In 2019, SARS-CoV-2, the causative agent of Covid-19, first appeared in Wuhan, China, it rapidly spread across nations and caused a global outbreak. Later, the World Health Organisation (WHO) declared it a pandemic. So far, it has been widely accepted that the virus originated from bats. However, the exact medium through which it was transmitted to humans remains debatable. Some researchers believe the virus was artificially created or maintained within a laboratory setting and accidentally reached the community. Although the probability of this hypothesis is very minimal, it remains a possibility that cannot be entirely dismissed.

Research centres (experimental laboratories) are expanding at a fast pace worldwide. Concurrently, there is an increasing concern regarding the potential use of laboratory microorganisms as tools for instilling fear or causing societal disruption. This phenomenon can be attributed to several factors, including heightened distrust between communities or nations, alongside an increasing threat of terrorism. If respiratory infections, in particular, are used as biological weapons in any location, they could spread as quickly as Covid-19, since air travel makes travelling across nations easy and fast, which in turn spreads infections rapidly.

Whether the outbreak is natural or man-made (artificially created in the laboratory), both scenarios pose a significant risk of global transmission. If biological weapons were to be used anywhere in the world, particularly in neighbouring countries, Nepal would not remain unaffected. So, is Nepal prepared for the consequences of bioterrorism?

Bioterrorism is when someone deliberately uses/releases viruses, bacteria, fungi and toxins produced from living organisms to spread disease or cause death among the human population or food crops and livestock. It intends to terrorise a civilian population or manipulate the government. Security experts have long expressed concerns about using biological agents in conflicts. There is also a growing fear regarding the potential acquisition of highly lethal pathogens by terrorist organisations. In 2001, the US experienced a series of attacks in which packages containing powdered anthrax spores (that cause anthrax disease) were mailed in through the postal service. This resulted in 22 confirmed infections (12 were mail handlers), with a mortality rate of 23 percent (5 deaths).

Further, if deadly pathogens are stored in laboratories for research and accidentally reach the community, they could trigger a pandemic. In recent years, there have been claims about the use of biological weapons in both internal conflicts as well as wars between nations. However, independent verification of such claims remains difficult.

Bioterrorism may lead to mass movement, resulting in displacement, meaning that people from the affected area may flee to other places/regions, potentially spreading the infection to new places. This increases the chances of outbreaks, possibly evolving into a pandemic.

Should bioterrorism occur, immediate treatment and containment measures will be vital. Nevertheless, controlling their spread and providing treatment could become almost impossible in cases where biological agents are both highly contagious and extremely lethal. During the Covid-19 pandemic, even the healthcare systems in developed nations collapsed, and millions lost their lives due to the lack of immediate treatment options and vaccines. For instance, in the US alone, over 1.2 million people died of Covid-19 complications.

Even now, if highly infectious deadly viruses like Ebola or bird flu (H5N1) were to be used as biological weapons, they could cause devastating health crises. Although some knowledge exists about these two viral diseases, no precise treatments or fully effective vaccines are available. This underscores the severe risks posed by bioterrorism, as the global community may still not possess the adequate resources or strategies to manage such an attack effectively.

Nepal must also prepare for potential health crises that could arise from bioterrorism. A few weeks ago, I had the privilege of giving a lecture on bio-security. I observed a notable dearth of research on this issue in Nepal. Even in India, it seems the country lacks extensive study/research on bioterrorism, although discussions and debates on bio-security or bioterrorism have started to gain attention.

With the advent of the 21st century, warfare tactics are evolving, and the use of chemical and biological weapons is on the rise. Notably, during the Covid-19 pandemic, new variants or waves that emerged or were seen in India eventually reached Nepal. This highlights the serious risk that Nepal could face if a highly contagious, deadly pathogen is employed as a biological weapon in India or any other country within the South Asian and Southeast Asian regions. Assessing Nepal’s preparedness for responding to such a crisis is essential. Security forces (border security force, i.e., Armed Police Force) and border officials would have a crucial role in the initial response. Training programmes must be conducted to equip them with the necessary knowledge and protocols for effectively handling bioterrorism incidents and their aftermaths.

More importantly, coordination among local, provincial and federal governments will be critical in implementing response strategies/plans if an outbreak reaches local communities. The Covid-19 pandemic has already taught us the importance of enhancing preparedness and responding to it, so we cannot afford to overlook the threat of bioterrorism.