Risk assessments for emerging infectious disease threats are often conducted independently of affected communities. Participatory approaches to risk assessment present an opportunity to integrate community knowledge early in the risk-based decisionmaking process. We conducted a scoping review to understand the breadth of evidence from human, animal, and environmental health disciplines for integrating community participation in steps of the risk assessment process. A systematic literature search in PubMed, Scopus, Ei Compendex, Embase, Web of Science, and Global Health Database identified 4993 articles, of which 138 met inclusion criteria for the review. The types of participatory approaches described in the risk assessment literature varied by degree of community involvement, types of communities engaged, and activities implemented to engage communities. There was substantial evidence from environmental contamination and climate change studies on conducting hazard and exposure assessments within a community-based participatory research model. However, examples of community participation in problem formulation, capacity assessments, data report-back, and pathway mapping were limited. Additionally, the limited examples of community-initiated and community-driven risk assessments suggest a need for improving community involvement from the earliest stages of research priority setting through all phases of data collection, analysis, and interpretation. Further research is also needed on adapting participatory approaches for emerging infectious disease risk assessments.

Portugal faces challenges in implementing the One Health approach for zoonotic disease. To foster integrated solutions, a "One Health Living Lab" initiative engaged diverse stakeholders, focusing on junior professionals (ie, veterinary students, public health residents, and environmental health technicians). For 2 months, multidisciplinary teams addressed Avian influenza H5N1 in cats, Mycobacterium caprae, Streptococcus suis, Crimean-Congo hemorrhagic fever (CCHF) through research, stakeholder engagement and solution codesign. Key outcomes included establishing a feline HPAI sentinel network, confirming S suis occupational risks, developing a timely CCHF preparedness exercise and identifying potential M caprae underdiagnosis. The living lab successfully fostered collaboration and generated practical, bottom-up initiatives. While highlighting persistent systemic barriers like data sharing, the model demonstrates a promising approach for engaging future professionals and strengthening Portugal's health security against zoonotic threats, ensuring sustained support and integration.

Artificial Intelligence (AI) has the potential to revolutionize biosecurity, health security, biodefense, and pandemic preparedness by offering groundbreaking solutions for managing biological threats. This landscape review explores recent advancements in AI across these fields, drawing from both grey literature and peer-reviewed studies published between January 2019 and February 2024. AI has demonstrated potential in predicting viral mutations, which could enable earlier detection of outbreaks, and streamlining resource allocation by analyzing diverse data sources. It could also play a crucial role in accelerating the development and deployment of medical countermeasures, such as vaccines and therapeutics. Additionally, use of AI may enhance laboratory automation, reducing human error and increasing biosafety. Despite these promising advancements, significant challenges related to the potential misuse of AI, data security, and privacy concerns necessitate careful implementation and robust governance. This article highlights the rapid progress and vast potential of AI in biosecurity and provides key recommendations for US policymakers to effectively harness AI's capabilities while ensuring safety and security. These recommendations include expanding access to advanced computing resources, fostering collaboration across sectors, and establishing clear regulatory frameworks to support the safe and ethical deployment of AI technologies.

Far ultraviolet-C (UVC) is an emerging, flexible technology for indoor air disinfection with the potential to reduce airborne transmission of pathogens while maintaining safety for human tissues. Despite its high efficacy to neutralize a wide range of pathogens and safety for human tissues, implementation of far UVC is hampered by regulatory gaps, consumer uncertainty, and unanswered research questions surrounding the formation and interaction of generated ozone and volatile oxidative byproducts. This commentary describes targeted recommendations for both epidemic-where rapid far-UVC deployment and ability to counter a wide variety of pathogens in balanced with potential environmental impacts on the indoor environment-and long term implementation scenarios, highlighting the need for human health risk studies, regulatory guidance for fa- UVC devices, and real-world cost benefit analyses, which consider the tradeoffs long term of far UVC and germicidal ultraviolet implementation. Far-UVC technologies demonstrate an exciting opportunity to promote the benefits of germicidal UV disinfection to more indoor spaces. More research is needed, however, to ensure its safe and equitable use and development. This work was in part informed by a workshop held by the Johns Hopkins Center for Health Security, which convened experts from academia, government, and industry to evaluate the scientific and policy considerations for far UVC, comparing the new technology to traditional germicidal ultraviolet.

Biological weapons can take many forms and have been designed for a variety of purposes, including-but not limited to-attacks on human populations. The 1972 Biological Weapons Convention has played a key role in the comprehensive prohibition and prevention of such weapons over the past 50 years. To sustain this prohibition into the future, states parties to the treaty must carefully monitor advances in science and technology, while also remaining vigilant against the risks posed by older, outdated forms of biological weapons.

