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Developmental Milestones/Developments to Date:

Current Assessment/State of the Field:




Enhorn v Sweden (2005) 41 EHRR 30 (56529/00)

  1. “In 1994 it was discovered that the applicant, a homosexual, was infected with the HIV virus and that he had transmitted it to a young man. A medical officer issued instructions to the applicant designed to prevent him from spreading the disease. In February 1995, finding that he had failed to comply with those instructions, the Court ordered that he be kept in compulsory isolation in a hospital for up to three months. Thereafter, orders to prolong his detention were issued every six months until December 2001. Since the applicant absconded several times, his actual deprivation of liberty lasted almost one-and-a-half years.”
  2. “The applicant complained that the compulsory isolation orders and his involuntary placement in hospital had deprived him of his liberty in violation of Art.5(1) of the Convention”
  3. “Held, unanimously that there had been a violation of Art.5(1);”
  4. “The compulsory isolation orders and the applicant’s involuntary placement in hospital constituted a “deprivation of liberty” within the meaning of Art.5(1).”
  5. “Since the purpose of the applicant’s detention was to prevent him from spreading the HIV infection, Art.5(1)(e) was applicable.”
  6. “The expressions “lawful” and “in accordance with a procedure prescribed by law” stated the obligation to conform to the substantive and procedural rules of national law. It was particularly important to comply with the principle of legal certainty. The conditions for deprivation of liberty had to be clearly defined and the law had to be foreseeable in its application. Furthermore, a deprivation of liberty had to be free from arbitrariness, necessary in the circumstances and in accordance with the principle of proportionality.”
  7. “The applicant’s detention had a basis in Swedish law. In the light of the relevant statutory provisions, the national courts considered that he had not voluntarily complied with the measures needed to prevent the virus from spreading; that there was reasonable cause to suspect that, if released, he would fail to comply with the instructions issued by the medical officer; and that such non-compliance would entail a risk of the infection spreading.”
  8. “The essential criteria when assessing the lawfulness of detention “for the prevention of the spreading of infectious diseases” were whether the spreading of the disease would have been dangerous for public health or safety, and whether detention of the person infected was the last resort in order to prevent the spreading of the disease, because less severe measures had been considered and had been found to be insufficient to safeguard the public interest. When these criteria were no longer fulfilled, the basis for the deprivation of liberty ceased to exist.”
  9. “Since the HIV virus was dangerous for public health and safety, the first criterion was fulfilled.”
  10. “As to whether the applicant’s detention had been the last resort in order to prevent the virus spreading, the Government had not provided any examples of less severe measures which might have been considered but which had been found to be insufficient to safeguard the public interest.”
  11. “Despite being at large for most of the period from February 16, 1995 until December 12, 2001, there was no indication that during this time the applicant had transmitted the HIV virus to anybody, or that he had had sexual intercourse without first informing his partner about his infection, or that had not used a condom, or indeed that he had had any sexual relationship at all. Although he had infected the young man with whom he had first had sexual contact in 1990, this had only been discovered in 1994 after he had become aware of his own infection. There was no indication that he had transmitted the virus deliberately or through gross neglect.”
  12. “The applicant’s compulsory isolation had not been a last resort in order to prevent him from spreading the HIV virus. Moreover, by extending the order for his compulsory isolation over almost seven years, with the result that he had been involuntarily detained in hospital for almost one-and-a-half years, the authorities had not struck a fair balance between the need to ensure that the HIV virus did not spread and the applicant’s right to liberty. Accordingly, there had been a violation of Art.5(1)”

Detention, Law, Sweden, Public Health, Europe


Concejo Superior de Investigaciones Scientíficas (Spain, Centre National de la Recherche Scientifique (France), Polish Academy of Sciences (Poland), The Royal Society (United Kingdom)Implementing the ERC in Partnership with the European Institutions The Scientific Autonomy and the Self-governance of the European Research Council (ERC)” Sept. 19, 2005.

  1. “The European Commission has made commendable and rapid progress in working towards the establishment of a European Research Council. …The essential point being that the ERC should be able to promote basic research solely in accordance with its own scientific standards.”

Scientific Self-Governance, Europe


Peek, Laura, “Chemist suspect cornered in CairoThe Daily Mail, online July 17, 2005.

