Pandora Report 7.7.2017

WHO Leadership Prioritization
There are six key positions the new WHO director general should prioritize, according to Mukesh Kapila of The Atlantic. The newly elected, first ever African director general has a lot on his plate and his future efforts will surely be evaluated against the mistakes and successes of his predecessors. Dr. Tedros comes into the position with somewhat of a dark cloud following him – during the election an advisor to his opponent made public comments accusing  Tedros of intentionally covering up outbreaks within his home country of Ethiopia. Kapila’s proposed to-do list for Tedros includes six main components. Firstly, promote home-grown national solutions, which focuses on sustainability and developing models that fit them and not a standardized solution for all countries. Secondly, remember that the WHO does not have a monopoly on health wisdom. “Delivering change will require a revisioning of WHO’s long-presumed position as the centre of the global health ecosystem. Today we have many well-resourced international bodies and national institutions with highly-qualified experts. Thus, WHO does not have a monopoly on health wisdom and its norm-setting and convening authority is questioned. It’s high time that the humbleness that has endeared Tedros to many people rubs off on the organisation.” Third, hire diverse talent that helps restore trust throughout member states instead of pulling from just a select few. Fourth, don’t get bogged down in international reform. “Tedros can’t afford to waste his five-year tenure on simply rearranging institutional furniture. All his recent predecessors as director general have huffed and puffed but ultimately failed to reform WHO. An effective and efficient organisation is just a means towards an end. So, Tedros only has to do enough to make WHO fit for the purpose of delivering his vision.” Fifth, look beyond traditional thought leaders – tackle the exhaustive list of issues by thinking outside the box and approach such challenges with a different vantage point. Lastly, accept that the WHO has to live within its means. “WHO is broke with budget gaps in priority areas and excessive reliance on ad hoc voluntary funding. But he should resist setting out with a begging bowl and instead reform the budgetary architecture and agree a new compact for consistent and predictable funding.” WHO headquarters alone are in an expensive location, but overall Tedros must work to truly budget accordingly while re-establishing the WHO as a leader in global health with a reputation that encourages participation and support.

Public Transit Emergency Preparedness Against Ebola and Other Diseases
Globalization and innovative developments in transit allows us to travel around the world within hours rather than days or months. Unfortunately, we’re not the only ones that travel with such new capabilities. Outbreaks like SARS, MERS, and even Ebola have all bubbled outside of their origins thanks to the ability of global travel. What can be done though? “The Transportation Research Board’s Transit Cooperative Research Program (TCRP) Legal Research Digest 50: Public Transit Emergency Preparedness Against Ebola and Other Infectious Diseases considers federal and state laws and available court decisions affecting transit agencies’ responses to infectious disease outbreaks, including potential cohesiveness among transit agencies’ procedures and federal and state guidance”. This finding highlights major topic areas like closures of major traffic generators, quarantine and isolation, employee protocols, etc. Overall, the TCRP digest investigates the legal basis for closures or emergency regulations on transit agencies as a response mechanism to pandemics or outbreaks. One particularly interesting component to the report is section VIII, which discusses infection control and disinfection measures related to transit.

Summer Workshop – Don’t Miss Out!
With just over a week before our Summer Workshop on Pandemics, Bioterrorism, and Global Health Security begins, don’t miss out on the last remaining spots! We’ll have instructors from all over the realm of biodefense discussing a range of topics as diverse as the threats themselves. Biotechnology and medical countermeasures? We’ve got it! Dual-use research and biosecurity? Got it. Don’t worry – we’ve got all the topics covered. You won’t want to miss this three-day workshop filled with wonderful topics and some of the top names in the biodefense field.

How Bill Gates Got Bioweapons Wrong
Following Bill Gates’s comments on bioterrorism, Filippa Lentzos points out that while his intentions were good, his comments about a terrorist wiping out 30 million people with a weaponized disease are wrong, especially as they draw such attention to amateurs as terrorists. Lentzos specifically highlights the tacit knowledge that would be needed for such an act and that frankly, it’s a stretch for terrorists to take advantage of biotech advances. “Available evidence shows that few terrorists have ever even contemplated using biological agents, and the extremely small number of bioterrorism incidents in the historical record shows that biological agents are difficult to use as weapons. The skills required to undertake even the most basic of bioterrorism attacks are more demanding than often assumed. These technical barriers are likely to persist in the near- and medium-term future.” Moreover, Lentzos points out that by making such comments, Gates distracts from those who are more concerning in terms of bioweapons – state-sponsored groups and national militaries. It’s within these groups that the capacity to develop and deploy weapons lies, not within the small DIY garage bioterrorist. “Another factor significantly limiting the use of biological weapons is their lack of perceived military utility. In the near-to-medium term, however, advances in science and technology may enable the development of more capable and more accessible biological weapons. These weapons might allow attacks to be targeted more precisely. Attribution would become more difficult. These technical developments—paired with changes in the social context around biological weapons—may lower barriers to the development and use of biological weapons.” To defend against these degrading barriers, Lentzos urges several things – modernizing the Biological Weapons Convention, use of a collective and convincing response for any breaches in norms against bioweapons or actual use of one, and development of national biodefense capacities. Lentzos leaves the reader with a final plea – within these biodefense programs, ensure biosafety and biosecurity, implement the BWC, declare the program to ensure confidence-building measures are submitted, and regularly review your program to ensure compliance with the BWC. In the end, it’s the state-sponsored or military bioattacks we should worry about rather than drawing attention to the potential for bioterrorists.

Bio: Separating Fact From Fiction
GMU biodefense PhD alum Daniel M. Gerstein evaluates the good, bad, and ugly of DIY biotechnology. Drawing on a range of events and even films, Gerstein first describes what exactly DIY biotechnology is as there is frequently confusion. He highlights the freedom that DIY biologists have in terms of their projects, especially since they aren’t driven by grants or deadlines that companies or universities place on such projects. The promises and perils of DIY bio has been met with an array of critics and supporters – some say that this freedom is how scientific discovery occurs, while others point to the lack of oversight and that people without fundamental understanding of scientific ethics may abuse such technology. “The DIY spirit is embedded in humankind’s quest for discovery and knowledge. As DIY bio continues to evolve, two ‘courses of action’ are available. The first would be to place harsh limitations on such activity, but that would ultimately be counterproductive and likely fail. The second would be to embrace DIY, understand its risks and limitations and work collaboratively with the community to shape activities to ensure the safety of those conducting the experiments and the general population. If and when boundaries are breached, swift and appropriate actions must be taken to remediate the actions and even discipline the offenders. Finally, important outreach will be important to ensure law enforcement and society at large understands DIY bio. The image of DIY bio in the movie Quarantined must be replaced with a more nuanced understanding of the benefits and risks of the use of biotechnology.”

Scientists Utilize Old School Approach Against Resistant Bacteria
In the fight against resistant bacteria, an old strategy may be worth a try – bacteriophages. Using viruses to kill bacteria is an old strategy but it may be effective for our new problem – resistance. While the strategy was first discovered in the early 20th century, isolating and truly utilizing bacteriophages was challenging. Fortunately, now we have technology and advances in medicine on our side. “As a result, scientists are taking a fresh look at what is called phage therapy. ‘They are starting to dust off their old laboratory notes and re-explore the use of bacteriophages as a ‘new’ way to treat serious, life-threatening infections,’ says William Schaffner, medical director of the National Foundation for Infectious Diseases. Increasingly, specialists in infectious diseases believe phage therapy holds promise against bacterial diseases, especially in cases where antibiotics have failed. In 2016, the approach saved a San Diego man who otherwise would have died. Several similar successes have been reported since then.” While phage therapy isn’t yet FDA-licensed for humans, it can be used in life-threatening situations (like the San Diego case), but researchers are working to combat the challenges with getting it approved. Despite its use in other countries as a means of treatment, there is limited phage data within the U.S. There’s a long road ahead for harnessing the power of phage therapy, but it just may be one of the greatest tools in the fight against the resistant germ.

Stories You May have Missed:

  • How the DRC Beat Ebola in 42 Days – After the destruction that the virus left in its wake in 2014/2015, the news that the Democratic Republic of the Congo (DRC) had a case, triggered PTSD for many. With the news of their initial case in May, public health response teams were dispatched and within 42 days, the outbreak was over. So how did the DRC manage such a feat? “This swift resolution was partly a matter of luck. The virus hit the remote and sparsely populated Likati region, which is 1,300 kilometers away from the capital city of Kinshasa, and nestled deep in equatorial rainforest. ‘People weren’t moving around in the way they were during the West African outbreak,’ says Anne Rimoin from the University of California Los Angeles, who has worked in the DRC for 15 years. ‘So it was a very small outbreak in and of itself’.”
  • The Trouble With Ticks– traditionally, we’ve seen ticks as a source for Lyme disease and not much else. Unfortunately, this isn’t the case as a bad tick season is afoot. “Experts say the Northern United States may be in for a bad tick season this summer, raising concerns about Lyme and other scary tick-borne diseases, including the Powassan virus, which causes encephalitis and can leave people with permanent neurological damage. ‘This spring definitely seems worse than others I remember,’ said Dr. Catherine Wiley, chief of general pediatrics at Connecticut Children’s Medical Center. ‘People are coming in from the yard with numerous ticks on them’.”
  • Ebola Exhibit – While we all remember the fear and frustration surrounding the most devastating outbreak of Ebola, a new exhibit is taking viewers through a visual journey of the epidemic. “A new and poignant special exhibit at the Centers for Disease Control and Prevention, in the agency’s David J. Sencer CDC Museum. Sencer, who died in 2011, happens to have been the CDC’s director in 1976, when the first known outbreak of Ebola occurred in Yambuku, Zaire — now the Democratic Republic of Congo.”

Pandora Report 6.23.2017

TGIF! Before we begin our weekly dose of all things biodefense, have you ever wondered the traits that predict animal or host spillover?

What Does A Post-Polio World Look Like?
Decades of battling diseases in eradication efforts has been a struggle throughout public health history, but what happens when you finally reach the finish line? Donors around the world have worked to eliminate polio and in the final stretch and last ditch efforts, many are asking what will happen when polio is eradicated and the donors are gone? The truth is that many polio eradication programs (which include vaccination and surveillance campaigns) actually form the foundation of public health for many countries and rural areas. These programs have been the backbone of establishing some semblance of public health for areas that many not receive it otherwise. “If and when polio is gone, however, much of the transition may fall to national governments. International funding stands to shrink dramatically. About 27 percent of WHO’s $587 million in spending in 2016 went to polio eradication efforts. The African region would also be particularly hard hit. Forty-four percent of WHO spending there went to polio efforts, and about 90 percent of all immunization staff and infrastructure on the continent are funded through the WHO’s Global Polio Eradication Initiative.” We haven’t really considered what it means to eradicate a disease like polio and how the withdrawing of funds and personnel might impact countries. Moreover, many of the polio eradication programs are closely tied to other vaccination programs (measles, tetanus, pertussis, etc.) and if funds are lost because polio is eradicated, these other vaccination programs could take a hit. Aside from vaccination initiatives, if stable public health programs are not established prior to eradicating polio, there is also a risk for loss of disease surveillance. Current polio eradication programs highlight the role of surveillance, which is also used to facilitate laboratory development, all of which could impact pandemic preparedness and global health security. It is vital that efforts to eradicate polio are also met with work from political leadership to ensure a transition occurs that maintains public health efforts. “The transition as polio is eradicated will be complex, and needs to be carefully managed, country specific and country led. Polio surveillance systems can provide an important foundation, and are tremendous assets to health care systems, said Irene Koek, the deputy assistant administrator of global health at the United States Agency for International Development. Civil society organizations will have a role to play in advocating to keep local governments and ministries on target, said John Lange, the United Nations Foundation‘s senior fellow for global health diplomacy.”

