Pandora Report 3.23.2018

TGIF and Pandora Report day! Tomorrow is World TB Day, in which we celebrate the progress made to eradicate TB, but also recognize the work that still needs to be done. Did you know that 53 million lives were saved through effective TB diagnosis and treatment from 2000-2016? In 2016 alone, there were nearly 500,000 cases of multidrug-resistant TB around the world and it takes $2.3 billion a year to fill the resources needed for existing TB interventions. If you happen to be traveling by air anytime soon, make sure to read these tips from public health experts.

How Prepared Are You For the Next Pandemic? Summer Workshop on Pandemics, Bioterrorism, and Global Health Security
Three days filled with global health security and all things biodefense from anthrax to Zika – what more could you want in a workshop? Learn from the top minds in the field when it comes to pandemic preparedness, vaccine development, biosecurity, etc. Between the centennial of the 1918 influenza pandemic, the recent horsepox synthesis, and the lift on the gain-of-function research moratorium, these three days will be packed with exciting topics and discussions. From July 18-20th, come get your biodefense on with us in Arlington, VA – registration prior to May 1st also gets an early bird discount!

Shining A Spotlight On Soviet Nerve Agents
A nerve agent attack in the UK has made the poison, Novichok, a household name, but also pointed a very large spotlight on Russia’s scientists and defense labs. “Few experts in the rarefied area of chemical weapons defense are willing—or able—to shed further light on them. Information about the Novichok nerve agents is classified, says one U.S. military scientist who, like other U.S. government scientists, declined to speak with Science.” Whatever the plan, this failed attempt for the quick deaths of Skripal and his daughter have left many questions about delivery of the agent and how this heavily guarded secret nerve agent found its way onto UK soil. An article from The Trench discusses the use of these nerve agents, formal accusations from the UK, and compliance of the Chemical Weapons Convention (CWC). “The OPCW experts travel to the UK under Article VIII, 38(e), which qualifies their activity as a ‘Technical Assistance Visit’ to help with the evaluation of an unscheduled chemical (the Novichock agent) is not listed in any of the three schedules in the Annex on Chemicals).  They will likely visit the sites of investigation and collect their own samples (if for no other reason than to validate any laboratory samples they may receive), take all materials and documents related to the forensic investigation back to the Netherlands where the sample will be divided up and sent to two or more designated OPCW laboratories.” On Wednesday, Russian diplomatic and military officials reportedly accused the UK of hiding evidence in the investigation of the attack. “Speaking to a lecture hall of diplomats, Vladimir Yermakov, deputy head of the ministry’s department for non-proliferation, suggested that the UK was ‘hiding facts’ about the case that may later ‘disappear’.” British diplomat Emma Nottingham noted that “Russia has offered us so far no explanation of how this agent came to be used in the United Kingdom and no explanation as to why Russia has an undeclared chemical weapons programme in contravention of international law,”.

Pandemic Preparedness
“Are we prepared for the next pandemic?” Such a question pulls at the string of a much larger web that tends to leave many feeling unsettled. The scary truth is that we’re not ready. We know there will be a pandemic – history, science, and society, all tell us this. Encroachment on nature, increasing globalization and populations, and struggles against more frequent threats like seasonal flu and even antimicrobial resistance, all reveal a severe vulnerability to infectious diseases. Lessons from HIV, Ebola, and Zika, are just the latest and on the centennial of the 1918/1919 influenza pandemic, many hope that we learned from such events and can help prevent future ones. Predictions trickle across many sectors – loss of healthcare worker lives, financial and economic struggle, etc. “Such a pandemic could cause a global stock market crash that obliterates the livelihoods and savings of millions of survivors. ‘A severe and prolonged global pandemic could … hit global GDP by as much as 5-10% in the first year,’ noted the authors of the Bank of America/Merrill Lynch 2015 Global Pandemics Primer report. Oxford Economics has suggested that the cost of a global pandemic, including spillover across industry sectors, could be as great as $3.5tn – an impact far greater than the magnitude of the great financial crisis of 2008.” With funding for the GHSA in peril, the question of preparedness becomes even more relevant…and pessimistic. The tricky thing about infectious disease threats is that we’re not sure where the next one will come from. We have hints and sometimes we’ll get a whiff of which way the wind is blowing before the storm hits, but ultimately, there is so much we can’t predict. Given these challenges, prevention efforts, like those of the GHSA, should be seen as even more critical. Infectious disease prevention strategies are always a good return on an investment. It’s also the unexpected that impacts disease control and surveillance efforts. Local news is one that doesn’t often come to mind when considering epidemiology and infectious disease forecasting. “Epidemiologists rely on all kinds of data to detect the spread of disease, including reports from local and state agencies and social media. But local newspapers are critical to identifying outbreaks and forecasting their trajectories. ‘We rely very heavily on local news. And I think what this will probably mean is that there are going to be pockets of the U.S. where we’re just not going to have a particularly good signal anymore,’ said Majumder, a Ph.D. candidate at the Massachusetts Institute of Technology.”

GMU Biodefense MS Open House & PhD Information Session
Looking to earn a Masters or PhD in a field that’s at the nexus of foreign policy and public health? GMU Biodefense is just the place for that. We’re hosting two information sessions for our biodefense graduate degrees – the MS Open House is next Wednesday at 6:30pm (Arlington Campus) and the next PhD Information Session is on Wednesday, April 18th at 7pm, in Arlington, VA. These are great opportunities to hear from faculty and students in each biodefense program about not only the application process, but also the classes and what it’s like to study what you love!

CDC Selects New Director
Dr. Robert R. Redfield was just announced as the new director for the CDC. Redfield will take over for interim director Dr. Ann Schuchat, who many were hoping would take post. The new director has a background in HIV and is said to be a dedicated researcher and physician. Unfortunately, Redfield also comes with a rather novel history for CDC directors – he has never worked for a public health department. “Critics also point to a resume marred with controversy. In the 1990s, Redfield was accused of falsifying data about an experimental HIV vaccine he worked on. He was eventually cleared of those charges, but the data had to be corrected.” On Tuesday, Sen. Patty Murray (Wash.) raised concerns regarding his appointment, noting that, “This pattern of ethically and morally questionable behavior leads me to seriously question whether Dr. Redfield is qualified to be the federal government’s chief advocate and spokesman for public health.”

Brazil Calls for Country-Wide Yellow Fever Vaccination
Brazil has been battling a yellow fever outbreak since 2017 and vaccine shortages have only fueled the challenges of outbreak response. “Brazil announced yesterday that all citizens should be vaccinated against yellow fever. The country is currently experiencing a spike in cases in what has shaped up to become the largest yellow fever outbreak to hit the country since the 1940s.The Associated Press (AP) reported that Ricardo Barros, Brazil’s health minister, said all 27 of Brazil’s states will be targeted in a vaccination campaign that will aim to reach 78 million people by 2019. Before the announcement, the vaccine was recommended in all but four Brazilian states.”

Importance of GHSA
GMU Biodefense PhD student Saskia Popescu wants clinicians to understand the importance of the GHSA and why US investment is critical. “Like many components of public health and infectious disease, the importance of prevention is often forgotten until an outbreak occurs. Hospital preparedness and infection prevention were not necessarily ‘big ticket’ items in the United States until we had Ebola in Dallas, Texas, but it only takes 1 laboratory incident to remind us of the importance of biosecurity and biosafety.”

Food Defense Conference
The Food Protection and Defense Institute will be hosting this conference on May 22 & 24th in Minneapolis, MN. “As the food system is becoming ever more global, companies need to be prepared to protect not only their products but also their reputation. The Food Protection and Defense Institute will be hosting a 2-day Food Defense Certification Training Course on May 21 & 22, 2018 that will teach food industry professionals how to navigate basic food defense principles, recognize vulnerabilities, and create a tailored food defense plans.”

Stories You May Have Missed:

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

Pandora Report 2.9.2018

Happy Friday fellow biodefense enthusiasts! The Winter Olympics are already starting off with a bang as Korean health officials have confirmed 128 cases of norovirus among security personnel, police officers, and Olympic workers.

WHO Releases List of Blueprint Priority Diseases
The WHO has just released their annual review of the Blueprint list of priority diseases, which includes a special tool for “determining which diseases and pathogens to prioritize for research and development in public health emergency contexts”. While the list includes diseases like Ebola, MERS and SARS, Nipah, and Zika, it is the inclusion of Disease X that highlights the unknowns of infectious diseases in the future.  “Disease X represents the knowledge that a serious international epidemic could be caused by a pathogen currently unknown to cause human disease, and so the R&D Blueprint explicitly seeks to enable cross-cutting R&D preparedness that is also relevant for an unknown ‘Disease X’ as far as possible.”

BioWatch Documents Left Behind on Flight
Biowatch officials are doing a bit of a damage control at the moment as multiple copies of an official DHS document regarding performances during a bioterrorism simulation were left behind on an airplane prior to the Super Bowl. The errant document offered a critique of how officials performed during a simulated release of the infectious disease anthrax in Minneapolis on the day of the Super Bowl. Other sensitive material was also found, CNN said, without further description.” Ironically, it was a CNN employee who discovered the forgotten papers in the seat-back pocket of a commercial plane. “The reports were accompanied by the travel itinerary and boarding pass of the government scientist in charge of BioWatch, the DHS program that conducted the anthrax drills in preparation for Super Bowl LII in Minneapolis. The reports were based on exercises designed to evaluate the ability of public health, law enforcement and emergency management officials to engage in a coordinated response were a biological attack to be carried out in Minneapolis on Super Bowl Sunday.” CNN waited to publish the incident until after Sunday’s game, but the papers revealed significant areas for response improvement during a bioterrorism incident. While not surprising, the identification of such gaps is critical for improvement however, it is the concerning nature of which they were left behind. Vulnerabilities are always present, but that doesn’t mean we want them being aired in the open for nefarious actors to utilize.

 GMU Biodefense PhD Student Selected As ELBI Fellow 
The Biodefense Graduate Program in the Schar School of Policy and Government at George Mason University is proud to announce that PhD student Yong-Bee Lim has been selected for the prestigious Emerging Leaders in Biosecurity Fellowship (ELBI) program within the Johns Hopkins Center for Health Security. Selected from a group of over 120 international applicants, the 2018 ELBI class includes professionals and scholars with a passion for health security and biosecurity. This year-long fellowship will deepen the biosecurity expertise and broaden the network of those passionate about furthering the field. Yong-Bee was also the recipient of an internship with the Center for Global Security Research at Lawrence Livermore National Laboratory and the SB7.0 Fellowship, which supported his attendance of an international synthetic biology conference in Singapore. His selection also marks the third consecutive year that the Schar School’s Biodefense program has had graduate students named ELBI fellows. Congrats Yong-Bee!

Smallpox Signalling
It’s been a couple of weeks since PLOS One published the horsepox synthesis paper and the truth is that many are still in awe that not only such work was done, but that it was published. Where were broader discussions regarding the merits of this research? Conversations about need to publish it? Moreover, what about the importance of oversight in the private biotech arena and not just those with federal funding? One thing is for certain though, this is a critical moment for life sciences and DURC oversight. “A vaccine against smallpox already exists. The research was carried out unilaterally, without a broader discussion of the merits beforehand. There are apparently few oversight mechanisms when experiments are done with private funding. The restrictions that now cover dual-use research funded by U.S. government — which include an independent review process, and a weighing of the risks and benefits, as well as the ethics — should be expanded to private-sector research.”

Topics of Interest at the DHS Meeting on Sequences of Interest
Synthetic biology has led to the creation of new products, markets, companies, and industries. At the same time, this technology poses potential risks to biosafety and biosecurity, as recently demonstrated by the synthesis of horsepox virus, a cousin of variola, the virus that causes smallpox.  On January 29-30, 2018, the Department of Homeland Security (DHS) Science and Technology Directorate sponsored a workshop to discuss the evolving role of databases that contain genetic sequences of pathogens and toxins that pose safety or security concerns, termed “sequences of interest.” The workshop brought together stakeholders from government, industry, and academia to discuss the need for such databases, review current databases and those under development, explore potential applications and users of these types of databases, and consider the potential risks that they pose due to malicious or inadvertent misuse. The workshop provided a valuable opportunity to explore the scientific and technical aspects of constructing such databases, maintenance and sustainability challenges, and the trade-offs involving functionality, accessibility, affordability, confidentiality, and security. While the workshop did not produce a consensus on the best path forward, it played an important role in educating the participants on the most critical issues and facilitating a dialogue among a diverse range of stakeholders on this important topic.  The workshop also came at a propitious time as stakeholders grapple with the changing landscape of the biotech industry and advances in DNA synthesis technology.  For instance, the International Gene Synthesis Consortium, a group of the leading DNA synthesis companies that have adopted customer and sequence screening protocols to prevent the misuse of their products, has expanded in size and geographic scope and recently updated its biosecurity protocols. The U.S. government is also reviewing the customer and sequence screening guidance it issued in 2010 and is considering whether, and how, to update it.  Should a decision be made to proceed, stakeholder engagement would be a significant part of the review, just as it was a significant part of the guidance’s original development.

The US Can’t Afford to Reduce Public Health Funding
GMU biodefense PhD alum Daniel M. Gerstein is evaluating the decision to reduce funding for global epidemic prevention activities and just how dangerous that would be for the United States. “Recent reporting suggests that the Trump administration is preparing to downsize the Centers for Disease Control’s (CDC) global epidemic prevention activities in 39 of 49 countries starting in 2019 when funding first authorized by Congress in 2014 expires. Such a move is potentially dangerous and could place the U.S. at significant risk.” Gerstein points to the notion of shared responsibility in global health security and how important efforts like the GHSA are for global public health. He also notes that the last decade alone has revealed just how undeniable public health is as a national security issue. “Without renewed funding, the long-term outlook could include weakened global disease surveillance and response systems, less capable partner nations and an increased likelihood of global disease outbreaks that would undoubtedly threaten the U.S.” Wanting more information regarding the implications of CDC cutting back on their global health security funding? Check out this article regarding the funding cliff the CDC is about to fall off.

Biosecurity in Putin’s Russia
The latest book from Raymond A. Zilinskas and Philippe Mauger delves into the biodefense world of Putin’s Russia. “In March 2012, at a meeting convened by the recently reelected Russian president Vladimir Putin, Minister of Defense Serdyukov informed Mr. Putin that a plan was being prepared for ‘the development of weapons based on new physical principles: radiation, geophysical wave, genetic, psychophysical, etc.’ Subsequently, in response to concerns expressed both in Russia and abroad, the Russian government deleted the statement from the public transcript of the meeting. But the question remains: Is Russia developing an offensive biological warfare program?”