  1. “Magdy Al Nashar, 33, was arrested in a dawn raid on his parents’ home by Egyptian secret service agents following a request for help from the British authorities.”
  2. “The Chemistry PhD student has been missing since June 30. He helped the fourth suicide bomber to rent a flat in Leeds last month. Al Nashar who has studied biochemistry at Leeds University since 2000 and his lodger, Jamal Lindsay, disappeared a week before the bombs.”
  3. “Lindsay carried out the attack which killed at least 25 people at Russell Square. On Tuesday police raided the housing association flat in Burley, Leeds, and evacuated neighbours after finding explosives.”
  4. “Egyptian security services spokesman General Mahmoud El Fishawi told the Daily Mail: ‘We just do not know if he is guilty or innocent. If we find a link with the London bombings, he will be sent back to Britain.’There was a series of secret meetings between the bombers at the Burley flat believed to be their bomb factory in the weeks leading up to the attacks.”
  5. “There was a series of secret meetings between the bombers at the Burley flat believed to be their bomb factory in the weeks leading up to the attacks.”
  6. “Police carried out a controlled explosion at the flat on Tuesday. Detectives found traces of evidence from all four bombers.”
  7. “The Arab Al-Maadi district of Cairo where Al Nashar grew up has been described as a hotbed for fanatics because it is so easy to disappear in its maze of narrow dusty streets.”

Law Enforcement, Academia, Egypt, Europe, U.K.


Editors, “Freed chemist worried over return to UK,” Daily Mail, Aug 10, 2005.

  1. ”An Egyptian chemist released without charge yesterday after three weeks of questioning over the July 7 London bombings said he wants to return to the UK.”
  2. ”Egyptian authorities found no evidence to link the former Leeds University student to the attack or to Al Qaeda.”
  3. ”He knew two of the suicide bombers casually – helping find Lindsey Germaine a place to live in Leeds – but said he was innocent of any involvement.”
  4. ”He was detained in Cairo after Britain notified Egyptian authorities they suspected he may have had links to some of the terrorists, three of whom were from Leeds.”
  5. ”El-Nashar had returned to Egypt on holiday a week before the attacks; Egyptian authorities arrested him on July 14, a week after the bombings.”

Law Enforcement, Academia, Egypt, Europe, U.K.


S v H.S.E. (2009) IEHC 106 (11th February 2009) Judgement of Edwards J

  1. “The patient (was) alleged to be detained unlawfully at the Mercy University Hospital, an institution operated by the (H.S.E), in purported pursuance of an order made by (the H.S.E.) pursuant to s. 38 of the Health Act, 1947…which provides for the detention and isolation of a person suffering from an infectious disease who is a probable source of infection.”
  2. “the patient’s detention, although initially unlawful, became lawful once she was delivered into the custody of the staff at the Mercy University Hospital who were directly authorised by the s. 38 order to isolate her there in a specialised negatively pressurised room.”
  3. “The key criterion is the need to ensure “effective” isolation. The section expressly provides that the power may only be invoked in cases where the patient cannot be effectively isolated in their own home. It is implicit in the section that the legislature intended that the power should be invoked sparingly and that it should not be resorted to save where absolutely necessary. It is difficult to conceive of any circumstances where it would be necessary to invoke the power save in the case of patient non co-operation with a proposed regime of isolation. Even in a case where a patient’s home is physically, or otherwise, unsuitable to provide effective isolation, it would be unnecessary to invoke the s. 38 power of detention in the case of a co-operative patient. He or she could simply be admitted to, and isolated within, a hospital or other suitable place on a voluntary basis.”
  4. “The power created by section 38 supports an important public interest objective, namely, it assists in safeguarding against the spread of particular infectious diseases amongst the general population by facilitating, where necessary, the compulsory effective isolation of a person who is suffering from such a disease.”
  5. “While it might be desirable that the section should contain more specific safeguards towards the defence and vindication of a detainee’s personal rights, the absence of such safeguards does not, of itself, render the section unconstitutional. A detainee may have recourse at any time to the High Court within the context of Article 40.4.2˚ of the Constitution for the purpose of seeking an inquiry into the lawfulness of his or her detention.”
  6. “The combination of (i) such safeguards as already exist within the section, (ii) the presumption that the section will be operated constitutionally, and (iii) the existence of a readily accessible remedy for the person affected if it is not in fact operated constitutionally, provides an adequate level of protection for the personal rights of detainees. I therefore dismiss the claim of constitutional invalidity.”

