Tag: GHSA

Pandora Report 10.6.2017

by spopescu, posted in Pandora Report

Welcome to your favorite weekly dose of biodefense news!

George Mason University Global Health Security Ambassador Fellowship
We’re excited to announce the selection of two GMU Biodefense students, Anthony Falzarano and Stephen Taylor, as recipients of the George Mason Global Health Security Ambassador Fellowship. As GMU Global Health Security Ambassadors, they will be attending the 4th Annual GHSA Ministerial Meeting in Kampala, Uganda as part of the Next Generation Global Health Security Network delegation. The Next Generation Network engages and facilitates contributions by emerging scholars, scientists, and professionals from government and non-governmental institutions to the Global Health Security Agenda (GHSA) and other global health security projects. The NextGen Network is led by Jamechia Hoyle, who is not only an infectious disease guru, but also an adjunct professor at GMU, teaching Global Health Security Policy. The GHSA meeting, which will take place from October 25-27, is the world’s premier meeting on global health security and will be attended by senior representatives of the Ministries of Health, Agriculture, Finance, and Security from more than 50 GHSA member states as well as implementing partners from civil society and the private sector. The theme of this year’s meeting is Health Security for All: Engaging Communities, Non-Government Actors, and the Private Sector.                                                                                                                                                       Thanks to the generous support of the Schar School, our Biodefense graduate students will be able to provide you with detailed accounts of the meeting from the front row. Following the GHSA meeting, we will be publishing their experiences and thoughts on the summit, so you’ll want to stay tuned. Anthony is a microbiologist and environmental engineer, who focuses his research on antimicrobial resistance, food and agriculture microbiology, and microbial enhanced oil recovery. Anthony also worked with Ohio State University’s Medical Center to study biofilms as a public health burden. Stephen is a biologist and Peace Corp-alum where he served in Mozambique  teaching biology, information technology, and English. Since 2015, he has worked for the U.S. Department of Agriculture at the Animal Parasitic Diseases Laboratory in Beltsville, Maryland.

Blue Ribbon Study Panel: U.S. Not Prepared to Identify Perpetrators of Biological Crimes, Terrorism, Proliferation, and Warfare
The Blue Ribbon Study Panel just released information on their recent special meeting, Biological Attribution: Challenges and Solutions, which sought to better understand the ability of the U.S. government to accurately identify pathogens and their sources, “attribute the use of biological weapons with scientific and other forms of evidence; and explore the processes used for investigative, legal, policy, and political decisions involving biological attribution.” “Effective prosecution depends on the ability to quickly and accurately attribute crimes to their perpetrators,” said Ken Wainstein, meeting chair, and former Homeland Security Advisor and United States Attorney. “In the aftermath of a biological attack, we need to find out who did it, how they did it, what disease agent they used, and where they obtained it. The biological threat is real and growing, and the Nation needs this attribution capability now.” Adds former Senate Majority Leader Tom Daschle, whose office received some of the anthrax letters in 2001, “We face some major challenges in microbial forensics and biological attribution, but we can overcome many of them. We need to do what we can to eliminate them now, before we find ourselves under attack again. We can’t afford to have another investigation drag on for years.” The Panel also addressed the impact of the President’s FY2018 budget request on biodefense efforts and how it could eliminate critical health security functions.

Fostering an International Culture of Biosafety, Biosecurity, and Responsible Conduct in the Life Sciences
GMU biodefense MS alum Kathleen Danskin and PhD student Elise Rowe are tackling the importance of biosecurity, biosafety, and responsible conduct in life sciences. Citing the lack of an internationally agreed upon definition and approach to disseminating lessons, they highlight “how these concepts are covered by relevant international treaties, international organizations, and professional organizations. While there are some efforts under way, opportunities exist to evaluate and strengthen the culture of biosafety, biosecurity, and responsible conduct in the life sciences in order to prevent the loss, theft, misuse, and diversion of biological agents, related materials, technology, or equipment, and the unintentional or intentional exposure to (or release of) biological agents.” Responding to this gap, Danskin and Rowe propose three changes: partnership between international regimes, organizations, and professional organizations to share and enhance best efforts, use of the nuclear safety and security culture as a model for creating organizational culture within life sciences, and that the international community should amplify efforts to recognize “champions of change” at the state level. “Challenges remain on how best to address the issue of operationalizing the concept of a culture of biosafety, biosecurity, and responsible conduct in order to address goals such as: (1) reducing the occurrence of laboratory-acquired infections (LAIs), incidents, and near misses, (2) ensuring that biosafety, biosecurity, and responsible conduct receive adequate attention, (3) ensuring that organizational members share the same beliefs and attitudes about risks, LAIs, and near misses, (4) increasing commitments to biosafety and biosecurity, and (5) assessing the breadth and strength of a biosafety and biosecurity program.”