Instructor Spotlight – Summer Workshop on Pandemics, Bioterrorism, and Global Health Security
We’re getting closer to the July 17th start date for our workshop (and the July 1st early registration discount expiration!) and this week we’re excited to show off one of our very own GMU Biodefense professors, Dr. Sonia Ben Ouagrham-Gormley. An economics and defense expert, biodefense guru, and world traveler, Dr. Ouagrham-Gormley is the kind of professor whose class you spend the entire time on the edge of your seat. Sonia Ben Ouagrham-Gormley, PhD, is an Associate Professor in the Schar School of Policy and Government at George Mason University. She holds affiliations with GMU’s Biodefense Program, Center for Global Studies, and the Department of History and Art History’s Master of Arts in Interdisciplinary Studies (MAIS) program. Prior to joining the faculty at George Mason in 2008, Professor Ben Ouagrham-Gormley was a Senior Research Associate with the Monterey Institute of International Studies’ James Martin Center for Nonproliferation Studies (CNS). While at CNS, she spent two years at the CNS Almaty office in Kazakhstan, where she served as Director of Research. She also was the founding Editor-in-Chief of the International Export Control Observer, a monthly publication focusing on proliferation developments and export controls around the globe. From 2004 to 2008, she was an adjunct professor at Johns Hopkins’ School of Advanced International Studies in Washington, D.C. She is the author of Barriers to Bioweapons: The Challenges of Expertise and Organization for Weapons Development (Cornell University Press, 2014). She received her PhD in Development Economics from the Ecoles des Hautes Etudes en Sciences Sociales (EHESS) in Paris; a graduate degree in Strategy and Defense Policy from the Ecoles des Hautes Etudes Internationales in Paris; a master’s degree in Applied Foreign Languages (triple major in economics, law, and foreign languages —Russian, and English) from the University of Paris X-Nanterre, and a dual undergraduate degree in Applied Foreign Languages and English Literature from the University of Paris X-Nanterre. She is fluent in French, English, Russian, and spoken Arabic, and possesses beginner competence in Kazakh. For more information, visit https://schar.gmu.edu/about/faculty-directory/sonia-ben-ouagrham-gormley

President’s Budget Would Leave U.S. Vulnerable to Global Health Security Threats and Why We Need An Emergency Fund For Future Outbreaks
Cuts to public health, health research, and international aid have some pretty far-reaching implications and faculty from the Johns Hopkins Center for Health Security are pointing to the inherent vulnerability that would come from Trump’s proposed budget. Health security incorporates several programs and the reality is that an epidemic anywhere means an epidemic everywhere – simply put, the outbreaks that could pose a threat to the U.S. commonly begin abroad. “The proposed budget would cut $76 million from CDC’s Global Health programs, including cuts to Global Disease Detection and other programs that train and prepare countries to diagnose and respond to emerging diseases, and to the Global Immunization Program. It would reduce by $65 million CDC’s Emerging and Zoonotic Infectious Diseases programs, which aim to prevent and control outbreaks of diseases such as Zika. It cuts by $136 million the CDC Preparedness and Response Capability budget, which includes the funding for CDC’s Emergency Operations Center and the deployment of its people abroad to emergencies such as the Ebola epidemic in West Africa.” The CDC, among other agencies with biodefense positions, has a significant volume of vacancies that haven’t been filled.  More over, the authors point to the gap within the president’s budget regarding the future work of the GHSA, which is a vital multi-lateral effort to strengthen global health security. The budget has many worried because together, these cuts paint a bleak future for health security efforts – impacting surveillance, preparedness, and response efforts across the board. Global health security is simply not an investment we can afford to ignore. Did I mention that co-author Jennifer Nuzzo is also an adjunct professor at GMU’s biodefense program? Even if you’re not worried about the impact of the budget on health security, Ebola and Zika revealed just how necessary an emergency fund for outbreaks really is. “Creating a similar ‘rainy day’ fund—and providing the Centers for Disease Control and Prevention with permission to use it in advance—could save lives and money, both at home and overseas. The idea behind an emergency fund is not to displace efforts to combat infectious disease but to ramp them up to meet a crushing temporary need. During an outbreak the CDC can call on many doctors and nurses to work without pay, but the costs of transportation, medical supplies and protective equipment still have to be covered.” While the president’s 2018 budget includes such a fund, it fails to give a specific dollar figure and is already cutting into public health funding, which may be counterintuitive. “Lawmakers need to follow through by approving one or both of the proposed measures for the president to sign to ensure that the money will be there when the next public health emergency strikes.”

North Korea & A Sea of Sarin
The threat of nuclear-armed ballistic missiles from North Korea is a growing concern and while many focus on their nuclear and ballistic missile ambition, Reid Kirby is examining North Korean chemical weapons. Looking at the Terminal High Altitude Area Defense (THAAD) missile system and South Korean capital of Seoul, which houses more than 10 million people, many worry about North Korea’s ongoing vague threats. “Proponents of preemptive military action against North Korea’s nuclear program, along the lines of Israel’s 1981 Operation Opera against Iraq’s nuclear program, typically ignore North Korea’s history of asymmetrical responses. But North Korea’s capacity to inflict mass chemical casualties on the Seoul area in a ‘sea of sarin’ attack rivals its capacity for nuclear destruction.” In 2010, it was estimated that North Korea possessed 2,500-5,000 tons of chemical weapons (mostly sarin and VX) and maintains roughly eight manufacturing facilities, which could ramp up production to 12,000 tons. Kirby addresses estimates of rounds per minute and calculations of how much sarin Seoul might receive in such an attack, noting that “a heuristic approach to estimating the total quantity of sarin required to inflict 25 percent casualties on a city such as Seoul under the specified conditions simplifies the problem into a box model of 600 square kilometers, with casualty rates integrated by area to find the necessary quantity. Using this approach, a ‘sea of sarin’ attack on Seoul would require about 400 kilograms of sarin per square kilometer”. He highlights the consequences of a 240-ton sarin attack on Seoul, noting that it would kill around 6.5% (higher lethal dosage) or potentially 25% of the population (if lower lethal dosage assumed). “If publicly stated intelligence estimates are to be believed, North Korea’s chemical arsenal represents a credible and present threat. How North Korea could apply this threat as a deterrent is speculative. But the destructive potential of the threat should give reasonable cause to hesitate regarding preemptive military options against North Korea’s nuclear weapons ambitions.”

Pandemic Flu Plan – A New Approach
The US Department of Health and Human Services (DHHS) just released their updates to pandemic flu plans. “The original plan was geared toward a more severe scenario and set a goal of delivering pandemic vaccine within 6 months of a pandemic declaration. The new document incorporates lessons learned from the 2009 H1N1 pandemic, which resulted in a less severe event. It also spells out the goal of having the first vaccine doses ready within 3 months of pandemic strain emergence, along with approved broad-spectrum antivirals.” Within the plan there are now seven domains of focus, which include objectives, goals, and key steps. The domains are: surveillance, epidemiology, and lab activities, community mitigation measures, medical countermeasures, healthcare system preparedness and response, communications and public outreach, scientific infrastructure and preparedness, domestic and international response policy, incident response, and global partnerships. You can read the plan here, in which HHS notes that they are exploring several innovative approaches to pandemic flu preparedness like re-conceptualizing respiratory protection, accelerating vaccine and antiviral development, building on emerging technologies for innovative diagnostic and diagnostic testing, etc. “Taken together, the updated domains reflect an end-to-end systems approach to improving the way preparedness and response are integrated across sectors and disciplines, while remaining flexible for the conditions surrounding a specific pandemic. This more-nuanced and contemporary approach recognizes the interdependence of domain areas, which should lead to a better understanding of how the system functions as a whole.” The updated HHS pandemic plan emphasizes that while the nature of influenza and pandemics may change, the importance of planning and strengthening critical infrastructure will always be necessary.

DoD Tick-Borne Disease Research Program
There’s been increasing attention to the threat of tick-borne diseases and the DoD is ramping up research efforts. Their Tick-Borne Disease Research Program (TBDRP) looks to help increase not only treatment efforts, but also diagnostic capacity. Created in 2016, the TBDRP works to fill the gaps within tick-borne disease research through programs like the Idea Award which encourages and supports investigators in the early stages of their career. The New Investigator aspect of this award aims at those postdoctoral fellows working to develop independent research and in the early stages of faculty appointments. “There are currently at least 16 known tick-borne illnesses, with emerging diseases being discovered all the time. In the United States, the yearly cases of Lyme disease and other tick-borne diseases, including spotted fever rickettsiosis, anaplasmosis, and ehrlichiosis, have been increasing steadily for years, currently totaling tens of thousands of people diagnosed annually, with more likely undiagnosed. Globally, the US Military prioritizes tick-borne Crimean-Congo hemorrhagic fever as an operational threat abroad. The FY17 TBDRP intends to support conceptually innovative, high-risk/potentially high-reward research in the early stages of development that could lead to critical discoveries or major advancements that will accelerate progress in improving outcomes for individuals affected by Lyme disease and/or other tick-borne illnesses.”

Health Sector Resilience Checklist for High- Consequence Infectious Diseases
Johns Hopkins Center for Health Security and the CDC jointed together to take the lessons learned from Ebola and build a checklist to strengthen the U.S. in the event of such high-consequence outbreaks. This checklist focused on high-consequence infectious diseases (HCIDs), which are novel, moderate to highly contagious, moderate to highly lethal, not easily controllable by MCM or non-pharmaceutical intervention, and cause exception public concern (think Ebola, MERS, H5N1, etc.). “The principal aim of this project was to develop evidence-based recommendations to enable communities to build health sector resilience to events involving HCIDs based on the domestic response to confirmed cases of EVD in the United States.” Aside from the checklist, their findings highlight issues with governance and coordination, communication, public health issues, health-care specific issues, EMS, and laboratories.  The general checklist itself includes sections on preparedness, leadership, creative flexibility, command structure, public trust, managing uncertainty, and crisis and emergency risk communication. There are also checklists for public health, healthcare, EMS, and elected officials, which includes things like a collaborative relationship with partners at other healthcare facilities and awareness of resources related to public health law expertise.