Detention, Quarantine, Law, Ireland, Public Health, Europe


Pollack, Andrew, “In Vaccine Additive, Benefit and Doubt, NYT, D1, Sept. 22, 2009.

  1. “Are Americans obliged to use an unproven vaccine to help protect people in other countries from the flu pandemic? That is the crux of a debate over adjuvants”
  2. “Early studies suggest that adjuvants (pronounced AD-joo-vants) could allow four times as many people to be immunized against H1N1 pandemic influenza with a given amount of vaccine.”
  3. “But while Canada and some European nations will use vaccines containing adjuvants, American officials have decided against it for now.”
  4. “Officials also fear that using an adjuvant would raise public fears about vaccine safety at a time when their challenge might be about to shift from producing enough vaccine to persuading people to use it.”
  5. “…There’s a concern that people would be reluctant to get vaccinated,’ said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.”
  6. “Officials say, one reason to use adjuvants is that they can increase a vaccines’s potency against a virus to which it is poorly matched. But the swine flu vaccine is well matched to the virus, which has not mutated.”

Vaccination, Flu, Canada, Europe, Adjuvants


Ippolito, Giuseppe, et alEuropean Perspective of 2-Person Rule for Biosafety Level 4 Laboratories,” Emerging Infectious Diseases, P. 1858,  Vol. 15, No. 11, November 2009.

  1. ”Recently, the directors of Biosafety Level 4 (BSL-4) laboratories in the United States published their views of the requirement of having ≥2 persons present at all times while biological work is undertaken in a BSL-4 laboratory.”
  2. ”we support the authors’ initiative and broadly agree with their position.  The consensus among European BSL-4 experts is that, in the interest of safety, standard practice should be for all laboratories to perform a risk assessment before any activity is undertaken.”
  3. ”They concluded that safety and security would be better assured in some situations by video monitoring systems rather than by the presence of a fellow scientist.”
  4. ”A 2-person rule is inappropriate simply because the best approach is not to have inflexible rules that are not objectively assessed according to laboratory-specific circumstances.”
  5. ”Surveillance video monitoring and data storing have their place in protecting laboratory facilities from unauthorized access and theft of materials, but their effectiveness for ensuring proper handling of pathogens is quite limited.”

Lab Security, Biosecurity, Personnel Reliability, Europe


Suk, Jonathan,, “Wealth, Inequality, and Tuberculosis Elimination in Europe“, EMERGING INFECTIOUS DISEASES, Volume 15, No. 11, November 2009.

  1. Europe- wealth inequality directly related to TB
  2. “decline of TB incidence in Europe preceded the advent of anti-TB drugs and coincided with rapid improvement of quality of life”
  3. “the current financial crisis could exacerbate the conditions of existing vulnerable groups as well as create new ones”

Europe, Public Health, Pandemic, Tuberculosis


Gray, Richard, “Swine Flu Spreading Faster in Britain than Rest of Europe.” Telegraph. 1 January 2011.

  1. “The Department of Health denied claims the country was facing a national shortage of the flu vaccine after some doctors surgeries reported they were running out of stocks.”
  2. “There has also been concern that flu vaccines were not offered for children under five years old this year despite advise from the Government’s Joint Committee on Vaccination and Immunisation in January that it would be “prudent” to include children aged six months to five years in this winter’s flu vaccine programme.”
  3. “The committee has subsequently said it did not believe healthy children under five years old should be given the flu vaccine, but insisted that “at risk” groups under the age of 65 years old, which includes those suffering from conditions such as respiratory, heart, kidney or liver disease, should be given the jab as a matter of priority.”

Pandemic, Flu, Public Health, Vaccination, Pharma, Europe


AP, “Officials Warn Swine Flu Outbreak in Britain May Spread to Rest of Europe,AOL Health. 7 January 2011.

