“Public health and public health infrastructure and systems in developed and developing countries must be seen as strategic and security issues that deserve international public health resource monitoring attention from disaster managers, urban planners, the global humanitarian community, World Health Organization authorities, and participating parties to war and conflict,” argue Frederick Burkle and P. Gregg Greenough of the Harvard Humanitarian Initiative in a new article in Disaster Medicine and Public Health Preparedness. Burkle, who is currently a public policy scholar at the Wilson Center, will discuss public health management after natural disasters at the Center on June 17th.

In their article, “Impact of Public Health Emergencies on Modern Disaster Taxonomy, Planning, and Response,” Burkle and Greenough discuss the public health consequences of disasters, which they classify as natural; failures of human or technological systems; or conflict-based. The authors contend that disasters’ indirect effects are often overlooked, despite the fact that they continue months and even years after the event. Disaster severity is typically measured by direct morbidity and mortality; however, Burkle and Greenough highlight the need to account for the indirect deaths and illnesses caused by the devastation of public health and other infrastructure, poor and overcrowded living conditions, displacement, food insecurity, and disrupted livelihoods. Furthermore, as acute deaths decrease, humanitarian aid wanes—at a time when it is desperately needed to rebuild public health infrastructure.

In the case of conflict-based disasters,“health care and other essential services . . . may not return to baseline for more than a decade.” The authors note that in 2004, the Iraqi Ministry of Health announced that more lives had been lost to insufficient health services than to violence. Yet the former fails to garner the same attention and condemnation as the latter.

The devastation wrought by Hurricane Katrina demonstrated that the safety, health, and infrastructure of even the wealthiest nations are at risk. No nation can afford to overlook the challenges highlighted by Burkle and Greenough.