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 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 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 8.25.2017

Happy Friday and welcome to your weekly dose of all things biodefense. Have you ever wanted to take a tour of Dugway Proving Ground? Here’s your chance at a virtual tour through some amazing photography.

GMU Biodefense Graduate Programs & Information Sessions
Classes are just starting up and if you’ve ever wanted to take classes on synthetic biology and biosecurity, global health security policy, nonproliferation and arms control, biosurveillance, or emerging infectious diseases, we’ve got just the program for you! GMU offers both Masters and PhD programs in biodefense and has several informational sessions coming soon. Our program provides the perfect intersection of policy and science with courses taught by a range experts. If your time is limited or distance is a problem, we also offer an online MS program, which means you can study biodefense from anywhere!

Revisiting NIH Biosafety Guidelines
It’s been forty years since NIH established the Guidelines for Research Involving Recombinant or Synthetic Nucleic Acid Molecules to assess the risks of genome editing. Now more than ever, with the speed of biotech development, it is relevant to take a moment and look back at the significance of such guidelines. “Responsibilities include setting up Institutional Biosafety Committees (IBCs) to assess risks and potential hazards through standards for containment and laboratory practices. Noncompliance on any project, whatever the funding source, can result in loss of all such NIH funding. In his address to the workshop.” Since its inception, there have been several advances in the field, like DIY gene editing and CRISPR, which may require changes to the existing guidelines. “And conventional risk management practices that focus on listed pathogens may underestimate risks of new, unlisted organisms. The informality of voluntary guidelines has enabled prompt responses by funders and researchers to emerging evidence on benefits and risks of technologies. But what has worked with those receiving NIH funding with IBCs may not work with the wider range of actors who now have access to these technologies.” How can the NIH meet these challenges with a forty-year-old set of rules? A few things might help it maintain relevancy- participation in international forums, facilitating researchers/publishers/insurers to set common benchmarks on researcher conduct, engage more with institutional biosafety officials, and working to ensure there are more IBCs. Overall, there is a need to modernize the guidelines to better meet and serve the expanding plain of the life sciences.

Revisiting Compliance in the Biological Weapons Convention                                                                       Have you noticed a trend this week? Revisiting is the name of the game and that’s just what the latest occasional paper from the Middlebury Institute of International Studies at Monterey is doing. The latest RevCon was a dud and the future of the BWC and its relevance is being tested. James Revill is looking at compliance and an incremental approach within the BWC. Revill notes that “compliance with the BWC is more than a simple binary choice to sign a commitment not to develop or produce biological weapons. It requires the adherence to all the obligations, both negative and positive, undertaken by BWC states parties in signing and ratifying the convention. In the BWC context, this is complicated by the ambiguity surrounding certain obligations, changes in science and security, and the limited resource capacity of some states to fulfill their obligations. Under such circumstances, without episodically revisiting compliance, there remains the risk that BWC will become ever more fragmented, outmoded and poorly implemented.” He emphasizes that despite many pushing for multilaterally negotiated, legally binding verification protocols, this is an unlikely outcome. An incremental approach to revisiting compliance, Revill suggests, could incorporate several activities – review relevant science and technology, enhance the collection and analysis of compliance indicators, develop the consultative mechanism, building the provision of assistance in the event of a violation of the BWC, explore voluntary visits, enhance the United Nations Secretary-General’s Mechanism, and remedy the institutional deficient. Overall, he points to the wavering nature of norms against bioweapons and that “without revisiting compliance and tending the convention, there is a risk that the regime will be left to fester and fragment, in time potentially diminishing the norms against biological weapons.”

Meeting on the Attribution of Biological Crime, Terrorism, and Warfare
The Blue Ribbon Study Panel on Biodefense will be hosting this October 3rd meeting in Washington D.C. “Effective prosecution and decisions regarding U.S. response depend on accurate attribution of biological attacks. Despite ongoing biological crimes and suspected development of biological weapons for the purpose of attacking the Nation, the United States has yet to establish this capability fully. The Study Panel will host a special focus meeting entitled Biological Attribution: Challenges and Solutions. This meeting of the Study Panel, chaired by former Homeland Security Advisor Ken Wainstein and former Senate Majority Leader Tom Daschle, will provide federal government, industry, and academic representatives with the opportunity to discuss their perspectives, experiences, challenges, and recommended solutions with regard to biological attribution.” Stay tuned for more details!