Stories You May Have Missed:

  • Anthrax: DoD Develops Biological Select Agents & Toxins Surrogate Solution – “The Defense Biological Product Assurance Office (DBPAO), a component of the Joint Program Executive Office for Chemical and Biological Defense, has announced the development of a Biological Select Agents and Toxins (BSAT) surrogate solution that will mitigate the risks associated with shipment and use of Bacillus anthracis. In addition to risk mitigation for Department of Defense (DoD) stakeholders and the community at large, this product demonstrates DBPAO’s commitment to providing quality reagents to the DoD and to the biodefense community. To accomplish this task, the DBPAO developed a Bacillus anthracis surrogate strain named Recombinant Bacillus anthracis with Assay Targets (rBaSwAT) using a recombinant DNA approach to create a BSL-2-level genetically modified organism that will allow continuation of operations with reduced risk. The strain is built in a novel, non-virulent Bacillus anthracis background and carries a comprehensive complement of anthrax specific molecular and immunological markers.”
  • Bioviolence- Matt Watson from Johns Hopkins Center for Health Security, is taking us through the history of bioviolence aka using infectious diseases for violent purposes. While not everyone truly sees the immediate threat of biological agents, Watson highlights the newer threats like synbio and biotechnologis that have growing potential for misuse. He also takes care to highlight the history of bioweapons to truly show the range of their application. “Of all the scourges of mankind, plagues and warfare are almost certainly the most dreaded and dangerous. Several times throughout history—and more frequently than most people are aware of—there have been attempts by individuals, organizations, and nation-states to harness the former in service of the latter.” If you want a brief overview of historical biological weapons and to truly understand the future of biothreats, don’t miss out on this great op-ed.
  • New York City Legionnares’ Cluster – Health officials are scrambling to investigate the source of a NYC Legionnaires’ cluster in Manhattan. “In a Jun 16 statement, the New York City Department of Health and Mental Hygiene (DOHMH) said seven illnesses have been confirmed over the past 11 days. Four people are recovering in the hospital, two have been discharged, and one person in his or her 90s with underlying health conditions has died. Authorities are sampling and testing all cooling tower systems within a half-kilometer radius of the affected area of Lennox Hill. The health department is urging New Yorkers who have respiratory symptoms such as fever, cough, and chills to promptly seek medical care. In a typical year, about 200 to 400 Legionnaires’ cases are reported in New York City.” Legionnaires’ can be deadly for immunocompromised patients and is often a result of water treatment issues or poor disinfecting processes with spas, hot tubs, humidifiers, condensers, etc.

 

Pandora Report 5.12.2017

TGIF and welcome to your favorite weekly dose of all things biodefense! Check out this film from PBS Digital Studios Brain Craft exploring the technical and ethical questions about CRISPR and genetic engineering.

The Growing Threat of Pandemics: Enhancing Domestic and International Biosecurity
The Bush School of Government and Public Service at Texas A&M University just released their new white paper on biosecurity measures. The paper highlights the increased threat of pandemics due to globalization and ease of transportation. In their review they found nine priority areas that will help address the current biodefense problem. Their priority areas/action items are leadership, international response, the anti-vaccine movement, animal and human health, uniform health screening, public health and healthcare infrastructure, effective outbreak response, cultural competency, and academic collaborations. The white paper notes that “there should be uniform health screenings for individuals seeking permanent or extended temporary residence in the United States. Currently, there are discrepancies between the vaccination requirements for immigrants and the vaccination requirements for refugees.” The inclusion of the anti-vaccination movement was particularly interesting as few reports truly capture this in regards to biodefense efforts. “The increasing influence of the anti-vaccine movement in the United States is another growing threat. Leaders of the movement spread misinformation to parents with questions or anxiety over the safety of vaccines. Many within the anti-vaccine movement incorrectly believe that vaccines cause autism and the number of individuals seeking nonmedical exemptions to the vaccination requirements of schools is on the rise.”

Pandemic Summer Workshop Sneak Peek 
We’re getting closer to the July 17-19 workshop on pandemics, bioterrorism, and global health security, which means that starting next week, we’ll be highlighting some of the amazing faculty teaching the courses. Make sure to look for our spotlight on Dr. Andy Kilianski in next week’s Pandora Report as we’ll be looking at his work on biosurveillance and its role within U.S. biodefense efforts! Make sure to take advantage of the early registration discount before June 1st!

2017 Infectious Disease Mapping Challenge
Don’t miss this wonderful chance to show off your infectious disease mapping skills! The Next Generation Global Health Security Network and DigitalGlobe Foundation are “seeking undergraduate and graduate students, in a team or individually, to generate up to three maps (one map is perfectly acceptable) that illustrate a research question related to any of the categories detailed below. Maps can be analytic (examining relationships between multiple domains, phenomena, or data sources) or descriptive (depicting a single phenomenon or data source). While analytic projects are ideal, descriptive projects will be accepted as long as students/teams describe why their map depicts a notable phenomenon. Similarly, while international maps are preferred, domestic maps will be accepted if the student/team can provide justification as to why a map focusing on the U.S. is necessary (e.g., U.S. data sets on a given topic are the most comprehensive).”

Scientists Take On HIV By Using CRISPR
Researchers have just made headway in the battle against HIV/AIDS by using the genome editing technology, CRISPR-Cas9. Current treatment for HIV involves anti-retrovirals, which are pretty harsh on the body and come with several nasty side effects. In their fight against HIV, the research team used the CRISPR technology like a pair of scissors to get rid of the HIV-1 DNA in the body of mice. “If you cut out the DNA, you stop the virus from being able to make copies of itself. The team is the first to show HIV can be completely annihilated from the body using CRISPR. And with impressive effect. After just one treatment, scientists were able to show the technique had successfully removed all traces of the infection within mouse organs and tissue.”

Public Interest Report – Chemical Weapons
Don’t miss the latest publication from the Federation of American Scientists, which includes several articles on chemical weapons. The Public Interest Report (PIR) is a great source for articles on human rights, counterterrorism, and more. The most recent edition includes articles on the threat of toxic chemicals, investigations regarding the chemical attacks in Syria, the value of scientific analysis of chemical weapons attacks, and more. The president of the Federation of American Scientists, Charles D. Ferguson, also wrote a special message regarding the value of scientific analysis, specifically in regards to chemical weapons attacks. He highlights several articles regarding chemical weapons attacks over the years, one of which includes an analysis of symptoms and potential agents used. This specific work includes analysis from GMU professor, Keith Ward, and highlights the use of chemical weapons in Darfur and Sudan and the limitations of NGO documentation of chemical warfare agents. The article points to the specific symptoms following chemical weapons attacks and notes that “NGOs find themselves at considerable disadvantage compared to national governments when faced with evaluating evidence of alleged attacks using chemical weapons.”

Could Saving Animals Prevent the Next Pandemic?
70% of emerging infectious diseases are zoonotic, meaning that some type of a spillover event had to occur. Ebola, HIV/AIDS, H1N1, and avian influenza are all examples of spillover that has resulted in human morbidity and mortality. The USAID PREDICT program is working to combat this growing threat of zoonotic diseases. PREDICT works to establish a global surveillance system for infectious diseases that can spillover into humans. PREDICT is a collaborative effort between the University of California at Davis’s One Health Institute and the School of Veterinary Medicine, as well as the Wildlife Conservation Society, Metabiota, EcoHealth Alliance, and the Smithsonian Institute’s Global Health Program. “In its first five years, PREDICT trained 2,500 government and medical personnel in 20 countries on things like the identification of zoonotic diseases and implementing effective reporting systems. They collected samples from 56,340 wild animals, using innovative techniques like leaving chew ropes for monkeys then collecting saliva afterwards. They also detected 815 novel viruses—more than all the viruses previously recognized in mammals by the International Committee on Taxonomy of Viruses.” One of the tools PREDICT uses for surveillance is to monitor animal health and diseases that are circulating in them. “When you disrupt an ecosystem by removing a species through culling, you have a less healthy ecosystem and higher risk of disease,” says Megan Vodzak, a research specialist for Smithsonian’s Global Health Program. “Sometimes you increase the level of the virus within the population because you eliminate some but not all of the animals, and they’re still circulating it.” This brings about a humbling notion – conservation and human health might go hand in hand. Some researchers note that by protecting wildlife, we can help prevent spillover events and outbreaks. This concept however, is a bit more complex and has many on the fence regarding the actual role of conservation in human diseases. Some work has found that increases in biodiversity have no impact on human health, emphasizing the murky water of those trying to sell conservation as a tool for fighting pandemics. “When researchers do embark on conservation projects, she cautions that they should also consider other possible outcomes besides the protective benefit humans get from healthy wildlife and ecosystems. ‘We have to recognize that conservation could provide benefits for public health and it could endanger public health,’.”

The Battle of the Resistant Bug
We often think of an infectious disease threat emerging from some hidden jungle or quiet spillover event. While these are are true scenarios, I offer one more – the moment a bacteria becomes resistant to antimicrobials. Whether it be related to over-use in farming or over prescribing in healthcare, this is often a forgotten battleground. We’ve become accustomed to the ease and availability of antibiotics, which has translated to increased and improper use. Antibiotic resistant has frequently been overshadowed by the flashier of infectious disease threats however, this is to our detriment. Antimicrobial resistance (AMR) has proven time and time again to not only be a devious adversary, but one that gets little attention. Research and development into new antibiotics has lagged in recent years, which has only compounded the issue. One of the issues is also the lack of coordinated international surveillance and response strategies. Interestingly, Russian scientists recently developed an interactive world map, which shows human gut microbiota and their potential for resistance. The ResistoMap (pretty outstanding name, right?) makes it easier to track national resistance trends and potentially create an international response plan. “Using the ResistoMap, it is possible to estimate the global variation of the resistance to different groups of antibiotics and explore the associations between specific drugs and clinical factors or other metadata. For instance, the Danish gut metagenomes tend to demonstrate the lowest resistome among the European groups, whereas the French samples have the highest levels, particularly of the fluoroquinolones, a group of broad-spectrum anti-bacterial drugs.” While the rise of an emerging infectious disease should not be ignored, it is important that we remember the slower burn of antimicrobial resistance. Even Alexander Fleming saw the future involving a world without effective antibiotics, as he noted just following his acceptance of the 1945 Nobel Prize, “The thoughtless person playing with penicillin treatment is morally responsible for the death of the man who succumbs to infection with the penicillin-resistant organism.”

Regional Action Needed to Prevent Syrian Chemical Weapons Attacks
GMU biodefense PhD alum, Daniel M. Gerstein, is focusing on the role regional actors could play with respect to Syria, especially in terms of dissuading the use of chemical weapons. Despite the horrific attack in early April, global response has been surprisingly tepid and Russian support is ongoing, but Gerstein also highlights the “deafening silence” on the issue by countries within the region. Pressure could be applied from surrounding countries to indicate a strong message that the use of such weapons will not be tolerated. “Borders with Syria could be sealed to prevent any of the re­maining stocks from leaving the country. This would likely require a mix of military, law enforcement and border police to ensure that any illicit crossings are immediate­ly halted. In the event that chemi­cal weapons do breach the Syrian border, response forces should be prepared to stop suspect ship­ments, conduct searches of cargo and have appropriate protection to avoid becoming casualties them­selves.” Gerstein also notes that regional leaders could direct efforts towards Assad specifically, making it clear that Syria’s future will not include him, by calling for the International Criminal Court to indict him for war crimes.”Over the past 15 years, the norms against the use of chemical weap­ons have continued to be threat­ened, with increasing state and non-state actor use. Most of these attacks have occurred in the Middle East. This trend cannot be allowed to continue.”