Reasonable Doubts: Foreseeing Failures in WMD Security
GMU biodefense MS alum Greg Mercer is evaluating the historical failures in WMD security and what we can take away from such terrifying events. Pulling on examples from the live anthrax spores being mailed due to poor DoD lab practices to antinuclear protesters managing to get into the Oak Ridge nuclear facility, Mercer addresses serious system failures and a “culture of complacency”. Unfortunately, since the creation of nuclear weapons, there has been a colorful history of accidents and close calls. Mercer cites such examples to point out that while not spectacularly dramatic (I’m thinking of something like the film, The Rock), they nonetheless highlight significant vulnerabilities. “As a class, these organizational problems are not unique to the management of WMD. Insights into their nature, and into the sorts of practices that could help to anticipate and remedy them, may also be found further afield. Especially within the broader study of national security, a new literature has begun to emerge proposing either a new framing of the issues, or identifying tools and ideas that might be employed to guard against recurring ‘complacency’.” Mercer points to analyses, like those from Janne E. Nola, which suggest grass-roots changes that aim at fixing things at the organization level. What is to be done though? Some suggest the use of red teaming, while others point to forecasting and prediction, as a means to identifying risks and vulnerabilities. “History shows that warning signs are often ignored until disaster strikes, and that disaster is the engine of change. In the United States, the public demands change. If better institutional checks are to be placed on American nuclear and biological security, it will take a public outcry like the one that follows a disaster. The public will have to demand that the country’s nuclear- and biological-defense enterprises stop stepping out to the brink, and instead avert the disasters foreshadowed by the many uncomfortable compromises and accidents we have seen.”

Madagascar Battles Plague
The death toll has risen to twenty as government officials are banning public gatherings in the country’s capital. While plague is endemic to the country and causes roughly 400 cases a year, this spike in cases and the swift spread is concerning the WHO after already 114 cases have been reported since August. “More than half of recorded cases – 73 out of 133 – are pneumonic plague, the most virulent form, which is passed through person-to-person transmission. If it is not treated, pneumonic plague can be fatal within 24 hours. The epidemic also involves bubonic plague, which is spread by rats and kills about 50% of people it infects.” The WHO has released $300,000 in emergency funds and is asking for $1.5 to support outbreak response as the disease has quickly spread to several cities and outbreak season (September-April) is just beginning. You can read the latest WHO report on the outbreak here.

HBO VICE’s Contagion Episode
Check out the latest VICE episode regarding two interesting topics – Russian hacking and contagions. “The outbreak of an infectious disease sparks worldwide panic nearly every year. And as humans cluster themselves in denser cities and encroach closer to the wildlife harboring disease, the chances of a devastating global pandemic only intensifies. But scientists are finding that diligent surveillance of these threats could help keep the next nightmare disease at bay. VICE founder Suroosh Alvi went to Uganda to see how vulnerable humans are to a new pandemic and the options there are for staving it off.”

Bavarian Nordic Wins Up-to-$539M BARDA Contract for Smallpox Vaccine BARDA has contracted with Bavarian Nordic to ensure the U.S. Strategic National Stockpile has smallpox vaccine in the form of freeze-drived Imvamune. “The contract consists of an initial $100 million base award toward manufacturing and storage of Imvamune vaccine bulk—the third bulk contract inked between the company and BARDA. The two earlier bulk contracts total a combined $233 million. In addition, the contract includes two initial options: Up to $299 million toward the filling and freeze-drying of Imvamune produced under the three bulk awards and up to $140 million toward clinical development, regulatory commitments, and portions of the establishment and validation of fill/finish activities.” This new contract will cover roughly 13 million doses at $48 per dose.