SynBio Salmagundi: Proposed Framework for Identifying Potential Biodefense Vulnerabilities Posed by Synthetic Biology – Report, SB7.0 & Options for Synthetic DNA Screening 
It’s a good day to get your synbio nerdom on with this potpourri of news! If you missed the webinar on Tuesday, you can now access the latest NAS interim report regarding the biodefense implications of synthetic biology. “Synthetic biology and related biotechnologies hold great promise for addressing challenges in human health, agriculture, and other realms. At the same time, synthetic biology raises concerns about possible malicious uses that might threaten human health or national security. This interim report is the first phase of a study by the National Academies of Sciences Engineering and Medicine to assess potential vulnerabilities. The report proposes a strategic framework that can be used to identify and prioritize potential areas of concern.” Within the report you can find definitions and study scope regarding synthetic biology in the context of biodefense, factors to assess capability for malicious use, technologies and applications to assess, and framework approach (parameters to consider, use and limitations, etc.). Check out this latest article regarding the screening processes of for synthetic DNA ordering. Sure, there are current screening processes (providers affiliated with the International Gene Synthesis Consortium voluntarily screen double-stranded DNA synthesis orders over 200bp to check for regulated pathogens and additional customer screening), but truly, the processes isn’t that easy…or cheap. Researchers, like Gigi Kwik Gronvall, pointed out actions that could help “preserve the effectiveness of DNA order screening as a security tool and develop additional mechanisms to increase the safety and security of DNA synthesis technologies.” Highlighting the DHHS screening guidance as quickly becoming obsolete, they emphasized options like including direct financial support to companies for screening, especially as we look to the future costs and responsibilities of the U.S. government. “The screening of dsDNA orders is not a panacea for biosecurity concerns: it is possible for nefarious actors to work around the screening. However, we believe that screening dsDNA orders still raises barriers to the development of biological weapons and may offer some protection against biosafety concerns.” The future of synthetic DNA ordering will surely be debated as experiments, like the recent horsepox reconstitution, bring to light new gaps. One such focus onto the realm of biosecurity and synthetic biology comes from Dr. Eric van der Helm, who participated at the latest SB7.0 synthetic biology conference. Van der Helm attended as part of the SB7.0 biosecurity fellowship and has highlighted some of the biorisks we worry about. He also points to the latest horsepox experiment which brought about so much attention to the biosecurity implications of reconstituting an extinct virus. “Synthetic biology has only been recently recognized as a mature subject in the context of biological risk assessment — and the core focus has been infectious diseases. The main idea, to build resilience and a readiness to respond, was reiterated by several speakers at the SB7.0 conference.  In the case of biosecurity, we’re already dependent on biology [with respect to food, health etc.] but we still have an opportunity to develop biosecurity strategies before synthetic biology is ubiquitous.  There is still an opportunity to act now and put norms and practices in place because the community is still relatively small.” Van der Helm emphasizes the need to have these conversations regarding biosecurity measures and synbio, like those at SB7.0, more frequently and openly.

North Korea’s Bioweapon Program: What do we actually know?
If you haven’t gotten enough on discussions regarding North Korea’s bioweapons program, check out GMU biodefense professor Sonia Ben Ouagrham-Gormley‘s latest interview in which she discusses what we know and what we might be missing. What a perfect way to enjoy the morning commute or a lunch break!