  1. “The annual flu season struck the U.K. early this year, with cases surging last month and doubling almost every week.”
  2. “The predominant strain infecting people is swine flu, which was responsible for the 2009 pandemic. Unlike most flu viruses, swine flu mostly affects people under 65 and many of its victims are previously healthy younger people with no underlying problems.”
  3. Vaccine Shortages: “In Britain, a vaccine shortage is forcing authorities to resort to leftover shots from last year’s swine flu pandemic. Some hospitals have been forced to cancel elective surgeries to accommodate extra flu patients.”
  4. “According to the World Health Organization, the swine flu virus detected in Britain is similar to the pandemic strain and no changes have been identified to suggest it is more lethal or transmissible.
  5. “Charles Penn, a WHO flu expert, said swine flu appeared to be the main virus spreading in Europe so other countries might soon experience an outbreak similar to Britain’s. ‘Any countries where (swine flu) is the predominant virus should be prepared for more incidents of infection in younger people than normal,’ he said.”

Pandemic, Flu, Public Health, Vaccination, Pharma, Europe, WHO


Suk, Jonathan, Zmorzynska, Anna, et al., “Dual-Use Research and Technological Diffusion: Reconsidering the Bioterrorism Threat Spectrum”, PLOS Pathogens, January 13, 2011, last checked February 20, 2011.

  1. ”Activities that have garnered substantial attention include chemically synthesizing the poliovirus [9] and the ΦX174 bacteriophage [10], demonstrating the importance of a variola virus gene for its virulence [11], and reconstituting the 1918 influenza virus [12]. Each has been classified as dual use research of concern (DURC), which is defined by the US National Science Advisory Board for Biosecurity (NSABB) as ‘research that, based on current understanding, can be reasonably anticipated to provide knowledge, products, or technologies that could be directly misapplied by others’.”
  2. ”The European Centre for Disease Prevention and Control (ECDC) was established in 2005 with the mandate to strengthen Europe’s defenses against infectious diseases through developing European Union–wide surveillance networks and early warning systems, coordinating scientific studies, and identifying emerging health threats.”
  3. ”As a part of ECDC efforts to evaluate potential bioterrorism threats, we reviewed 27 assessments (published between 1997 and 2008) that address the links between life science research and bioterrorism with the objective of identifying DURC relevant for public health (Text S1). The focus of the review was limited to the application of DURC by terrorist organizations and it did not consider state-sponsored biological weapons programs.”
  4. ”…we conducted a threat assessment during an expert workshop. The purpose of this threat assessment was to identify those DURC activities that would be the most easily deployed by bioterrorists. The key parameters for this assessment were the level of expertise required for conducting any given DURC activity and the level of equipment required to conduct the work. In the threat assessment, an estimated threat level was calculated for each DURC activity by giving a score ranging from 1 (high threshold) to 3 (low threshold) for both parameters, and then multiplying these scores to yield the final threat, which could be 1, 2, 3, 4, 6, or 9. Higher scores indicate a higher likelihood of success if they were to be undertaken by bioterrorists.”
  5. ”The recent history of bioterrorism also suggests that more attention should be allotted to low tech threats [30].”
  6. ”We do not suggest that high tech bioterrorism threats do not exist—rather, that their likelihoods should be re-evaluated. Biosecurity policy discussions could gain more nuance and credibility by adopting more sophisticated notions about the challenges inherent in conducting and replicating advanced research.”
  7. “The United States Commission on the Prevention of Weapons of Mass Destruction Proliferation and Terrorism believes it is very likely that a weapon of mass destruction will be used in a terrorist attack by the end of 2013, and that an attack with a biological weapon is more likely than one with a nuclear weapon” (Pg. 1)
  8. “Al Qaeda is believed to have failed to obtain and work with pathogens by the early 2000s [32], and this likely remains the case. In comparison, the contamination of food and water, and direct injection/application of a pathogen, all have much lower technical hurdles and might be expected to be rather more successfully deployed [31]. The best known example is the contamination of salad bars with Salmonella by the Rajneeshee cult in 1984, which led to roughly 751 illnesses and 45 hospitalizations” (Pg. 2)
  9. “the most successful ‘‘bioterrorists’’ of all, nature and globalization, which have led to the emergence of numerous new communicable diseases in recent years [39–41]. A focus on strengthening global health security has been put forward by the Obama administration [42] and the European Commission [38], and has also gained prominence in fora such as the Biological and Toxin Weapons Convention [43]. Public health, too, is dual use: it can be leveraged to counter natural and intentional disease outbreaks” (Pg. 3)

Dual Use, Bioterrorism, Information Policy, Biosurveillance, Europe


Pollack, Andrew, “Scientists See Success in Flu Vaccine Made by Faster Method,” NYT February 15, 2011. last checked February 16, 2011.