The Chemical Attack in Syria – Sorting Truth from Propaganda
Rod Barton takes us through the April chemical weapons attack in Syria and argues against those who claim it was a “false flag” operation, staged by rebels to draw the U.S. into further intervention efforts. The most notable proponents of this argument have been former MIT professor Theodore Postol and Sydney University professor, Tim Anderson. In efforts to help break the cycle of a false narrative, the U.S. has released intelligence reports however, those who support the “false flag” narrative continue to point to misinformation and confusion about the April 4th attack as evidence. Barton argues against the “false flag” narrative by highlighting several points as evidence for the attack – victims seeking medical care following a Syrian air strike with classic symptoms of nerve agent poisoning, analysis samples that confirmed sarin, and the air raid crater found in the road north of the town, which tested positive for sarin and hexamine. Postol, on the other hand, while continuing to claim that the U.S. intelligence reports fail to prove definitively that the attack was done by the Assad regime, does not argue that it was sarin that killed the people in Khan Sheikhoun. “His case is largely based on the nature of distortion of the metal fragment in the crater – he claims this proves that it was not dropped from an aircraft, as stated by US intelligence. His theory is that a sarin-filled tube, possibly a 122mm artillery rocket body, was placed on the road by individuals on the ground and overlaid with a small explosive charge to disperse the agent.” Barton argues against Postol’s comments for several reasons – Postol fails to explain the origin of the sarin in the tubes, how the rebel groups managed to coordinate the detonation of their device with that of a Syrian government air raid, and that Postol fails to account for the evidence of a second chemical round that detonated around 300m from the road crater. Barton notes that “Postol was an eminent scientist and his views cannot simply be ignored. However, on this occasion the evidence to support his argument is not there – he has got it wrong. His writings on this subject have nevertheless been useful in that they have forced analysts to question the evidence closely to determine their degree of certainty in their assessments. But while the particulars are difficult to ascertain, there is still sufficient evidence to state beyond reasonable doubt that the Syrian military is responsible for the attack. In other words, the jury should convict – sadly, in today’s world, the reality may be different.”

Stories You May Have Missed:

  • 3-D Structures vs. Infectious Diseases– Northwestern University Feinberg School of Medicine is leading a team of international researchers to determine the 3-D atomic structure of more than 1,000 proteins to help develop treatments and vaccines against infectious diseases. “Almost 50 percent of the structures that we have deposited in the Protein Data Bank are proteins that were requested by scientific investigators from around the world,” said Wayne Anderson, PhD, professor of Biochemistry and Molecular Genetics at Feinberg, and director of the project. “The NIH has also requested us to work on proteins for potential drug targets or vaccine candidates for many diseases, such as the Ebola virus, the Zika virus and antibiotic-resistant bacteria. We have determined several key structures from these priority organisms and published the results in high-impact journals such as Nature and Cell.”
  • The Million Dollar Minnesota Measles Outbreak – the growing measles outbreak in Minnesota is projected to cost the state $1 million and is quickly growing. “When it began last month, public health officials knew this outbreak could be large and ongoing, because many Somali-Americans have been refusing the measles, mumps, and rubella (MMR) vaccine for years over unfounded rumors that the childhood immunization, whose first dose is routinely given to babies at 12 to 15 months, causes autism.” Sadly, the vaccination declinations in the Somali-Americans in Minnesota are considered to have been a result of targeting from anti-vaccine groups.

Pandora Report 4.28.2017

If you’ve ever wondered about the 1998 story regarding the WWI anthrax sugar cube, we’ve got this gem for you.

March for Science
This past Saturday (Earth Day), cities around the world saw hoards of scientists and supporters of research marching to both celebrate science, but also push for the preservation of funded and publicly communicated research. “The March for Science is a celebration of science.  It’s not only about scientists and politicians; it is about the very real role that science plays in each of our lives and the need to respect and encourage research that gives us insight into the world.  Nevertheless, the march has generated a great deal of conversation around whether or not scientists should involve themselves in politics. In the face of an alarming trend toward discrediting scientific consensus and restricting scientific discovery, we might ask instead: can we afford not to speak out in its defense?” Cities like Chicago saw 40,000 participating in the march, armed with lab coats, pink knit brain hats, and some pretty outstanding signs. Even some furry friends got involved to celebrate science. The D.C. march battled against rainy weather and included speakers like Bill Nye on the National Mall.

Summer Workshop on Pandemics, Bioterrorism, and Global Health Security
The May 1st deadline for an early registration discount is fast approaching, so don’t miss your chance to attend this educational and captivating workshop for a lower price! The three-day workshop will provide you with not only seminars from experts in the field, but also discussions with others interested in biodefense. You can check out the flyer and register for the event here. A returning participant, GMU student/alumni, or have a group of three or more? You’re eligible for an additional discount! Check out the website to get the scoop on all our expert instructors and the range of topics the workshop will be covering. From Anthrax to Zika, this is the place to be in July to get your biodefense nerdom on!

French Intelligence Brings Insight Into Syrian Chemical Weapons          A new French intelligence National Evaluation report details the direct evidence linking the April 4th chemical weapons attack in Syria to the Syrian regime. “The French report casts fresh doubts on the efficacy of what at the time was billed as a landmark U.S.-Russian chemical weapons pact, which was signed by U.S. Secretary of State John Kerry and Russian Foreign Minister Sergei Lavrov in late 2013. The pact was touted as practically eliminating Syria’s ‘declared’ chemical weapons program.” The French report is considered the most detailed evaluation of environmental analysis (among others) following the Syrian chemical weapons attacks. Not only does the April 4th sarin match that previously used by the Syrian regime, but it also points to the hexamine chemical signature found in the Syrian chemical weapons program. “The French intelligence report provides the most robust scientific evidence linking the Syrian government to the sarin attack in Khan Sheikhoun,” said Gregory Koblentz, the director of the biodefense graduate program at at George Mason University.”This scientific evidence is a direct refutation of the misinformation being peddled by Russia and Syria.”

The World Needs a DARPA-Style Project to Prevent Pandemics             We truly are not ready for a global pandemic. Across the board, all the reports, studies, and experts say the same and the latest article from Tom Ridge and Dante Disparte highlights this unpleasant reality. Zika, Ebola, SARS, and avian influenza have all shown us just how globally unprepared we are for such an event. “In public health, it is much easier to play offense than it is to play defense. Playing offense well, however, is going to require a lot more coordination – both internationally and within national borders. We believe an important first step in this effort is for the U.S. and governments around the world to develop an equivalent to the Defense Advanced Research Projects Agency (DARPA), that focuses cross-sector efforts on advancing biological and pandemic risk readiness.” No single sector can fix this problem, but rather it requires cross-sector collaboration to tackle organisms that know no borders. Ridge and Disparte insist that a a global “invest now or pay later” economic philosophy is needed to break away from stovepiping that allows biological threats to appear sector specific. “As with DARPA, the science and technology community are the unsung heroes in improving global biodefense and pandemic risk readiness. But unlike advanced military research, which is conducted under strict secrecy, the scientists working on improving our defenses to emerging threats must have a charter that encourages open collaboration and transparency. All too often research and technology investments, particularly those in the private sector, follow a zero-sum approach.”

U.S. Preparedness Index Points to Scattered and Mediocre Progress
The National Health Security Preparedness Index (NHSPI) was just released by the Robert Wood Johnson Foundation, which tracks progress at the state level regarding their capacity to respond to health emergencies. The good news is that overall, the U.S. score has increased over the past couple of years – 6.8 in 2016, up from 6.7 in 2015, and 6.4 in 2013. “Of six main dimensions—ranging from mobilizing resources after health incidents to involving stakeholders during crises—the nation as a whole improved except for one area: the ability to prevent health impacts from environmental or occupational hazards. That area is the only one showing decline from 2013”. Overall trends pointed to preparedness improvements except for those states in the Deep South and Mountain West States. Sadly, Alaska ranked lowest in the 10-point scale. “Challenges some states face include grappling with health policy uncertainties because of health insurance proposals, a situation that detracts attention and energy from other health security needs. Also, the analysis found that extreme weather events are increasing in frequency and intensity in many parts of the country, putting extra burden on food and water systems and other infrastructure areas. Though federal aid helps reduce fiscal capacity differences across states, federal preparedness funding falls far short in eliminating the health security gaps that separate affluent from poorer states, according to the report.” Policy recommendations based off their findings focus on engaging private sector, including health insurance coverage as a health security strategy, developing emerging response funding, etc.

Hospital Preparedness Program Performance Measures 
Speaking of preparedness…the 2017-2022 Hospital Preparedness Program Performance Measures Implementation Guidance was released via the Office of the Assistance Secretary for Preparedness and Response. “ASPR’s Hospital Preparedness Program (HPP) enables the health care delivery system to save lives during emergencies and disaster events that exceed the day-to-day capacity and capability of existing health and emergency response systems. HPP is the only source of federal funding for health care delivery system readiness, intended to improve patient outcomes, minimize the need for federal and supplemental state resources during emergencies, and enable rapid recovery. HPP prepares the health care delivery system to save lives through the development of health care coalitions (HCCs) that incentivize diverse and often competitive health care organizations (HCOs) with differing priorities and objectives to work together.” Within the latest guidance, you can find capabilities regarding healthcare and medical readiness, continuity of healthcare service delivery, and medical surge.

Meeting of the Presidential Advisory Council on Combating Antibiotic-Resistant Bacteria
Don’t miss the upcoming meeting on the battle against the resistant bug! You can catch this in person or via webcast on May 3rd (9am-5pm ET) and May 4th (9am-3pm ET). “The Advisory Council will provide advice, information, and recommendations to the Secretary of HHS regarding programs and policies intended to support and evaluate the implementation of Executive Order 13676, including the National Strategy for Combating Antibiotic-Resistant Bacteria and the National Action Plan for Combating Antibiotic-Resistant Bacteria. The Advisory Council shall function solely for advisory purposes.” If you’re planning to attend, make sure to register ASAP as this will be a great venue to discuss new treatments, alternatives for antibiotics, and transmission prevention strategies.

Unexplained Deaths in Liberia 
The good news is that heath officials have ruled out Ebola in the nine unexplained deaths following a funeral-related event. The bad news is that we’re still not sure what caused the deaths. “The United Nations has issued a precaution to its staff in Liberia regarding an unusual number of deaths at the FJ Grante Hospital, where the patients died. The agency added that health workers in the area have been advised to don personal protective equipment, even when treating patients who aren’t suspected cases.”

Stories You May Have Missed:

  • Sandia National Labs Honored in Fight Against Ebola– The New Mexico-based laboratories are being honored for their hardworking and dedication during the Ebola outbreak. “On April 11, Dmitri Kusnezov, chief scientist and senior adviser to the secretary of energy, visited Sandia to honor nearly 60 Sandians for work to mitigate the effects of the Ebola epidemic and the work of the Technology Convergence Working Group.” The Sandia lab teams worked to cut down detection times to help reduce the risk of transmission while rule-out cases were awaiting confirmation. Their teams also aided in modeling and analyzing Liberia’s national blood sample transport system.
  • Unpasteurized Cow’s Milk and Cheese Outbreaks – If you’re a fan of unpasteurized milk, you may want to reconsider. A recent study found that unpasteurized dairy products cause 840 times more illness and 45 times more hospitalizations than their pasteurized counterparts. “We estimated outbreak-related illnesses and hospitalizations caused by the consumption of cow’s milk and cheese contaminated with Shiga toxin–producing Escherichia coliSalmonella spp., Listeria monocytogenes, and Campylobacter spp. using a model relying on publicly available outbreak data. In the United States, outbreaks associated with dairy consumption cause, on average, 760 illnesses/year and 22 hospitalizations/year, mostly from Salmonella spp. and Campylobacter spp. Unpasteurized milk, consumed by only 3.2% of the population, and cheese, consumed by only 1.6% of the population, caused 96% of illnesses caused by contaminated dairy products.”

Pandora Report 4.7.2017

Don’t forget to tune in to CNN’s Unseen Enemy tonight at 7pm ET/PT to hear about the next potential pandemic from some of the world’s top disease experts!