The Risk of Adoption of Chemical and Biological Weapons by Non-State Actors in the EU                                                                                                                                             James Revill addresses growing concern over the potential for non-state groups to utilize chemical or biological terrorism within the European Union. Pulling on historical events involving CBW use by non-state actors, he addresses the current and future risks. “To achieve this, the article analyses six interlinked clusters of factors that can be seen as important in assessing the risk of whether or not to adopt such weapons. These are: the perceived relative advantage of CBW and their utilities; the complexity of such weapons; their ideological compatibility; the role of organisational structures; the visibility and ‘fashionability’ of such weapons; and the wider environmental context.” Overall, Revill finds that while there is potential for sophisticated CBWs to do great harm, they are unlikely, and the use of a “scruffy low-level chemical weapon” is much more realistic.

ABSA International 60th Annual Biological Safety Conference
October is national Biosafety Month, so don’t miss out on this conference held by the Association for Biosafety and Biosecurity on October 13-18th in Albuquerque, New Mexico. The conference will include special meetings like public health interest groups, next generation/new biosafety professionals shared interest group meetings, and great networking opportunities for biosafety and biosecurity professionals!

How the 1918 Flu Pandemic Revolutionized Public Health
As the centennial of the 1918/1919 pandemic approaches, it encourages us to really look at what has changed and what we’ve learned from such a global catastrophe. Public health itself has evolved – no longer restricted by the antiquated policies that were marked with eugenics and social stigma. At the time, influenza was not a reportable disease either, which meant that public health surveillance was shotty at best and quarantine efforts were usually too little, too late. “The lesson that health authorities took away from the catastrophe was that it was no longer reasonable to blame an individual for catching an infectious disease, nor to treat him or her in isolation. The 1920s saw many governments embracing the concept of socialized medicine—healthcare for all, delivered free at the point of delivery.” Now, disease surveillance and epidemiology are a cornerstone of public health, not to mention the development of the WHO in 1946. The 1918 flu pandemic forced us to change our approach to public health, but also taught a vital lesson – infectious disease was a global problem and not isolated to a single country, region, or group of people.

Biosafety Governance
The Federal Experts Security Advisory Panel (FESAP) just released their report on ensuring institutional compliance with biosafety, biocontainment, and laboratory biosecurity regulations and guidelines. FESAP recommendations are crucial, as they are supposed to be followed within research facilities that perform work with human, plant, and/or animal infectious agents and toxins. “The United States has a comprehensive biosafety, biocontainment, and biosecurity oversight system designed to protect laboratory workers, public health, agriculture, the environment, and national security. Biosafety and biocontainment oversight rests on a foundation of federal regulations, guidelines, and policies and is provided at multiple levels. Oversight of day to day research activities is largely a responsibility of the institutions and the investigators conducting the research with direct biosafety oversight being implemented at the local level.” In efforts to ensure compliance and build a culture of responsibility, FESAP has released guidance that aims to ensure biosafety, biosecurity, and biocontainment, while encouraging research. Some of the regulations and guidelines include: “conduct regular assessments of committees, offices, and departments with responsibilities for biosafety and biosecurity oversight to assess their function and strengthen their performance when necessary” and “promote transparency regarding institutional biosafety and biosecurity oversight.” The report also includes federal regulations and guidelines regarding research conduct, environmental regulations, dual-use research of concern oversight at the institutional level, etc.

Stories You May Have Missed:

  • BioShield Adds Ebola Vaccine To SNS & BARDA Industry Day – Project Bioshield, responsible for acquiring MCM against CBRN agents, is now adding two Ebola treatments and two vaccines to the Strategic National Stockpile (SNS). The new additions include “a single-dose vaccine licensed by Merck, a prime-boost vaccine regimen from Johnson & Johnson, and monoclonal antibody treatments from Mapp Biopharmaceutical and Regeneron Pharmaceuticals.” If you’re looking to get more information on MCM, you can also attend the 2017 BARDA Industry Day on November 7-8, at the Ronal Reagan Building. Presented by ASPR (Assistant Secretary for Preparedness and Response), the conference will give individuals the opportunity to learn about the past, present, and future of BARDA, MCM development opportunities, experiences partnering with BARDA, and more. Robert Kadlec, Assistant Secretary for Preparedness and Response, will be the keynote speaker for the event.
  • Bioweapons and Virtual Terrorism – Considering the threat of biological weapons and virtual terrorism? It was recently estimated that the cost of a bioweapon is 0.05% the cost of a convention weapon that would produce the same casualties per square kilometer. What are your thoughts on the author’s notion that biological weapons are “comparatively easy, using common technology available for the production of some antibiotics, vaccines, foods, and beverages, and delivery systems such as spray devices from an airplane, boat, or car are commonly available”?
  • History and Future of the Global HIV/AIDS Response: A Conversation with Dr. Michael Merson and Dr. Stephen Inrig– The Center for Strategic and International studies will be hosting this event on Monday, October 16th from 10-11:30am. Drs. Merson and Inrig will discuss the origins and evolution of the global HIV/AIDS response, as well as critical current and future issues affecting the fight against the disease worldwide, which were recently highlighted in papers issued by the CSIS HIV Working Group.  “This ambitious book provides a comprehensive history of the World Health Organization (WHO) Global Programme on AIDS (GPA), using it as a unique lens to trace the global response to the AIDS pandemic. The authors describe how WHO came initially to assume leadership of the global response, relate the strategies and approaches WHO employed over the years, and expound on the factors that led to the Programme’s demise and subsequent formation of the Joint United Nations Programme on HIV/AIDS (UNAIDS). The authors examine the global impact of this momentous transition, portray the current status of the global response to AIDS, and explore the precarious situation that WHO finds itself in today as a lead United Nations agency in global health. The global response – the strategies adopted, the roads taken and not taken, and the lessons learned – can provide helpful guidance to the global health community as it continues tackling the AIDS pandemic and confronts future global pandemics.” The event will be webcast live from the event page. Please register by clicking the “Register” button above and contact Sara Allinder, sallinder@csis.org, with questions.
  • MoBE 2017 Symposium to highlight research on the Microbiology of the Built Environment – October 10-12th, in Washington, D.C.  The event will highlight recent research on the Microbiome of the Built Environment and explore ways to bridge the gaps between research and applications. More specifically, The MoBE 2017 Symposium will bring together leading researchers and stakeholders to discuss MoBE findings pertinent to human health, safe drinking water, healthy built environments and urban design. Ed Yong of The Atlantic, Susan Lynch of the University of California at San Francisco and Marc Edwards of Virginia Tech will provide keynote addresses.

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 8.26.2016

by spopescu, posted in Pandora Report

A new report by the Organization for the Prohibition of Chemical Weapons (OPCW) is pointing to a harsh reality that despite incomplete and inaccurate Syrian disclosures, there are traces of nerve agents in their laboratories. While they promised to destroy their entire arsenal, there is a growing concern that Damascus has not followed through on commitments to destroy all of its armaments.   Feel like a biodefense arts and crafts project?  You can learn to make a plague doctor’s mask here. Chem-Bio warfare suits may be getting a fashionable upgrade as companies like Lululemon and Under Armor are competing to revolutionize the protective equipment. 

UN Security Council – Calls for Eradicating WMD’s  689139
On Tuesday, GMU Biodefense Graduate Program Director and Professor, Dr. Gregory Koblentz, briefed the UN Security Council on how terrorists could exploit advances in science and technology to acquire weapons of mass destruction. He delivered the briefing as part of a Security Council open debate on WMD nonproliferation that is part of the comprehensive review currently being conducted of Resolution 1540. You can read the summary of the meeting here, but the focus was on the evolving threat of WMD’s falling into the hands of non-state terrorists and actors. Emphasizing the threat of biological weapons, Secretary-General Ban Ki-Moon “questioned the international community’s ability to prevent or respond to a biological attack.  He also suggested giving a closer look at the nexus between emerging technologies — such as information and communication technologies, artificial intelligence, 3-D printing and synthetic biology — and weapons of mass destruction.” Dr. Koblentz (27 minutes into the broadcast of the meeting here) pointed to the Fourth Industrial Revolution as a source for huge gains in both productivity and prosperity, but also a darker potential for mis-use by non-state actors. Within his talk, Dr. Koblentz noted the five advances in science and technology that “increase the risk of CBRN weapons proliferation to non-state actors”. The advances include unmanned aerial vehicles (UAVs), 3D printing, accessibility of illicit items on the Dark Web, malicious software and cyber attacks, and genetic engineering tools like CRISPR-Cas9. While these advances reveal the diverse technology, there are also seven deadly traits within these emerging technologies – dual-use, disruptive, diffusion, reliance on a digital component, decentralization, deskilling, and the DIY (do-it-yourself) movement. Simply put, these seven characteristics make emerging technologies that much more challenging to prevent mis-use. “The international community faces a continuous challenge of encouraging innovation and maximizing the benefits of such innovation with the need to mitigate the security risks posed by these new technologies. I hope the Security Council will take advantage of the Comprehensive Review of Resolution 1540, which this open debate is an important contribution to, to update the resolution to take into account the impact of scientific discoveries and technological breakthroughs on the proliferation of weapons of mass destruction to non-state actors.” There was substantial discussion regarding the strengthening of Resolution 1540, especially to consider the implications of a biological attack in light of recent outbreaks like Ebola, MERS, and SARS.  During her remarks, Ambassador Michele J. Sison, U.S. Deputy Representative to the United Nations, described Dr. Koblentz’s briefing as, “a very interesting, but also very sobering intervention.” Hopefully, with the focus on these evolving threats, the current review of Resolution 1540 can be further strengthened and focused to reduce the risk of terrorists acquiring WMD’s.

