Pandora Report 10.26.2018

Happy Friday! Halloween is next week but Europe is already taking measures against some of the scariest germs out there – antibiotic resistant microbes. The European Parliament just adopted two laws to limit the use of antimicrobials in food-producing animals.

U.S. National Security Action Plan: Strengthening Implementation of the International Health Regulations
This newly released plan is based upon the 2016 Joint External Evaluation and an effort coordinated by ASPR. “The U.S. Health Security National Action Plan follows an intensive Joint External Evaluation (JEE) of U.S. capacities in May 2016, which was conducted as part of our commitment to the domestic implementation of the International Health Regulations (IHR) (2005)—an international legal framework for global health security, where countries build their own health security capacities and take part of a global surveillance and response network created through the IHR. As a result, the activities proposed in the plan address capacity gaps found by national and international subject-matter experts during the JEE and also further the multi-sectoral and multi-disciplinary approach promoted by the IHR to adequately prevent, detect, and respond to public health security threats.” The plan reinforces participation in the GHSA and emphasizes the importance of working across multiple sectors and disciplines to help prevent, detect, and respond to public health threats.

GMU Biodefense Journal Club Meeting
Are you a current GMU biodefense graduate student? Don’t miss out on the next meet-up with a fun group of fellow biodefense nerds, where you can chat about it all- from anthrax to Zika. The next meeting is on November 5th and the topic of discussion will be the 100th anniversary of the 1918/1919 flu, so check your email for the location info, etc.

 Anticipating Emerging Biotech Threats
GMU Biodefense professor Sonia Ben Ouagrham-Gormley teamed up with Kathleen Vogel to discuss CRISPR and its potential as an emerging biotech threat. “In light of literature on the sociotechnical dimensions of the life sciences and biotechnology and literature on former bioweapons programs, this article argues that we need more detailed empirical case studies of the social and technical factors shaping CRISPR and related gene-editing techniques in order to better understand how they may be different from other advances in biotechnology — or whether similar features remain. This information will be critical to better inform intelligence practitioners and policymakers about the security implications of new gene-editing techniques.” Ouagrham-Gormley and Vogel note the importance of considering issues with off-target effects and replication of experiments when evaluating CRISPR and its popularized ease of use and diffusion.

2018 Arizona Biosecurity Workshop
Don’t miss this two-day workshop in Phoenix, AZ, on December 13th/14th. Held at the Arizona State University campus, “this two-day workshop focuses on community engagement with biosecurity concerns in an applied and practical manner. The goal of this workshop is to foster awareness and to stimulate conversation about the ethical, moral and social implications of biosecurity.” You can view the agenda here.

Ebola Updates
On Saturday, 11 civilians were killed and many more attacked in the town of Mayongose, on the outskirts of Beni. UN Secretary-General Atonio Guterres “condemned Saturday’s attack in the town of Mayongose on the outskirts of Beni, in which at least 11 civilians were killed, and several more were injured and abducted. He said he is also ‘deeply troubled’ by reports that on Friday, two Congolese health workers helping to combat the Ebola outbreak, were killed in Butembo by armed militia. Such attacks continue to hamper humanitarian access in the conflict-torn region and prevent health workers from tackling the outbreak.” Cases in Beni have topped 100 and on Thursday, 3 new cases and 2 deaths were reported in Beni, which brings the total case count to 247, including 150 deaths. “In its regular situation report, the WHO said top concerns are the spike in cases over the past 4 weeks, especially in Beni, and the security challenges response teams are facing in Beni and Butembo. ‘Continued security incidents severely impact both civilians and frontline workers, forcing suspension of EVD response activities and increasing the risk that the virus will continue to spread,’ it said. Vaccination in Beni could not take place in Beni on Oct 21 because of community demonstrations in the wake of attacks the day before, the WHO added. It also said investigations continue into the steady stream of confirmed cases that aren’t from known transmission chains, a sign that the virus continues to spread undetected.” Response efforts have also been an issue as the “The director of the Centers for Disease Control and Prevention said Tuesday that he argued that American experts should stay in the outbreak zone of the latest Ebola epidemic but was overridden by others in the Trump administration because of security concerns. ‘Those decisions are security decisions that really are outside the realm of my public health expertise,’ said the director, Robert Redfield, who said he made a case to the Department of Health and Human Services about why public health experts should remain in the outbreak area but that, at the end of the day, his argument didn’t win out.” Due to security concerns, the CDC withdrew workers from the outbreak several weeks ago. Stephen Morrison of CSIS noted that “There’s a fear of making a mistake and getting clobbered by Congress. There’s a fear of a Benghazi-type situation, that Americans might be targeted,” he said. “We’re looking at possible change of power in the House of Representatives in another 14 days.” (In 2012, an Islamic militant group attacked US government facilities in Benghazi, Libya, leading to the deaths of four Americans.)”

The Dangers of Forced Quarantine
The efficacy of forced quarantine has been questioned for years. Many experts have underscored that this antiquated measure desperately needs to be evaluated in light of the growing threat of a pandemic in this globalized, heavily populated world. From the HIV/AIDS epidemic to Ebola, the stigma that has been associated with disease does little to aid response efforts. “Perhaps the greatest danger of forced quarantines that isolate the poor and vulnerable is that they often don’t work. By eroding trust in public health measures, they undermine the ultimate goal of protecting societies from the spread of disease. People find ways to break free. It is thus possible that giving patients and the public more choices—and the option to quarantine themselves—could in some instances be more effective at fighting off pandemics than police or military-enforced quarantine.”

The Price of Pandemic Prevention
The Coalition for Epidemic Preparedness Innovations (CEPI) just released a new study regarding the cost of developing vaccines for 11 epidemic infectious diseases. Accounting for the constraints of vaccine pipelines and challenges of R&D, their findings are particularly helpful for pandemic prevention efforts. “The cost of developing a single epidemic infectious disease vaccine from preclinical trials through to end of phase 2a is US$31–68 million (US$14–159 million range), assuming no risk of failure. We found that previous licensure experience and indirect costs are upward drivers of research and development costs. Accounting for probability of success, the average cost of successfully advancing at least one epidemic infectious disease vaccine through to the end of phase 2a can vary from US$84–112 million ($23 million–$295 million range) starting from phase 2 to $319–469 million ($137 million–$1·1 billion range) starting from preclinical. This cost includes the cumulative cost of failed vaccine candidates through the research and development process. Assuming these candidates and funding were made available, progressing at least one vaccine through to the end of phase 2a for each of the 11 epidemic infectious diseases would cost a minimum of $2·8–3·7 billion ($1·2 billion–$8·4 billion range).”

Stories You May Have Missed:

  • UK Parliament Emphases AMR As A Priority – “The report by members of the House of Commons’ Health and Social Care Committee warns that “modern medicine will be lost” if the government does not take more aggressive action to reduce inappropriate use of existing antibiotics and promote development of new antibiotics. ‘Visible and active Government leadership needs to be restored to tackle AMR,’ members of the committee wrote in the report. ‘We therefore urge the Prime Minister to work closely with her relevant ministers to raise the profile of AMR both at home and on the international stage’.”


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