Global Biosafety and Biosecurity Challenges Dealing with Bioterrorism: A Systematic Review for Policy and Health Preparedness

Background: The global community faces growing risks from emerging infectious diseases and bioterrorism, driven by shifts in national security, globalization, and advances in biotechnology. Biosafety plays a vital role in fostering international collaboration to counter terrorist threats, promote shared benefits, and enhance biosecurity. This study explores global biosecurity challenges and suggests strategies to enhance global biosecurity against bioterrorism. Methods: A comprehensive search strategy was designed to identify English-language literature across Scopus, PubMed, and Web of Science. Gray literature was additionally gathered via Google and other relevant websites. The databases were exhaustively searched for articles up to April 20, 2025, irrespective of the publication period. The Preferred Reporting Items for Systematic Review and Meta-Analysis Statement 2020 checklist was applied to screen articles, extract information, and synthesize related findings. This protocol is registered in the PROSPERO database with the number CRD42023445914. Results: In total, 25 out of 676 records met the inclusion criteria for the systematic review. The information obtained from the studies was organized and summarized into five sections and 24 subsections. The main categories were biosafety defense, biosafety issues and challenges, health sector challenges, legal frameworks, and solutions to deal with bioterrorism. Conclusion: This research systematically reviews biosafety concerns related to bioterrorism, proposing solutions and countermeasures. It offers a roadmap for decision-makers to enhance community preparedness by improving surveillance, strengthening laboratories, enforcing restrictive laws, and promoting international cooperation.