A Tribute to D.A. Henderson
There are few times in the history of public health that we can say we’ve eradicated a disease. D.A. Henderson, smallpox guru and disease detective, led such efforts within the WHO and his absence has been felt throughout the health community. A legend among public health and biodefense students, his dedication to the field inspired generations. As an epidemiologist, his work in both infectious diseases and bioterrorism gave me hope that such a career was not only possible, but also filled with the kind of adventure that many only dreamed about. Having just read Scourge (and I would highly encourage you to read it), the dedication to the smallpox eradication efforts is still an inspiration. After conquering what many considered impossible, Henderson worked as Dean of the Johns Hopkins School of Public Health, founding director of the Johns Hopkins Center for Civilian Biodefense Strategies (now UPMC Center for Health Security), and following 9/11, led the Office of Public Health Preparedness. Described as a “Sherman tank of a human being- he simply rolled over bureaucrats who got in his way”, Henderson’s death is truly felt throughout the international community. In the wake of his death, we take a moment to truly applaud and appreciate all he’s given and inspired within global health security.

How Far Will the U.S. Luck Run?
With the anticipation and preparations for Zika having started months before it reached U.S. soil, many are wondering if our luck with infectious disease is running out. We were lucky with Ebola- a handful of cases and once we hit the panic button, we were able to overcome the crisis. Despite insufficient funds and battling diseases we had little to no experience in handling, U.S. efforts have been fortunate in their successes. Zika may be a different kind of ball game though – mosquito control efforts are flawed at best and with a disease that is often asymptomatic, we may have finally hit a wall. Did we really learn from Ebola? Have we strengthened our surveillance and response practices? Dr. Johnathan Fielding notes that “HHS must play a greater role in coordinating the global public health response through implementation of the Global Health Security Agenda, a cooperative arrangement launched in 2014 by over 50 nations, nongovernmental organizations and other stakeholders; better coordination with other government agencies, and state, local and private sector partners; and clear delineation of roles and responsibilities within and among HHS offices.” We need both the monetary and personnel support to properly address the failures from Ebola, but also implement the recommendations that so many have made following the crisis. The contingency funding that has been pushed recently is an indication of our potentially faltering luck – have we reached such an impasse in which our politics will override our disease response capacity or capabilities?

A Lot of Zika Goes a Long Ways 
Palm Beach is seeing its second case of Zika virus, with active transmission continuing in Florida. Florida Governor, Rick Scott, has expressed frustration that the promised federal support of antibody tests and lab support has not been delivered. “In a teleconference on Wednesday, Scott made a plea for more support in fighting Zika, complaining that ‘Congress and the White House have not been good partners.’ Scott said he asked the U.S. Centers for Disease Control and Prevention for 5,000 Zika antibody tests last week, but so far had only received less than 1,200.” Johns Hopkins is opening the first multidisciplinary Zika center, the Johns Hopkins Wilmer Zika Center, which is dedicated to caring for affected patients. As of August 24, the CDC has reported 2,517 cases of Zika virus in the U.S. The CDC has also awarded $6.8 million to partners to help support Zika response. “This funding will help enhance surge capacity for Zika case identification and mosquito surveillance. It will also help improve communications to key populations, by developing focused educational materials, sharing mosquito control guidance, and refining community public awareness campaigns.”

