Autocratic leaders in history have a direct impact on health security. Dictatorships, with direct knowledge of the negative impact on health, create adverse political and economic conditions that only complicate the problem further. This is more evident in autocratic regimes where health protections have been seriously and purposely curtailed. This summary acknowledges that autocratic regimes are seriously handicapped by sociopathic narcissistic leaders who are incapable of understanding the health consequences of infectious diseases or their impact on their population. They will universally accelerate defenses indigenous to their personality traits when faced with contrary facts, double down against or deny accurate science to the contrary, delay timely precautions, and fail to meet health expectations required of nations under existing International Health Regulations, laws, and Epidemic Control surveillance.82