Introduction

CBRN is an acronym for Chemical, Biological, Radiological, and Nuclear, referring to hazardous agents and materials capable of causing serious harm to humans, animals, plants, the environment, and the economy through intentional misuse, accidental release, terrorism, or warfare. These hazards include toxic chemical substances, pathogenic microorganisms such as bacteria and viruses, radioactive materials, and the effects of nuclear incidents or weapons.

The international community, national governments, and local authorities must establish comprehensive preparedness and response systems for CBRN threats by: 1) maintaining integrated surveillance and prevention systems; 2) conducting tactical response operations during incidents; 3) activating Whole-of-Government and Whole-of-Society integrated crisis management mechanisms during large-scale or complex emergencies; and 4) ultimately strengthening systemic resilience to ensure the continuity of critical local, national, and international functions.

Surveillance and Coordination System (UN & WHO Framework)

The United Nations Security Council has identified CBRN terrorism and proliferation as major threats to international peace and security through Resolutions 1373 (2001), 1540 (2004), and 2325 (2016) (UNODC, 2016). These resolutions call upon Member States to strengthen national non-proliferation systems, improve counter-terrorism capacity, secure hazardous materials, and reinforce coordinated preparedness and response mechanisms against CBRN incidents. In addition, the United Nations Global Counter-Terrorism Strategy emphasizes preventing the misuse of biotechnology, strengthening border and customs controls, combating illicit trafficking of hazardous materials, and promoting international cooperation (UNGA, 2006).

International governance mechanisms for CBRN security currently rely on the Chemical Weapons Convention (CWC), the Biological Weapons Convention (BWC), and the Nuclear Non-Proliferation Treaty (NPT). While the Organization for the Prohibition of Chemical Weapons (OPCW) and the International Atomic Energy Agency (IAEA) provide implementation and monitoring mechanisms for chemical and nuclear threats, respectively, the Biological Weapons Convention still lacks a formal verification and monitoring organization. This governance gap remains a significant challenge for global biological security preparedness.

Recent global events have demonstrated that CBRN risks are becoming increasingly complex, interconnected, and globally significant. Examples include chemical attacks in Syria, the VX assassination of Kim Jong-nam, Novichok poisonings involving Russian opposition figures, the 2001 anthrax attacks, the COVID-19 pandemic, the Fukushima Daiichi nuclear disaster, and ongoing nuclear tensions involving North Korea and Iran (Figure 1). These incidents collectively highlight the urgent need for integrated preparedness systems combining military medical capabilities, public health systems, intelligence, emergency management, and international cooperation.

The World Health Organization (WHO) provides practical implementation tools to support national preparedness and response capacities for CBRN and other public health emergencies. The International Health Regulations (IHR 2005), which are legally binding for all Member States, define 15 core capacities including those related to chemical events and radiation emergencies. Complementing the IHR, the Joint External Evaluation (JEE) tool assesses national capacities across prevention, detection, and response functions, while also addressing points of entry, chemical events, and radiation emergencies.

Yoon et al. (2025) analyzed health security implementation strategies to assess countries’ capabilities and capacities to prepare for and respond to CBRN threats and infectious disease outbreaks. Their findings suggest that countries should prioritize strengthening surveillance capacity and improving immunization performance indicators as foundational elements of national health security.

Military Medical Capabilities

Military medical systems provide rapid, organized, and scalable capabilities essential for responding to CBRN emergencies and other complex crises. During the COVID-19 pandemic, the Republic of Korea (ROK) Armed Forces Medical Command (AFMC) demonstrated a notable example of military medical support by transferring approximately 300 patients from the Armed Forces Daegu Hospital to another military medical facility and subsequently converting the hospital to receive and manage severe civilian COVID-19 patients (Konrad-Adenauer-Stiftung e., 2022).

Effective CBRN preparation and response requires coordinated action among government sectors by integrating defense, health, security, and emergency management systems. For example, chemical accidents are supported by the Ministry of Environment's Chemical Accident Response Information System (CARIS), and infectious disease accidents utilize the KDCA's national infectious disease monitoring and information system. Nuclear and radioactive accidents are supported by the Nuclear Safety Commission's National Radiation Emergency Medical Network. These mechanisms demonstrate the importance of integrating military, public health, and emergency management capabilities into an integrated national response framework.

CBRN threats are evolving rapidly in the context of geopolitical instability, technological advancement, climate change, and increasing global interdependence. Chemical accidents, biological pandemics, radiological disasters, and nuclear crises demonstrate that modern CBRN risks are no longer isolated events, but interconnected threats capable of simultaneously disrupting healthcare systems, economies, governance, military readiness, critical infrastructure, and societal stability. Strengthening preparedness against these threats therefore requires integrated approaches combining military medical capabilities, public health systems, multisectoral coordination, and international cooperation. Tactical preparedness must encompass prevention, surveillance, rapid detection, emergency response, medical countermeasures, risk communication, recovery governance, and long-term resilience planning.

Military medical systems provide unique operational advantages including rapid deployment capability, organized command structures, field medical operations, decontamination systems, logistics support, and surge healthcare capacity during national emergencies. However, military capacity alone is insufficient to manage large-scale CBRN disasters (United Nations Medical Support Section & Department of Peacekeeping Operations, 2024). Effective preparedness requires continuous collaboration between civilian and military sectors before crises occur.

Conclusion

Preparedness must begin during peacetime. Regular joint simulation exercises, integrated surveillance systems, interoperable communication platforms, shared stockpiling strategies, coordinated emergency operation centers, and collaborative education and training programs are essential for building trust and operational readiness between civilian and military sectors.

Whole-of-Government and Whole-of-Society approaches should become central pillars of national CBRN preparedness strategies. Future global health security efforts should prioritize integrated bio-surveillance systems, AI-supported early warning mechanisms, strategic stockpiling systems, One Health collaboration, and strengthened military-civilian medical partnerships.

Ultimately, strengthening CBRN preparedness requires a balanced combination of international governance, national public health capacity, military medical readiness, and societal resilience. Reinforcing cooperation under frameworks such as the IHR, CWC, BWC, and NPT will remain essential for reducing CBRN risks and enhancing both national and global resilience in an increasingly uncertain security environment.

Fig. 1.

CBRN Risks (example).

References

• Konrad-Adenauer-Stiftung e. V. (2022). Berlin Editorial Team: Daniela Braun, Amelie Stelzner-Doğan. The Role of Armed Forces in the Covid-19 Pandemic.
• United Nations General Assembly. (2006). The United Nations Global Counter-Terrorism Strategy (A/RES/60/288).
• United Nations Medical Support Section, & Department of Peacekeeping Operations. (2024). Medical support manual for United Nations field missions. United Nations.
• UNODC. (2016). The International Legal Framework against Chemical, Biological, Radiological and Nuclear (CBRN) Terrorism. United Nations Office on Drugs and Crime.
• Yoon, M., Fairusya, N., Nguyen, T. L. N., Jimenez-Baez, D. I., Prak, V., Afreh, O. K., & Chu, C. (2025). SWOT strategy for future global health security: insights from Indonesia, Cambodia, Vietnam, Dominican Republic, Ghana, and the Republic of Korea using the World Health Organization International Health Regulations monitoring tool. Osong Public Health and Research Perspectives, 16(2), 152-159. https://doi.org/10.24171/j.phrp.2024.0314ArticlePubMedPMC

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