Human Mobility and Epidemics
Tracking infectious disease cases is never an easy task – whether it be an asymptomatic patient, mosquito-spread disease, or global travel, epidemiology and case tracking is not for the faint of heart. An increasingly mobile population is only adding to this difficulty. The first few days of an infection with Dengue or Zika are often so mild that many don’t even seek medical care. How many times have you had a fever and it didn’t stop you from traveling or going about your day? Disease ecologists are now looking at the impact of a fever on human mobility and the shock this may have during an outbreak of a vector-borne disease. “We’ve found that people with a fever visit 30 percent fewer locations on average than those who do not have a fever, and that they spend more time closer to home. It may sound like stating the obvious, but such data have practical applications to understand how human behavior shapes epidemics,” says Gonzalo Vazquez-Prokopec, an assistant professor in Emory University’s Department of Environmental Sciences, and senior author of the study. “No one had previously quantified how a symptom such as fever changes mobility patterns, individually and across a population, in a tropical urban setting like Iquitos.” Not surprisingly, human mobility is a huge driver for spreading these diseases in urban settings. With the ongoing spread of Zika, researchers are continuing to learn about the impact of human behavior and mobility on the spread of these mosquito-spread diseases.

Stories You May Have Missed: 

  • Global Reaches of Antibiotic Resistance – Check out my latest comments on the global implications of antibiotic resistance for first responders and security personnel. It’s a topic we’ve so frequently cited as an international health emergency, and yet it gets so little attention. In this article, I point to the obvious implications, but also the worries that dual-use technologies of concern and genetic modification could allow for increased resistance for a more sinister reason.
  • South Sudan Crisis Calls for Additional WHO Surveillance  – the continued chaos and violence in South Sudan has translated into the WHO ramping up disease surveillance efforts. More than 1.6 million internally displaced persons (IDP) have been caught in the conflict, leaving the region more susceptible to malaria and diarrheal illnesses. “The conflict has exacerbated existing challenges with the health system and disease surveillance,” Dr Usman says. “With so many health workers and partners moving to safety, data is more difficult to collect and challenges have emerged as humanitarian access remains limited.” The WHO is coordinating with the Ministry of Health to strengthen surveillance efforts to help detect and respond to outbreaks.
  • FBI WMD Directorate Marks 10 Years – A program we’d rather have and not need than need and not have, the WMD Directorate within the FBI has been imagining worst-case scenarios for over a decade to better prepare and protect the U.S. “The Directorate has three sections: countermeasures, investigations and operations, and intelligence. In its first five years, the Directorate established itself as a central hub for WMD subject-matter expertise.” Assistant Director, John Perren, notes that while they’re intelligence driven, the things that keep him up at night aren’t what he knows, but what he doesn’t know.

Pandora Report 7.8.2016

by spopescu, posted in Pandora Report

We hope you had a lovely Fourth of July holiday and are ready to get your feet wet with the latest news in global health security! Global health advocates are pointing to the impending reality of blurring between national security interests and global health agendas. Researchers in Belgium have discovered E. coli samples from cows and pigs that contain a novel gene, MCR-2, that is colistin-resistant. Colistin-resistant bacteria are particularly concerning as colistin is the antibiotic of last resort. This week has been busy with three major reports on lessons learned from the 2014 Ebola outbreak.

Panel Urges Reform After HHS Ebola Response Failures 
The plain and simple truth of the 2014/2015 West Africa Ebola outbreak is that the U.S. was not prepared to handle it – we struggled internationally and seriously failed domestically. In the wake of this sobering reality, an independent review of the Department of Health and Human Services (HHS) efforts found serious flaws within their response to the outbreak. You can read the report here, which stresses that the lessons from HHS’s response to Ebola can be applied to future outbreaks, including Zika virus. There were thirteen findings from the panel ranging from “lack of strong leadership and response coordination from WHO hindering HHS and international response efforts” to “HHS did not apply existing pandemic plans and coordination mechanisms during the Ebola response” and “HHS is not configured or funded to respond to a prolonged public health or medical emergency overseas or at home”. Key recommendations focussed on coordination with the National Security Council and federal partners to finalize a government framework for multi-agency response, clarification on strategy for communicating risk-related information to the public, Congress, and other key stakeholders during public health crises, etc. Communication and consistent messaging was definitely a huge issue during this outbreak and just from my experience in healthcare during the outbreak, the dissemination of information was muddy at best and only served to add fuel to an already chaotic fire. “Four thousand HHS personnel were unable to travel to West Africa, the panel said, because of untested regulations outlined in the Affordable Care Act (ACA). Additionally, US government workers who wanted to work more than 30 days overseas had to complete a training course before traveling to an outbreak country. The course had only limited availability, making it difficult to deploy staff quickly”. The report is definitely worth the read and includes some great explanations for each finding and excellent timelines throughout the outbreak.