  1. “A flu vaccine made by a new, faster method works just as well as existing products, researchers reported Tuesday.”
  2. “The finding … could allow for a more reliable supply of seasonal flu shots and quicker responses to pandemics.”
  3. “The new vaccine, which could become available in the United States in the next few years, is made by growing the influenza virus in cultures of animal cells rather than in the chicken eggs that have been used for more than half a century.”
  4. “Using animal cells could shave weeks off the six months or so that is now required to produce a vaccine for a pandemic. In the 2009 swine flu pandemic, large quantities of vaccine were not ready until after the wave of disease appeared to have crested.”
  5. “Using animal cells, which are grown in enclosed steel tanks, also reduces the risk of bacterial contamination, which has led to shortages of seasonal vaccines in some years.”
  6. “Dr. Glezen said shorter production times would allow health officials to wait longer before deciding which strains to include in the next winter’s flu vaccine, a decision that now has to be made around February. That would increase the chance that the strains in the vaccine match the strains in circulation.”
  7. “The clinical trial was paid for by the Department of Health and Human Services, which awarded $1.3 billion to six companies in 2006 to develop cell-culture flu vaccines, including $242 million to Baxter and its partner, the DynPort Vaccine Company.”
  8. “Baxter began selling the vaccine in parts of Europe last October. The company, which is based in Deerfield, Ill., would not say when it would apply for approval in the United States.”
  9. “Dr. Robinson said cell culture was an “interim solution” until even faster techniques come along that do not require growing the virus at all.”
  10. “The clinical trial was conducted in the United States during the flu season of 2008-9. … That translates to an effectiveness of 78.5 percent.”

Vaccination, Flu, Pharma, Europe


Kelland, Kate, “Insight: Evidence grows for narcolepsy link to GSK swine flu shot,” January 20, 2013, Yahoo Health-Reuters Last checked January 24, 2013.

  1. Emelie is one of around 800 children in Sweden and elsewhere in Europe who developed narcolepsy, an incurable sleep disorder, after being immunized with the Pandemrix H1N1 swine flu vaccine made by British drugmaker GlaxoSmithKline in 2009.”
  2. “Europe’s drugs regulator has ruled Pandemrix should no longer be used in people aged under 20.”
  3. “In total, the GSK shot was given to more than 30 million people in 47 countries during the 2009-2010 H1N1 swine flu pandemic. Because it contains an adjuvant, or booster, it was not used in the United States because drug regulators there are wary of adjuvanted vaccines.”
  4. “Independent teams of scientists have published peer-reviewed studies from Sweden, Finland and Ireland showing the risk of developing narcolepsy after the 2009-2010 immunization campaign was between seven and 13 times higher for children who had Pandemrix than for their unvaccinated peers.”
  5. “Narcolepsy is estimated to affect between 200 and 500 people per million and is a lifelong condition. It has no known cure and scientists don’t really know what causes it. But they do know patients have a deficit of a brain neurotransmitter called orexin, also known as hypocretin, which regulates wakefulness…. Around 25 percent of Europeans are thought to have this genetic vulnerability.”
  6. “Scientists investigating these cases are looking in detail at Pandemrix’s adjuvant, called AS03, for clues. Some suggest AS03, or maybe its boosting effect, or even the H1N1 flu itself, may have triggered the onset of narcolepsy in those who have the susceptible HLA gene variant.”
  7. “GSK is funding a study in Canada, where its adjuvanted vaccine Arepanrix, similar to Pandemrix, was used during the 2009-2010 pandemic. The study won’t be completed until 2014, and some experts fear it may not shed much light since the vaccines were similar but not precisely the same.”
  8. “While estimates vary, Stiernstedt says Sweden’s mass vaccination saved between 30 and 60 people from swine flu death. Yet since the pandemic ended, more than 200 cases of narcolepsy have been reported in Sweden. With hindsight, this risk-benefit balance is unacceptable. ‘This is a medical tragedy,’ he said. ‘Hundreds of young people have had their lives almost destroyed.’”
  9. “Pandemrix was authorized by European drug regulators using a so-called “mock-up procedure” that allows a vaccine to be authorized ahead of a possible pandemic using another flu strain. In Pandemrix’s case, the substitute was H5N1 bird flu.”
  10. “The ECDC’s Nicoll says early warning systems that give a more accurate analysis of a flu strain’s threat are the best way to minimize risks of this kind of tragedy happening in future.”