Post-Ebola Recovery – An Upside to an Epidemic
A recent mudslide in Sierra Leone is revealing a positive outcome from the 2014/2015 Ebola outbreak – sustained disaster response. Shortly after the mudslide, emergency response crews were already working alongside volunteers to help rescue victims. Sidi Tunis chatted with Buzzfeed, noting that “During Ebola we had a lot of community engagement, so they knew how to be first responders. They knew how to do search and rescues, they knew how to convey corpses safely to the morgue.” Many of the young men digging through rubble were already experienced, having helped with Ebola burial teams and the ambulance system was better equipped and supported as a result of the outbreak. “There was a lesson learnt from Ebola that instead of creating parallel system of NGOs, let’s take leadership from the start,” she said. “So this time it’s been led by the government from the onset, and having them take that ownership is more of a sustainable system.” “Still, NGOs playing a critical role are in a better position than they might typically have been. Three days after the mudslide, unclaimed bodies piling up in Freetown’s main mortuary posed another health risk. There were so many that they began to decompose in the tropical heat, prompting the government to order mass burials over the following two days. Workers from UNICEF were among those who helped scrub out the morgue during a massive clean-up operation that followed. ‘That needed a lot of infection prevention equipment – gloves, boots, aprons,’ James said. ‘UNICEF had emergency stock ready to go from Ebola’.”

Meeting of the Presidential Advisory Council on Combating Antibiotic-Resistant Bacteria
Don’t miss out on this September 13th and 14th meeting in which the “Advisory Council will provide advice, information, and recommendations to the Secretary regarding programs and policies intended to preserve the effectiveness of antibiotics by optimizing their use; advance research to develop improved methods for combating antibiotic resistance and conducting antibiotic stewardship; strengthen surveillance of antibiotic-resistant bacterial infections; prevent the transmission of antibiotic-resistant bacterial infections; advance the development of rapid point-of-care and agricultural diagnostics; further research Start Printed Page 38913on new treatments for bacterial infections; develop alternatives to antibiotics for agricultural purposes; maximize the dissemination of up-to-date information on the appropriate and proper use of antibiotics to the general public and human and animal healthcare providers; and improve international coordination of efforts to combat antibiotic resistance.” The meeting will be held at the DHHS Hubert Humphrey Building or you can attend online here.

Pandemic Readiness (Hint: We’re Not There Yet)
Despite funding for the Hospital Preparedness Program (HPP) and an increase in funding to the Public Health Emergency Preparedness Program (PHEP), many are pointing out that these programs are chronically underfunded to begin with. “This House bill also does little to create a realistic public health emergency response fund, a standing pot of money to meet the immediate needs of a public health crisis. We saw how long it took to get emergency funds to respond to Zika, Ebola and Hurricane Sandy, with each event taking longer and longer to help these communities respond to devastating disasters.” You can also check out this latest meeting with Judy Woodruff and Liberian-born Dr. Raj Panjabi at Spotlight Health. Dr. Panjabi discusses the seriousness of infectious disease threats and the challenges of pandemic prevention.

Forecasting Outbreaks One Image at a Time
Tracking infectious diseases is a tough job and requires a lot of boots on the ground (shout out to gumshoe epidemiologists who go door to door doing contact tracing). Researchers at Los Alamos National Laboratory have been using computer modeling for a while to track disease movement, but a new partnership with Descartes Labs, is bringing high-resolution satellite imagery into the arsenal. “By mapping where high-moisture areas intersect with those social media signals and clinical surveillance data, we can help identify areas at risk for disease emergence and subsequently predict its potential path. Descartes Labs collects data daily from public and commercial imagery providers, aggregating the images into a single database. Our team at Los Alamos will use the Descartes Labs Platform to correlate satellite imagery with multiyear clinical surveillance data from approximately 5,500 Brazilian municipalities for mosquito-borne diseases such as dengue, chikungunya, and Zika in order to better understand how they spread.” This new imagery will allow Los Alamos Lab researchers to focus on specific neighborhoods and other small geographical areas. By using retrospective analysis via historical data, they’ll make sure the mathematical models are accurate and ensure that future models are truly capable of prediction.

