Chemical, biological, radiological, and nuclear medical countermeasures: Current challenges and future directions in...

Chemical, biological, radiological, and nuclear (CBRN) hazards encompass CBRN materials that can have adverse effects if accidentally or deliberately released. With the increase in the use of CBRN-related agents for research, therapeutics, diagnostics, industrial use, etc., these agents have become available. Thus, the probability of occurrences of CBRN emergencies has also increased. Therefore, nations are striving hard to strengthen themselves to handle such situations. CBRN emergency preparedness is a vast area comprising devices, drugs, equipment, systems, etc. Each aspect of CBRN preparedness is humungous, and proportionately meager efforts are under progress for various reasons. The most important aspect is that it is a matter of state because the cost of CBRN preparedness is very high. Among the different aspects, drug development for the management of CBRN emergencies is extremely important wherein several efforts by the agencies have resulted in a handful of antidotes. Additionally, research toward the development of drugs and drug products for CBRN agents is an extremely important area to be encouraged. This paper highlights the challenges in CBRN drug development. Additionally, it also suggests the measures that may help to empower the researchers and manufacturers to contribute toward CBRN medical management preparedness. SIGNIFICANCE STATEMENT: This paper underscores the urgent need for focused drug development to address the unique challenges posed by chemical, biological, radiological, and nuclear threats. It highlights existing gaps and proposes strategies to strengthen medical preparedness and response.