Global Monitoring of Disease Outbreak Preparedness
The Harvard Global Health Institute has released their new report that is “a step towards developing a shared framework and monitoring mechanism” for outbreak response and preparedness. “This report is primarily intended for the community of policymakers and researchers concerned about the rising risks of domestic, regional, and global infectious disease epidemics, and the collective failure to take the coordinated actions required to reduce such risks. These risks include the expected health, economic, and societal costs that are borne by countries, regions, and even all nations in the case of pandemics (which are worldwide epidemics). These risks also include the consequences of increasing antimicrobial resistance (AMR) and its spread within regions and globally.” The report focuses on strengthening public health capacity as a foundation, improving S&T, reinforcing risk analysis and incentives for action, strengthening global mechanisms, and revised shared monitoring framework and next steps.

 The Fearsome Future of Flu
This year has been rough for seasonal flu and while it has been a cold dose of reality in terms of hospital response, are we really learning our lesson or just running from fire to fire? 2018 marks the centennial of the 1918/1919 influenza pandemic and with a larger, more connected population, have we made ourselves safer? The next flu virus with pandemic potential will either enhance our response capabilities or exploit our most damning weaknesses. “And influenza viruses excel at the element of surprise. Few would have guessed Mexico as the origin of that 2009 H1N1 pandemic, for example, notes Fukuda. That outbreak was recognized in San Diego—never considered a hotspot—when a little girl happened to seek treatment at a clinic participating in a study focused on diagnosis, Adalja explains. That’s why he believes it is important to build up the diagnostic capacity for frontline clinicians, and not be satisfied with non-specific diagnoses—failing to pin down the specific microbial cause.” Unfortunately, we are still practicing the methods of frenzied response, delayed information sharing, and dangerous hysteria that can spread even faster through social media. These concerns highlight yet another reason why we need a universal flu vaccine.

Johns Hopkins Center for Health Security Event: Healthcare Disaster Resilience
Don’t miss this event at the National Press Club Holeman Lounge on Thursday, February 22nd from 8:30-10am EST. The Johns Hopkins Center for Health Security will release new policy recommendations for building a more effective disaster health system in the United States. Speakers include Dr. Luciana Borio from the White House National Security Council staff, Sally Phillips of HHS, Linda Langston from the National Association of Counties, as well as Drs.Tom Inglesby, Eric Toner, Monica Schoch-Spana from the Center for Health Security.

 Genetic Sequencing and the Dangers of DIY Genome Editing
Nebula Genomics will sequence your genome for just under $1,000 and you can even share it using a blockchain.  “Nebula is the brainchild of geneticist George Church, PhD student Dennis Grishin, and graduate Kamal Obbad, all from Harvard. Mirza Cifric, CEO of Veritas Genetics, which offers a genome-sequencing service for $999, is a founding advisor. When you pay to take a DNA test—through 23andMe, Helix, or Ancestry.com, for example—the company that does the testing owns your genetic data. Nebula wants to sequence people’s entire genomes and let them own it, allowing them to earn digital money by sharing it.” While professionals may be providing your genomic data through these companies, many are looking to actually learn to experiment with genes themselves. DIY gene therapy is becoming increasingly accessible, which has many worried and the FDA issuing a warning to the public. The FDA, on “November 21 cautioned against do-it-yourself (DIY) gene therapies. But even as the agency’s statement also warned that selling gene editing kits aimed at homemade therapeutics is illegal, CRISPR–Cas9 kits are available to buy online, and the number of providers is growing, raising concerns that DIY gene therapy enthusiasts could be putting themselves and others at risk.”

Biodefense Policy Landscape Analysis Tool
B-PLAT is a new tool from Pacific Northwest National Laboratory scientists Rachel Bartholomew and Kristin Omberg that aims to help coordinate national biodefense preparedness. It “captures and presents a slew of information about U.S. efforts to protect its citizens and others around the world from threats as diverse as the flu, diseases like Ebola, threats from terrorists, potential risks to water and food supplies, and myriad other concerns. The tool is freely available. In 2017, PNNL chartered an internally funded working group, the Policy Wranglers, to capture relevant biodefense policy directives, public laws, and corresponding sections of the U.S. Code, in a format conducive to visualization. The resulting tool can be utilized to better understand the current state of the U.S. biodefense enterprise.” A presentation on B-LAT will also be made at ASM’s Biothreats next week as part of a town hall on Tuesday.

Stories You May Have Missed:

  • US Battles IV Bag Shortage During Record-Setting Severe Flu Season – GMU biodefense PhD student Saskia Popescu is looking at the impacts of this IV bag shortage during the severe flu season. “Even prior to Hurricane Maria, the United States was already battling challenges with meeting the demand for IV fluids; however, the storm crippled Puerto Rico-based manufacturing sites for materials. In a news release on January 16, the FDA reported that they were taking additional steps to combat the shortages, such as ‘asking companies to submit data to extend expiration dates for these products.’ They noted that, ‘if expiration dates can be safety extended [for these products], it would allow some near-expiry product that remains at the hospital level to be used’.”
  • DARPA Program to Track Genetic Markers for Past WMD Material Exposure – “The program is being called Epigenetic Characterization and Observation (ECHO), and its endgame is the creation of a field-deployable system that could analyze someone’s epigenome and identify markers of whether or not–in that person’s entire lifetime–been exposed to WMD-associated materials. DARPA officials are billing it as worlds quicker than sending to a lab to test for biological or chemical agents in clothing or hair.”

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

Pandora Report 12.15.2017

Welcome back to your weekly dose of all things biodefense! We’ve got a packed newsletter for you, so buckle up. Curious about CRISPR and how it works? Check out the best and worst analogies here.

Read Out On The GHSA Ministerial Meeting in Kampala
If you missed our Read-Out on the GHSA meeting in Kampala, we’ve got a great overview with attachments. The NextGen Global Health Security Network Reflections can be found here and Coordinator Jamechia Hoyle was kind enough to provide her powerpoint from the Read-Out, which you can access here. The Read-Out involved presentations and discussions from not only NextGen GHSA Coordinator Hoyle, but also Jennifer Nuzzo from the Center from Health Security, and two GMU Biodefense MS students – Anthony Falzarano and Stephen Taylor. In fact, Anthony and Stephen provided several great photos from the Kampala summit, which you can see here. “While they discussed that the dialogue was driven by high level members of government. The overall consensus was the need to bring in non-governmental and academic voices. The panel members emphasized this by showcasing the work with Next Generation Global Health Security Leaders and the continued efforts to bring young professionals and students into these working groups. From the discussion, it is evident that GHSA’s efforts are being felt in many nations. The Response Center in Uganda, while small, had the hallmarks of the CDC and other organizational support.” Dr. Nuzzo brought her talk to a close with a poignant quote from the summit – “it is much cheaper to spend on preparedness than it is to spend on response.” Attendee and biodefense MS student Janet Marroquin noted that “the containment of the Marburg virus in Uganda during the conference perfectly illustrated the benefits of improved health security measures, but it is easy to overlook this success when good health is expected as a guarantee. In addition to bringing attention to current deficiencies in global health security, the GHSA is needed to look to the future and anticipate and prevent roadblocks in implementation.”

Biological Weapons Convention Meeting of States Parties – Recap
Last week, GMU biodefense PhD student Saskia Popescu attended the Biological Weapons Convention Meeting of States Parties (MSP) with the Johns Hopkins Center for Health Security ELBI program. This MSP started on somewhat of a bated breath as last year’s Review Conference was, as described by many, an epic failure. Having endorsed the Joint NGO Statement, Popescu noted that “the role of the NGOs felt even more important in such a disjointed climate where the future of the BWC was in many ways, up in the air. The importance of support and pushing for future cohesion regarding not only the intersessional process (ISP), but also S&T developments, was a significant point within the NGO statement.” As you can find in many of the live-tweeting that was occurring (#MSP2017), the MSP started off with a bang as Iran noted that they were not convinced further ISP work would be productive and if the BWC isn’t legally binding, it can’t truly be universal. Chairman Gill started the MSP with a quote from Rumi and worked tirelessly to maintain focus and forward momentum. Thankfully, despite several days of closed-door discussion, consensus was reached and the ISP was established to include 4 days of meetings of the MSP and 5 meetings of experts, which would focus on cooperation and assistance, development S&T, strengthening national implementation, assistance for preparedness and response, and the institutional strength of the BWC.  You can also find detailed overviews of each day here. A few of Popescu’s favorite moments from attending: “Sweden’s inclusion of antimicrobial resistance in their opening statement, Australia’s comments on the need for a more diverse attendance in the future and the growing presence of women within the BWC. It was also surprising how shockingly low the states costs for BWC inclusion are…and how some are delinquent by a few hundred dollars. Lastly and perhaps the most important part of the trip was getting to attend a pivotal event in biodefense history with such an amazing group of people who were all as excited and enthusiastic as I was. As we took a break to visit the WHO and peered upon the famous smallpox statue, I think it all hit us how vital this work is on a global level.”

Jurassic Ticks?
Paleontologists have recently announced the finding of a 99-million-year-old tick that not only was holding on for dear life within the feathers of a dinosaur, but provides evidence that these blood-suckers fed on dinosaurs. While this tick came from the Cretaceous period, it feels eerily similar to how Jurassic Park began. “This study provides the most compelling evidence to date for ticks feeding on feathered animals in the Cretaceous,” said Ryan C. McKellar, a paleontologist at the Royal Saskatchewan Museum in Canada who was not involved in the study. “It demonstrates just how much detail can be obtained from a few pieces of amber in the hands of the right researchers.” Imagine the kind of dino-arboviruses we might come across with this finding! It’s hard not to chuckle at the timing of the announcement since the latest Jurassic World movie trailer was released just last week.

Podcast “Syria(s) Problem: Chemical Weapons & International Norms from Power Problems
Don’t miss this episode of the bi-weekly podcast Power Problems from the Cato Institute hosted by Emma Ashford and GMU biodefense professor Trevor Thrall. In this episode on the use of chemical weapons in Syria, GMU biodefense professor and graduate program director Gregory Koblentz discusses how the use of such weapons calls into question the utility of international norms. Some of the show notes also include the discussion of taboos against chemical weapons, and antibiotic resistance as a biological threat.

Is North Korea’s Bioweapons Threat Growing With Increasing Biotech Expertise?
Are the technical hurdles to biological weapons eroding in North Korea? Advances in the life sciences have brought forth a wealth of new capabilities, like manipulating DNA, but are we also lowering the bar for bioweapons development? There’s been increasing talk regarding the potential for North Korea to develop and deploy biological weapons. While there certainly has been a lowering of technical hurdles in some aspects of bioweapons development, has North Korea truly developed a functioning program? “The gains have alarmed U.S. analysts, who say North Korea — which has doggedly pursued weapons of mass destruction of every other variety — could quickly surge into industrial-scale production of biological pathogens if it chooses to do so. Such a move could give the regime yet another fearsome weapon with which to threaten neighbors or U.S. troops in a future conflict, officials and analysts say. Current and former U.S. officials with access to classified files say they have seen no hard evidence so far that Kim has ordered production of actual weapons, beyond samples and prototypes. And they can only speculate about the reasons.” Many note that their possession of biological agents is known but that the unknown is just how far along a bioweapons program might be. The development of a high-functioning and successful bioweapons program requires significant funding, human resources, and tacit knowledge. Dr. Sonia Ben Ouagrham-Gormley recently broke down just how realistic these concerns are (hint: she’s a GMU biodefense professor and guru on tacit knowledge). In response to this week’s increased attention on a potential program in North Korea, Dr. Ben Ouagrham-Gormley was also interviewed regarding the cost of a biological weapons program and just how much it would take to truly develop and maintain one. “The cost of maintaining an active biological weapons program is high, according to Sonia Ben Ouagrham-Gormley, associate professor in the Schar School of Policy and Government at George Mason University. She said the Soviet Union spent ‘several billion dollars’ on its program, while terrorist group Aum Shinrikyo spent about $10 million, though the latter ‘failed at every step.’ The United States spent about $700 million on its program, which was active over the course of roughly 27 years. ‘The challenge is in acquiring the expertise to handle and manipulate living organisms that are fragile and unpredictable: that requires time and a work organization that ensure continuity and stability of work,’ Ben Ouagrham-Gormley said. ‘These are conditions that are difficult to maintain in a covert program. That’s why most covert bioweapons programs have failed thus far’.”

Global Health Security and the US Export Economy
It’s easy for many to think that outbreaks only impacts public health, but the truth is that the effects of health security threats are felt across many sectors and industries. The export economy is not immune to disruption should there be a public health emergency. A recent study reviewed economic vulnerability to the US export economy that would be impacted by disruptions in 49 countries. These 49 countries are currently being targeted by the CDC and partners to improve capabilities to prevent/respond to public health infectious disease threats throughout laboratories, workforce, surveillance, and response systems. Enhancing global health security by strengthening the country capacity is the goal for these 49 countries. “US exports to the 49 countries exceeded $308 billion and supported more than 1.6 million jobs across all US states in agriculture, manufacturing, mining, oil and gas, services, and other sectors. These exports represented 13.7% of all US export revenue worldwide and 14.3% of all US jobs supported by all US exports. The economic linkages between the United States and these global health security priority countries illustrate the importance of ensuring that countries have the public health capacities needed to control outbreaks at their source before they become pandemics.” The numbers are startling, especially if you consider that the 2002-2003 SARS epidemic was estimated to have a global economic impact of almost $40 billion USD. The total value of US material goods/services exported to all countries was estimated to be $2.3 trillion in 2015. The findings of this study point to the significant economic disruption that would occur if a health security event occurred in one of these 49 countries. Global health security is truly an investment that provides a return, as we know that an outbreak anywhere is an outbreak everywhere.