U.S. Department of Health and Human Services Ebola Response Improvement PlanScreen Shot 2016-07-05 at 6.53.46 PM
Following the aforementioned report and lessons learned, HHS released their Ebola Response Improvement Plan. The plan breaks down priorities and actions into six main categories: global health security and coordination with international partners, incident management and operation coordination, public health and healthcare response, risk communication, medical countermeasures, and response funding. Aside from supporting the Global Health Security Agenda (GHSA), the improvement plan discusses codifying infectious disease emergency management under the National Response Framework (NRF) via the Biological Incident Annex and better defining roles during such events. I found the healthcare side particularly interesting as plans included the pre-identifiction of healthcare facilities that can be used for quarantine, isolation, and treatment, strengthening waste management interagency concept of operations, refining personal protective equipment (PPE) guidance and developing a mechanism to coordinate the purchase of PPE by federal partners, etc. Regarding risk communication, HHS will “Identify and train a cadre of personnel from across HHS that have public health expertise and a thorough understanding of, and fluency in, health crisis and risk communications to serve as spokespersons during domestic or international public health and medical emergencies. This training can draw upon a body of work developed since the 9/11 terrorist attacks”. Overall, the report addresses several key categories, vulnerabilities, and makes correlations to the independent panel report.

Safeguarding Deadly Pathogens and Poisons and U.S. Progress on Global Health Security Screen Shot 2016-07-05 at 7.07.37 PM
The term “select agents” gets thrown around a lot, but what really does it mean and why is it so important? The CDC recently published two new segments in their “Public Health Matters Blog” that gives the basics on select agents, why work involving them is so important, and how the U.S. is doing in terms of global health security. “While it might be easier to avoid handling deadly pathogens and poisons in the first place, scientists have to work with them in order to better understand how to protect people from their effects. Research leads to discoveries that save lives – for example, when we create vaccines to protect from exposure to smallpox or when we’re able to track mutations of killer diseases like Ebola.” The blog discusses the role of the Federal Select Agent Program and lab safety, specifically the response practices in the event of a “whoops” moment. They also reference the findings from the recently published 2015 Annual Report of the Federal Select Agent Program and the continuous commitment to both safety and increased transparency. While this may seem like the tourist’s brochure to select agents and concerns over lab safety, it’s a nice strategy to better educate the public on the work surrounding these agents and the safety mechanisms in place. They also have a pretty fantastic infographic accompanying the post. The next Public Health Matters blog talks about how the U.S. is handling global health security. Centering around a photo that includes colleagues from the HHS and USDA, the blog discusses the Joint External Evaluation Team. The team, which is part of GHSA, works to assess how well the U.S. is prepared to prevent, detect, and respond to major public health threats. The best part about this team is that its work is independent and unbiased. The group spent five days in May assessing federal response capabilities, the CDC’s work and technical practices, etc. Aside from finding excellent reporting mechanisms within the CDC and other federal agencies, they also found that we could improve in a few areas: “communicating risks quickly and consistently with communities across the country, combining and utilizing data from multiple surveillance systems, including systems that monitor human, animal, environmental, and plant heart, and conducting triage and long-term medical follow-up during major radiological disasters”.

