Pandora Report: 6.17.2022

Monkeypox, plague, and COVID-19-Oh my! We have another mixed bag this week, covering the WHO’s formation of an external committee to help determine if monkeypox is a PHEIC, new research that helps determine the Black Death’s origin, INTERPOL’s collaboration with the WOAH, and the US Government’s new MOU on public health emergency testing capacity. As always, we round out the week with new publications, upcoming events, and announcements. Finally, we wish everyone a meaningful Juneteenth holiday weekend, as the US observes its newest federal holiday this Sunday.

No More Monkeying Around- WHO to Convene Emergency Committee on Monkeypox Spread

This Tuesday, the WHO announced it will convene a meeting next week of external experts to help the organization determine if the current spread of monkeypox is a public health emergency of international concern (PHEIC). As of June 16, 37 countries where the disease is not endemic are reporting outbreaks, with confirmed cases breaking 2,100 globally. These are mostly in Europe, with the UK reporting 524 confirmed cases, followed by Spain at 313, Germany at 305, Portugal at 241, and France at 183. Canada is reporting 159 cases and the US currently sits at 99.

This casts a dark shade over ongoing Pride celebrations for some, as many caution that the virus’s spread primarily in men who have sex with men echoes the spread of HIV/AIDS in the 1980s. Montreal announced this week that the city would expand its monkeypox vaccination campaign to all men who have sex with men, calling the city the “epicentre of the North American monkeypox outbreak.” As the diseases spreads in New York City, officials are cautioning the public to “Be aware, but don’t panic.” Sharon Otterman wrote in The New York Times that, “Grindr, the social networking app, sent a pop-up message about the risk of monkeypox to millions of European and American users. A sex party organizer in New York asked invitees to check themselves for lesions before showing up. And the organizers of the city’s main Pride celebrations posted a monkeypox notice Sunday on their Instagram account.”

The WHO’s monkeypox page is available here and is routinely updated with new guidance, press releases, and fact sheets. The US CDC’s global case tracker is available here and the US map and case count is available here.

The Black Death’s Origin Solved?

New research published in Nature this week identifies the origin of the infamous Black Death that killed an estimated 30-60% of all Europeans in the mid-14th century. Spyrou et al.’s article, “The Source of the Black Death in Fourteenth-Century Central Eurasia,” uses DNA data from seven people exhumed at two cemeteries located near Lake Issyk-Kul in modern Kyrgyzstan to shine light on this enduring debate. Ian Sample explains how the team came to focus on this location in The Guardian, writing “The international team came together to work on the puzzle when Dr Philip Slavin, a historian at the University of Stirling, discovered evidence for a sudden surge in deaths in the late 1330s at two cemeteries near Lake Issyk-Kul in the north of modern-day Kyrgyzstan. Among 467 tombstones dated between 1248 and 1345, Slavin traced a huge increase in deaths, with 118 stones dated 1338 or 1339. Inscriptions on some of the tombstones mentioned the cause of death as “mawtānā”, the Syriac language term for “pestilence”.”

Researchers at Germany’s University of Tübingen extracted DNA from these individuals’ teeth, finding that three of them contained Y. pestis. The bacteria’s genome was determined to be a “…direct ancestor of the strain that caused the Black Death in Europe eight years later and, as a result, was probably the cause of death for more than half the population on the continent in the next decade or so.” This determination also helps settle historians’ debate over whether the Black Death spread into Europe via Eurasian trade routes or Mongol military actions in the early 13th century, as Gina Kolata explains in The New York Times.

“Under a magnification of 500X, this photomicrograph of a Giemsa-stained lung tissue sample, harvested from a Pecos, New Mexico patient with secondary plague pneumonia, revealed the histopathologic findings that resulted from this illness. Note the presence of numerous, Yersinia pestis bacteria, which exhibited characteristic pleomorphism. In this view, the exudate was scant, though it did harbor the most abundant quantity of plague organisms.” Source: CDC Public Health Image Library, Dr. H.E. Stark

World Organisation for Animal Health Partnering with INTERPOL to Prevent Biocrimes

The World Organisation for Animal Health (WOAH) and INTERPOL (the International Criminal Police Organization) are partnering together to collaborate on building global preparedness and countering biocrimes and bioterrorism. This approach will see improved understanding between veterinary services and law enforcement, which is critical given the world’s current challenges. For example, INTERPOL’s website identifies several crimes as being linked to animal disease and able to harm human populations, including sales of falsified products, animal cruelty and abuse, agroterrorism, food fraud, non compliance, illicit wildlife use, smuggling, and poaching. To learn more about this collaboration, check out this interview with Fanny Ewann, Specialized Officer in INTERPOL’s Bioterrorism Prevention Unit, discussing what constitutes and biothreat, the agroterrorism risk today, and how INTERPOL, WOAH, and the Food and Agriculture Organization of the United Nations are working together to help improve collaboration between veterinary and law enforcement organizations. If you would like a re-fresher and brief history of the differences between biocrime, bioterrorism, and biowarfare, check out Oliverira et al.’s work discussing it here.