CyberbiosecurityDNA Has Gone Digital – What Could Possibly Go Wrong?
As biotechnology and biology go full-steam ahead, there is increasing use of technology and informatics databases to support such innovation. Where does that leave us in terms of cybersecurity? Coined as “cyberbiosecurity”, many in the field, like Colorado State University’s Jean Peccoud, are drawing attention to the risk this new frontier has for researchers, industry, and the government. Peccoud and his colleagues point to the potential for accidental or intentional breaches, noting that “In the past, most biosecurity and biosafety policies were based on sample containment,” Peccoud says. “Now, it’s so easy to read DNA sequences, for example, or to make DNA molecules out of sequences publicly available from bioinformatics databases. Most projects have a cyber dimension, and that introduces a new category of risk.” Traditional biosecurity efforts focus on containment of the organism from accidental or nefarious use, but that doesn’t really focus on the computational aspect of new biotech, like synthetic biology. “The authors recommend employee training, systematic analyses to examine potential exposure to cyberbiosecurity risks, and the development of new policies for preventing and detecting security incidents. ‘Once individuals in a community are aware of cyberbiosecurity risks, they can begin to implement safeguards within their own work environments, and work with regulators to develop policies to prevent cyberbiosecurity breaches,’ they write.” Peccoud also pointed to the potential for computer viruses to impact the physical world. Citing the 2010 computer virus that caused equipment failure at an Iranian nuclear plant, such malware could result in biological outcomes that could be dangerous. It doesn’t take much of a venture down the rabbit hole to think about the automated processes that are used in laboratories, especially high-containment labs, and how they could be damaging if commandeered for nefarious purposes. So what can be done? The first step is truly recognizing the threat – “The threats are bidirectional. And not all cyberbiosecurity threats are premeditated or criminal. Unintentional errors that occur while translating between a physical DNA molecule and its digital reference are common. These errors might not compromise national security, but they could cause costly delays or product recalls.” Synthetic biology and biotech have taken us to places we would’ve never dreamed of, but it’s critical that the ability to manipulate DNA be protected through proper measures and we protect the digital components as well. The growing attention to cyberbiosecurity also comes at a time when the FDA has issued a warning on DIY gene therapy, noting that “the sale of these products is against the law. FDA is concnered about the safety risks involved.” “Last month, Josiah Zayner, CEO of The Odin, which sells DIY biology kits and supplies through its website, posted a video in which he injected himself with the gene-editing tool CRISPR during a biohacker conference in California. That video has been viewed more than 58,000 times on YouTube. In its statement, which FDA Commissioner Scott Gottlieb tweeted on November 21, the same day it was posted to the agency’s website, the regulator took aim directly at companies selling CRISPR supplies intended for self-administration.”

Biodosimetry: A Future Tool for Medical Management of Radiological Emergencies                                                                                                                          How can we better manage patients in radiological emergencies? GMU biodefense PhD student Mary Sproull and professor/graduate program director Gregory Koblentz are looking at biodosimetry as a medical management tool for this very predicament. “The field of radiation biodosimetry has advanced far beyond its original objectives to identify new methodologies to quantitate unknown levels of radiation exposure that may be applied in a mass screening setting. New research in the areas of genomics, proteomics, metabolomics, transcriptomics, and electron paramagnetic resonance (EPR) applications have identified novel biological indicators of radiation injury from a diverse array of biological sample materials, and studies continue to develop more advanced models of radiation exposure and injury. In this article, we identify the urgent need for new biodosimetry assessment technologies, describe how biodosimetry diagnostics work in the context of a broad range of radiation exposure types and scenarios, review the current state of the science, and assess how well integrated biodosimetry resources are in the national radiological emergency response framework.”

Fellowship in Grand Strategy, Security, and Statecraft
The International Security Program of Harvard Kennedy School’s Belfer Center for Science and International Affairs and the MIT Security Studies Program at the Center for International Studies in the School of Humanities, Arts, and Social Sciences are launching a collaborative program to mentor the next generation of foreign policy scholars. The Project on Grand Strategy, Security, and Statecraft is made possible with support from the Charles Koch Foundation: a $1,846,200 grant to MIT and one for $1,853,900 to Harvard Kennedy School (HKS). Those interested in this fellowship should apply to the International Security Program Fellowship when the Belfer Center’s online application system becomes available on December 15, 2017.  Those desiring to apply before then may apply through MIT’s application system. For more information, click here.

National Academies Publication – Combating Antibiotic Resistance
The National Academies has released their latest report on a one health approach to the global threat that is antimicrobial resistance. “As of 2017, the emergence and spread of antimicrobial resistance continues unabated around the world, leaving devastating health and economic outcomes in its wake. Those consequences will multiply if collaborative global action is not taken to address the spread of resistance. Major drivers of antimicrobial resistance in humans have been accelerated by inappropriate antimicrobial prescribing in health care practices; the inappropriate use of antimicrobials in livestock; and the promulgation of antibiotic resistance genes in the environment.” The report focuses on the global momentum to counter AMR, microbial movements across the one health domain, utilization of social and behavioral sciences to combat AMR, R&D, and strengthening partnerships and international cooperation. AMR is a multi-sectoral, international problem that requires a One Health approach to combat it – reports like these are a critical step towards combatting AMR

Boston University’s Needle Gets the Greenlight
After years of controversy and $200 million in federal funds spent on a BSL 4 high-containment lab, the Boston University Lab “The Needle” is finally opening. Located in the heart of the city, local citizens raised substantial opposition over biosafety concerns for the neighboring areas. It’s taken nearly a decade to get to this point, but the Boston Public Health Commission gave the official greenlight for the lab to open. “The commission’s OK was the final step allowing the study of Biosafety Level 4 pathogens — those that have no treatment or vaccine, such as Ebola. Level 4 research could begin in a month or two at the facility, called the National Emerging Infectious Disease Laboratories. Facing fierce opposition from neighbors and others concerned that dangerous germs would escape, the biolab underwent more than a dozen years of risk assessments, public hearings, and failed lawsuits. It received more than 50 permits and approvals from federal, state, and city agencies, most recently passing muster a year ago with the US Centers for Disease Control and Prevention.”

Doreen and Jim McElvany Nonproliferation Challenge
To advance this goal, the Doreen and Jim McElvany Nonproliferation Challenge will recognize the most outstanding new ideas and policy proposals published in Volume 25 (2018) of the Nonproliferation Review. The Challenge will award a grand prize of $5,000, a $3,000 runner’s-up prize, and a $1,000 honorable mention prize. The deadline to submit is 11:59 pm/EST, July 6, 2018. However, due to the limited number of pages that we can publish in a single volume, eligible articles will be accepted for publication on a rolling basis. We therefore encourage interested authors to submit early. Decisions on the winners of the scholarly award will be announced in early 2019

Stories You May Have Missed:

  • Most Americans Think A Zombie Pandemic Is Likely – We recently stumbled across this survey and were surprised to find that while a surprisingly high number of Americans think a zombie plague is going to happen, few are prepared for it. “Only 9% of respondents considered it likely that undead zombies might ever walk the earth. Nearly three times that many respondents (28%) consider it likely that a worldwide epidemic of a neurological disease that makes people more aggressive and likely to lose control of their thoughts and motor functions.”

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

Pandora Report 12.1.2017

Are you registered for the Read-Out on the GHSA Summit in Kampala? Just a friendly reminder – we’ll be on hiatus next week as we attend the Biological Weapons Convention Meeting of States Parties. Make sure to look out for a packed newsletter on 12.15 as we’ll be covering both the Read-Out on the GHSA Summit and the BWC meeting! If you’d like real-time updates, check out our Twitter account @PandoraReport.

 Read-Out on the GHSA Summit in Kampala
Global health security on your lunch break? Only at the Read-Out on the GHSA Summit will you get lunch and an in-depth recap of this international health security event. Don’t miss this exciting opportunity to hear from global health practioners and young professionals who attended the 4th annual Global Health Security Agenda (GHSA) Ministerial Meeting in Kampala, Uganda in October. You’ll want to register ASAP for this exciting opportunity on December 4th, from 12-1:30pm at the George Mason University Founders Halls in Arlington. The GHSA meeting, Health Security for All: Engaging Communities, Non-governmental Organizations, and the Private Sector, was a multi-sectoral collaboration between governments, civil society, and industry dedicated to the strengthening of globaly capacity to prevent, detect, and respond to infectious disease threats. Attended by the ministers of health, finance, and agriculture and other senior officialfs from more than 50 nations, this was the first Ministerial GHSA Meeting held on the African continent. The meeting was held in late October at the same time as an unprecedented outbreak of pneumonnic plague in Madagascar and a rare outbreak of Marburg in Uganda itself. These outbreaks were timely, but unfortunate reminders, that global health security is still very much a work in progress. Our panel will include four participants who were on the ground in Kampala and actively engaged in this historical step forward for global health security. Attendees will have the opportunity to engage and hear the perspectives of esteemed public health practitioners and rising health security professionals. Lunch will also be provided. This event is free and open to the public.

Mason, Stanford Researchers Join Forces To Study The Science, Benefits And Dangers Of Genome Editing
GMU Biodefense researchers are teaming up with Stanford University to better address the complexities of genome editing and what it means for science, security, and governance. “The study is the only unclassified, independent academic project of its kind, said Gregory Koblentz, director of George Mason’s Schar School of Policy and Government biodefense graduate program and co-principal investigator. The Mason and Stanford researchers will examine scientific advances in the field of genome editing that can have benefits for human health and the bioeconomy, as well as the security aspects of preventing the misuse of this technology. They expect to deliver a suite of policy recommendations based on their research in summer 2018.” Genome editing has not been without controversy, as the technology allows the deletion and replacement of DNA within living organisms and many are concerned about the dual-use nature of such work. While there is potential to eradicate disease and strengthen agriculture, there is also worry that such technology will be misused for nefarious purposes or even poorly handled and result in negative outcomes. This collaborative effort is a huge step to ensuring we’re aware of the risks, benefits, and oversight needed for this exciting new technology.

Maintaining U.S. Investment in Global Health Security
Progress must continue on the global health security front and industrialized countries like the United States have a critical role in sustaining forward movement. “However, the work of the GHSA, including motivating and assisting countries to improve their capacities to prevent epidemics like Ebola from reoccurring, is now at a crossroad. Even though senior officials in the Trump administration have voiced support for the GHSA, and at a recent GHSA ministerial meeting in Uganda signed onto the Kampala Declaration to extend the GHSA for at least another 5 years, US funding for the initiative is ending and no commitment for future financial support has been made. Without additional funding, prospects for the next phase of the GHSA will be endangered. It is important for the United States to commit to support the GHSA to help protect the nation and the rest of the world from epidemic disease.” U.S. financial support encourages other countries to pledge funds but if our efforts waver, it may cause a domino effect. Not only does U.S. engagement encourage others to support the GHSA, but it also supports our own national security. “If vulnerable countries do not have the capacity to quickly cope with disease outbreaks, those outbreaks are more likely to spread internationally, including to the United States.” You can hear more about the importance of the GHSA from Jennifer Nuzzo (one of the authors of this paper) at the Read-Out on the GHSA Summit in Kampala event on December 4th!

Failure to Diagnose Monkeypox Highlights Nigeria’s Poor Health Infrastructure
Like most outbreaks, Nigeria’s monkeypox cases have exposed weaknesses in the country’s ability to rapidly identify and test potential patients. These inadequacies highlight gaps within their International Health Regulations compliance as there were no national labs that could test patients for the disease. “Consequently, for more than two weeks after the outbreak (from the September 22 to October 13), there was no conclusive confirmation that the suspected case was actually that of monkeypox. According to experts, the implication of this is that the country may be dealing with a dangerous outbreak, but unsure of what it is dealing with on time, thereby giving room for a lot of things to go wrong during the waiting period. For instance, during the waiting period for the monkeypox confirmation, different statistics on the actual number of cases were being bandied, even as the large number of suspected cases (94 cases) and the manifestation of the disease had already caused fright and panic.” Laboratory delays can be devastating to outbreak control as it can delay treatment, isolation, quarantine, and data collection. Public health laboratories are the early warning system in many ways. Many are drawing attention to these gaps as a way to reinforce the need to strengthen country-level laboratory infrastructure and capacity. The National Centre for Disease Control (NCDC) was established in 2011, but still is struggling to find the capacity to respond to health threats due to funding and personnel issues. As 14 more cases of monkeypox were reported in Nigeria, this services as a reminder of  why the GHSA is so vital!

The WHO Reports on Fake Drugs
This week the WHO released a report on medical products  that shed light upon the startling realities of patient safety and public health in low and middle income countries. The report, “Global Surveillance and Monitoring System for Substandard and Falsified Medical Products”, found that 1 in 10 products circulating in such countries are either substandard or fake. The findings of this report are extremely worrying as it means that people are taking medications intended to treat life-threatening ailments and they are either fake or not effective. In many cases, the individual is paying a considerable amount of money for such medications and can have severe medical complications from contaminated or expired products. “Substandard and falsified medicines particularly affect the most vulnerable communities,” says Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “Imagine a mother who gives up food or other basic needs to pay for her child’s treatment, unaware that the medicines are substandard or falsified, and then that treatment causes her child to die. This is unacceptable. Countries have agreed on measures at the global level – it is time to translate them into tangible action.” You can read the report here. The report also cites some of the work being done around this endemic issue – 17 WHO training workshops, 126 Member States and more than 400 regulatory personnel trained, 1500 product reports, etc.

How Will We Handle Contamination On An Airplane?
What would happen if you were on a plane with a patient who had a highly infectious disease like SARS or Ebola? What’s our national plan to deal with such issues? Hint: we don’t have a plan. How do flight attendants or pilots relay to ground control that a patient or entire plane needs to be quarantined? These are all the sorts of questions that need to be considered when planning and responding to such events. How would we quarantine an entire plane? On February 7, 2011, such an event occurred – a pilot issued a public health emergency to the air traffic control tower in Milwaukee, WI, for 3 (of 115) passengers with flu-like symptoms. “Airport officials soon learned something interesting about Flight 703 that could point to the presence of a communicable disease. The plane included at least 12 people who had returned from Cozumel, Mexico, on a cruise in which many of the passengers had fallen ill with flu-like symptoms. The incident revealed gaps in America’s emergency planning for communicable diseases aboard planes — gaps that were still present four years later when the U.S. Government Accountability Office investigated. ‘The United States lacks a comprehensive national aviation-preparedness plan aimed at preventing and containing the spread of diseases through air travel,’ the GAO found.” Sadly, it seems as if there’s still no plan. The creation of such a plan would require collaboration between the CDC and U.S. Department of Transportation, and while meetings have occurred, it is reported that no one has taken the lead. So, how are airports currently handling infectious disease incidents? “The lack of uniformity in dealing with communicable diseases during air travel was evident when the National Academy of Sciences asked 50 different airports in the U.S. and Canada how they expect to learn of an incident aboard a plane. They found 15 different notification procedures.” Report after report has found a gap within these response efforts and with the holiday season upon us and airline travel to be busy, it seems that should a public health emergency arise, we may be flying by the seat of our pants.

