This article explores the demand-side rationale for chemical, biological, radiological, and nuclear (CBRN) medical countermeasures (MedCMs) and the critical factors that shape preparedness policy. It highlights that while CBRN events may be considered low probability, their potential for catastrophic health, economic, and political impact makes preventive investment indispensable. Medical countermeasures—including vaccines, prophylactics, and postexposure treatments—remain limited or unavailable for many CBRN threats. Developing and stockpiling effective MedCMs requires significant research and development funding, robust procurement systems, and long-term political commitment.
The paper identifies both soft and hard factors that influence demand-side decision-making. Soft factors include behavioral and political economics, the role of fear messaging, emotional responses, and policy nudges that can motivate leaders to prioritize CBRN preparedness despite long timelines and high costs. Hard factors include funding and sustainability models, collaborative infrastructure, and innovative financing mechanisms such as taxation, bonds, insurance, and auction systems that can make investment more viable. The authors argue that MedCMs should be treated as global public goods, necessitating international cooperation and coordinated funding strategies.
In this piece, the authors conclude that effective CBRN MedCM policy requires moving beyond narrow cost-benefit analysis to incorporate broader economic models that reflect opportunity costs, global public good frameworks, and collaborative governance. Without such approaches, governments risk underfunding preparedness and facing economic and social losses far greater than the upfront costs of investment. By integrating behavioral insights with financial innovation, nations can strengthen resilience and ensure access to life-saving countermeasures when future CBRN events occur.
Johnson, M. L. et al. (2019). Disaster Medicine and PH Preparedness, Cambridge University Press.
