Pandora Report 3.9.2018

Nerve agent attacks, horsepox synthesis, and funding global health security, oh my! On top of all the biodefense news we’ve got in store for you this week, we’re also thoroughly excited to announce the 2018 summer workshop on pandemics, bioterrorism, and global health security.

Summer Workshop on Pandemics, Bioterrorism, and Global Health Security – From Anthrax to Zika
We’re delighted to release the dates for the summer workshop on all things global health security. The recent publication of the horsepox synthesis study, uncertain future of U.S. investment in global health security, and a severe flu season, are just a handful of the topics we’ll be addressing in this three-day workshop from July 18-20, 2018. Did I mention that it’s also the centennial of the 1918/1919 pandemic? We face unprecedented microbial challenges in this modern age – whether it be the risk of nefarious actors misusing genome editing, antimicrobial resistance, or the speed at which a disease can circumvent the globe. Our workshop is the perfect place to learn from experts in the field and meet with a diverse group of fellow biodefense gurus. If you register before May 1st or are a returning member or GMU alum, you can even get a discount! From anthrax to Zika, our July workshop is the place to be for all things health security.

 The Herculean Challenge of Assessing the De Novo Synthesis of Horsepox 
Nine-headed Hydra or cleaning out the Augean stables? None of these tasks were particularly easy, and neither is truly assessing the risks and benefits of the recent horsepox synthesis. Two of the latest articles analyzing the implications of this research have been released this week in mSphere.  In the editorial, Michael J. Imperiale points to the increased attention on DURC and the debate surrounding the benefits of a new vaccine versus the potential for a nefarious actor to misuse the process. “The two articles posted today come from Gregory Koblentz at George Mason University, who argues that this work was poorly justified on two fronts, scientifically and commercially, and from Diane DiEuliis and Gigi Gronvall from National Defense University and the Center for Health Security at Johns Hopkins University Bloomberg School of Public Health, respectively, who discuss this study in the larger context of how the risks and benefits of dual use research are assessed and managed. (mSphere asked the leadership of Tonix to submit a manuscript, but we received no response.)” Koblentz first underlines the weak scientific foundation for the claim that the horespox synthesis aids in the development of a new smallpox MCM. He states that the “combination of questionable benefits and known risks of this dual use research raises serious questions about the wisdom of undertaking research that could be used to recreate variola virus.” Within his commentary, Koblentz addresses the scientific and commercial rationale for synthesizing the virus as well as the weak scientific basis for its use as a safer alternative for human vaccine use and the lack of demand for a new smallpox vaccine. “At the heart of the dual use research dilemma is the need to assess and balance the benefits and risks presented by an experiment or line of research. This is a difficult task given the largely theoretical risks posed by unknown adversaries in the future and the enticing yet uncertain benefits that the research may eventually yield. Indeed, measuring risks and benefits and weighing them can be a wicked problem that defies simple or straightforward conclusions. The difficulty of the task, however, does not excuse researchers, funders, or journal editors from trying to do so. While the benefits of biotechnology and life sciences research are beyond question, we should not take for granted the benefits of specific experiments or avenues of dual use research.” In their counterpoint article, Diane DiEuliis and Gigi Kwik Gronvall emphasize that the horsepox researchers went through due biosecurity diligence at their research institution, the importance of utilizing an analytical framework for assessing the risks and benefits of DURC, and discuss “relevant components of biosecurity policy and the biodefense enterprise (including the acquisition of medical countermeasures) in the United States.” DiEuliis and Kwik Gronvall point to the horespox synthesis (and the controversy) as an opportunity to evaluate how dual-use risks should be handled, the complicated approach to stockpiling MCM, and “the challenges of forecasting risks and benefits from a particular scientific discovery or technology”. They highlight the National Academies Imperiale report framework for evaluating the capacity for technology to be misused, which includes factors like weighing the use of the technology itself against consequence management, etc. They also note three issues that have been raised by the horespox paper that require additional consideration – “The decision of what to do with a technology or research area that is dual use cannot be black or white, MCMs cannot be a check-the-box procedure for the USG, The synthesis of and booting up of a pathogen should serve as strategic warning that current biosecurity controls and preparedness are insufficient.” DiEuliis and Kwik Gronvall note that “Now that the work has been published, the authors examined the research according to the Imperiale report framework, which aims to provide a systematic way to evaluate biosecurity risks. We again found that while dual use information would benefit highly experienced actors who are intent on misuse, the recreation of smallpox virus may require additional research and development steps than have been described in this publication: smallpox virus is less similar to horsepox virus than horsepox virus is to vaccinia virus, the tools to recreate horsepox virus were originally developed for vaccinia virus, and they might require additional troubleshooting for re-creation of smallpox virus.”

