The nation is critically underprepared to confront transnational biological threats ranging from DIY bioterror agents to natural pathogens that outpace current pharmaceuticals and overwhelm medical facilities, the Blue Ribbon Study Panel on Biodefense heard at a Wednesday event at the Hudson Institute.
James Lawler, a retired Navy commander whose experience includes serving as director for medical preparedness policy on the National Security Council and director for biodefense policy on the White House’s Homeland Security Council, warned that the country is “woefully unprepared for these biological threats” in an increasingly interdependent world.
“Events halfway around the world have rapid effects,” he said, and the nation suffers from a “lack of threat awareness and poor situational awareness as it comes to biological threats.”
Problems include “excruciatingly slow and moribund” programs that rely too much on “backwards engineering” of the last big threat along with insufficient staffing and not enough human intelligence on biological programs, as well as a “lack of situational awareness in day-to-day health activities.”
Lawler stressed that there are “still significant problems connecting the clinical world with the public health world,” while the ability “to be able to understand those events in real time is critical to being able to defend ourselves in rapidly evolving events.”
As genetic engineering continues to evolve, he warned, the threat will “exponentially” increase with “significant potential for malevolent use.”
“Innovation is going to be the key to moving us ahead,” he said, with a need “to think beyond the linear approach we’re using now.”
“If you’re the kind of person who lies awake at night thinking about problems, this is one of the problems you should be thinking about… we’re now in the era of the iPhone 10 and we’re still using a flip phone.”
Kenneth Luongo, president and founder of the Partnership for Global Security, echoed that the U.S. “remains woefully underprepared” for a biological attack or a “new intensity level” of pathogens. He cited Rhode Island hospitals being overwhelmed by flu patients this past winter to the point of having to transfer overflow patients, “and this is an infectious disease that we prepare for every year.”
Better modeling is needed to map the potential spread of disease, he said. Synthetic biology presents new challenges from a risk perspective as new biological systems can be used for malicious purposes, he warned.
Because of the natural lack of transparency about biological programs from authoritarian regimes, it “falls to the intelligence community to determine what’s happening” in research programs with “serious questions” like Russia — where Luongo has “no doubt” there’s an active biological program with weapons potential.
“Is there any reason to believe even if we had global rules and we signed the convention that anyone would live by the rules?” former Homeland Security Secretary Tom Ridge asked about synthetic biology developments. “If you think it’s developing at a rapid pace… where do we focus our efforts?”
“Start with the intelligence community — that’s where the information about the dark corners is going to come from,” Luongo advised.
Even though the lack of a biological attack has lowered the priority of addressing biological threats, Luongo warned “that’s a mistake.”
Ridge’s co-chairman on the Blue Ribbon Study Panel, former Sen. Joe Lieberman (I-Conn.), said later in the conference that while he’s worried about a bioterror attack the impact of an infectious disease pandemic could be worse as “the potential for devastation is great.”
Former USAID Director Andrew Natsios, director of the Scowcroft Institute of International Affairs, told the panel that the country is “a lot more fragile than we realize” when it comes to emergency response, and the ebola crisis demonstrated the need for several central points at which decisions can be made rapidly. “Time is of the essence — the longer the delay, the more people could die,” he said.
Natsios warned of the consequences of a lack of U.S. leadership in the international system. “We are sort of like Jimmy Stewart — we are going to see what the world looks like without that honorable man in the movie,” he said, referencing “It’s a Wonderful Life.”
With deficits in drug development, he suggested expanding upon the Gavi Vaccine Alliance model in which pharmaceutical companies are promised that if they mass produce, the products will be marketed through NGOs and the UN.
“Do not reinvent the federal organization wheel,” he suggested, while emphasizing the need for coordination. “Do not try, in cases of international aid programs, try to transplant what works well in a Western country to a developing country.”
And, Natsios recommended, “do not confuse emergency response with other biomanagement issues” – coordinating before the emergency and, once the event takes place, decentralizing to the lowest levels “or we won’t get there in time.”
Elizabeth Cameron, vice president for Global Biological Policy and Programs at the Nuclear Threat Initiative, emphasized that “bringing home people overseas working on this mission is not a good idea” as “detecting an outbreak at the source and stopping it there is certainly best for the country.”
She noted that, to the detriment of a “global biosecurity dialogue,” foreign and defense ministers are often not present at biodefense meetings.
“Pay attention to emerging risks including those associated with advances in technology,” Cameron said, including the ability to whip up a batch of smallpox from scratch.
She recommended an accountability framework focused on safer and secure biotechnology and transparency to account for gaps in commitments, and said a country index is forthcoming from the Bill and Melinda Gates Foundation.