In 2003, epidemiologist Nicholas Thomson was doing HIV prevention work in Chiang Mai, Thailand, when the country’s president, Thaksin Shinawatra, launched an aggressive war on drugs. “Thaksin gave permission to extra-judiciously take out what were meant to be drug traffickers, and we lost a couple hundred people out of our prevention trials who weren’t drug traffickers,” says Thomson, who was working with a team from the Johns Hopkins Bloomberg School of Public Health in Baltimore, Maryland. “We were decimated.”
Thomson, who today has a joint appointment with Hopkins and the University of Melbourne in Australia, realized that part of the problem was that the Hopkins and Chiang Mai University research collaboration had not forged strong enough connections with the nation’s police, Ministry of the Interior, and prisons. “I thought this can’t happen again, and I spent the next 10 years trying to go as deeply as I could into the ministries responsible for public security across Southeast Asia to see what the levers were that could be adjusted to get a better public health outcome—without mentioning public health or human rights,” Thomson says. He soon realized that the intersection of public health and security, which involves both the police and the military, reached far beyond HIV/AIDS, and today affects responses to polio, Ebola, Zika, malaria, mental health, bioterrorism, and disasters.
That rarely acknowledged intersection is the topic of a special series of three papers that Thomson coordinated and were published online today in The Lancet. ScienceInsider spoke with Thomson about the topic and the changes he’s advocating. This interview has been edited for clarity and brevity.