NTI Launches GHS Video: Act Now to Protect U.S. Investment in Global Health Security
The Nuclear Threat Initiative (NTI) has launched a new video urging Congress to act now and ensure funding for global health security. Dr. Elizabeth Cameron, NTI VP, global biological policy and programs, is spear-heading the endeavor to turn the tides and ensure sustained funding for global biodefense. “Without sufficient funding of $208 million a year for the Center for Disease Control (CDC) and $172 million a year at the United States Agency for International Development (USAID), we weaken the global network of protection, increase risk to American lives, and threaten investments from other governments and the private sector. Urge Congress to act now to provide sustained funding for global biodefense.” Cameron notes that “in response to the devastating Ebola crisis of 2014, the United States Congress authorized over $900 million in supplemental funding to support the Global Health Security Agenda (GHSA) for five years to help countries prepare for and address biological threats. This critical funding runs out at the end of fiscal year 2019, placing up to 80% of our global health security efforts abroad – offices, personnel, and programs – at risk. Also at risk?  U.S. health security and extended biodefenses. Without sufficient funding of $208.2 million a year for the Center for Disease Control (CDC) and $172.5 million a year at the United States Agency for International Development (USAID), we weaken the global network of protection, increase risk to American lives, and threaten investments from other governments and the private sector.”

Ominous Biosecurity Trends Under Putin
If you ever needed a reminder of the importance of investing in global health security, this just might provide that cold dose of reality. The latest book from Raymond Zilinskas and Philippe Mauger, Biosecurity in Putin’s Russia, assesses Russia’s actions regarding DURC and biosecurity measures. “They investigate — solely through open sources — the current Russian position. They especially dig into issues such as ‘genetic weapons’ (bioweapons aimed at damaging DNA, potentially of specific individuals or groups) and biodefence research. Their underlying intention throughout seems to be to examine the likelihood that the Russian government is itself willing to engage in banned activities related to biowarfare agents. The book thus becomes a technical-scientific detective story.” This is an in-depth analysis by two top biological weapons specialists – definitely worth the read!

A Nerve Agent, An Ex-Russian Spy, And A Bench in the U.K. 
Speaking of Russia…..a former Russian spy was recently found alongside his daughter in critical condition on a bench in Salisbury. The former spy, Sergi Skripal, and his daughter, Yulia, were found slumped over on Sunday and in desperate need of medical attention. It is now being reported that they were poisoned by a nerve agent, which has raised the suspicion that this was an assassination attempt. “The development forces the British government to confront the possibility that once again, an attack on British soil was carried out by the government of President Vladimir V. Putin, which Western intelligence officials say has, with alarming frequency, ordered the killing of people who have crossed it. Prime Minister Theresa May and her cabinet ministers held a meeting on Wednesday of the government’s emergency security committee to discuss the matter. ‘This is being treated as a major incident involving attempted murder by administration of a nerve agent,’ said Mark Rowley, Britain’s chief police official for counterterrorism and international security.” Twenty-one people are also being treated for exposure to the nerve agent in connection to the attack.

Netflix Documentary – Rajneesh Salad Bar Bioterrorism
Get ready for some Netflix and nerdom on March 16th as the documentary on the largest bioterrorist attack in the United States is released. “In 1984, more than 700 people in The Dalles, OR, contracted Salmonella infections after followers of Rajneesh sprinkled the pathogen on salad bar ingredients in 10 local restaurants. The action was an effort to swing the results of an election.” Don’t miss out on the biosecurity twitter activity during a virtual viewing party – @pandorareport!

#NoImpunity: Will The Newest International Effort to Stop Chemical Attacks in Syria Succeed?
How can we stop the use of chemical weapons if there is no authority on attribution? GMU professor Gregory Koblentz is delving into the latest strategy to hold the Assad regime accountable for their continued use of chemical weapons. Between Russian vetoes that halt OPCW efforts and the death of the Joint Investigation Mechanism, many worry that the lack of punishment will encourage further CW use by the Assad regime. “To fill this gap in the global anti-chemical weapon architecture, France launched an international initiative in January to pressure the Assad regime to halt its use of chemical weapons. The Partnership Against Impunity, which uses the hashtag #NoImpunity on Twitter, is a group of 25 countries motivated by the twin goals of deterring future chemical attacks and bringing to justice the perpetrators of past attacks.” Sure, the sanctions by some of these countries are ultimately more symbolic than behavior-changing, but they are now infusing a dose of public shaming into the mix. “First, by curating a public database that lists all of the front companies and procurement agents used by the SSRC, the Partnership Against Impunity makes it easier for other countries and companies around the world to avoid doing business with Syria’s chemical weapons program. While sanctioning these shadowy companies and middlemen is like playing ‘whack-a-mole,’ it is an essential element of preventing Syria from rebuilding the capabilities that the OPCW destroyed after Syria joined the Chemical Weapons Convention.” The Partnership Against Impunity is also laying “the groundwork for future prosecutions of military officers and government officials who engaged in war crimes” and establishing a “concrete manifestation of the noble goal enshrined in the preamble of the Chemical Weapons Convention ‘to exclude completely the possibility of the use of chemical weapons’.”