New MOU for Diagnostic Surge Testing Capacity for Public Health Emergencies Released

The US FDA, CDC, and several other stakeholders signed and released a memorandum of understanding earlier this month on enhancing lab testing capacity outside of CDC and public health laboratories before and during public health emergencies. After the US failed to build-up testing capacity rapidly in the early days of the pandemic, it became clear that many changes in regulatory policies are needed in order for this to not happen next time. The MOU reads in part:

The capability and capacity of PHLs was utilized during several outbreaks, including Anthrax 2001, the response to the Middle East Respiratory Syndrome, and Ebola outbreaks. However, public health laboratory systems are not currently designed to handle and execute diagnostic testing at a large scale and scope beyond the initial critical phases of public health emergencies. Furthermore, in the early phase of an emergency response, FDA-authorized tests and testing platforms may be inherently limited and may not be optimized for high throughput. The need to supplement public health laboratory diagnostic testing capacity has been demonstrated in previous virus outbreaks. At the advent of the H1N1 influenza virus outbreak, hospital- based clinical laboratories responded rapidly and effectively and the need for a coordinated and streamlined response from both public health and clinical diagnostic laboratories became apparent. The Zika virus outbreak resulted in the engagement of large independent laboratories with nationwide facilities. At the same time, hospital-based laboratories served the diagnostic needs of their patient populations. Most recently, the extensive demands for diagnostic testing during the coronavirus disease (COVID-19) pandemic quickly extended beyond public health laboratories and independent laboratories to other Clinical Laboratory Improvement Amendments (CLIA) certified testing facility types.

The Biden administration is also expected to release a revised National Biodefense Strategy as early as this month, signaling that some major pitfalls may start to be addressed in the United States’ biodefense game plan.

Summary of Expert Insights for the US Department of Defense Biodefense Posture Review Meeting

The Johns Hopkins Center for Health Security recently released this report discussing expert input on the Department of Defense’s first Biodefense Posture Review, including that of our own Dr. Gregory Koblentz. The Center writes that, “During the meeting, a variety of participants discussed two recurring recommendations:

  1. The DoD, and the nation, would benefit from organizational realignment so that one person or office is responsible for biodefense policy across the DoD. This would help the Department to plan, build resources, and engage experts. Current efforts that shift responsibilities depending upon the nature of the health security crisis—for example if it is deliberate or natural, outside the contiguous US (OCONUS) or domestic—inhibit coherent planning.
  2. Disinformation is a threat in all aspects of the biodefense posture, ranging from operational restrictions to reputational impacts on the United States. The DoD should routinely consider how its statements and actions can both enable and counter disinformation and take steps to minimize impact. Also, DoD should consider using its communications abilities to dissuade other nations from developing biological weapons.”

“Public Health Preparedness: Medical Countermeasure Development for Certain Serious or Life-Threatening Conditions”

The US Government Accountability Office released this new report this week discussing MCM development and the Food and Drug Administration’s Animal Rule, implemented in 2002 to guide animal efficacy studies when human clinical trials are not ethical or feasible. GAO writes, “We found that FDA has provided guidance to support development of medical countermeasures under the rule, such as by clarifying the types of data needed to demonstrate product efficacy. FDA has approved 16 medical countermeasures under this rule.”

“Back to the Future for Verification in the Biological Disarmament Regime?”

The UN Institute for Disarmament Research recently released this report from Revill, Borrie, and Lennane. They write, “Twenty years after the termination of the Biological and Toxin Weapons Convention (BWC) Ad Hoc Group negotiations, the notion of adopting a BWC verification protocol is now almost an article of faith among some States Parties to the Convention. Yet it is clear that in 2001, the work of the Ad Hoc Group was a long way from agreement around a robust regime capable of ensuring confidence in compliance with the BWC’s prohibitions. Moreover, if there are some elements of continuity in the biosecurity sphere since then, much has also changed – geopolitically, technologically and economically. These changes generate challenges as well as opportunities to strengthen the BWC, which remains a central multilaterally-agreed component of a much wider set of measures that have emerged over the last two decades to prevent the hostile use of biology and manage the challenge of dual use biology around the globe. This report looks at these changes and identifies areas to move forward.”