Chemical Attack in Syria
On Tuesday, a chemical weapons attack killed dozens in northern Syria. While the Organization for the Prohibition of Chemical Weapons is working to collect data to determine the perpetrator, most are pointing to the Assad regime as the attacks appear to be consistent with a military-grade nerve agent. On Thursday it was announced that the autopsies performed on victims show they were subject to chemical weapons that were likely sarin nerve gas. Later last night, President Trump ordered a targeted missile strike on the Syrian Al Shayrat airfield via 59 Tomahawk cruise missiles. Some are saying the death toll from the chemical attack is between 70 and 100 and the volume of injured reported to be high. Russia is denying involvement in the latest attack that is said to have killed many children. Dr. Greg Koblentz notes that this has the implications of a sarin nerve attack, and if proven to be done by the Syrian regime, it’s one of the largest attacks. He emphasized that the U.S. will need to work to put pressure on Syria and on the Russian and Iranian allies who shouldn’t be immune to suffering the consequences from backing a regime who performs such attacks. Dr. Koblentz also recently spoke to the BBC regarding resolutions and international response towards the chemical attack, highlighting the importance of helping the victims and bringing the perpetrators to justice.

Can Bill Gates Rescue the Bioweapons Convention?
Who can save the Biological Weapons Convention? GMU biodefense graduate program director and professor Dr. Gregory Koblentz highlights the growing monetary deficits within the BWC. Dependent upon international cooperation and funding, many treaty members have been inconsistent at paying their budgetary share, which puts the implementation services unit and future meetings in jeopardy. Pointing to the challenges of acquiring funds, Koblentz draws attention to an individual who is both extremely wealthy, philanthropic, and interested in public health – Bill Gates. “Gates, ever the businessman, pointed out that this dire outcome could be avoided by spending an estimated $3.4 billion a year on pandemic preparedness. To his great credit, Gates and his foundation have already contributed vast sums to global health. Most recently, the Bill and Melinda Gates Foundation provided $100 million to help launch a public-private initiative called the Coalition for Epidemic Preparedness Innovations, with the goal of accelerating the development of new vaccines.” His recent comments at the Munich Security Conference regarding the realities of biological threats shine a harsh light the devastation a biological weapon could cause. Koblentz looks outside the box in this article, highlighting that dire times may call for unusual actions to save the BWC. “The global health community has achieved great gains over the decades, but a single bioweapon attack could reverse all that. Now more than ever, an ounce of prevention is worth a pound of cure.”

Safeguarding the Bioeconomy – Securing Life Sciences Data
Check out the latest meeting recap from the NAS workshop, which worked to assist the FBI WMD Directorate “in understanding the applications and potential security implications of emerging technologies at the interface of the life sciences and information sciences.” This workshop brought together experts from a wide range of fields to help solve the challenges of encouraging a strong bioeconomy, while preventing nefarious use and considering the implications of such data. “Advances in the life sciences are increasingly integrated with fields such as materials science, information technology, and nanotechnology to impact the global economy. Although not traditionally viewed as part of bio-technology, information technology and data science have become major components of the biological sciences as researchers move toward –omics experimental approaches.” “There is currently no government agency charged with holistically assessing the security of the bioeconomy, and the emerging importance of data (and data security) within it. These concerns will continue to grow as the world becomes more digitized and interconnected. There are a number of different types of data that can be aggregated and analyzed as part of the bioeconomy, and the collection, sharing and use of these different types of data may pose different potential concerns.” Within the workshop summary, you’ll see the division of bioconomy economy into clinical and nonclinical data, the biosecurity perspective from academia, technological advances that will further data access, data sovereignty issues, and much more.

Novel Antimicrobials – The Quest For The Grail?
The new CARB-X partnership is trying to combat the growing threat of antimicrobial resistance through innovation and supporting new research. “The CARB-X board thoroughly vetted 168 proposals and selected 11 projects that represent truly exciting early stage research. Three of them could become the first in new classes of antibiotics, and four are innovative non-traditional products. Some of the projects also take new approaches, known as mechanisms of action, to target and kill bacteria. All of the potential new medicines target Gram-negative bacteria prioritized by the U.S. Centers for Disease Control and Prevention and the World Health Organization.” BARDA is also in the race for halting the rise of the resistance bug – they’ve got a clinical-stage antibacterial program which has 13 products that are looking promising. The threat of antimicrobial resistance means that partnerships in even the most unlikely places are unfolding to help develop anything from new drugs to diagnostic tests that can determine if a lung infection is bacterial or viral. The truth is that the looming antibiotic apocalypse truly requires all hands on deck, so what’s the hold-up? At least we may have a potential cure in maple syrup

Pandemics, Personnel, and Politics: How the Trump Administration is Leaving Us Vulnerable to the Next Outbreak
GMU Biodefense graduate program director and professor, Dr. Gregory Koblentz, and MS student Nathaniel M. Morra are looking at the increase in infectious disease outbreaks in recent years (Ebola, Zika, SARS, MERS-CoV) and how the new administration is prioritizing public health. “Despite this heightened risk of a global pandemic, the Trump Administration has dragged its feet in appointing senior officials to key Federal agencies responsible for preparing and responding to a pandemic or bioterrorist attack. These agencies are also subject to steep budget cuts under Trump’s budget for Fiscal Year 2018. The delays in installing senior leaders at these agencies and pending budget cuts puts U.S. and global health security at risk.” Interim directors, a lack of Assistant Secretary for Preparedness and Response within HHS, and a planned cut in funds are already creating vulnerabilities within U.S. health security. “If a major influenza pandemic were to occur, no wall would be high enough to stop the virus from entering the United States. The best defense against pandemics and other disease threats are Federal, state, and local health agencies and international partners with strong leadership and the necessary resources to fund vital surveillance, preparedness, response, and research activities. Mother Nature doesn’t play politics; Trump shouldn’t play politics with global health security.”

Pandemics, Bioterrorism, and Global Health Security LinkedIn Group
If you’re not already already a member, make sure to check out this LinkedIn group “dedicated to the analysis of the challenges facing the world at the nexus of health, science, and security. The group’s purpose is to serve as a unique forum for discussion and debate on critical issues in global health security.” We’re happy to announce that the group just reached 3,000 members thanks to Arthur Seward-El and Veena R. Kumar! If you’re looking for a LinkedIn group dedicated to global health security and includes members from all over the world, don’t miss out!

Center for Health Security Emerging Leaders Take on The Eight Ball
I’m a biodefense nerd – always have been and always will be, so you can imagine my excitement when part of the ELBI class of 2017 fellowship workshop involved getting to visit the Eight Ball near USAMRIID. The Eight Ball is from the days of America’s active bioweapons program and despite its history, is now a rather interesting sight stuck between two buildings and surrounded by trash dumpsters. Dr. Koblentz has provided some great trivia regarding the Eight Ball – it cost $715,468 (in 1950 dollars), is four stories high and weights 131 tons, was used to test animals ranging from mice to horses, and held its first human tests in 1955 as part of Operation Whitecoat. “This one million liter metal sphere is currently tucked away behind a service building, but at one point it was the epicenter of Operation Whitecoat, the US Cold War biodefense program. From the 1950s through the ‘70s, researchers developing treatments for biological agents released small amounts of these selected agents into the eight ball, allowed them to disperse, and then exposed volunteers to this contaminated air via specially rigged gas masks. By treating the volunteers (who signed consent forms) with their newly developed vaccines and therapies, scientists were able to develop effective methods to respond to biological warfare. Whitecoat volunteers were exposed to agents that cause diseases such as rabbit fever (tularemia), Q fever, yellow fever, and plague.”

Digital Surveillance of Emerging Infectious Disease and Outbreaks: A One Health Approach 
Don’t miss out on this Next Generation Global Health Security Network Webinar on April 7th, at 1pm EST. You can check out the webinar here to learn from Maja Carrion, Assistant Director of ProMED, about digital health surveillance in human and animal sectors.

Investing In Public Health Keeps America Great
Simply put, a nation cannot be great if it lacks health. The proposed budgetary measure that drastically cut funding for HHS point to what public health has been battling for decades – a necessary force that receives too little funding amid too many expectations. Investing in public health is the most obvious thing one could do to make a country strong and capable of growth. Whether it be extending life, eradicating disease, or even a thriving workforce, public health is a force that simply can’t be ignored. “Instead of making deep investments in public health, and thus public safety, we allocate pennies. Americans spend more per capita on health care than any other country in the world, but less than 3 percent of all health spending goes to public health. The CDC’s budget has declined slightly over the past decade, and funding cuts at the state and local levels have been ‘drastic,’ says Trust for America’s Health.” At the end of the day, we have to ask ourselves – at what price do we value our own health and that of those around us?

Dynamic Challenges & Opportunities for Global Health Security Talk
All GMU biodefense students and alum are welcome to attend Dr. Gene Olinger’s talk during Professor Nuzzo’s BIOD 710 class on Tuesday, April 11th, from 6:15-7:10pm! Dr. Olinger serves as principal science advisor for MRIGlobal Biosurveillance and Global Health Division and will be talking about global health security as a subject matter expert for multiple federal panels related to biodefense and emerging viral pathogens.

Stories You May Have Missed:

  • Two Very Different Views of Terrorism and What To Do About Them – GMU biodefense PhD alum Daniel M. Gerstein is looking at the reaction to two major events – the aviation electronics ban and the London terrorist attack. He emphasizes that risk perception and personal inconvenience plays a big role in the limitations people are willing to accept in the name of safety. “Risk perception will undoubtedly continue to be an important determinant in the types of security policies and measures that will be acceptable to governments and the public. Clear and precise communications on the various threats faced, the vulnerability to particular attacks and the potential consequences of such attacks, could help reduce inflated perceptions of risk while at the same time making people more accepting of security enhancing initiatives.”
  • Measles Takes Hold in Eastern Europe– Europe is seeing a large outbreak of measles currently as over 500 cases were reported just in January 2017. 474 cases were reported in endemic countries (France, Germany, Italy, Poland, Romania, Switzerland, and Ukraine). “The largest current measles outbreaks in Europe are taking place in Romania and Italy. Romania has reported over 3400 cases and 17 deaths since January 2016 (as of 10 March 2017). The majority of cases are concentrated in areas where immunization coverage is especially low. According to reported data, the 3 measles genotypes circulating in Romania since January 2016 were not spreading in the country before, but were reported in several other European countries and elsewhere in 2015. Comprehensive laboratory and epidemiological data are needed before the origin of infection and routes of transmission can be concluded.”
  • 10 Saudi MERS Hospital-Associated Cases– Infection prevention goes well beyond the normal hand hygiene and healthcare-associated infections. MERS-CoV is a prime example of a disease that takes advantage of poor infection prevention efforts in healthcare. “A MERS-CoV outbreak linked to a dialysis unit at a hospital in Wadi Aldwaser has sickened 10 people, 2 of them with asymptomatic infections, the World Health Organization (WHO) said yesterday in an update covering 18 recent cases in Saudi Arabia.” Two of those infected are healthcare workers.

Pandora Report 10.2

All this rain and grey weather (at least in DC) makes us want to curl up with a good book and luckily, we’ve got just the reading list! This week we’re sharing some top-notch work by our phenomenal faculty and alumni for you to enjoy. Earlier this week, straight out of a James Bond movie, Elon Musk presented Tesla’s Model X and its Bioweapon Defense Mode. Google had its 2015 Science Fair and a pretty amazing high school student took home top honors for her work on Ebola. Did I mention Kansas is prepping for the zombie apocalypse? Needless to say, there was a lot going on this week in the world of biodefense, so let’s venture down the rabbit hole….