 Assessing CRISPR – The Dread And the Awe
Genome editing is a hot topic – both in terms of future possibilities, but also potential peril. GMU biodefense professor Sonia Ben Ouagrham-Gormley and doctoral student Saskia Popescu are teaming up to review two new books on this gene editing technology. First, A Crack in Creation by Jennifer Doudna, one of CRISPR’s creators, who discusses the revolutionary marvel with a mixture of hope and dread. “Doudna became aware of this paradox soon after publishing the seminal 2012 article that announced her discovery. She was surprised and delighted by the technology’s rapid spread and its use in a variety of fields, yet some applications—such as the use of Crispr to edit human embryos, as performed for the first time by Chinese scientists in 2015—made her uneasy about the future of the technology. Unscrupulous individuals’ interest in using Crispr for pure profit made her uneasy as well.” Next, Modern Prometheus by computational biologist and freelance writer, Jim Kozubek. “He ponders the power of genetic manipulation as a gateway to the dehumanization of medicine and the objectification of human beings. Kozubek draws comparisons with ‘Jurassic Park’ and Mary Shelley’s Frankenstein to pose larger questions about genetic engineering—and also to point out that, though people are fascinated with technological advances, they often neglect to consider technologies’ implications, notably on people themselves.”

The U.S. and Global Health Security At A Time of Transition
The Kaiser Family Foundation will be hosting this free event on Monday, March 12th from 2-3:30pm EDT at the Kaiser Family Foundation Barbara Jordan Conference Center in Washington, D.C. This event will seek to explore the future of U.S. global health security efforts, what role the U.S. will play in the future of the GHSA, and more through a panel of experts. “Jen Kates, Vice President and Director of Global Health and HIV Policy, will provide opening remarks, and Anne Schuchat, Acting Director, Centers for Disease Control and Prevention (CDC), will give a keynote address on U.S. global health security efforts. Josh Michaud, Associate Director of Global Health Policy at the Kaiser Family Foundation, will moderate a follow up discussion with Beth Cameron, Vice President for Global Biological Policy and Programs at the Nuclear Threat Initiative (NTI); Rebecca Katz, Associate Professor and Co-Director of the Center for Global Health Science and Security at Georgetown University; Nancy Knight,Director of the Division of Global Health Protection at CDC; and J. Stephen Morrison, Senior Vice President and Director of the CSIS Global Health Policy Center.”

New Paradigms for Global Health: Building Capacity through Science and Technology Partnerships
The American Association for the Advancement of Science and Hitachi Ltd. will be hosting this event on March 21st from 11:30am-12:30pm at the AAS headquarters in New York City. “Why are science and technology partnerships — and science diplomacy — more critical to global health than ever before? Jimmy Kolker, former U.S. ambassador to Uganda and to Burkina Faso and the Obama Administration’s chief HHS health diplomat, offers a practitioner’s perspective on new ways of integrating and advancing global health science, security, and assistance. Public-private and technical partnerships can enable the best experts to build sustainable capacity in low- and middle-income countries, strengthening global health science, policy, systems, and delivery.”

Stories You May Have Missed:

  • The Troubling Truth About Medicine’s Supply Chain –  Maryn McKenna (author of Big Chicken and all around global health guru) is lifting back the curtain on the painful reality that is America’s hospital supply chains. While not something the public generally considers, it’s something we need to start fixing. “Missing IV bags and missing pharmaceuticals seem like unrelated problems, a temporary disruption layered on top of a longstanding problem. But in fact, they are unavailable for the same reason. The United States has allowed the manufacturing of most of its drugs and medical devices to drift offshore, at the end of long, thin supply chains.”

Thank you for reading the Pandora Report. If you would like to share any biodefense news, events, or stories, please contact our Editor Saskia Popescu (biodefense@gmu.edu) or via Twitter: @PandoraReport

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