“Lack of Access to Medicine is a Major Driver of Drug Resistance. How Can Pharma Take Action?”

The Antimicrobial Resistance Research Programme recently released this new report on antimicrobial resistance’s global rise. They write, “Antimicrobial resistance (AMR) is rising faster than expected. Worldwide, more than one million people die of AMR each year, most of them in low- and middle-income countries (LMICs). Resistant infections can rapidly spread without appropriate access to essential antibiotics and antifungals. Yet, the issue of responsibly providing access for people living in resource-poor settings has been largely overlooked. Pharmaceutical companies are only using a limited number of the opportunities that exist to expand access in poorer nations, resulting in significant gaps. This study sets out how companies and their partners are using a combination of access strategies to cut through the complexity and address access at a local level.”

“The Pig as an Amplifying Host for New and Emerging Zoonotic Viruses”

McLean and Graham’s new article in One Health discusses how the growth of pig demand and changes in pig husbandry practices have led to an environment that is conducive to increased emergence and spread of infectious diseases from swine populations. They write, “These include a number of zoonotic viruses including influenza, Japanese encephalitis, Nipah and coronaviruses. Pigs are known to independently facilitate the creation of novel reassortant influenza A virus strains, capable of causing pandemics. Moreover, pigs play a role in the amplification of Japanese encephalitis virus, transmitted by mosquito vectors found in areas inhabited by over half the world’s human population. Furthermore, pigs acted as an amplifying host in the first and still most severe outbreak of Nipah virus in Malaysia, that necessitated the culling over 1 million pigs. Finally, novel porcine coronaviruses are being discovered in high pig-density countries which have pandemic potential. In this review, we discuss the role that pigs play as intermediate/amplifying hosts for zoonotic viruses with pandemic potential and consider how multivalent vaccination of pigs could in turn safeguard human health.”

Book Talk- Biocrisis: Defining Biological Threats in US Policy

Al Mauroni, current Director of the US Air Force Center for Strategic Deterrence Studies, will be giving a book talk at the Center for Nonproliferation Studies in DC on June 21 at 10 am EST. How should the US government address biological threats today? In Biocrisis: Defining Biological Threats in US Policy, Al Mauroni provides a timely analysis of US policy on the intersection of national security and public health. He explores disease prevention, bioterrorism response, military biodefense, biosurety, and agricultural biosecurity and food safety, and proposes a new approach to countering biological threats. Learn more about the event and register here.

Reframing Vaccine Diplomacy amid Strategic Competition: Lessons from COVID-19

The Wilson Center is offering this panel event on June 23 at 10 am ET via webcast. Learn more and RSVP here. Addressing continuity and change in different actors’ global health policies over time, this panel will try to explore new strategies for vaccine diplomacy while sharing the perspective of less represented voices in health diplomacy. What lessons can be learned from the competitive nature of COVID-19 vaccine diplomacy to better understand the power and struggle of competition in the global health domain? What hidden layers of great power competition, diplomacy, philanthropy, and regional and national dynamics were revealed? How should new multilateral and bilateral phenomena of vaccine cooperation inform the global health policy making and international relations?

Schar School Applications Open- Deadline July 15

The Biodefense program is accepting Fall 2022 applications for our MS and graduate certificate program through July 15. Learn more about our admissions process and apply here.

Disarmament and Non-Proliferation of WMD 2022 Training Programme

The OPCW and Asser Institute are offering this training program September 19-23 in The Hague. The preliminary program is available here and includes information and discussion sessions on core WMD topics and contemporary policy issues offered by world-renowned experts in the field. There will also be networking opportunities. Registration is open and there are scholarships available. Scholarship applications are due by July 4, 2022.

Russian WMD Disinformation Resources

We are currently working on creating a searchable collection of resources on Russian WMD disinformation on the Pandora Report site. The page is a work in progress, and currently just lists resources we have highlighted in the past. In the meantime, here are some recent updates and works on the topic:

“The Pentagon Didn’t ‘Admit’ That There are 46 US-Funded Biolabs in Ukraine”

PolitiFact recently posted this debunking referencing the factsheet we added last week after internet users ran wild (again) with its discussion of CTR-supported facilities.

“Fact Sheet on WMD Threat Reduction Efforts with Ukraine, Russia and Other Former Soviet Union Countries”

The Department of Defense recently released this fact sheet covering the history and accomplishments of US collaboration with the international community to reduce WMD threats in Ukraine, Russia, and other countries who were formerly part of the USSR. It provides a comprehensive yet concise timeline of efforts, including the Nunn-Lugar CTR program, and discusses efforts by Russia and China to undermine these immense accomplishments today to further their agendas.

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