 Zombie Preparedness Month Starts for Kansas 
I’m thinking we may need to take a class trip to Kansas since Governor, Sam Brownback, will be signing a proclamation to officially designate October as “Zombie Preparedness Month”! Brownback’s rationale is to emphasize preparedness in any form, stating, “If you’re prepared for zombies, you’re prepared for anything. Although an actual zombie apocalypse will never happen, the preparation for such an event is the same as for any disaster: make a disaster kit, have a plan, and practice it.” During Zombie Preparedness Month, state emergency management services will have activities and information for residents to help get their preparedness on. They’ll also be using social media to engage people people on these topics. The one thing we’ve learned in biodefense, Gov. Brownback, is to never say never!

Connecticut Teen Wins Google Science Award By Developing Affordable Ebola Test
High school junior, Olivia Hallisey, just took home the Google Science Fair top prize for developing an affordable and easy Ebola test in her project, “Ebola Assay Card”, which quickly (we’re talking 30 minutes quick!) detects the virus and doesn’t require refrigeration. Each test only costs $25 and picks up antigens on photo paper. Hallisey summarizes, “In this new device, that is stable and stored at room temperature, 30µl drops of water were used to dissolve silk-embedded reagents, initiating a timed-flow towards a center detection zone, where a positive (colored) result confirmed the presence of 500pg/ml Ebola(+)control antigens in 30min, at a cost of $25,” Hallisey hopes this project will encourage other girls to pursue their passions in science. Hallisey is truly an inspiration and we tip our hats to her passion for solving world problems while encouraging her peers!

Let’s Talk Dual-Use!
Come listen and chat with Dr. David R. Franz, former commander of USAMRIID, about balancing research and regulations when it comes to dual-use!
Date & Time: Monday, October 5, 2015, 4:30-6pm
Location: Hanover Hall, L-003 George Mason University, Fairfax, VA, see map

​Dr. Franz was the Chief Inspector on three United Nations Special Commission biological warfare inspection missions to Iraq and served as technical advisor on long-term monitoring.  He also served as a member of the first two US-UK teams that visited Russia in support of the Trilateral Joint Statement on Biological Weapons and as a member of the Trilateral Experts’ Committee for biological weapons negotiations.  He previously served as member of the National Science Advisory Board for Biosecurity (NSABB). Dr. Franz currently serves on several committees including the National Academy of Sciences Committee on International Security and Arms Control and the National Research Council Board on Life Sciences. Dr. Franz is a leader in the areas of cooperative threat reduction and health security and an expert in the development of U.S. regulations for biological threat reduction and biological security.  Dr. Franz will discuss the history and current debates related to U.S. and international regulations for select agents, dual use research of concern, and gain-of-function experiments.

1977 H1N1 Influenza Reemergence Reveals Gain-of-Function Hazards
Dr. Martin Furmanski discusses the gain-of-function (GoF) research hazards in relation to the 1977 H1N1 strain and it’s laboratory origins. Highlighting a previous article on the GoF debate, Dr. Furmanski notes that “separating the risks of vaccine development from those of basic GoF research is inappropriate, because GoF research seeks to discover antigenic and genomic changes that facilitate human-to-human transmission and/or augment virulence, with the aim of preemptively producing vaccines.” He also notes that while the 1977 H1N1 epidemic originated in a lab and it’s release was unintentional, the culprit laboratory matters little in the GoF debate.

Define Acceptable Cyberspace Behavior
GMU Biodefense alum, Dr. Daniel M. Gerstein, discusses the US-China cybersecurity agreement and the Friday announcement between Chinese Premier Xi Jinping and President Barack Obama. The agreement highlights the mutual desire to prevent cybertheft of business secrets. Dr. Gerstein emphasizes that while this agreement is a step in the right direction, it points to larger preparedness and response capability gaps. He notes, “So while a U.S.-China agreement is a welcome step, it also underscores the greater issues facing the United States, and indeed the international community, in this largely ungoverned space.” Dr. Gerstein highlights the necessity to define cyberspace boundaries, especially as there are delays in DHS security system deployments while US vulnerabilities continue to develop.

Implementation for the US Government Policy for Institutional Oversight of Life Sciences Dual Use Research of Concern
As of September 24, 2015, all institutions and USG funded agencies are now required to comply with the policies. Agencies now must have “a mechanisms in place to evaluate research that is potentially Dual Use Research of Concern (DURC).” Institutions must also organize an Institutional Review Entity (IRE) to review and manage compliance with these requirements.

Dr. Sonia Ben Ouagrham-Gormley’s  new book, Barriers to Bioweapons, received glowing reviews in the latest issue of Perspective on Politics. Her work, which is a staple for biodefense courses, and particularly this text, focusses on the perception of risk and lethality of bioweapons while addressing the realities of these assumptions. Ouagrham-Gormley discusses the key role of tacit versus explicit knowledge in the development and dissemination barriers for bioweapons. “The author identifies important factors internal to a weapons-development program- talented individuals and cohesive groups, corporate culture, communities of practice, organization structure- as critical nodes or ‘reservoirs’ of knowledge that must be configured to optimize the sharing of ideas and information.” The case studies of Iraqi and South African programs, as well as Aum Shinrikyo, lay the foundation for her points on the role of internal and external variables that can hinder or help a bioweapons program. Whether you’re reading  it for class (GMU Biodefense folks, I’m looking at you!) or you’re looking to brush up on nonproliferation, this book is a well-written and captivating necessity to understand bioweapon development. Did I mention how awesome the cover is?
Our very own GMU Biodefense PhD alum, Dr. Denise N. Baken, has a wonderful new book being released – let’s check it out! Al Qaeda : The Transformation of Terrorism in the Middle East and North Africa examines violence and the way it is marketed by the global terrorism industry.  Authors Denise Baken and Ioannis Mantzikos frame the violence discussion through the prism of its use by Al Qaeda, Al Qaeda in the Arabian Peninsula (AQAP) and Islamic State of Iraq and Syria (ISIS).Baken and Mantzikos look at the business parameters of violence –its cost, return on investment, efficiency, and effectiveness; They propose a new approach to that violence. One that looks at violence as a controlled commodity that evolved from Al Qaeda’s initial presentation of future possibilities, AQAP exploited those possibilities and ISIS pushed the boundaries of usability.
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Pandora Report 9.18.2015

What an interesting week! Ongoing salmonella cases, imported plague in Michigan, ISIS was found to be using chemical weapons, and a new prion disease was discovered. Pretty busy in the world of biodefense, I’d say. The Pandora Report is also fortunate to share with you a great piece by one of our graduate students, Greg Mercer, who tapped into Google Trends to look at ISIS nomenclature, and an upcoming book written by Dr. Brian Mazanec, regarding cyber warfare. So sit back and relax while we catch up on the week’s biodefense news.

US Confirmation of Islamic State Chemical Weapons

Operational_Readiness_Exercise_121014-F-LP903-827Sulfur mustard traces were found on fragments of ordnance used by the Islamic State, as well as on scraps of clothing from victims in Syria and Iraq. There have been several accounts by Kurdish officials that have claimed chemicals, like chlorine, were dispersed this summer, which is concerning for the ongoing use of these internationally banned substances. Testing done in the US was reported by officials on Friday, September 11, 2015, stating that, “there’s no doubt ISIS has used this,”. Officials have also said that the chemical residue recently found does not match known chemical ordinance that was used in the former Iraqi inventory. Overall, the use of chemical weapons is highly distressing and the method of acquisition, either manufacturing or from undeclared stocks, is under investigation.

Michigan Experiences Imported Plague Case

 A Michigan woman is the second case of bubonic plague that was traced back to the Little Rainbow area of Colorado. The Michigan resident was visiting family in Salida, CO during a music festival in late August. While her exact exposure hasn’t been established, she became ill after returning home and was hospitalized shortly thereafter. Lucky for the diagnosticians, she displayed textbook plague symptoms, leading to CDC involvement and antimicrobial treatment. Fortunately, she was released from the hospital and is beginning the long road to recovery, although it’s probably the last time she’ll attend that particular music festival or go hiking around it….

The So-Called Islamic State 2
By Greg Mercer

In February, I wrote about a topic that had been puzzling me- the contentious nomenclature of the Islamic State, or ISIS, or ISIL, or Daesh.  I decided to revisit this question now that the issue is a staple in the news, and that we’re probably saying it more frequently while thinking less about what we call it.  So I fired up my good friend Google Trends[1] again to take a look.  Google is a decent measure of public interest in a subject.  It’s the most popular search engine[2] in the world, with 66.78% of search volume worldwide as of August 2015.

Last time, I found that ISIS was the most popular term by a fair amount.[3]  This seems to be true this time around too, which isn’t terribly surprising.  Here’s what I got:
Screen Shot 2015-09-17 at 6.24.26 PM

 

 

 

 

 

This time around, ISIS is still the most popular, but Google’s added a feature that tells us a little more.  While I suspected that the terrorist organization was driving most of the searches for ISIS before, it’s true that ISIS is the only of the names that has other popular uses, notably an Egyptian goddess, a think tank, and of course a fictional intelligence organization.  The new “topics” option in Google Trends lets us identify search volume for an entire subject.  The dotted purple line indicates all searches for the organization, regardless of naming specifics.  Since the searches for “ISIS” specifically and all of the searches for the organization are strongly correlated, it’s safe to say that mythology enthusiasts, nuclear scholars, and Archer fans aren’t skewing the trends.

It’s also still the case that search volumes for all of the names spike with major news events- no surprise there.

I also found the search trends by country interesting, here’s a look at the different terms and how they show up globally:

Screen Shot 2015-09-17 at 7.33.14 PM
Click on image to see Google Trend analysis and additional graphs

 

 

 

 

 

 

 

 

 

 

A couple of takeaways:  Looking at the organization as a whole, the two most interested parties (by Google search) are Iraq and Iran.  That’s not too surprising.  Iran is also #1 for “Daesh”, which is used in both Arabic and Farsi and is considered more a disparaging name.  In fact, the Iranian foreign minister told Iranian state media in January (fair warning, this links to Iran Daily) that he hates the term “Islamic State” and prefers “Daesh.”  In my earlier article, I noted that other foreign policy practitioners share this sentiment, and prefer a name that doesn’t recognize the organization as a state or representative of Islam.  This is also definitely the least popular name in mainstream American media.[4]  Ethiopia and Peru are the highest by volume for ISIS and ISIL, respectively, neither of which I would have expected offhand.

It’s interesting to see how these trends break down, and to look at a single massive political issue and international crisis with such a proliferation of terms.  I think the name that finally sticks remains to be seen.

[1] This links to the search parameters I used for this article, so you can play around with the data.
[2] This site is really cool if you’re into this sort of thing- you can see what site users choose based on browser, operating system, and device type.
[3] Personally, I tried ISIL in the name of accurate translation, but I tended to use ISIS when being flippant, and then it ended up sticking.
[4] To get anecdotal, the only person I’ve heard use it is my buddy who does Arabic translation and Middle East studies for a living.

The Evolution of Cyber War

Screen Shot 2015-09-18 at 6.39.11 AMGMU’s very own, Dr. Brian Mazanec, delves into the world of cyber warfare and the reality of this threat. “Already, major cyber attacks have affected countries around the world: Estonia in 2007, Georgia in 2008, Iran in 2010, and most recently the United States. As with other methods of war, cyber technology can be used not only against military forces and facilities but also against civilian targets. Information technology has enabled a new method of warfare that is proving extremely difficult to combat, let alone defeat.” Available on November 1, 2015, we’re excited to share Brian’s phenomenal work!