The Biological Weapons Convention (BWC) was the first international disarmament treaty to eliminate an entire class of weapons. As it celebrates its semicentennial, the BWC is recognized for enshrining norms against the misuse of biology, even during the height of the Cold War: norms that encapsulated humanity's repugnance of bioweapons. Nevertheless, the BWC faces unique challenges compared to other disarmament treaties, such as the Nuclear Non-Proliferation Treaty or the Chemical Weapons Convention. These include debates around verification, sociopolitical friction across the states parties, and even accusations that states parties have maintained biological weapons programs despite their treaty obligations. Many experts note difficulties in strengthening the BWC, particularly in a multipolar, competitive geopolitical environment. One potential pathway to support the BWC is using open-source information collection, analysis, and methods applied toward a "layered approach to verification [which] could help build confidence in compliance and potentially verify the BWC." Colloquially known as open-source intelligence (OSINT), this intelligence-gathering discipline uses publicly available information and signals sources for fact-checking, investigating suspicious occurrences, and examining items of interest. This approach has shown promise in other weapons of mass destruction applications, from tracking and tracing Syrian and Russian use of chemical weapons to uncovering nuclear weapons arsenals. Further, as stakeholders generate and retain more biological data from multisource samples, now is an opportune time to examine how open-source information and methods might mitigate bioweapons risks. This is particularly germane to the present, as people explore OSINT information and methods as 1 tool to both help strengthen the BWC architecture and support transparency and norm-setting efforts outside of the treaty.

Over the past 5 decades, the Biological Weapons Convention (BWC) and the broader biosecurity agenda have evolved significantly, shaped by the widespread and rapid development of emerging science and biotechnologies. This evolving landscape demands more inclusive governance mechanisms and has driven scientific communities and networks of nonstate actors to play a crucial role in shaping biosecurity governance, thereby paving the way for a new approach for the BWC in the coming decades. In this commentary, we explore innovative approaches to strengthening global biosecurity governance by emphasizing the role of scientific communities and networks of new actors in enhancing the BWC's framework. We identify 5 key approaches for advancing biosecurity by analyzing cases we observed: (1) exploring governance strategies and providing early warning for emerging technology risks, (2) promoting biosecurity by design and responsible innovation, (3) capacity building through grassroots networks of new actors, (4) building action networks based on knowledge sharing and collaboration for rapid response to biosecurity risks, and (5) engaging in science diplomacy and bridging governance gaps. Building on the analysis of the linkages between these innovative approaches and the BWC, we seek to offer a forward-looking vision for revitalizing the BWC by incorporating efforts through a well-designed bottom-up mechanism, ensuring a more inclusive, collaborative, and proactive biosecurity governance framework in the coming decades.

India bears a quarter of the world's tuberculosis (TB) burden. In 2018, the country set an ambitious goal to eliminate TB by 2025-5 years ahead of the global target. While India has launched several large-scale public health initiatives, including Pradhan Mantri TB Mukt Bharat Abhiyan and Ni-kshay Poshan Yojana, several challenges persist that threaten progress toward elimination. These include data transparency issues, overburdened healthcare systems, and an unrealistic timeline for achieving elimination. In this article, we highlight underaddressed health security challenges-including multidrug-resistant TB, weak biosafety infrastructure, relapse without posttreatment monitoring, environmental contributors like air pollution, and a lack of targeted strategies for tribal populations and undocumented immigrants-and call for a revised approach to TB elimination aligned with the global 2030 goal, emphasizing evidence-based policy, improved surveillance, workforce support, multisectoral coordination, and environmental and technological interventions.

Upon the commencement of their second term in 2025, the Trump Administration initiated significant policy shifts within health security, driven by an "America First" agenda. This marks a notable departure from the United States' long-standing role as a central and influential leader in global health security. Historically, the US has championed this domain through substantial financial contributions, the sharing of critical technical expertise, and the establishment and support of numerous international health initiatives. This leadership was underpinned by a bipartisan consensus that recognized global health as integral to American values, enhancing its soft power and global standing. Decades of this commitment yielded tangible progress in controlling infectious diseases, strengthening health systems in low- and middle-income countries (LMICs), and fostering essential international cooperation. However, this recent pivot in US policy carries profound implications for the established global health architecture. It is generating a cascade of both tangible and intangible consequences across various health security domains, including funding mechanisms, global health governance, preparedness and response capabilities, outcomes in LMICs, science diplomacy, US soft power, and ultimately, US national security. Given the inherent difficulty in predicting the next pandemic, global solidarity and collective international efforts are paramount. In this, effective prevention and management demand proactive, multidisciplinary preparations worldwide where continued US support and leadership through increased investment in surveillance networks, strengthened international collaboration, and data-driven decisionmaking are instrumental. There is an urgent need for prioritizing global health leadership and ensuring sensible health security policies that reverse the systematic dismantling of established public health infrastructure.

The demands for vaccination, testing, and community outreach during the COVID-19 pandemic extended beyond public health capabilities. The role of independent pharmacies proved invaluable as they partnered with local, state, and federal public health entities to provide additional capacity. However, the complexities of federal partnering agreements and the limited awareness of independent pharmacy networks could delay engagement and support for underserved communities in future responses. Addressing this challenge requires tailored public-private partnership agreements and resilience frameworks for data sharing based on experience and exercises. This case study describes the experiences of independent pharmacies during the COVID-19 response, opportunities for sustained public health and pharmacy engagement, and recommendations for building a framework for rapid scale-up before the next public health emergency. Under the direction of the National Community Pharmacists Association Innovation Center, aggregators of independent pharmacies have collaborated to form the Independent Community Pharmacy Consortium for Federal Government Engagement. This consortium represents a majority of the 18,900 independent pharmacies in the United States and establishes a single initial point of contact for government agencies to reach independent pharmacies. The development and management of the consortium remains outside of the government, enabling continuity and flexibility. This case study offers a unique perspective of public health engagement and partnership with independent pharmacies based on documented responses, exercises, and discussions.