Vaccination, Adjuvants, Flu, Syndromic Surveillance, Pharma, Europe, Sweden


Namazi, Siamak, “Sanctions and Medical Supply Shortages in Iran” February 2013, Woodrow Wilson Center, Middle East Program, Viewpoints, No. 20,, Last Checked February 14, 2013.

  1. ”Reports from Iran that describe patients who are suffering from or dying of treatable maladies due to shortages of life-saving medical supplies are well established by now. “
  2. ”Imports from American and European drug makers were down by an estimated 30 percent in 2012 and falling. In the highly patented world of pharmaceuticals, substitution is often unfeasible, particularly when it comes to advanced medicines used to fight diseases such as cancer and multiple sclerosis. “
  3. “There is no doubt that Tehran’s general unpreparedness for and mismanagement of the sanctions imposed on it compounded and exacerbated the complex problem of medical shortages in Iran.  In fact, Iran’s own Minister of Health and Medical Education Marziyeh Vahid Dastjerdi lost her job after unambiguously rebuking the government for its maladroit handling of the medical shortage crisis.”
  4. ”Two factors stand out and are more pronounced than the others: (1) Sanctions create a bottleneck in the banking facilities necessary for trade; (2) Sanctions cause scarcity of hard currency needed for trade with European and American manufacturers.”
  5. ”Drilling holes in the painstakingly-crafted sanctions wall around Iran may be a hard pill to swallow for Western policymakers.  But unless action is taken, medical supply shortages in Iran will become more acute, and the West will fail to live up to its objective of “not contributing to the suffering of ordinary Iranians.”

Export Control, Iran, U.S. Foreign Policy, Europe


Oppenheimer, AndyCBRN Terrorism: Threat Becomes RealityMilitary Technology, Volume 40 Issue 3. Pages 60-61. 2016.

  1. “The long-heralded threat of CBRN terrorism became real in 2015 following several reported incidents of mustard gas used in IEDs and mortars by the so called Islamic State (IS) mainly against Kurdish forces.” – page 60
  2. “IS has acquired more wealth and territory than al-Qaeda in setting up its proto-caliphate and hence has been rapidly attracting regional and international affiliates; acquiring an arsenal of weapons and purloined resources unprecedented for any insurgency or terrorist group in modern history.” – page 60
  3. “… IS applies means of conventional warfare, such as bombing and artillery, while also relying on ways of non-conventional warfare and the tried and tested terrorist MO of numerous suicide bomb attacks” – page 60
  4. “Areas under attack are spreading in the Middle East and North Africa (MENA).” – page 60
  5. “IS is said to be actively recruiting experts with a background in physics and chemistry, and has already proven its capability to use CW against its adversaries. In Libya, Syria, and Iraq they control facilities that stored raw CB material, including traces of sarin-type chemical weapons, ricin-type biological weapons and mustard agents.” – page 60
  6. “Several organisations such as the European Parliamentary Research Service (EPRS) and the NATO WMD Non-Proliferation Centre have urged that Europe must prepare for the possibility of a chemical or biological attack by IS…” – page 60
  7. “Major terrorist plots in the Middle East, Europe and the USA show that IS successfully infiltrated local societies with either comprehensive sleeper cells or lone wolves. The consequences in European security and defence policies were severe: IS’ new tactics lead to a lockdown of Brussels the week after the Paris attacks.” – page 60
  8. “Apart from arresting and putting on trial returnees from Syria with suspected IS allegiance, several EU countries have set up de-radicalisation programmes with varying degrees of limited success” – page 6

Libya, Iraq, Syria, Europe, Africa, Military, Chemical, Nuclear, WMD, Sarin, Ricin, Terrorist/Offender, Al-Qaeda, Isis, NATO, Bioterrorism