Stories You May Have Missed:

  • Munich Re Signs Strategic Agreement With Metabiota to Enhance Insurability Against Epidemic Losses – The risk analytics firm Metabiota has announced a strategic agreement with Munich Re, one of the world’s leading reinsurers, to better establish insurability “by protecting companies and local economies from the financial loss related to epidemics. This really is the next frontier for the insurance industry – given the high risk of infectious disease outbreaks, it is imperative that we find new ways to manage and finance these risks for our customers.” Metabiota’s newest platform is a modeling method for estimating epidemic preparedness and risk, as well as the cost and severity of outbreaks by using historical data and disease scenarios and analytics.
  • Ebola Survivors Plagued With Long-term Disabilities – Imagine becoming infected with one of the most deadly viruses on the planet. Now, imagine by some stroke of luck and medical marvel, you’re able to survive. After the long, miserable road that is Ebola infection, survivors have been finding themselves with chronic conditions and high rates of disabilities. A new study found that Ebola survivors have seven times the disability rate compared to their close contacts. “In the first study, researchers followed 27 Ebola survivors in Sierra Leone for 1 year after diagnosis and found they were seven times more likely than their close contacts to report a disability. Almost 80% of the survivors (77.8%) reported a disability 1 year post-infection, compared with 11.1% of their close contacts. Disabilities included major limitations in vision, mobility, and cognition. ‘This study has demonstrated that a year following acute disease, survivors of the recent EVD outbreak have higher odds of persisting disability in mobility, vision, and cognition,’ the authors concluded. ‘Mental health issues such as anxiety and depression persist in EVD survivors and must not be neglected’.”
  • Minnesota Measles Woes & Anti-vaxxers– The benefits of vaccines have been under fire from anti-vaccine activists, despite the overwhelming good they’ve done for the world. While Minnesota continues to battle their worst outbreak of measles in decades, the antivaxxers are becoming energized in their efforts. “In Facebook group discussions, local activists have asked about holding ‘measles parties’ to expose unvaccinated children to others infected with the virus so they can contract the disease and acquire immunity.” The initial cases of this outbreak were in the Somali American community, which are believed to be the result of anti-vaccine activists speaking to community members and instilling fears and concerns. “Despite the anti-vaccine drumbeat, Minnesota’s Somali American community has begun to push back, according to some health-care providers. As part of an unprecedented collaboration clinicians and public health officials launched this summer, ­Somali American imams are urging families to protect their children by getting the measles-mumps-rubella (MMR) vaccine.”

Pandora Report 8.18.2017

ECDC Tool for Prioritizing Biothreats
The European Centre for Disease Prevention and Control has released their tool for the prioritization of infectious disease threats. “This qualitative tool, implemented as an Excel workbook, is based on multi-criteria decision analysis. It ranks infectious disease threats in a transparent, comparable and methodologically reproducible manner. The tool enables the relative ranking of different infectious disease threats. It is intended as a supplement to other methods that also support decision-making in preparedness planning.” Part of the tool involves a scoring of diseases, in which it suggests that a multidisciplinary expert group works to establish reliable information and adequate scoring. The ECDC tool also includes a handbook and manual for users to get the most out of it.

 Long Ignored: The Use of CBW Against Insurgents
GMU Biodefense PhD alum Glenn Cross investigates the use of chemical and biological weapons in counterinsurgency campagins like that of Rhodesia, South Africa, and Syria. Cross notes that history has shown the efficacy of CBW against ill-equipped and often poorly trained insurgents. He points to the debate regarding application of use – some say that these weapons are used when conventional forces are ineffective and often a last resort, while others note that the lack of an international and effective response have given insurgents incentive. “The conclusion from these examples is that regimes in extremis — when the battle is for their very survival — seem to have little compunction about resorting to chemical and biological weapons use. The much-heralded international norms and conventions prohibiting and condemning chemical and biological development and use go out the window when a regime’s survival is at stake. The examples of Rhodesia and Syria show that the international community must be united and demonstrate the requisite political will to enforce norms if the use of chemical and biological weapons is to be prevented.” Cross highlights two case studies, Rhodesia and Syria, pointing to the use of biological weapons by Rhodesian forces as being the only example of a nation using bioweapons since the end of WWII. While the regime was aware of treaty obligations, it had no bearing on their decision to use such weapons. So what are effective constrains on the use of CBW? The case studies reveal that regimes care little about their efficacy, international norms, or international agreements, but it is really deterrence that likely prevents the use of such weapons. The credible threat of military action is the strongest deterrent and realistically, until international norms include uniform enforcement amongst nations, they won’t be as effective. “As we’ve seen in Syria, such consensus is elusive, and the international community has failed to act. As a consequence, the world faces a sad, but inevitable conclusion. The Syrian regime is unlikely to ever face justice for its use of chemical weapons.”

