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Dual use opportunity and public health infrastructure
  1. Thomas May
  1. Correspondence to Dr Thomas May, Institute for Health and Society, Medical College of Wisconsin, Institute for Health and Society, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA; tmay{at}mcw.edu

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The paper ‘Biodefence and the production of knowledge’ by Buchanan and Kelley1 is an extremely valuable addition to the scientific and bioterrorism defence literature. It points out the myriad of ways that the structure of current debates about the dual use problem(s) neglects important values, and discussions of how these values should be considered in policy making. In this commentary, I will focus on only one of these areas: what the authors characterise as ‘dual use opportunity’. My goal is not to challenge the authors’ main points (which I largely agree with), but to draw out the complicated set of value conflicts that this single area of bioterror defence policy has neglected.

Buchanan and Kelley characterise the concept of ‘dual use opportunity’ as the idea that ‘research undertaken for biodefence may contribute, or might be made to contribute, to the alleviation of the burden of disease among the world's worst-off people.’ I have argued for a similar idea of dual use opportunity in a different context by suggesting that we should prioritise global public health infrastructure over narrowly defined research on specific agents and/or projects that seek to prevent altogether (rather than quickly respond to) biological attacks—a goal that, I have argued, is futile given the almost limitless number of forms of, and mutations to, disease bacteria and viruses that might be employed by biological terrorists.2–5 Effective control of an epidemic requires a fundamental infrastructure of surveillance and reporting. Because the …

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