 Flu Season is Upon Us!
Flu season is starting to hit the United States as the CDC reports an up-tick is influenza positive tests. A majority of the positive specimens have been Influenza A (78% are H3, 13% have been H1N1). “Three southeastern states are reporting high or widespread flu activity, and the CDC said it received reports of five more pediatric flu deaths. In its report, which covers the week ending Nov 18, the CDC also reported one more novel flu infection, an H1N1 variant (H1N1v).Globally, flu activity in the Northern Hemisphere is rising, with H3N2 and influenza B the most frequently detected strains, the World Health Organization (WHO) said yesterday in an update.” Flu season and vaccination compliance is increasingly becoming an issue even in healthcare – in fact, many hospitals are terminating employees who don’t get their flu shot. Remember – get your flu vaccine, stay home when sick, wash your hands, and cover your cough!

Stories You May Have Missed:

  • Exclusive Interviews: Tackling Regulatory and Economic Challenges of Antimicrobial Resistance – “It is imperative for medical experts and drug discovery specialists to stay on top of the latest clinical advancements, developments and industry initiatives related to antimicrobial resistance. SMi Group will gather industry experts and government bodies to share their insights at the 20th annual conference on Superbugs and Superdrugs taking place on 19-20 March 2018 in London, UK. SMi Group recently had the opportunity to sit down with three of the event’s featured speakers to discuss some of the challenges they face in the industry and their strategies for overcoming them.”
  • Raw Flour and E. coli – this whole time we thought it was the eggs in the cookie dough that were doing it, but it seems that flour may also be a culprit for foodborne illness! “Research published today in the New England Journal of Medicine describes how raw flour, an unlikely suspect, caused an Escherichia coli outbreak in 2016. Because of its low-moisture properties, flour was not thought to be a conduit of E coli bacteria, but a multistate team of investigators discovered that flour processed in one facility was linked to the outbreak.”

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

Pandora Report 11.10.2017

Looking for a great podcast? Check out the American Society for Microbiology’s Meet the Microbiologist – especially the latest episode on biopreparedness and biosecurity with Gigi Kwik Gronvall. From island emergency preparedness to antimicrobial resistance and monkeypox, we’ve got you covered for all things biodefense this week.

Top 5 Challenges in Emergency Preparedness: An Island Perspective
Imagine dealing with a natural disaster or health security threat like a major outbreak, but instead of being on mainland where you can rapidly get aid, you’re on an island. GMU Biodefense MS student Tara Hines provides unique insight into emergency preparedness for islands and how these efforts must overcome unusual challenges. From the health security perspective, there are always challenges, but what would be the biggest ones if you were on an island, like Bermuda? “The great part about biodefense is that it integrates public health, public safety, and basic science to provide health security. This interdisciplinary approach lets us tap into all of these areas to identify potential problems and suggest possible solutions, before a disaster strikes. Plus, biodefense work can be done anywhere and is crucial everywhere!” Tara addresses the challenges of not only collaboration and communication, but also military history and capacity, and several other factors that come into play. Make sure to read about her take on these response efforts and what it has been like responding to such events from an island.

Center for Health Security – ELBI Fellowship Application Now Open
If you’re looking to become an EBLI fellow with the Center for Health Security, good news – applications are now open! “The Emerging Leaders in Biosecurity Fellowship is an opportunity for talented career professionals to deepen their expertise, expand their network, and build their leadership skills through a series of sponsored events coordinated by the Johns Hopkins Center for Health Security.” The GMU Biodefense program is proud to have seen four students selected for this prestigious fellowship. For more insights into the ELBI fellowship, check out 2017 fellow and current GMU biodefense PhD student Saskia Popescu’s take on her ELBI experience. If you are a GMU biodefense student or alum looking to apply and hoping to get a golden ticket (aka letter of recommendation) from Dr. Koblentz – make sure to email him ASAP and make sure to send him your CV/resume/statement letter prior to December 4th.

Summit on Global Food Security and Health: “Integrating Global Food Security and National Security: Problems, Progress, and Challenges”
We’re excited to see this amazing summit on food security and national security is right around the corner. Don’t miss your chance to attend this November 15th event at the Schar School of Policy and Government, Founders Hall Auditorium. “The Fourth Annual Summit on Global Food Security and Health will take place George Mason University’s Schar School of Policy and Government on Wednesday, November 15, 2017 at our Arlington Campus from 9:00 am to 5:00 pm in the Founders Hall Auditorium at 3351 Fairfax Drive, Arlington, Va. The conference is co-sponsored by the Stimson Center, RTI International, and The Policy Studies Organization. Our focus this year is on the interrelationship between food security and national security, progress and challenges under Feed The Future (FTF) and the Global Food Security Act, and the growing importance of food security private-public partnerships, resilience, critical indigenous food security challenges, nutrition and health issues.  Summit speakers will represent a wide array of government, international organization, NGO, private sector, and academic experts. Our Summit follows the issuance of a recent USAID Feed The Future 2017 Progress Report, the enactment of the July 2016 Global Food Security Act, the related completion of new USAID global food security and food aid strategies, and the issuance of USAID’s December 2016 Feed The Future Global Performance Evaluation. The Summit will follow the World Food Prize Conference in Des Moines, Iowa , October 18 – 20 which addresses opportunities for innovative agriculture to eliminate the scourge of global hunger and poverty. Our GMU Summit takes place during a particularly important period marked by protracted uncertainty about U.S. support for International food aid, global food security, and foreign aid.” The event is free, but make sure you RSVP!

Antimicrobial Resistance, WHO Agriculture Recommendations, & USDA’s Not-So-Subtle Shade
AMR is slowly becoming the “I told you so” of infectious disease threats. Even Alexander Fleming warned of a day when antibiotics would no longer be effective. “Back in 2013, the UK’s chief medical officer Dame Sally Davies started warning the world that antibiotic resistance posed a deadly threat to humanity. But, she believes, that her lack of hard data meant few people took her seriously. ‘One crucial thing that got the whole world to take climate change seriously was the Stern Review on the Economics of Climate Change back in 2006’ she explains. ‘So we launched our own Stern Review – and found superbugs will kill us before climate change does’.” Reports since then have also highlighted the millions that will die every year due to AMR, but we’re still struggling with incentives for drug discovery and development. “Superbugs are a classic example of market failure – Dame Sally gave a timeline and a point of no return that we have to solve or we’re FUBAR. Government is too linear, industry sees no profit, VC’s don’t see any capital, labs have other problems and NGOs struggle to innovate.” While efforts to invigorate industry are underway, the WHO’s new recommendations are addressing AMR from the agriculture angle. The latest report is calling for a reduction in antimicrobial use across the board in food-producing animals and the halting of use in healthy animals for growth. “The formal guidelines issued by the WHO further recommended that when animals are diagnosed with a bacterial infection, antibiotics that are considered critically important for human medicine should not be used for treatment or to prevent the spread of the infection within a herd or flock, unless tests indicate those drugs are the only treatment option. Instead, antibiotics used for the treatment of sick animals should be chosen from those the WHO considers least important to human health.” Responding to these new recommendations, the USDA has thrown some not-so-subtle shade in their recent press release. The USDA Acting Chief Scientist, Dr. Chavonda Jacobs-Yong, has stated that the WHO recommendations are “not in alignment with U.S. policy and are not supported by sound science. The recommendations erroneously conflate disease prevention with growth promotion in animals.” Fighting AMR is a like fighting a chimeric hydra – a multi-headed, regenerating beast made of different animals – all dangerous and different. What herculean effort will be required for us to win the battle of the superbug?

Schar School Master’s Open House – Biodefense MS
It’s the last MS Open House of the season and you won’t want to miss this opportunity to learn about our biodefense graduate programs and talk to faculty. Next Wednesday, November 15th at 6:30pm at GMU’s Arlington campus, you can get the scoop on earning your master’s degree in biodefense on campus or remotely – don’t miss out!

Panel Discussion: Security in the New Era of Targeted Sanctions
Don’t miss the Fall 2017 Symposium hosted by the National Security Law Journal on November 13th at 11:30am! Hosted at GMU’s Founders Hall Auditorium, you can hear from a distinguished panel of attorneys and policy experts specializing in foreign policy, economics, and current events for this event, two of whom are George Mason professors. Dr. Gregory Koblentz, Dr. Mark Katz, and Dr. Adam Smith, will be panelists on this great symposium – infact, Dr. Koblentz will be speaking on the role of sanctions in responding to Syria’s use of chemical weapons. Mark sure to RSVP by emailing symposium@nslj.org

Chasing a Killer – Hunting Monkeypox
While we talk of pandemic flu and synthetic biology, it’s easy to forget some of the more mysterious, and yet, equally sinister natural outbreaks that are occurring. The Congo Republic is currently battling a surprising outbreak of monkeypox, which is a cousin of smallpox. “Over the past year, reports of monkeypox have flared alarmingly across Africa, one of several animal-borne diseases that have raised anxiety around the globe. The Congolese government invited CDC researchers here to track the disease and train local scientists. Understanding the virus and how it spreads during an outbreak is key to stopping it and protecting people from the deadly disease.” In fact, the U.S. has experienced its own monkeypox outbreak – in 2003 due to an exotic pet that was imported (sounds like the beginning of that movie Outbreak…). Zoonotic spillover is normally how these outbreaks begin and while monkeypox is not as deadly as smallpox or ebola (a mortality rate of around 10%), researchers are working to understand the ecology of monkeypox hosts and reservoirs. Take a minute to check out this article as there are some wonderful photos and maps that will take you along for this on-the-ground virus hunting expedition.

CBFP Biosciences Fellowship Program
CBFP welcomes applications from early to mid-career biological scientists working in government ministries, government-operated biological science laboratories, and/or research and diagnostic facilities with experience in laboratory operations, research, and diagnostics from Jordan, Lebanon, and Turkey. Only applications from these three countries will be considered. Selected fellows will conduct a science exchange fellowship of up to six months in duration to engage in research at a host institution including, but not limited to, the United States, Europe, and the Middle East beginning no earlier than September 2018. Applications are due December 17th, so make sure to apply here!

Canada To Prioritize Biothreat Reduction During G7 Presidency        In 2018, Canada will assume the G7 presidency role and Global Affairs Associate Deputy Minister Mark Gwozdecky has made it known that the country will prioritize biological threat reduction. “Infectious diseases have plagued mankind since the dawn of time. They’ve proven to be ruthless, persistent and all too adaptive and have been responsible for unparalleled death, suffering and economic loss,” Gwozdecky said.” He pointed to the recent outbreak of bubonic plague in Madagascar, which has infected more than 1,300 people, as an example of the ongoing challenges facing public health officials.” Efforts will also focus on the growing issue of antimicrobial resistance and the threat of biological weapons. Canada has continued to prioritize the full spectrum of biological threats and importance of biosecurity and biosafety within labs through its BSL4Znet network, which is a global information and resource sharing program to protect against biothreats. “While these threats, both natural and intentional are formidable, they are not beyond our means to overcome,” he said. “Key to this, however, will be enhanced cooperation, collaboration and collective effort.” “We look forward to engaging all of our partners to identify new ways, means and opportunities to strengthen global biological security,” Gwozdecky added.

The U.S. Government and Global Health Security
The Henry J. Kaiser Family Foundation’s latest issue brief focuses on the roe of the U.S. government and global health security. Ranging from a number of threats like Ebola, HIV, and SARS, global health security efforts are vital and must be as diverse and adaptable as the infectious diseases they thwart. “U.S. funding for its primary global health security programs –activities primarily carried out by the U.S. Agency for International Development (USAID), Centers for Disease Control and Prevention (CDC), and Department of Defense (DoD) – has remained relatively flat from FY 2006 ($390 million) through FY 2017 ($402 million), with episodic funding spikes through supplemental funding mechanisms reflecting specific outbreak events, including Ebola in FY 2015 ($1 billion) and Zika in FY 2016 ($145.5 million). The Administration has proposed reduced global health security funding for FY 2018 ($353 million).” This comprehensive report addresses the current global situation of infectious disease outbreaks and reviews U.S. government efforts and funding.

Stories You May Have Missed:

  • Financial Misappropriations, Ebola, and The Red Cross – The Red Cross organization recently confirmed that nearly $6 million in donated funds were misappropriated during the 2014 Ebola outbreak. “The organisation’s own investigations uncovered evidence of fraud, with more than $2.1m (£1.6m) lost in Sierra Leone, probably stolen by staff in collusion with local bank officials, according to a statement. In Guinea, a mixture of fake and inflated customs bills cost it $1m.” Investigations found the prices of relief goods and payrolls were inflated and while this isn’t the first time corruption has been associated with humanitarian relief, the Red Cross has yet to issue an apology.
  • Minnesota’s Drug-Resistant TB Outbreak– Minnesota’s Ramsey County is battling a deadly multi-drug resistant tuberculosis (MDR-TB) outbreak. “Six of the 17 have died, with three of those deaths being directly attributed to tuberculosis, said Kris Ehresmann, director for Infectious Disease at the Minnesota Department of Health, on Monday. Of the 17 cases, 14 were in the Hmong community and 10 are associated with individuals who participate in activities at a senior center, Ehresmann said.”

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

Pandora Report 11.3.2017

Welcome to your weekly dose of all things biodefense. Today we get to celebrate Global One Health Day, in which the goal “is to build the cultural will necessary for a sea change in how planetary health challenges are assessed and addressed.”

High-Containment Laboratories: Coordinated Actions Needed to Enhance the Select Agent Program’s Oversight of Hazardous Pathogens
The latest U.S. Government Accountability Office (GAO) report is focusing on high-containment labs and how we can enhance the Select Agent Program’s oversight of hazardous pathogens. “Safety lapses continue to occur at some of the 276 laboratories in the United States that conduct research on select agents—such as Ebola virus or anthrax bacteria—that may cause serious or lethal infection in humans, animals, or plants, raising concerns about whether oversight is effective. GAO was asked to review the federal oversight approach for select agents and approaches from other countries or regulatory sectors. This report (1) evaluates the extent to which the Select Agent Program has elements of effective oversight and strategic planning documents to guide it, and (2) identifies approaches selected countries and regulatory sectors have used to promote effective oversight.” The Select Agent Program is managed through a partnership between DHHS and USDA, which oversees how labs handle these deadly pathogens. The biosecurity and biosafety failures that have occurred in recent years highlights the challenges of not only performing such work, but also oversight. The GAO report found that the Select Agent Program hasn’t assessed the risks of its current structure, has reviews that may not target the highest-risk activities, continues to have significant workforce and training gaps, etc. Eleven recommendations were made, which range from “To improve transparency, the CDC director of the Select Agent Program should work with APHIS to determine what additional information about laboratories’ use of select agents, incidents, and violations of the select agent regulations is appropriate for the program to share with registered laboratories” to “improve independence, the Administrator of APHIS should formally document the reporting structure for the APHIS component of the Select Agent Program from the APHIS director of the program to the Administrator of APHIS”. You can read the full report here or get the highlights here.