Drug Resistant Bacteria in Rio Waters
Jaws made you wonder if it was safe to go back into the water, but multi-drug resistant organisms (MDRO’s) are the growing threat for aquatic events at the approaching Rio de Janeiro Olympic Games. Researcher Renata Picao believes that the resistant bacteria made their way into the waters from sewage that local hospitals have been dumping. The research team tested water samples from 2013 to 2014 for MDRO’s and found carbapenem-resistant Enterobacteriaceae, or CRE. Sadly, the team doesn’t believe these levels have changed and with reports of athlete infections and irritations due to water contact, that’s likely an accurate prognosis. CRE is easily one of the nastiest MDRO’s and is extremely difficult to treat, with a report citing 50% mortality rates. The concerns over Zika and drug-resistant organisms are just two in a laundry list of trouble that has followed Brazil’s Olympic bid – athlete mugging, financial issues, and unfinished buildings. While the acting governor of Rio has expressed concerns, he says that the city will be ready for the games, but also encouraged visitors to moderate their expectations. While some athletes have quit the games due to concerns over Zika, it’s interesting that the concern for drug resistant organisms in the water haven’t raised the same fears.

Is the Biological Weapons Convention Falling Behind?
While the Eighth Review Conference of the Biological Weapons Convention (BWC) won’t be until November, the Preparatory Committee for the Review Conference is next month. One can only imagine the scientific and technological advancements since the BWC was initiated in 1972. Despite some countries struggling to develop effective national biosecurity programs, the growing capabilities of CRISPR and other biotech breakthroughs have moved full-steam ahead. Many are pointing to the U.S. challenges to merely agree on an oversight system for gain of function research. “The discussions of science at the experts’ meetings should be split off into a separate dedicated parallel track. This is the best way to create the necessary time. Even then, it will be impractical to cover all relevant ground across the sciences, so each year a specific topic — CRISPR editing, say — should be considered. Researchers and scientific bodies should present the facts, and then discuss the implications with government officials at the experts’ meeting.” Between dual-use technologies of concern and CRISPR-Cas9, the BWC must adapt to the rapid pace of the biotech industry and the growth of biosecurity developments.

What Direction is the Zika Storm Blowing?
The ECDC has released their sixth Zika update, which discusses several uncertainties that prove difficult when developing response options. Some of these uncertainties include: “all the currently reported sexual transmission events are linked to symptomatic index cases. There is no evidence of transmission by asymptomatic sexual partners” and “there is growing evidence that Zika virus infection during the first and second trimester is associated with increased risk for central nervous system malformation of the foetus. The risk associated with infection during the third trimester is unknown. Therefore, Zika virus infection should be considered as a risk throughout the entire duration of pregnancy.” Fort Benning is trapping and freezing mosquitoes in effort to help the military combat the virus and quickly identify any positive Aedes mosquitos. National Institute of Health supported researchers will be monitoring Zika virus exposure in a group of U.S. athletes, coaches, and Olympic Committee staff attending the games in Brazil. A recent news poll found that most Americans aren’t worried about Zika, in fact they were more worried about Ebola than they currently are about Zika. When asked what they’re doing to limit exposure to Zika, 67% of respondents said they’re waiting to see if it is necessary. The CDC has reported 1,133 cases of Zika virus in the U.S. as of July 6th, 2016. You can also find the full transcript of President Obama’s remarks on Zika on July 1st, following an update from his public health team.

Zika Funding – The Disease Slush Fund
GMU Biodefense MS student Greg Mercer talks about the funding issues related to Zika virus in this week’s commentary. Greg’s overview of the funding struggles reveals a deeper issue when it comes to public health funding and emergency outbreaks. While the U.S. likes to paint itself as a global force for epidemic response, the truth is that we’ve struggled to combat government dysfunction and partisanship. “Government agencies might be funded by the fiscal year, but there’s no telling what the CDC, NIH, and others will have to fight next, not how big that fight will be.”

National Biosafety Systems – Case Studies 
Researchers from the UPMC Center for Health Security released their report on case studies to analyze current biosafety approaches and regulations for Brazil, China, India, Israel, Pakistan, Kenya, Russia, Singapore, the United Kingdom, and the U.S. “In previous research, we found that there is a lack of international norms governing biosafety precautions for dangerous or especially contagious; by describing a variety of biosafety governance approaches in these nations, we hoped to find areas of commonality which could be further developed into international norms.” Five trends were identified during comparison of the ten nations – biosafety regulation exists in all ten nations, information availability was extremely variable, making comparisons difficult, the incentives behind biosafety regulation are varied, ranging from agricultural development to infectious disease control to biotechnology investments, advanced or synthetic biology is not consistently addressed by national-level biosafety policy, and funding information for biosafety was generally available. Aside from evaluating each nation, the case studies will aid in future evaluations by establishing nation-level biosafety norms.

Stories You May Have Missed: