Making medical countermeasures requires documentation to assess vulnerabilities, threats and operational risks and bioterrorism through the collection and processing of specific multidisciplinary data in human medicine, veterinary, phytosanitary, the environment, defense and national security, etc. Based on retrospective data and late information (medical intelligence), we can estimate the prospective risk to public health, respectively for troops and civilian population in a given area, the area of operations. The biological military or bioterrorist attack, whether overtly or masqueraded as human or animal epidemics can cause a major biological crisis for troops and the civilian population, for domestic and wild animals, for crops or wild plants or for the environment, which remains contaminated. Therefore, it is important to constantly monitor the situation of infectious diseases in the area of responsibility (national territory, operations theaters) to assess vulnerability, threat and bioterrorist risk but also for making medical anti-bioterrorist countermeasures, which can only be effective by genuine cooperation between all specialized structures of the Ministry of Defense, other departments and the civil society.
The “volatile” international context requires the strengthening of the national security measures, including in the field of CBRN and public health. The medical countermeasures for the defense are based ultimately on the prophylactic treatment (pre-exposure, intra-exposure and post-exposure) and on the curative treatment (of emergency, maintenance and recovery) of the contaminated and the sick. Depending on the rapid and correct etiological diagnosis, the appropriate treatment is immediately applied. Although in times of peace this scenario is almost non-existent, during war or terrorist attack it can be a mass pathology, like an explosive epidemic, that requires specific therapeutic means. Military medicine had and has the conceptual capacity to make antidotes for CBRN medical protection; some have been patented and/or produced as experimental models, but it has no manufacturing capacity anymore.
All large armies (EU and/or NATO) have pharmaceutical production facilities to provide the necessary antidotes for the troops and the population: The French Army Medical Directorate produces many military-specific pharmaceutical products in its own laboratory, the Turkish Army owns its own medicines factory, including CBRN antidotes, the US Army, in addition to a sustained drug purchase program in the pharmaceutical industry has launched a new concept: Pharmacy on demand. Providing the armed forces with antidotes is a necessity, the concept for their endowement in this sense can be based on imports (sometimes impossible to achieve) or on the national development of a specialized production structure. The design or construction of a specific production capacity for antidotes can be accomplished on multiple variants, with a complexity proportional to the identified need. The total costs are high, but the objective and implementation of effective antidote supply mechanisms is a security guarantee for the armed forces and the civilian population (through commercialization to allied forces), given the risks of terrorist threats and hybrid warfare.