GHSA Ministerial Meeting
Last week’s Ministerial Meeting at Kampala was a success and a great time to reflect on GHSA accomplishments from member countries. You can get all the information here regarding the success stories across GHSA members. We will also be reporting on stories from those attendees who were able to join NextGeneration GHSA for the meeting, so don’t miss out on some great deep-dives from GMU biodefense students and their stories from Kampala!

COMMENTARY: Pandemic preparedness and missed opportunities             CIDRAP Director Dr. Michael T. Osterholm is honing in on a dogma for so many within public health – we need pandemic preparedness and we’re just not prepared. Unfortunately, sometimes our efforts to change this can result in a backfire. “Last week PATH issued a report titled, Healthier World, Safer America: A US Government Roadmap for International Action to Prevent the Next Pandemic. PATH, a leading international nonprofit organization, is widely recognized for its work to save lives and improve health, especially among women and children.” “The PATH report, if it commented only on epidemic preparedness, would be a home run. But by stating that the recommendations in the report will stem the risk of the next pandemic, the report ends up contributing to the ongoing mischaracterization about what pandemic preparedness truly means and what is needed to reduce any impact of a future pandemic. Understanding the difference between a pandemic and epidemic is absolutely necessary for consequential preparedness and response planning and action to be accomplished.  Let me illustrate the difference between the two and why it matters.” Osterholm points to this very vital misstep that can easily add confusion when working towards preparedness. He highlights the substantial difference between pandemics and epidemics and that ultimately, before we can truly address preparedness and response, we need to sincerely understand the discrepancies. Osterholm also highlights the biothreats we should be worried about for potential pandemics – influenza and antimicrobial resistance. Osterholm points to these two pandemic concerns while highlighting the importance of the GHSA, the vital role of early and effective detection to epidemic diseases, and that pandemic clocks are ticking. “The influenza and antimicrobial pandemic clocks are ticking; we just don’t know what time it is. Misunderstanding and misrepresenting what we need to do to be better prepared takes an understanding of what a pandemic is and what it isn’t. To date we are not doing a very good job of understanding that point and responding accordingly. The PATH report is a clear reminder.”

Early Insights from Madagascar’s Plague Outbreak: Lessons Learned from Ebola?
Have we really learned some of those difficult lessons from Ebola? Joshua Hutton, Doctoral Candidate at the University of Sussex is evaluating the current plague outbreak in Madagascar under the lens of Ebola. Hutton looks at the epidemiology and cultural impact of these diseases, their similarities and differences, and what lessons can be learned. Hutton looks at the health systems within Madagscar and the Ebola-affected West African countries, noting that Madagascar has 1 doctor per 100,000, while Liberia has 0.1 and Sierra Leone has 0.2 per 100,000. “Furthermore, both Ebola and plague elicit very strong emotional reactions. Ebola has been sensationalized by popular books and major motion pictures (such as Outbreak). Its haemorrhagic symptoms, exaggerated in popular culture, instil fear and remain memorable as an object of cultural anxiety.” “Despite these similarities, there are some obvious differences that affect the public health responses to these outbreaks. The first is that plague is a very different pathogen from Ebola. While Ebola is a virus, Y. pestis is a well-characterised bacterium. One important implication of this difference is that while treatments for Ebola remain elusive, antimicrobials to combat plague do exist. Plague is curable when caught early enough. This not only helps the response, but also reduces the heavy emotional burden placed on healthcare workers who felt helpless caring for Ebola patients without a treatment.” Hutton also notes the differences between public health responses, especially by the WHO – highlighting the lessons learned from the Ebola outbreak. “The early response to this anomalous outbreak of pneumonic plague in Madagascar seems to suggest that lessons are being learned from the Ebola outbreak. While there are distinct differences between the two outbreaks – not the least the availability of rapid diagnostics to identify infected individuals and the availability of antibiotics to treat them – the broader context, the rapid response, and the engaging of local communities produce a cautious optimism for the future.

US-Malaysia Workshop on BWC
The November 30-December 1st workshop at the Council Chamber, Palais des Nations, will focus on BWC-relevant developments by international experts. This workshop will feature expert presentations about global activities during the past year that strengthen the BWC. The purpose of the workshop is to inform States Parties about recent developments relating to national implementation, cooperation and assistance, preparedness and response, and science and technology; and to exchange ideas about their relevance to the Convention.

 My Time As An Emerging Leader in Biosecurity Initiative Fellow                         Take a journey down the biosecurity rabbit hole with GMU biodefense PhD student Saskia Popescu and her experience as a fellow at the Johns Hopkins Center for Health Security. “The Johns Hopkins Center for Health Security has maintained a fellowship since 2012 that seeks to provide opportunities for biosecurity professionals and helps to broaden their careers through contacts and experiences. The Emerging Leader in Biosecurity Initiative (ELBI) program is something I’ve been striving to join for years. I’ll admit it – it wasn’t my first time applying and while this is a highly competitive group, I was definitely disappointed when I didn’t get that acceptance email. Fortunately, 2017 was my year and I was selected as an ELBI fellow and that’s where this adventure begins.” Popescu describes her experiences at the three workshops, the engagement with some of the top minds in the field, and just how much fun it can be to geek out with fellow biosecurity nerds.

Fourth Annual Summit on Global Food Security and Health
Don’t miss this great opportunity to focus on the interrelationship between Food Security and National Security! Held at GMU’s Schar School of Policy and Government on Wednesday, November 15th, you’ll want to make sure you register for this full-day summit! “The conference is co-sponsored by the Stimson Center, RTI International, and The Policy Studies Organization. Our focus this year is on the interrelationship between food security and national security, progress and challenges under Feed The Future (FTF) and the Global Food Security Act, and the growing importance of food security private-public partnerships, resilience, critical indigenous food security challenges, nutrition and health issues. Summit speakers will represent a wide array of government, international organization, NGO, private sector, and academic experts. Our Summit follows the issuance of a recent USAID Feed The Future 2017 Progress Report, the enactment of the July 2016 Global Food Security Act, the related completion of new USAID global food security and food aid strategies, and the issuance of USAID’s December 2016 Feed The Future Global Performance Evaluation. The Summit will follow the World Food Prize Conference in Des Moines, Iowa , October 18 – 20 which addresses opportunities for innovative agriculture to eliminate the scourge of global hunger and poverty. Our GMU Summit takes place during a particularly important period marked by protracted uncertainty about U.S. support for International food aid, global food security, and foreign aid.”

Preppers: On the Frontline of U.S. Preparedness
Are you prepared for an apocalyptic event? GMU Biodefense PhD student and VP of marketing at Emergent BioSolutions student Rebecca Fish is taking us on a deep-dive into the world of preppers. “In 2015, Emergent BioSolutions undertook a multi-phase research project to better understand the prepper movement.  A random sample of 1,022 people aged 18-65 was surveyed to explore prepping behavior.  Findings suggested that the average prepper is not as extreme as many television programs would have you believe.  Rather, your average prepper is an ordinary person trying to do his/ her best for his/her family by preparing for emergency events.  The defining characteristic of a prepper is a belief in self-sufficiency and a desire to be prepared for whatever life throws at you.” This study found some interesting data on preppers – 67% are married and 43% earn over $100,000 per year, while 45% hold a college or advanced graduate degree. The volume and commitment of preppers is also indicative of a market for MCM product and other CBRNe products. “After the 2011 Fukushima Daiiche nuclear disaster in Japan, potassium iodide tablets stocked out everywhere due to overwhelming demand. Similarly, during the Ebola crisis, CBNBC reported that sales of one type of full-body protective suit increased 131,000 percent on Amazon. Gas masks and Ebola survival guides shot up the rankings as well.” As a further example, twenty four percent of preppers in our research own a gas mask.  These data suggest that preppers have demonstrated interest in CBRNe supplies and represent a market for some preparedness supplies.” Fish not only provides new insight into the Prepper community, but also encourages us to start learning more about this group and their interests in preparedness.

BARDA Industry Day
Don’t miss out on BARDA Industry Day next week, from November 7-8th, at the Ronald Reagan Building. “BARDA remains committed to engaging with our industry and government partners to fulfill our mission, saving lives and protecting America through the research and development of medical countermeasures against serious threats. The theme of BARDA Industry Day 2017 is: Innovation in products and partnerships for flexible, dynamic response capabilities.” The keynote speakers will be Robert Kadlec, Assistant Secretary for Preparedness and Response, U.S. Department of Health and Human Services, and Senator Tom Daschle, Founder and CEO of the Daschle Group.

 New Biosecurity Threats Appear in Less Familiar Forms                                    Following the anthrax attacks in 2001, focus within biodefense and biosecurity fell upon bioterrorism and the potential attack that could impact millions of Americans. Since then, health security has evolved to include a wider range of potential issues and threats – natural, manmade, and accidental. GMU biodefense PhD student Saskia Popescu highlights some of these newer threats and that while they may be less familiar to health professionals, it is vital we involve them in the narrative of hospital preparedness. Discussing the gaps within U.S. biodefense efforts, genetic engineering, and how dual-use research impacts bio-vulnerability, Popescu implores infectious disease practitioners to soak in this knowledge. “How can we, as infectious disease practitioners, prepare or respond? First, knowledge is key. It is crucial to understand the threats, whether they are a natural outbreak, a lab breach you read about, or even just a review of the signs and symptoms of organisms we tend to worry about but may not see in the United States (such as severe acute respiratory syndrome, Middle East respiratory syndrome, anthrax, etc). Researchers should also consider the implications of their work and take the necessary review processes to ensure the proper biosecurity measures are taken.”

Should FEMA Be a Stand Alone Agency?                                                                            GMU Biodefense PhD alum Daniel M. Gerstein is at it again – evaluating DHS and the potential for major realignments in the Department. “As Congress considers reauthorizing the Department of Homeland Security, principles guiding any major realignments could include assessing whether the organization would be performing operational or staff management functions. Additionally, those principles could examine whether mission effectiveness would be improved through those major realignments and whether implemented changes would introduce new points of friction or inefficiency.” Gertstein notes several major realignments under consideration – replace the National Protection and Programs Directorate at DHS with a new Cybersecurity and Infrastructure Security Agency, remove FEMA from the DHS and make it a stand-alone department, and standing up a counter WMD organization. “As part of comprehensive department legislation, these realignments should be considered with an eye towards increasing operational effectiveness and efficiency while minimizing organizational friction in the transformed organizations and avoiding loss of key support relationships.”

Stories You May Have Missed:

  • The Unforgiving Math That Stops Pandemics– Another prime example of herd immunity and the importance of vaccination – “When talking about vaccination and disease control, health authorities often invoke “herd immunity.” This term refers to the level of immunity in a population that’s needed to prevent an outbreak from happening. Low levels of herd immunity are often associated with epidemics, such as the measles outbreak in 2014-2015 that was traced to exposures at Disneyland in California. A study investigating cases from that outbreak demonstrated that measles vaccination rates in the exposed population may have been as low as 50 percent. This number was far below the threshold needed for herd immunity to measles, and it put the population at risk of disease.”
  • Biosecurity Implications for the Synthesis of Horsepox, an Orthopoxvirus– Gigi Gronvall evaluates the biosecurity and biodefense implications of the recent horsepox synthesis. “The ability to recreate horsepox, or smallpox, will remain no matter what policy controls are put into place. It will be impossible to close off all avenues for nefarious misuse of gene synthesis, or misuse of biological materials more broadly. As a result, we advocate for the implementation of policy, regulations, and guidance that will make illicit recreation harder, more burdensome, more detectable, and, thus, more preventable without having sweeping negative consequences for the research enterprise. As part of our biosecurity efforts, we must also encourage and enable scientists to participate actively and to do all they can to safeguard their technical fields from irresponsible or illicit actions.”

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

Pandora Report 10.27.2017

TGIF and Pandora Report day! Buckle up because we’ve got an abundance of biodefense news that covers GHSA, chemical weapons, synbio, and more.

 Global Health Security – WHO & PATH Reports and GHSA Ministerial Meeting
As the Global Health Security Agenda Ministerial meeting in Kampala, Uganda takes place this week, several reports were released highlighting the deficiencies in global biosecurity and biosafety efforts, as well as the importance of investing in global health security. Fortunately, on the eve of the GHSA Kampala summit, the Trump administration endorsed the future of the GHSA. Don’t forget to stay tuned to our weekly reports as two GMU Biodefense graduate students are participating (as recipients of the George Mason Global Health Security Ambassador Fellowship) in the Ministerial meeting alongside NextGen GHSA and they’ll be reporting on their experiences in the coming weeks. The first report this week is from NTI, which called on countries to improve biosecurity after WHO demonstrated that there are substantial biosecurity/biosafety gaps worldwide. NTI analyzed 39 Joint External Evaluation (JEE) peer reviews and mapped the related biosecurity and biosafety related scores. Here are their findings: “74% of the assessed countries demonstrated limited or no capacity for a whole-of-government national biosafety and biosecurity system. 64% of the assessed countries demonstrated limited or no capacity for biosafety and biosecurity training and practices. 41% of the assessed countries demonstrated limited or no capacity for linking their public health and security authorities during a suspected or confirmed biological event.” The map they’ve created is also a great visualization for how truly weak biosecurity and biosafety efforts are on a global scale. NTI also used this information to track commitments and biosecurity assistance and partners. The next report comes from PATH, which just released their work: Healthier World, Safer America: A US government Roadmap for International Action to Prevent the Next Pandemic The latest PATH analysis focuses on global health security and global efforts to respond to threats. “This paper aims to examine the benefits of investments in pandemic preparedness, as well as recommends the US Administration and Congress come together behind a comprehensive US strategy, robust investments, and continued vigilance both at home and abroad. The recommendations focus on global leadership, a US plan for international action, and research and development; underpinned by the risks of unsustainable funding, with special focus given to the Ebola supplemental funding sunset set to occur in FY2019.”

Reauthorizing & Improving The Department of Homeland Security
Don’t miss the recent National Interest series by GMU Biodefense PhD alum Daniel Gerstein  on the DHS reauthorization bill. This three-part series starts with a focus on why it’s time to improve the Department of Homeland Security. Gerstein notes that “reauthorization of the Department of Homeland Security is vital to clarifying responsibilities and setting expectations for the continued evolution of the department.” The second part in the series highlights methods for fixing the fractured department. “The question is not whether reauthorization of DHS is necessary. It  most definitely is. However, we should also ask whether the bill goes far enough and what other issues should a comprehensive DHS bill encompass? This second commentary considers whether the DHS structure with  relatively weak central authorities should be reevaluated. Interestingly, each successive secretary has sought to consolidate power and authorities at the department level. Is it time to legislate this outcome? ” Lastly, Gerstein addresses why updating the DHS Acquisition System matters. “This third commentary considers how to better align the department’s requirements, research, development and acquisition processes. Currently, the processes are not synchronized and should be harmonized to better align these critical departmental systems.”

Global Health Security Forum 2017 
Don’t miss out on this November 7th event hosted by the Center for Strategic & International Studies. The all-day event will be held at the CSIS headquarters and will even include an entire session on “Hurtling Toward a Genomic 9/11”! Don’t miss out on the “CSIS’s annual flagship conference on the top challenges facing U.S. and global security. This year’s Forum will focus on national security priorities ten months into the Trump Administration and one year prior to U.S. midterm elections.”

 The Collision Of Civil War And Threat Of Global Pandemics
Infectious disease outbreaks can be challenging for even the most stable country and those experiencing civil war are even more impacted by such biological events. Currently, there are 30 civil wars going on around the world – between cholera in Yemen, polio in Syria, and yellow fever in the DRC, countries that have experienced civil war also tend to experience infectious disease outbreaks. “The Daedalus issue, “Civil War & Global Disorder: Threats and Opportunity,” explores the factors and influences of contemporary civil wars. The 12 essays look at the connection of intrastate strife and transnational terrorism, the limited ambitions of intervening powers, and the many direct and indirect consequences associated with weak states and civil wars. Barry and Wise believe there is significant technical capacity to ensure that local infectious outbreaks are not transformed into global pandemics. But those outbreaks require some level of organized and effective governance—and political will. Prevention, detection, and response are the keys to controlling the risk of a pandemic. Yet it’s almost impossible for these to coincide in areas of conflict.” Civil war impacts not only communication, but access to health resources and can challenge early detection and response of outbreaks. Moreover, the traditional hotspots for emerging infectious diseases (tropical and subtropical areas where spillover is likely) are also areas continually “plagued by civil conflict and political instability.”

Chemical Weapons and Syria
On Tuesday, Russia vetoed a vote at the United Nations Security Council that would “renew a mandate to continue an investigation into who was responsible for the use of chemical weapons during Syria’s civil war.” The Joint Investigative Mechanism (JIM) was initially set up in 2015 to help identify those responsible for chemical attacks and is currently reviewing the April nerve agent attack in Khan Sheikhoun. “But Russia could not get enough support and instead used its veto to block adoption. Russia, along with the UK, China, France and the US, have veto powers at the Security Council. It is the ninth time Russia has blocked action against its ally Syria, something rights group Amnesty called ‘a green light for war crimes’.” The United States has already released a statement through the State Department – “We are disappointed, we are very disappointed that Russia put what it considered to be political considerations over the Syrian people who were so brutally murdered,”.

The Good, The Bad, and The Ugly of Pandemic PredictionPreparation, and Medical Countermeasure Communication 
Pandemic preparedness often feels like a teetering game of picking your poison. Will we see an avian influenza like H7N9 or will it be a novel disease? The CDC “evaluates every potentially dangerous strain, and gives them two scores out of 10—one reflecting how likely they are to trigger a pandemic, and another that measures how bad that pandemic would be. At the top of the list, with scores of 6.5 for emergence and 7.5 for impact, is H7N9.” While there isn’t strong transmission capacity between humans with the H5 and H7 viruses, the H7 strains are more worrisome in that they require fewer mutations to get to that point. Our efforts against avian influenza pandemics go beyond surveillance, and also focus on vaccine responses. “In the meantime, vaccines are being developed to match the viruses seen in the fifth and current epidemic. Other control measures have waxed and waned. When the first of the epidemics struck, Chinese health ministries closed markets and slaughtered birds. But as Helen Branswell reports in STAT, some of those containment efforts became more lax in 2015 and 2016.” Preparedness and response exercises can also gives great insight into problems that may arise when dealing with a pandemic. A recent pandemic simulation was held during the World Bank’s annual meeting in Washington D.C., in which participants addressed everything from hospital closures to mass quarantine. “For the World Bank simulation, organizers looked at the impact on travel and tourism of an outbreak of a mysterious respiratory virus in a hypothetical country. Discussions during the 90-minute session were off the record. But in interviews after the event, organizers said the step-by-step scenario made the theoretical possibility seem very real for participants. In particular, it drove home the need for speedy, accurate information-sharing and strong coordination within and across governments and institutions.” These kinds of exercises are crucial to not only address gaps, but bring together a variety of people that will be critical to pandemic response and recovery. The Johns Hopkins Center for Health Security also just released their self-guided exercise scenario that focuses on communication dilemmas that occur during development of medical countermeasures. The exercise is aimed at public health communicator and risk communications researchers, and revolves around a novel coronavirus outbreak in 2025. “Over a 3-year period, the virus spreads to every US state and more than 40 countries, where case fatality rates vary depending on the capabilities of local health systems. In the United States, an existing drug is repurposed to treat SPARS symptoms while federal regulators work with a pharmaceutical company to fast-track the production of a SPARS vaccine. The response differs in other nations. What follows is a nationwide vaccination effort and lingering strains on the US healthcare sector from a steady stream of patients seeking treatment for serious post-SPARS complications.”

Security Implications of Genome Editing – Meeting of Experts in Hanover
Earlier this month, a meeting of scientists and experts on policy and security gathered to discuss the potential implications of genome editing technologies like CRISPR. GMU Biodefense professor Dr. Sonia Ben Ouagrham-Gormley attended, noting that “Over 100 CRISPR scientists form all over the world (China, India, U.S., Europe, Africa), and policy and security experts gathered in Hannover, Germany,  to discuss the security implication of the new gene-editing technique CRISPR.The group reviewed various threat scenarios and discussed potential policy responses. The meeting was particularly successful as both the scientists and security experts engaged in a productive dialogue about the importance of ensuring security without hampering the use of this new technology to promote progress in medicine and agriculture among other things.” The conference focused on establishing proactive international dialogue about genome editing and incorporating experts that range from ethics and philosophy to economics and political science. “Many workshop participants emphasised that it is vital to support and sustain a culture of responsibility and integrity in research and innovation and to engage with stakeholders. Moreover, researchers and policy makers must commit to continuing an open and inclusive dialogue that builds trust. As with other new and emerging technologies, a lack of communication about any uncertainties may undermine public confidence in science. Scientists and security experts should listen to concerns or fears regarding the misuse of genome editing, and provide their expertise on what is and is not likely.”

Synthesizing Biological Threats—A Small Leap From Horsepox to Smallpox
GMU biodefense PhD student Saskia Popescu discussed dual-use research concerns with GMU professor and graduate program director Dr. Gregory Koblentz and how these relate to healthcare and infectious disease professionals. Drawing on the recent horsepox synthesis, Dr. Koblentz emphasized how this opens Pandora’s box even wider for potential smallpox synthesis and misuse of synbio. Popescu highlighted these concerns and how important it is for healthcare workers to be aware of such events and vulnerabilities. “From the healthcare perspective, it may not seem like something we should worry about, but the direction of gene editing and dual-use research of concern is something that is intrinsically linked to public health. Nefarious outcomes of such experiments, regardless of the origin or intent, will inevitably make their way into an emergency department, urgent care, or worse, the community. Although we may not be seeing the implications today, as medical providers and healthcare workers, we must keep our ears to the ground, listening for these biotech advancements, and then thinking through what they mean for us tomorrow.”

Step Away From The Backyard Poultry
Do you keep poultry in your backyard? If so, you may want to rethink it as the number of Salmonella infections related to contact with backyard poultry has quadrupled since 2015. “This year, nearly every state has been pecked by outbreak strains; only Alaska and Delaware can crow about dodging them. The Centers for Disease Control and Prevention has confirmed 1,120 cases. Nearly 250 of those involved hospitalization, and one person died.But that is likely just scratching the surface of the real numbers, according to CDC veterinarian Megin Nichols. ‘For one Salmonella case we know of in an outbreak, there are up to 30 others that we don’t know about,’ she told the AP.” The issue is that chickens and other fowl can carry organisms without having symptoms and shed them in their feces. While some hatcheries will test prior to selling their birds, it’s important that owners be aware of the risks for such infections.

The Schar School of Policy & Government Presents: Strategic Trade and International Security: Policy and Practice
This Brown Bag Seminar Presentation by Dr. Andrea Viski is the place to be on Thursday, November 2nd, from noon to 1:30pm. “Dr. Andrea Viski is the founder and director of the Strategic Trade Research Institute, an independent organization dedicated to providing authoritative research on issues at the nexus of global security and economic trade. She is also the editor-in-chief of the Strategic Trade Review, a peer reviewed journal dedicated to sanctions, export controls, and compliance. She previously worked for Project Alpha at King’s College London and for the Stockholm International Peace Research Institute (SIPRI). She has published numerous articles and book chapters in the areas of strategic trade controls, nuclear non-proliferation, and international law. Dr. Viski received her Ph.D. from the European University Institute, her M.A from Georgetown University’s Institute for Law, Science and Global Security, and her B.A in International Politics from Georgetown University’s School of Foreign Service.” The seminar will be at Founders Hall 602, 3351 Fairfax Drive, Arlington, VA 22201.

Stories You May Have Missed:

  • Uganda’s Marburg Outbreak – Uganda has just confirmed the death of a 50-year-old woman as a result of the hemorrhagic fever, Marburg. “The victim, a 50-year old woman, died on October 11 at a hospital in eastern Uganda after “she presented with signs and symptoms suggestive of viral hemorrhagic fevers”, the minister said. The woman had nursed her 42-year old brother who died on September 25 with similar signs and symptoms and also participated in cultural preparation of the body for burial, she added.”
  • Big Chicken – Are you reading the latest book by Mary McKenna on antibiotic misuse in the poultry industry? “In Big Chicken, McKenna lays out in extensive detail the unintended consequences that resulted from experiments performed at Lederle Laboratories in December 1948 when scientist Thomas Jukes began adding trace amounts of the antibiotic aureomycin (later to be known as chlortetracycline) to chicken feed. The discovery that the drug could quickly fuel growth in chicks raised in confinement revolutionized the poultry industry, turning chicken into America’s favorite protein.”

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

Pandora Report 10.20.2017

Happy Friday and welcome to our weekly rundown of all things health security!

Smallpox Could Again Be A Serious Threat
GMU Biodefense professor, graduate program director, and all around health security grand master, Dr. Gregory Koblentz, is working to make sure we’re not ignoring the threat of smallpox due to synthetic biology. The problem isn’t just within the amazing capabilities of synbio, but its dual-use nature, meaning that it has the potential to be misused by nefarious actors. This concern has become even greater with the horsepox recreated by Canadian researchers who demonstrated not only capability, but also the low cost of such work. It’s not a far jump from horsepox to smallpox, especially when we have mail-order DNA fragments available at prices that continue to lower. Koblentz notes just how much of a disaster a re-emergence of smallpox would be on a global level, especially since it’s highly contagious and routine immunization has long been gone. “If resurrecting horsepox virus provides a roadmap to synthesizing smallpox virus, then why would anyone try to synthesize it? Because there are potentially legitimate uses for. Tonix claims that the horsepox virus is a good candidate for developing a new, safer smallpox vaccine. Unfortunately, the current legal and technical safeguards against the synthesis of smallpox virus are weak and fragmented. There is no clear international legal or regulatory framework to prevent the synthesis of smallpox virus. The WHO has a policy banning the synthesis of the smallpox and regulating who can produce and possess large fragments of smallpox DNA, but it hasn’t been widely adopted by states. Furthermore, there is no mechanism—at either the national or international level—for detecting or punishing violations of this policy.” Aside from some substantial gaps in regulations, there are some voluntary industry screening processes however, these are pretty limited and tend to be minimal at best. Koblentz points out that there is still time to get ahead of the pox in this case – specifically by rallying international organizations, national governments, the DNA synthesis industry, and the synbio community. Check out his recommendations and comments in the article here!

Global Health Security Supplement – CDC’s EID Journal
Don’t miss out on this ahead-of-print alert for the December edition of the CDC’s Emerging Infectious Disease journal. Volume 23 will include a section on global health security, with articles on the contributions made by the CDC and other partners, establishment of the CDC Global Rapid Response Team, and Joint External Evaluations. There’s also a great commentary by Dr. Michael T. Osterholm on the unfinished journey of global health security. “All countries need to have the laboratory, trained workforce, surveillance, and emergency operations capabilities to prevent, detect, and respond to disease threats. Only when these accomplishments are realized can we truly be on the road to global health security for infectious diseases. Until then, the goal of global health security remains an unfinished journey.”

GMU Biodefense PhD Info Session – October 26th!
Don’t miss your last chance to catch our biodefense PhD info session before applications are due! On Thursday, October 26th at 7pm at our Fairfax campus, we’ll be hosting this session where you can meet with professors, current students, and find out how much fun getting a PhD can be. Where else can you study everything from synbio to Ebola and even how to stop biological threats? GMU Schar School’s Biodefense program is just the place for all things health security.

The Worrying State of Epidemic Preparedness & Global Spread of Hemorrhagic Fever Viruses: Predicting Pandemics
University of London professor Sanjeev Krishna studies neglected infectious diseases and like so many, wasn’t surprised at the 2014/2015 Ebola outbreak. He notes that globally, we could’ve been better prepared to handle the outbreak and that vaccine development, among other things, is critical. “At the start of this year an organisation was launched to lead the way, the Coalition for Epidemic Preparedness Innovations (CEPI). Its mission is to bring politicians, academics, drug firms and philanthropists together to help prepare for the next epidemic. It was launched at the World Economic Forum in Davos in January, and is backed with $620m (£466m) from the governments of Norway, Germany, Japan, Canada, Belgium and Australia and the world’s two largest health charities the Wellcome Trust and the Bill and Melinda Gates Foundation. It is working to establish the lab and distribution infrastructure and access to funds needed to rapidly develop vaccines in a crisis.” CEPI Chief Executive Richard Hatchett has continually emphasized the importance of recognizing warning signs and investing in prevention efforts. Hatchett points out that the biggest lesson from Ebola, like so many outbreaks, is that we simply can’t be complacent about diseases with epidemic potential. Vaccine development can take a while and is costly (some say it’s about $1 billion per vaccine) and it’s taken groups like the Bill and Melinda Gates Foundation and Wellcome Trust to really support some of these efforts when government investments have been lacking. These gaps in preparedness and funding are worrisome in the event of a pandemic flu. “Sir John Bell, scientist at Oxford University and author of the UK’s life sciences industrial strategy, agrees on the threat posed by flu, noting that the last flu pandemic in 1918 killed 50m to 100m people, around 3-5pc of the world’s population at the time. ‘The experience of the epidemic in 1919 should give ample cause for concern about the impact of such an event globally,’ he says.” The truth is that we’re still working to prepare and respond to these biological events, but the real question is – will we learn from our mistakes? You can also read Dr. Alaa Murabit’s comments on the challenges of securitizing health and how this UN High-Level Commissioner is tackling global health issues. Epidemics usually occur when health systems are unprepared.” These words ring especially true this week, during International Infection Prevention week (read below). Hemorrhagic viruses and hantavirus have shown an uncanny ability for epidemic expansion, whether it be through people or rodents across significant geographical areas. “The ultimate goal is to develop a resilient global health infrastructure. Besides acquiring treatments, vaccines, and other preventive medicine, bio-surveillance is critical to preventing disease emergence and to counteracting its spread. So far, only the western hemisphere has a large and established monitoring system; however, diseases continue to emerge sporadically, in particular in Southeast Asia and South America, illuminating the imperfections of our surveillance. Epidemics destabilize fragile governments, ravage the most vulnerable populations, and threaten the global community.” The truth is that we so frequently follow the pattern of poorly prepared health systems responding to epidemics and governments re-alligning preparedness efforts only after the event. The current world is in a state of flux to fix these health issues despite constant external stressors like conflict, growing populations, migration, climate change. Despite these challenges, it is vital we strengthen our health systems to more effectively and efficiently identify biological threats, prevent them, and respond to them.

Measuring Radiation Doses in Mass-Casualty Emergencies                 We’re getting a double-dose of GMU biodefense in this fascinating article on radiation measurement. GMU biodefense professor and graduate program director Dr. Gregory Koblentz and doctoral candidate Mary Sproull (who is also a radiation guru at the Radiation Oncology Branch of the National Cancer Institute at the National Institutes of Health) are teaming up to address diagnostic challenges and technologies in the event of a nuclear attack. This article is especially relevant with tensions rising between the United States and North Korea in the wake of nuclear tests. In the event of something this horrific, one of the challenges is to appropriately and accurately diagnosis and treat radiation-related injuries. “Fortunately, new types of diagnostics to address this critical need are being developed in the field of radiation biodosimetry. Radiation biodosimetry is the estimation, through observation of biological variables, of received dose from previous radiation exposure; the new diagnostics use changes in various biological markers to estimate the severity of radiation doses.” Koblentz and Sproull highlight several gaps within U.S. preparedness related to biodosimetry, especially in terms of surge capacity and how such diagnostic capabilities may be challenged in a large-scale event. They also point to research into new assays, like those using newly identified radiation biomarkers. Lastly, Koblentz and Sproull focus on recommendations to better integrate biodosimetry, whether it be integrating medical management of radiation injuries into healthcare provider education or equipping federal response teams with deployable point-of-care biodosimetry diagnostic capability.

Meeting of the Blue Ribbon Study Panel on Biodefense – National Biodefense Strategy: Implementation and Implications
Don’t miss this event at the Hudson Institute on Thursday, November 2nd from 10:30am to 2pm. “This meeting of the Study Panel will address implementation of the National Biodefense Strategy and its implications for the Office of Management and Budget, congressional authorization and appropriation, leadership, coordination, collaboration, and innovation. Thought leaders will draw upon current and previous experiences with implementing national strategies and high-level policy directives. These speakers will also share their thoughts on: (1) the biological threat, the priority they place on biodefense, and efforts to address their concerns; (2) what the Administration should consider as it goes about populating the Implementation Plan for the National Biodefense Strategy; and (3) how Congress should use the Strategy and its Implementation Plan to inform its biodefense oversight and legislative activities.” Make sure to RSVP here by October 30th if you’re attending in person – the event will also be webcast.

Doreen and Jim McElvany Nonproliferation Challenge
Don’t miss out on this wonderful opportunity through the James Martin Center for Nonproliferation Studies (CNS) to encourage innovative thinking and help address nonproliferation. “The James Martin Center for Nonproliferation Studies (CNS) and its journal, the Nonproliferation Review, aim to spur new thinking about nonproliferation and disarmament.To advance this goal, the Doreen and Jim McElvany Nonproliferation Challenge will recognize the most outstanding new ideas and policy proposals published in Volume 25 (2018) of the Nonproliferation Review. The Challenge will award a grand prize of $5,000, a $3,000 runner’s-up prize, and a $1,000 honorable mention prize.”

The Evolution of the Islamic State’s Chemical Weapons Efforts               The Islamic State has grown increasingly comfortable with using chemical weapons and Columb Strack is taking us through the evolution of their practices. While their use of chemical weapons seems to have been abandoned since the loss of Mosul in June 2017, intelligence sources have suggested that a new chemical weapons cell has been established within the Euphrates River Valley. “The Islamic State’s use of chemical agents in Iraq and Syria is characterized by three phases. During the initial phase, which encompasses the first year of the caliphate’s existence (between June 2014 and June 2015), chemical attacks drew on tried and tested techniques, adapted to include widely available industrial chemicals—mainly chlorine and phosphine—from stockpiles captured as part of the group’s territorial expansion. These attacks were carried out using crude delivery mechanisms, in most cases adding canisters of chemicals to roadside or vehicle-borne improvised explosive devices (IEDs). The second phase, from July 2015 to January 2017, represents the enhanced capability the group had achieved by combining the production of sulfur mustard agent with the means to deliver it using projectiles, such as mortar bombs and improvised rockets. During this period, chemical attacks were carried out simultaneously across the caliphate, from Syria’s Aleppo province in the west to Iraq’s Kirkuk province in the east, indicating the existence of multiple operational units with the required expertise. Attacks peaked in April 2016, with eight separate recorded chemical attacks in one month. The third phase began with the last recorded chemical attack in Syria on January 8, 2017, and ended with the Islamic State’s apparent abandonment of its CW production following the loss of Mosul in July 2017.” Strack traces the history of intent and methodology development from two decades of experimentation by other militant groups. Strack also discusses experiments and sources for the weapons, including the seizure of military sites where chemical weapons could have been stored. Lastly, he discusses the slow degradation of capability that occurred following airstrikes against facilities and individuals, but that ultimately, the Islamic State has “the capability not only to transfer the know-how to produce toxic chemicals via secure online communications to operatives already living in target countries, but also to ship materials, including explosives, undetected.”

Blue Ribbon Study Panel on Biodefense- Animal Agriculture Vulnerabilities
Diseases that impact animals and have the potential to cross over to humans, let alone impact the agriculture industry, can be devastating. The Blue Ribbon Study Panel on Biodefense has just released their report evaluating the threats to animal agriculture and how this can not only impact human health, but also the U.S. economy. “In December 2014, a highly pathogenic strain of avian influenza entered the United States via migrating wild birds. The ensuing outbreak resulted in the largest animal health disaster ever experienced by the United States. Federal and state governments spent $879 million on outbreak response. The outbreak impacted 21 states, lasted until the middle of 2015, and led to the depopulation of more than 50 million birds on 232 farms. Subsequent trade bans impacted as many as 233,770 farms. The total cost to the U.S. economy was estimated at $3.3 billion. In 2015, the agriculture, food, and related industries contributed $992 billion (5.5%) to U.S. gross domestic product (GDP), making it one of the largest sectors of the U.S. economy. Given its critical importance to food safety and availability in the United States and around the world, protecting this sector is a matter of national security.” The report covers the threat to food and agriculture, zoonoses, how federal response is organized, collaborative efforts like biosurveillance, and the innovative work within next-generation medical countermeasures.

Why You Should Be Celebrating International Infection Prevention Week                                                                                                                                         Are you celebrating infection control this week? GMU Biodefense PhD student Saskia Popescu is pointing out how vast the role of infection prevention is across healthcare and why we should all be celebrating it. “October 15-21, 2017 marks International Infection Prevention Week and while this may seem like a week where we rally around hand hygiene, it’s much bigger than that. Infection prevention goes beyond the nuances of hand hygiene and expands to almost every corner of medical care and healthcare. Whether it be a dental clinic, operating room, or even an outpatient treatment center, infection prevention plays a vital role in keeping patients and healthcare workers safe. Not convinced? On any given day, the Centers for Disease Control and Prevention estimates that roughly 25 people in the United States will acquire a healthcare-associated infection (HAI). In a given year, it’s estimated that 722,000 HAIs occur, of which 25,000 of those patients die due to the infection. Realistically, it’s believed that the annual number of HAIs within the United States is closer to 2 million, which is astounding.”

Monkeypox in Nigeria
Nigeria is currently experiencing an outbreak of monkeypox after confirming three cases. “Since Sep 22, there have been 60 reports of suspected monkeypox cases from across Nigeria. The laboratory analysis showed that 12 suspected cases from the Bayelsa state were not positive for monkeypox. The NCDC said that all patients with suspected and confirmed monkeypox are currently receiving supportive medical care and improving. The NCDC offered no further details on the confirmed cases, besides noting that they were from Bayelsa state. The agency said the likely source of infection is through primary zoonotic transmission, and cautioned Nigerians to avoid contact with squirrels, rats, and any animals that appear sick.” Samples are currently being analyzed at the WHO regional office in Dakar, Senegal.

Stories You May Have Missed:

  • Did Disease Impact the Fall of Rome?– We know that disease can have devastating consequences on societies and even ancient Rome experienced several outbreaks of smallpox and plague, but just how impacting were these biological events? “Rome was far from the only advanced society shaken to its core by the explosive force of infectious diseases. The medieval Black Death sent some leading-edge polities (like the communities of Italy) backward, while opening the space for the ascent of others, such as England. The lethal role of pathogen exchange in the European conquest of the New World is relatively famous, if still imperfectly understood.”
  • Supportive Care Recommendations for Ebola Patients– Treatment for patients afflicted with Ebola can be tricky and there’s often little time to get the right mixture. “The study, by a team of international experts, was published yesterday in The Lancet. The authors write that at the beginning of the outbreak in 2013, case-fatality rates were 70%, but that number was lowered significantly (to 40%) as supportive care practices improved over the course of the outbreak. Using Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology, the authors present evidence-based recommendations for patient care during the next Ebola outbreak. Oral hydration and intravenous hydration had the strongest recommendation. When administered properly, the measure carries no risk of transmission to healthcare workers, the experts say. and making sure patients, especially the very young, are adequately hydrated is a necessary supportive measure.”

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

Pandora Report 9.15.2017

Global Health and the Future Role of the United States
The latest report from the National Academies of Science Engineering, and Medicine, is now available! “Growing forces for globalization have increased the interconnectedness of the world and our interdependency on other countries, economies, and cultures. Monumental growth in international travel and trade have brought improved access to goods and services for many, but also carry ongoing and ever-present threats of zoonotic spillover and infectious disease outbreaks that threaten all.” The report includes chapters on investing in global health for America and how such investments protect U.S. interests, the effects of globalization, and looking into the future. There are individual chapters on infectious diseases like pandemic influenza and global health security as national security, TB, and how we can enhance productivity and economic growth. “By investing in global health over the next 20 years, there is a chance to save the lives of millions of children and adults. Beyond these health benefits to individuals, global health is directly linked to economic productivity and growth worldwide. According to the Lancet  Commission on Investing in Health, the return on investments in global health can be substantial—as the benefits can exceed the costs by a factor between 9 and 20, for low-income and lower middle-income countries, respectively. Worldwide, investing in core capacities to prevent, detect, and respond to infectious disease outbreaks through the development of multidisciplinary ‘One Health’ systems focused on the interface of human and animal health can result in an estimated savings of $15 billion annually from the prevention of outbreaks alone.” The report emphasizes the importance of continued commitment to global health and that ultimately, aid is truly an investment in global health, which benefits us all. Disease knows no borders and an outbreak anywhere is an outbreak everywhere. Melinda Gates also recently discussed the importance of foreign aid, noting that “If we don’t make these investments in global health, my argument to people is, you’re going to see a lot more things like Ebola in our own country, and we’ll be dealing with them in our own health clinics because borders are porous,”.

GMU Biodefense Graduate Program Information Sessions 
Don’t miss out on the chance to learn about our PhD program on September 21st! You can join the info session at 7pm at the GMU Arlington Campus. The GMU Schar School PhD info session will also include a panel of current PhD students to discuss their experiences and answer questions. This is also a great chance to chat with faculty and learn about admissions. Where else can you study a range of topics that include biosurveillance, select agents, global health security, and policy with such an engaged group of faculty and students?

Tom Frieden Launches New Global Health Initiative
Former CDC director Dr. Tom Frieden is launching a new program to combat not only global cardiovascular disease, but also infectious diseases. The new initiative Resolve to Save Lives, will be located in New York City, and “will prevent heart attacks, strokes, and epidemics with the goal of saving 100 million lives and making the world safer from epidemics.” The initiative has $225 million in backing over the next five years by major funders including the Chan Zuckerberg Initiative, Bloomberg Philanthropies, and the Bill and Melinda Gates Foundations. Frieden hopes to work with major players like the WHO and CDC “to persuade more countries to ban trans fats and lower the salt content in foods and shore up defenses against disease outbreaks”.

Johns Hopkins Center for Health Security ELBI Workshop
The Johns Hopkins Center for Health Security Emerging Leaders in Biosecurity Initiative (ELBI) recently hosted their last event for the 2017 class. The 2017 group capped off their fellowships with a day of engaging lectures and discussions including talks from FBI SSA Ed You, STAT reporter Helen Branswell, MIT’s Peter Carr, and more. The group was able to tour the Ginkgo Bioworks and George Church labs while chatting with Andy Weber, George Church, Patrick Boyle, Tom Knight, and Devin Leake about the future of synbio and biotechnology. Last but not least, the fellows participated in a viral storm exercise, which challenged them through a real-world scenario that required policy, security, public health, and science responses on a global scale. GMU biodefense PhD student Saskia Popescu attended as a member of the class, noting that “one of my favorite parts from this workshop was getting to hear from Tom Inglesby and several analysts from the CHS regarding their research and initiatives they’ve worked on. Learning about projects like Outbreak Observatory, data-driven outbreak response (outbreak science), and healthcare capacities during natural disasters, was fascinating and really opened my eyes to the range of topics the CHS is involved in.”

Biological Engagement Programs: Reducing Threats and Strengthening Global Health Security Through Scientific Collaboration
Don’t miss out on this latest eBook addressing biological engagement programs and the health security perspective. “Biological engagement programs are a set of projects or activities between partner countries that strengthen global health security to achieve mutually beneficial outcomes. Engagement programs are an effective way to work collaboratively towards a common threat reduction goal, usually with a strong focus on strengthening health systems and making the world a safer place. Cooperative programs are built upon trust and sharing of information and resources to increase the capacity and capabilities of partner countries.” You can download the PDF here – make sure not to miss the chapter “Strengthening Biosecurity in Iraq: Development of a National Biorisk Management System”, co-authored by GMU biodefense professor and graduate program director, Dr. Gregory Koblentz.

NAS Symposium on Cooperative Threat Reduction (CTR) for the Next Ten Years and Beyond
The National Academy of Science will be hosting this symposium on September 18-19 at the Keck Center in Washington, D.C. “In 2009 the National Academy of Sciences (NAS) report Global Security Engagement: A New Model for Cooperative Threat Reduction concluded that expanding and updating U.S. Government Cooperative Threat Reduction (CTR) programs in both form and function would enhance U.S. national security and global stability. The NAS Committee on International Security and Arms Control (CISAC) is convening a symposium to examine how CTR has evolved since that time and to consider new approaches for CTR programs and related WMD elimination efforts to increase their ability to enhance U.S. security. The symposium is sponsored by the Project on Advanced Systems and Concepts for Countering Weapons of Mass Destruction (PASCC) in the Naval Postgraduate School and will be open to the public. A ‘meeting in brief’ document will be issued by NAS after the symposium. For detailed information on this event and a draft agenda please visit:  www.nas.edu/cisac.”

Stories You May Have Missed:

  • GAO Report on Medical Devices for Infectious Disease Rapid Diagnosis – The latest GAO report is looking to the capabilities and challenges of technologies that allow for the rapid diagnosis of infectious diseases. Diagnosis of bio-threats is a crucial component to prevention and control, which makes the efficacy of these technologies critical. “Some stakeholders GAO spoke to identified the need for more clinical studies to establish the benefits of these technologies. Implementation challenges included reluctance by medical users to adopt these technologies, due to factors such as (1) lack of familiarity with such technologies, (2) costs and resources to use them, and (3) reluctance to order, and pay for, all of the tests for a given multiplex assay. Further, in some situations, positive test results for rare diseases are more likely to be false positives; thus systematic testing for such diseases may result in wasted resources to address all patients who test positive.”
  • CSIS Event: The New Barbarianism- don’t miss out on this event organized by the CSIS Global Health Policy Center on Monday, September 18th, from 6:30-9pm at the Newseum. “This hour-long film explores the recent surge of violence we’ve witnessed against the health sector across multiple wars, both new and old, and the accompanying shredding of international humanitarian norms”. Make sure to register here.

Pandora Report 9.8.2017

Happy Friday and welcome to your weekly source for all things biodefense. Got plague? Good news – if you have some live chickens hanging around, you can try this medieval treatment.

Defense Against Biological Attacks
Biological threats come in all shapes and sizes – whether it’s an outbreak of Ebola, a biological weapon, a laboratory mishap, or even the potential for biosafety breaches following  a hurricane. Preparedness and response efforts need to be just as diverse. As Texas begins the process of rebuilding and the threat of nuclear weapons has been fresh in everyone’s mind, it is crucial we don’t forget about the importance of health security. Disease knows no borders and it’s easy to diminish the threat of it however, Laura Holgate and Elizabeth Cameron are drawing attention to the need for President Trump to prevent the next biological attack before it happens. “As Congress and the Trump administration mull a new biodefense strategy, we urge them to use this time — the time in between biological crises — to get ahead of the curve before the next major biological event inevitably comes our way.” They point to several different strategies that should to be followed – watch out for emerging threats in unstable regions, fund and renew the Global Health Security Agenda, replenish the budget to maintain global biosecurity, keep laboratory assets for attributing biological attacks, and use biosurveillance to stop outbreaks before they start. We need to take the National Bioforensics Analysis Center off the chopping block, stop slashing the biosecurity budget as programs like the Cooperative Biological Engagement Program are vital, and truly, the GHSA renewal is a no-brainer. These efforts not only defend against current threats, but work to address the next generation of bioweapons and biothreats.  Holgate and Cameron note that “We know that biological threats must remain at the top of the national security agenda, and leaders must recognize that stopping outbreaks at the source requires strong global and domestic capacity to prevent, detect and rapidly respond to naturally occurring outbreaks and biological attacks”

Health Security – Call for Papers
The Health Security journal is currently looking for papers on communication and health security: improving public health communication in response to large-scale health threats. Manuscript deadlines are October 20, 2017. “Effective communication is an essential tool in establishing an appropriate response to any large-scale health threat or disaster, such as a newly emerging infectious disease, terrorism, environmental catastrophe, or accident. Yet, public health communication is occurring in an increasingly complex world with competing messages, new platforms, and limited trust.A special feature in Health Security will be devoted to analysis of the current communication environment and efforts to effectively communicate during outbreaks of infectious diseases and other health threats. The journal seeks papers that address the wide range of policy, practice, and research issues relevant to communication in large-scale health events.” Topics might include exploration of the communication environment during recent infectious disease events or public health disasters, investigation of the role of social media and other emerging or recently emerging communication platforms, etc. Submission information can be found here.

GMU Biodefense MS – Open House on September 14th
Don’t miss out on the Master’s Open House next week for the GMU Biodefense MS program!  From 6:30-8:30pm next Thursday, September 14th, at the GMU Arlington campus, you can speak to faculty, learn about admissions, and why biodefense students have a blast while getting their graduate degrees. This is a great chance to learn about the MS program (for both online or in-person) and chat with faculty about the exciting classes and activities GMU biodefense students get to enjoy.

The Biological Weapons Convention At A Crossroad
As Robert Frost once said, “Two roads diverged in a wood, and I- I took the one less traveled by, and that has made all the difference.” Which direction will the BWC take? Bonnie Jenkins investigates the uncertain future of the BWC, its current challenges, which direction it might take, and the direction it should take. Despite its relevance and capacity to endure decades of challenges, the latest RevCon was considered a monumental disappointment and left many in a state of disagreement. “Some of the major issues that were discussed at previous meetings—but at this point have no platform for discussion at the BWC—include advances in science and technology, disease outbreak preparedness and response, and national BWC implementation. Previously-held mid-year experts’ meetings have also been dropped, so there is now no chance for the exchanges with experts from relevant international organizations, including input from the World Health Organization that has been so useful in the past. These are all steps backward.” Despite a lack of Meeting of States Parties in August, there is hope that the December meeting with work towards developing an inter-sessional work program. On top of these barriers, the BWC has funding challenges, which severely impacts the Implementation Support Unit (ISU). Against these odds, the BWC ISU continues to promote universal membership and treaty implementation. Global initiatives are also beneficial to promotion of health security and prevention of biological weapons. “When global initiatives interconnect like this, it reinforces all of the initiatives. The Global Health Security Agenda, for instance, brings over 55 countries together to strengthen countries’ capacities to prevent, detect, and respond to infectious disease threats, whether natural, deliberate, or accidental.” These efforts seek to strengthen the BWC through global health security, but there is still work to be done. Jenkins suggests three tasks are crucial to maintain BWC relevancy and sustainability: “1) Sufficient and sustained funding by states parties, to include payments now in arrears; 2) Strong leadership and a successful December MSP that reaffirms the importance of the treaty to the international community and that also develops an inter-sessional work program; and 3) A vision for developing the role of the BWC as part of a larger interconnected global security architecture.”

Using Ebola Data to Fight Future Outbreaks
Learning from past outbreaks to avoid future failures is always a tough aspect of public health however, a new strategy is using data to help stop the next outbreak of Ebola. Researchers have developed a new platform to help organize and share Ebola data that was previously scattered and unable to be utilized. This was a significant issue on the ground during the 2014/2015 outbreak, which makes this project all the more important. “The information system is coordinated by the Infectious Diseases Data Observatory (IDDO), an international research network based at the University of Oxford, UK, and is expected to launch by the end of the year. At a meeting to discuss Ebola on 7–9 September in Conakry, Guinea, the team heading the platform will seek input from West African scientists, health officials and advocacy groups.” One of the most vital components to the system is the emphasis of partnership and involvement of African collaborators. Not only will this focus encourage the use of historical data, but will also allow utilization during future outbreaks. Control of the data has also been a challenging hurdle to overcome, as there are many cooks in the kitchen. “Amuasi says that he would have liked the database to be hosted and curated in Africa, rather than in Oxford, because training and paying African researchers to manage the platform would teach them how to use the information and improve their ability to respond to future outbreaks in the region. But he adds that this seems unlikely, because it would raise the cost of the project, and the infrastructure already exists at Oxford. Merson says that a copy of the database will be maintained in West Africa, although its exact location has yet to be determined. She adds that an African committee may be in charge of deciding who gets access to the data. And she says that fellowships are likely to be made available for West African students who want to work on the database.”

The Global Health Security Agenda: Public & Private Partnerships
The Global Health Security Agenda Consortium and EcoHealth Alliance will be hosting this meeting on Thursday, September 14th at 12pm. Held at the ONE UN New York Hotel in NYC, you can catch this event with speakers like Dr. Beth Cameron from the Nuclear Threat Initiative and Admiral Tim Ziemer from the US National Security Council. Make sure to RSVP here.

Launch of International Health Regulations Costing Tool
Georgetown University Center for Global Health Science & Security is launching their new open-access IHR costing tool. “In 2016, the World Health Organization adopted the Joint External Evaluation tool (JEE) to measure country-specific progress in developing the capacities needed to prevent, detect, and respond to public health threats, as mandated under the 2007 International Health Regulations (IHR). However, national governments and development partners have struggled to accurately define the costs of strengthening and maintaining critical health security systems that often depend on multi-sectoral coordination. This poses a serious dilemma for global health security and presents a compelling opportunity to improve the drafting and implementation of practical health security policies.” A joint effort with Talus Analytics, this new tool was developed to help estimate the cost to build capacity under the IHR. You can access the tool here (you may want to use Google Chrome).

IDSA Slams Budget Cuts to AMR
Biodefense budgets aren’t the only ones to be taking a beating… The president’s FY2018 budget released in May would cut the CDC’s Antibiotic Resistance Solutions Initiate (ARSI) by 14%, as well as 23% from the NIH and NIAID, which funds research on AMR. Leaders from Infectious Disease Society of America (IDSA) are rallying to oppose such efforts. “In a letter published yesterday in Annals of Internal Medicine, IDSA treasurer Helen Boucher, MD, past president Barbara Murray, MD, and current president William Powderly, MD, argue that the budget cuts for public health and research proposed by the Trump administration will not only diminish the nation’s surveillance capacity and its efforts to reduce infections and promote appropriate antibiotic use, but also undercut US leadership in global efforts to tackle the AMR threat, which is responsible for more than 700,000 deaths each year globally.” The letter emphasizes that such cut would severely impact AMR efforts, which is highly worrisome and dangerous given the severity of the global AMR threat. You can read the letter here.

An Integrated Approach to Forensic Investigation of Threat Agents
In the wake of a chemical or biological event, threat analysis is a high-stakes operation that has little room for error. Determining the substance, origin, and components all make for a stressful situation that requires effective analytical methods. “Traditional analytical methods are good at confirming the presence or absence of a particular agent or substance. If a sample is believed to contain Bacillus anthracis, standard biological analysis will quickly determine whether or not this is the case. But it will not provide insight into its virulence, origin or how it might have been manipulated. And if the sample turns out to be something other than B. anthracis, it will not tell you what it actually is. An integrated approach to CB forensics provides investigators with richer information. Integrated forensics combines advanced forensic science technologies to provide more comprehensive and timely technical intelligence.” Some of these strategies include advanced genomic analysis like massively parallel sequencing and advanced chemical analysis like gas chromatography and high resolution mass spectrometry. Currently, the extraction methods for biological analysis can render the sample unusable for chemical analysis, which make analysis problematic. A new strategy from Battelle is looking to combat these discrepancies, which involves a new process to “systematically triage samples and integrate biological and chemical forensics, as well as developing and testing new technologies to help investigators more quickly identify and characterize biological agents, including new, emerging and synthetic agents, to glean more forensic information from the samples.”

Stories You May Have Missed:

  • Zika Vaccine Efforts Slow– Sanofi recently announced they are halting work on a candidate Zika vaccine. The vaccine was a joint effort with Walter Reed Army Institute of Research however, budgetary cuts and federal efforts to scale back put the project in jeopardy. “In its Sep 1 statement, Sanofi said BARDA informed the company on Aug 17 that the agency reassessed its Zika-related projects and have decided to focus on a more limited set of goals and deliverable, and that BARDA has decided to “de-scope” its contract with Sanofi for the manufacture and clinical development of an inactivated Zika vaccine. BARDA said it would limit its funding to a case definition and surveillance study, as well as any activities needed to pause work on the vaccine until an epidemic re-emerges. As a result, Sanofi said it doesn’t intend to continue developing or seek a license from WRAIR for the Zika vaccine candidate.”
  • Australia Battles Influenza – As Australia experiences a particularly harsh flu season, many are wondering what this will mean for Europe and North America.”In general, we get in our season what the Southern Hemisphere got in the season immediately preceding us,” Fauci said. An “intelligent guess,” therefore, is that the north will probably have a bad flu season. “With influenza, it is never 100%,” he said. “So when you talk about influenza, almost nothing is absolutely precision,” Fauci said. “In general, one can say we usually see here what they see there in their season.” Schaffner agrees: “There’s not a one-to-one correlation.” Still, hearing about Australia’s high number of flu cases, he said, “I started to tighten my belt.”