The use of intelligence to determine attribution of the 2010 Haiti cholera disaster

Some public health crises and disasters represent threats to national security. In 2010 and 2011, Haiti experienced a cholera disaster surpassing all others in the world following a catastrophic earthquake. A novel integrated intelligence system, the Haiti Epidemic Advisory System (HEAS), provided critical information indicating the United Nations was the accidental source of the cholera disaster. This report reviews the operational context of the HEAS in relation to traditional public health surveillance and the role of intelligence in the determination of biological threat attribution.