Stories You May Have Missed:

  • Flu vaccination rates went up a bit for the 2014/2015 season, however, the efficacy was only 18% due to an antigenic drift. Fortunately, vaccination compliance for healthcare workers increased and overall rates showed that women were more likely than men to get vaccinated.
  • The Australian government will pass a new law, the “No Jab, No Pay Bill“, that will penalize parents who don’t vaccinate their children by withholding child care and other payments.
  • An additional 77 cases of Salmonella Poona were reported since September 9, 2015, related to the multi-state cucumber outbreak. The total infected is now 418 people across 31 states, with 91 hospitalizations.
  • A new prion disease has been identified by a team of scientists led by Stanley Prusiner. Their report outlines the discovery and the potentially infectious nature of this new prion.

America’s War on Terror: Democracy is No Panacea

Nine days after the attacks of September 11, the President declared America’s war on terror had begun. After the Bush Administration perceived early successes in Afghanistan, spreading democracy became one of the key policies supporting America’s strategy for the war on terror. Over time, the President came to view the promotion of democracy as a positive and transformational change agent for the Middle East and Muslim-majority countries. Empirical analysis, however, suggests democracy promotion did not help America achieve its broad objectives in the war on terror, though democracy indicators did marginally improve.          

This is Part 4 of 4 of Erik Goepner‘s paper. In case you missed them, read Part 1, Part 2, and Part 3; the full paper is available here.

America’s efforts in the war on terror have not achieved the desired objectives. Whether measuring the number of global terror attacks, number of attacks against the U.S. homeland, fatalities caused by terrorists, number of Islamist-inspired terror groups or the amount of fighters aligned with Islamist-inspired terror groups, the data suggests U.S. efforts in the war on terror have achieved disappointing results. During the 12 years prior to 9/11, terrorists committed an average of just over 3,200 attacks annually. In 2001, that number dropped to under 1,900 attacks. Since the U.S. initiated its war on terror, however, the average number of attacks has climbed to almost 4,300 per year.[1] Regarding the U.S. homeland, the attacks of 9/11 were a statistical outlier, making it difficult to determine if other similarly sized attacks might have followed. In the 13 years before 2001, there were five Islamist-inspired terror attacks in America. That compares to four attacks in the 13 years since.[2] Another 63 Islamist-inspired terror attacks against the homeland have been thwarted in the past 13 years, as well.[3]

Similar to the rise in worldwide terror attacks, the number of fatalities have likewise climbed, but at a faster rate. Nearly 6,500 people were killed worldwide per year in terror attacks for the decade-plus before 9/11. In 2001, more than 7,700 were killed. Then, in the 12 years since, the annual average has risen to just under 9,500. The before and after numbers for U.S. citizens killed by acts of terrorism are similarly discomforting, with 45 killed per year before 9/11 and 64 each year since.[4]

A final macro measurement for the war on terror examines the number of Islamist-inspired groups identified by the Department of State (DoS) as foreign terrorist organizations and how many fighters comprise those groups. Since 2000, the overall number of foreign terrorist organizations (FTOs) increased by 86 percent, from 29 to 54. The subset comprised of Islamist-inspired FTOs, though, grew by 185 percent, from 13 to 37 groups.[5] Moreover, the number of fighters within those groups has dramatically increased from an estimated 32,200 in 2000 to more than 110,000 in 2013.[6]

Unlike the overall measures of performance for the war on terror which have all worsened since 2001, governance and democracy measures are not as clear-cut. Freedom House’s indicators show a marginal, though statistically insignificant, improvement for the 47 Muslim-majority countries since 2001. The average political rights and civil liberties’ scores for all Muslim-majority states were essentially identical in the years prior to, and including, 2001. Since that time, they have improved by nearly 6 percent (Freedom House scores range from 1 “most free” to 7 “least free”).[7] However, a chi-square statistical analysis indicates the difference in pre- and post-9/11 scores were not statistically significant (X2=7.819, p=0.729). Though insignificant, the modest improvement occurred as average freedom scores declined worldwide for the past nine years.[8]

Afghanistan and Iraq had the lowest possible Freedom House scores for the years prior to 9/11 (i.e., 7). Scores for both countries have improved since, though neither has yet been listed among the 125 countries currently meeting the definition of an “electoral democracy.” The Polity IV Project from the Center for Systemic Peace provides another governance measurement. Their assessment of Afghanistan is unchanged from 2001. Throughout the past 13 years, they have assessed the country as “moderately fragmented,” meaning 10 to 25 percent of Afghanistan is ruled by authorities unconnected to the central government.[9] The assessment of Iraq, though, has changed rather dramatically. In the decade prior to the U.S. invasion, they assessed Iraq as extremely autocratic. Beginning in 2003 and holding for the next six years, they assessed Iraq as seriously fragmented, with between 25 and 50 percent of the country being ruled by authorities that were not connected to the central government. Then, beginning in 2010, Iraq was listed as slightly democratic and that assessment remained through 2013, which was the last year recorded. [10] No assessment has been made since the Islamic State seized sizeable portions of the country, so it is quite likely that the next report will list Iraq as moderately or seriously fragmented.

In conclusion, the decision to include democracy promotion as a key part of the war on terror did not happen immediately. Rather, it appears to have occurred in response to perceived early successes in Afghanistan. Policymakers apparently missed or ignored much of the research and intelligence available at the time that highlighted the numerous challenges to successfully democratizing Afghanistan and Iraq. Additionally, the research since 9/11 largely corroborates the earlier research. Finally, the quantitative analysis indicates democracy promotion did not help achieve the desired outcomes in the war on terror, though modest gains in democracy measures were observed.

Image Credit: Cpl. James L. Yarboro


[1] Data from the Global Terrorism Database, available at http://www.start.umd.edu/gtd/.
[2] National Consortium for the Study of Terrorism and Responses to Terrorism (START). (2013). Global Terrorism Database [globalterrorismdb_0814dist-1.xlsx]. Retrieved from http://www.start.umd.edu/gtd.
[3] David Inserra and James Phillips, “67 Islamist Terrorist Plots Since 9/11: Spike in Plots Inspired by Terrorist Groups, Unrest in Middle East,” The Heritage Foundation, April 22, 2015, http://www.heritage.org/research/reports/2015/04/67-islamist-terrorist-plots-since-911-spike-in-plots-inspired-by-terrorist-groups-unrest-in-middle-east.
[4] Data from the National Consortium for the Study of Terrorism and Responses to Terrorism (START). (2013). Global Terrorism Database [globalterrorismdb_0814dist-1.xlsx]. Retrieved from http://www.start.umd.edu/gtd.
[5] Bureau of Public Affairs Department Of State. The Office of Website Management, “2000 (Patterns of Global Terrorism),” March 23, 2006, http://www.state.gov/j/ct/rls/crt/ 2000/; Bureau of Public Affairs Department Of State. The Office of Website Management, “Country Reports on Terrorism 2013,” U.S. Department of State, April 30, 2014, http:// http://www.state.gov/j/ct/rls/crt/2013/index.htm; Martha Crenshaw, “Mapping Militant Organizations,” Stanford University, accessed March 27, 2015, http://web.stanford.edu /group/mappingmilitants/cgi-bin/groups.
[6] Martha Crenshaw, “Mapping Militant Organizations,” Stanford University, accessed March 27, 2015, http://web.stanford.edu/group/mappingmilitants/cgi-bin/groups. See also Department of State Country Reports and Patterns of Global Terrorism at http://www. state.gov/j/ct/rls/crt/.
[7] Data from https://freedomhouse.org/report-types/freedom-world#.VTwGJBd422k.
[8] Arch Puddington, “Discarding Democracy: A Return to the Iron Fist,” Freedom House, 2015, https://freedomhouse.org/report/freedom-world-2015/discarding-democracy-return-iron-fist#.VRIay2Z422k.
[9] Monty Marhsall, Ted Gurr, and Keith Jaggers, Political Regime Characteristics and Transitions, 1800-2013: Dataset Users’ Manual (Vienna, VA: Center for Systemic Peace, 2014), 13.
[10] Monty Marshall, Ted Gurr, and Keith Jaggers. 2014. Polity IV Project: Political Regime Characteristics and Transitions, 1800-2013. [p4v2013-2.xls]. Retrieved from http://www.systemicpeace.org/inscrdata.html.

AMERICA’S WAR ON TERROR: DEMOCRACY IS NO PANACEA

America’s goal to democratize Afghanistan started haphazardly, no doubt buffeted by the chaos of the days immediately following 9/11. However, what began as a relative afterthought soon became the perceived cure-all for Islamic extremism—bring democracy to the Middle East and watch the underlying causes of terrorism erode away. As the Bush administration began developing that policy, a fair amount of scholarly research and intelligence (now declassified) was available to assist policymakers.

This is Part 2 of 4 of Erik Goepner‘s paper. Read Part 1 here

The pre-9/11 scholarly research

The pre-9/11 scholarly research could have helped answer two key questions:

  1. Would democracy be likely to succeed in Afghanistan and Iraq?
  2. Would a shift from autocracy to democracy in Afghanistan and Iraq help reduce the number of terrorists and terror attacks?

The research suggested that establishing a functioning democracy would be quite challenging in either country. Regarding democracy in Muslim states, ample research cautioned that many democracy enablers—cultural and institutional—could not be found within Islamic tradition.[1] Several notable scholars agreed obstacles existed, but they assessed them as surmountable.[2] Looking at democracy more broadly, the eminent democracy scholar, Seymour Martin Lipset, highlighted cultural factors as determinants of success, cautioning that culture is “extraordinarily difficult to manipulate.”[3] Seven years prior to 9/11, Lipset wrote that successful democracies in Muslim-majority countries were “doubtful.” He argued that an enduring democracy necessitated a connection between efficacy and legitimacy that could be observed by the population. Progress in either the political or economic arenas, he said, would build perceived legitimacy and help cement democracy.[4] With respect to Afghanistan in particular, Robert Barro observed that democracy was unlikely to take hold because of low education levels, the marginalization of women, and the patchwork of different ethnicities.[5] Fareed Zakaria stressed the potential problems associated with ethnic fractionalization and democracy, noting the chance of war could actually increase if democracy were introduced in a country that did not yet have a liberal culture or institutions.[6] Similarly, Amitai Etzioni, a former advisor to President Carter, noted the difficulties of a society jumping from “the Stone Age to even a relatively modern one.” He pointed to the failed experiences of the World Bank and U.S. foreign-aid programs, ultimately concluding that democratic failure would result in Afghanistan.[7] These observations highlight the tension between the legitimate aspirations of President Bush and his national security team and the numerous obstacles that the pre-9/11 research had already identified.

States in transition from autocracy to democracy have more political violence within their borders than do either strongly democratic or autocratic states. In terms of stable, entrenched democracies, the research is divided on whether democracy reduces terrorism more effectively than other forms of government or not. On the one hand, scholars like Rudy Rummel and Ted Gurr contend that democracies provide a system within which grievances can be non-violently addressed, whereas autocracies are much more prone to political violence because they deny their citizens alternate forms of political communication.[8] On the opposite side, researchers like Havard Hegre suggest that democracies are home to increased amounts of political expression, both non-violent and violent.[9] Empirical studies suggest developed and stable democracies do have lower levels of political violence, but so do harshly authoritarian states. Higher levels of political violence, however, tend to occur in intermediate regimes, such as infant democracies.[10]

Based on the pre-war intelligence

The Bush administration planned the Iraq War for more than a year, and authorities have declassified much of the pre-war intelligence. As a result, ample intelligence is now available to the public. Conversely, for the war in Afghanistan, essentially no intelligence regarding governance issues is available since the war came quickly after the 9/11 attacks and the military had no plans for Afghanistan until after September 11th (beyond tactical plans to attack bin Laden).[11] Much of the available intelligence regarding Afghanistan comes from the 9/11 Commission Report, but it does not include useful information for analyzing the decision to democratize. Therefore, only an analysis of the pre-war Iraq intelligence is provided.

