Warning of the risk of a “myopic focus on coronaviruses to the exclusion of all other pathogens” as “other microbial threats to human health could prove far worse,” the Bipartisan Commission on Biodefense recommended comprehensive steps for agencies and private-sector partners to take with the ambitious goal of eliminating the threat of pandemics within 10 years.
“Despite all the turmoil and grief of the past two years, there is hope. We developed a vaccine in less than a year, pushing technology and innovation beyond what was thought possible, and we created new treatments and diagnostics,” the commission said in its new report The Athena Agenda: Advancing the Apollo Program for Biodefense. “Yet, while we stemmed the tide and averted an even greater catastrophe, we might not be so lucky next time. Whether natural, accidental, or deliberate, infectious disease threats are increasing in frequency and severity. It is a question of when, not if, the next pandemic arrives.”
The commission released The Apollo Program for Biodefense: Winning the Race Against Biological Threats in February 2021, detailing ambitious initiatives to develop and deploy technologies needed to defend against all biological threats and end the era of pandemic threats by 2030. In October, the report Saving Sisyphus: Advanced Biodetection for the 21st Century said collaborative action is needed now to replace an insufficient BioWatch system used by the Department of Homeland Security.
The Apollo Program is based on multiple tracks of “groundbreaking solutions,” public-private partnerships, strong international relationships, “sustained bipartisan support and stalwart leadership,” the commission said in its new Athena Agenda report. The program aims to detect new pathogens, “continually trace them from the source” and distribute rapid point-of-use tests “to every household in the country within days of detection” to foster real-time situational awareness, while advancing an “integrated innovation ecosystem that encourages high risk, high reward research” where success will depend “on forceful actions to transcend current institutional silos and technical constraints, while also avoiding the historical cycles of crisis and ‘out of sight, out of mind’ policies.”
“The Commission remains convinced that COVID-19 is not a once-in-a-century pandemic. Another biological event will occur much earlier than that,” the report states, noting that the risk of naturally occurring pandemics grows with diminished wildlife habitat quality, the exploitation of wildlife through hunting and trade, and genetic biotechnology advances that “are dual-use technologies that could yield accidental, unintended, and deliberate misuse by creating deadly pathogens or disrupting ecological balances.”
“Examples include the accidental release of smallpox from a laboratory in the United Kingdom, engineering of a deadly strain of influenza by a professor in the Netherlands, inadvertent self-injection of Ebola by an experienced scientist in Russia, and the unintended escape of Brucellosis from an industrial facility in China.”
The Athena Agenda recommends that the White House, Congress, and federal government fully implement the commission’s A National Blueprint for Biodefense released in 2015, including “prioritize innovation over incrementalism in medical countermeasure development,” “fully prioritize, fund, and incentivize the medical countermeasure enterprise,” “reform Biomedical Advanced Research and Development Authority contracting,” “incentivize development of rapid point-of-care diagnostics,” “develop a 21st century-worthy environmental detection system,” “review and overhaul the Select Agent Program,” and “lead the way towards establishing a functional and agile global public health response apparatus.”
The Apollo Program for Biodefense or its equivalent would be implemented across government agencies supported by multi-year adequate funding, and the National Security Council and White House Office of Science and Technology Policy would produce a National Biodefense Science and Technology Strategy, the report continues.
Congress, the NSC, and the Federal Emergency Management Agency would be tasked with producing “a comprehensive mid- and post-crisis report on continuity of government” during COVID-19 while Congress, the Food and Drug Administration, and Health and Human Services would “revamp regulatory processes and policies to authorize or approve innovative technologies before, during, and after biological events” and “modernize and accelerate approval pathways for platform technologies to produce medical countermeasures” incorporating lessons learned from COVID-19.
Congress, HHS, and the U.S. Postal Service — which has distributed free COVID test kits under the Biden administration plan to supply all households — would build on that experience by developing a strategy and implementation plan for distributing at-home tests and therapeutics in future pandemics. The White House and the Centers for Disease Control and Prevention would “develop a strategy for crisis and risk communications that builds public trust.”
On the technology side of the agenda, Congress, HHS, the Defense Department, and Department of Agriculture would be tasked with developing “at least one vaccine candidate for each of the 26 viral families that infect humans” along with “a suite of broad-spectrum antiviral drugs.” Congress and HHS would “develop a strategy for the rapid development of a virus-specific antiviral during an emerging outbreak” and, along with DoD, would “review previous advanced manufacturing capability efforts for technologies for medical countermeasures” and “expand advanced manufacturing capability for platform technologies for medical countermeasures.” USDA would join in the effort to “produce a research and development plan for needle-free methods of drug and vaccine administration.” Agencies would also focus on increasing U.S. sequencing capability and capacity, including developing affordable portable sequencing, and “further develop the ability to detect infections with minimally- and non-invasive methods” as well as “advance massively multiplexed detection capabilities” and “develop a plan for rapid development, approval, scaling, acquisition, procurement, and distribution of point-of-use diagnostic tests.”
Congress, HHS, DoD, USDA, DOI, and the Department of Veterans Affairs would invest in digital pathogen surveillance with enhanced information sharing to include the Office of the Director of National Intelligence. DHS would work with Congress and agencies to establish a secure National Public Health Data System, and Congress would authorize CDC’s Center for Forecasting and Outbreak Analytics beyond its COVID-era initial startup funding.
The agenda recommends that Congress, HHS, DoD, USDA, and DHS assess biosurveillance capabilities across the federal government, with NASA and the Labor Department assisting in developing next-generation personal protective equipment. The departments of Education and Transportation would work with DHS, HHS, and Congress on researching pathogen transmission in built environments, and DoD, FEMA, and GSA would assist in developing and implementing technologies that can reduce pathogen viability and transmission in built environments. The National Science Advisory Board for Biosecurity, HHS, DoD, and DOE would “review adequacy of biosafety and biosecurity standards, practices, and oversight to identify gaps, needs, and upgraded approaches.”
Congress, HHS, CDC, USDA would address laboratory biosafety and biosecurity challenges while a strategy would be developed to screen DNA synthesis providers and users. Entities would be required to purchase genetic material from verified vendors.
“We envision a time when people will look back and wonder how we ever let infectious diseases wreak havoc on our society — how we ever tolerated seasonal flu, let alone viruses like COVID-19,” the commission said.