children in the region over several rounds of national immunization days.
Polio is just one of many serious biological threats that public health systems face in the former Soviet Union. Not only must these underfunded systems detect and contain naturally occurring diseases such as plague, anthrax, and cholera but they are also charged with responding to a potential terrorist bio-attack. And they are responsible for safeguarding dangerous pathogens that are used for laboratory research, which could threaten human health and agriculture if accidentally or intentionally released. The public health systems in the former Soviet Union constitute a vital link in the international biological monitoring and response network -- one that can easily atrophy without ongoing efforts to maintain it.
For two decades, the post-Soviet region has been a priority for international attention and funding because of its former clandestine biological warfare program, which notoriously exploited a broad range of civilian public health and agriculture institutions. Despite significant progress over the past 20 years in securing research facilities, redirecting scientists to peaceful projects, and improving disease surveillance capabilities, major challenges remain -- particularly in training a new generation of epidemiologists, strengthening personnel policies to prevent unauthorized use of pathogens, and increasing cooperation between nations.
Growing transnational threats of disease and terrorism in other parts of the world have prompted international donors to move into Africa and Asia. The former Soviet Union continues to face similar threats; but despite serious and long-standing needs to address these multifaceted problems, international partners seem to lack both a long-term strategy for the region and the ability to convey a clear message to the experts on the ground about whether the partnerships are to continue -- and, if so, within what framework. Consequently, it is unclear whether program budgets will include any support for activities in the former Soviet Union beyond 2015.
Two decades of progress. When the Soviet Union collapsed in 1991, its secret biological warfare program was suddenly revealed in its full scope.
The full contents of this article are available in the July/August issue of the Bulletin of the Atomic Scientists and can be found here.