The policy choice to promote democracy appears to have discounted significant portions of the pre-war intelligence. In August 2002, a CIA report noted that Iraqi culture has been “inhospitable to democracy.” The report went on to say that absent comprehensive and enduring US and Western support, the likelihood of achieving even “partial democratic successes” was “poor.”[12]

In late 2002, the CIA provided a slightly more optimistic assessment which said most Shia would conclude that a “secular and democratic Iraq served their interests.”[13] At the same time, though, a DIA report asserted that Shia preferences could not be accurately assessed because of the fear and repression they lived under.[14] Several months later, the CIA released another assessment indicating the potential for democratic stability would be “limited” over the next two years, but a US-led coalition “could” prepare the way for democracy in five to 10 years.[15]

Additionally, the National Intelligence Council (NIC) published two Intelligence Community Assessments in January 2003, which the Senate Select Committee on Intelligence described as the “best available ‘baseline’” of prewar assessments on postwar Iraq.[16] The reports described democratic concepts as “alien to most Arab Middle Eastern political cultures.”[17] The NIC also noted “Iraqi political culture does not foster liberalism or democracy.” As a result, they assessed the potential for the democratization of Iraq as a “long, difficult, and probably turbulent process.”[18] In a particularly prescient set of comments, the NIC assessed that “political transformation is the task…least susceptible to outside intervention and management.”[19]

Considerable scholarly research and intelligence were available to policymakers before the decision was made to aggressively pursue democracy in Afghanistan, Iraq, and the broader region. The numerous cautions contained in the intelligence and research, however, were either missed or ignored.

Next week, part 3 will examine the research published since 9/11 in light of the decision to pursue broad democratization. Erik Goepner’s full paper is available here.


[1] Alfred C. Stepan, “Religion, Democracy, and the ‘Twin Tolerations,’” Journal of Democracy 11, no. 4 (2000): 47.
[2] Niloofar Afari et al., “Psychological Trauma and Functional Somatic Syndromes: A Systematic Review and Meta-Analysis,” Psychosomatic Medicine 76, no. 1 (January 2014): 2–11; John Esposito and John Voll, Islam and Democracy (Oxford University Press, 1996).
[3] Seymour Martin Lipset, “The Centrality of Political Culture,” Journal of Democracy 1, no. 4 (1990): 82–3.
[4] Seymour Martin Lipset, “The Social Requisites of Democracy Revisited: 1993 Presidential Address,” American Sociological Review 59, no. 1 (February 1, 1994): 6, 17.
[5] Robert Barro, “Don’t Bank on Democracy in Afghanistan,” Business Week, January 21, 2002, 18.
[6] Fareed Zakaria, “The Rise of Illiberal Democracy,” Foreign Affairs, December 1997, 35.
[7] Amitai Etzioni, “USA Can’t Impose Democracy on Afghans,” USA Today, October 10, 2001.
[8] W. Eubank and L. Weinberg, “Terrorism and Democracy: Perpetrators and Victims,” Terrorism and Political Violence 13, no. 1 (March 1, 2001): 156.
[9] Eubank and Weinberg, “Terrorism and Democracy.”
[10] Håvard Hegre, Tanja Ellingsen, Scott Gates and Nils Petter Gleditsch, “Toward a Democratic Civil Peace? Democracy, Political Change, and Civil War, 1816-1992,” American Political Science Review, no. 01 (March 2001): 42; Daniel Byman, The Five Front War: The Better Way to Fight Global Jihad (Hoboken, N.J: John Wiley & Sons, 2008), 158–9.
[11] The 9/11 Commission Report, 135–7, 208, 332.
[12] United States Senate Select Committee on Intelligence, Report on Prewar Intelligence Assessments About Postwar Iraq (Washington, D.C., May 25, 2007), 103.
[13] U.S. Senate Select Committee on Intelligence, Report on Prewar Intelligence, 100.
[14] U.S. Senate Select Committee on Intelligence, Report on Prewar Intelligence, 93–4.
[15] U.S. Senate Select Committee on Intelligence, Report on Prewar Intelligence, 97.
[16] U.S. Senate Select Committee on Intelligence, Report on Prewar Intelligence, 4.
[17] National Intelligence Council, Regional Consequences of Regime Change in Iraq, January 2003, 30.
[18] National Intelligence Council, Principal Challenges in Post-Saddam Iraq, January 2003, 5.
[19] National Intelligence Council, Principal Challenges in Post-Saddam Iraq, 9.


Image Credit: Library of Congress

America’s War on Terror: Democracy is No Panacea

Nine days after the attacks of September 11, the President George W. Bush declared America’s war on terror had begun. Over time, the spread of freedom and democracy came to be seen as key objectives of the war. Freedom and democracy, it was thought, would be the solution to Islamic extremism.[1]

This is Part 1 of 4 of Erik Goepner‘s paper. 

Afghanistan

The goal of democratizing Afghanistan came haphazardly. As U.S. policymakers prepared to launch strikes to root out al Qaeda, they did not initially plan to conduct regime change in Afghanistan. Planning efforts left open the possibility that the Taliban might cooperate sufficiently and, therefore, be allowed to remain in power.[2] Soon after the CIA initiated covert operations, however, it became obvious regime change was coming. The first formal expression of regime change appears to have occurred at an October 3 meeting. At that meeting, Secretary of State Colin Powell said he wanted leadership in Kabul available to fill the void left by the removal of the Taliban, leadership that represented all of the Afghan people.[3] The U.S. launched its first airstrikes four days later.

The Taliban had to go, but what a future Afghan government might look like received scant attention early on. Part of the disconnect resulted from the rapid success of military operations. Within the first week of airstrikes, Pakistani and U.N. officials began pressuring the U.S. government to slow the Northern Alliance advance. They wanted an interim government in place before the Northern Alliance took Kabul.[4] Despite those attempts, the Northern Alliance did enter Kabul and establish a quasi-government before a broad-based, internationally recognized interim government could be appointed.

On November 10, President Bush spoke before the U.N. General Assembly, where he articulated his support of U.N.-led efforts to broker a post-Taliban government that would represent all Afghans.[5] A month later, the U.N.-brokered talks concluded in Bonn, Germany. The talks aimed to place the various Afghan groups front and center, with the U.N. and international community taking a supporting role.[6] Afghans would govern themselves, assisted by a light international footprint to help bolster their capacity.[7] The final agreement read, in part, “Acknowledging the right of the people of Afghanistan to freely determine their own political future in accordance with the principles of Islam, democracy, pluralism…”

Hamid Karzai took the oath as interim President of Afghanistan on December 22, 2001.

Iraq

Five years before the U.S. invaded Iraq, Congress and President Clinton enacted a law authorizing 97 million dollars for opposition forces who would remove Saddam from power and promote democracy in Iraq.[8] The Bush Administration, though, needed little encouragement. By this point in the War on Terror, buoyed by perceived success in Afghanistan, the President frequently spoke of America’s responsibility to free the oppressed.

In January 2003, the President Bush met with several Iraqi dissidents. They articulated a favorable picture of what a post-Saddam Iraq might look like. Each spoke optimistically regarding democracy’s future in Iraq, noting the technological skills of the citizenry while discounting what they perceived as overblown commentaries regarding the Sunni-Shia split. When the President asked about the possibility of the U.S. being seen as imposing its will, they had no response.[9]

On March 4, Doug Feith, the Under Secretary of Defense, briefed the President and the NSC on U.S. objectives in Iraq. Moving Iraq towards democracy was high on the list. Iraq, they hypothesized, would soon serve as a model for the region. U.S.-led coalition airstrikes began March 20, 2003.

Eight months after the invasion of Iraq, President Bush presented a “new policy, a forward strategy of freedom in the Middle East.”[10] The President’s lofty ambitions for the Middle East could be interpreted as politically motivated perhaps, but the consistency of his message and his passion on the subject suggest he truly did perceive a responsibility to liberate the oppressed. Whether feasible or not, whether politically motivated or not, President Bush appeared to believe that bringing freedom to other nations was the right, and necessary, thing to do.

In June 2004, the United States transferred power to an interim Iraqi government and elections were held in January 2005.[11]

After the Elections

After the first elections in Afghanistan and Iraq, President Bush intensified his calls for democracy in the Middle East. Promoting democracy became a cornerstone of his War on Terror strategy. [12] Mentions of freedom, liberty, and democracy can be found throughout his speeches during that time. His 2006 National Security Strategy celebrated the “extraordinary progress in the expansion of freedom, democracy, and human dignity” that had occurred in Iraq and Afghanistan.

The January 2006 elections that brought Hamas to power, however, may have had a tamping effect on the Bush Administration’s push for broader democratization in the region. The Hamas victory, along with electoral inroads by the Muslim Brotherhood and Hezbollah, brought a chorus of criticism against the President.[13]

Efforts to democratize Afghanistan started haphazardly, but what began as a relative afterthought in Afghanistan soon became the perceived cure-all for Islamic extremism.

Next week, part 2 will examine the decision to democratize in light of the intelligence and scholarly research available in the run up to both wars. Erik Goepner’s full paper is available here.


[1] Council on Global Terrorism, State of the Struggle: Report on the Battle against Global Terrorism, ed. Lee Hamilton and Justine A. Rosenthal (Washington, D.C: Council on Global Terrorism : Brooking Institution Press [distributor], 2006), 83.
[2] Bob Woodward, Bush at War (New York: Simon & Schuster, 2003), 130.
[3] Woodward, Bush at War, 191–2.
[4] Peter Baker, Molly Moore and Kamram Khan, and Washington Post Foreign Service, “Rebels Delay Move Against Kabul; Devising Plan for New Government in Afghanistan Becomes Priority,” The Washington Post, October 11, 2001, sec. A.
[5] George Bush (United Nations General Assembly, New York, November 10, 2001), http://georgewbush-whitehouse.archives.gov/news/releases/2001/11/20011110-3.html.
[6] Simon Chesterman, “Walking Softly in Afghanistan: The Future of UN State-Building,” Survival 44, no. 3 (September 2002): 39.
[7] Chesterman, “Walking Softly in Afghanistan,” 38.
[8] Bob Woodward, Plan of Attack: The Definitive Account of the Decision to Invade Iraq (New York: Simon & Schuster, 2004), 10.
[9] Woodward, Plan of Attack, 258–60.
[10] Mark N. Katz, Leaving without Losing: The War on Terror after Iraq and Afghanistan (Baltimore: Johns Hopkins University Press, 2012), 23–4.
[11] Dominic Johnson and Dominic Tierney, Failing to Win: Perceptions of Victory and Defeat in International Politics (Cambridge, Mass: Harvard University Press, 2006), 245.
[12] Raphael Perl, Combating Terrorism: The Challenge of Measuring Effectiveness, November 23, 2005, 4.
[13] Steven R. Weisman, “Bush Defends His Goal of Spreading Democracy to the Mideast,” The New York Times, January 27, 2006, sec. Washington, http://www.nytimes.com/2006/01/ 27/politics/27diplo.html.

 

Image Credit: U.S. Army