A View from the CT Foxhole: Edward You, FBI Weapons of Mass Destruction Directorate, Biological Countermeasures Unit
As if we need any more reasons to think Edward You is a biosecurity action hero! The Combating Terrorism Center recently sat down with Supervisory Special Agent in the FBI’s WMD Directorate, Biological Countermeasures Unit, and discussed not only his role within the FBI but also their work and coordination with partners. You notes that hisprimary mission is to support outreach and engagement, but probably most importantly it is to backstop the WMD Coordinators who are positioned in the field. They have to cover the whole broad range of modalities—chem, bio, nuke, explosives. They do the initial engagements, the partnerships, the initial response, but they can always call back to headquarters where we leverage all of our expertise as subject matter experts. We can bring in the laboratory division; we can bring in Centers for Disease Control and Prevention (CDC), if necessary, the Department of Homeland Security to support them when they run into an incident out in the field.” He emphasizes the importance of the relationship the FBI has with the private sector, not only in terms of shared interests, but also communicating security problems to help get more buy-in and coordination. When asked about the DIY biohacker, You notes that “We look at these community labs as a big positive force in the economy and engines of innovation. That has helped us overcome the natural tendency for such outfits to be a little bit anti-establishment. By engaging with them, we’re helping them to raise their level of awareness that they could potentially be targeted by malicious actors seeking to subvert their work, steal their technology, or recruit insiders on their staff. By helping them establish a form of ‘neighborhood watch,’ they will be best positioned to identify and report on instances of suspicious activity both internal and external to their community. Who better to identify threats than the community members themselves?” While the partnerships with DIY labs haven’t garnered any leads to potential threats, they help the FBI understand the direction biotech is heading, which allows them to flag areas of concern faster than if they used a top-down approach. You also addresses the 2016 Europol warning of potential ISIS experimentation with bioweapons, commenting that “With ISIS, al-Qa`ida, or any other threat actor for that matter, we are faced with two significant challenges. The first is ideology. What happens if that lone individual that becomes persuaded by their ideology happens to be a microbiologist or a biochemist? The counter WMD mission has always proceeded by identifying the actors expressing the intent to acquire, develop, or use WMDs (e.g., counterproliferation efforts). And historically, significant effort and investments have been made to counter the biological weapon threat ranging from state/non-state actors to individual level biological crimes (e.g., attempted ricin poisonings). But this introduces the second challenge. Unlike the chemical and radiological/nuclear realms where materials of concern are highly regulated and the expertise is almost arcane, biology could be classified as dual use or multi-use. The strength of the field is based on the fact that it is inherently open in nature (e.g., peer-reviewed scientific journals), which has led to significant advances in areas such as healthcare.” Lastly, You points to what he considers the greatest biosecurity threat facing the U.S. – the concerns of non-state actors, but also the role of data in terms of gene editing and other biotech, noting that “we may have have been short-sighted. Most of our legal frameworks have been focused on privacy and not on security.” “Because there’s a lack of understanding about where bio is going, we’re in danger of falling behind, and my biggest concern is that for lack of our foresight and being strategic in this space, I think China is going to become a potential biological superpower.” Did I mention that Edward You is frequently a speaker at our summer workshops?

North Korea’s Chemical Arsenal Complicates U.S. Options 
As concerns over North Korea’s nuclear weapons program grows, the threat of chemical weapons has seemingly been downplayed. Tackling nuclear threats through preemptive strikes could push North Korea to utilize their chemical weapons program and sizable stockpile, which is considered to be one of the largest. “Experts are also disturbed by Kim Jong-un’s brazen public assassination of his half-brother using the nerve agent VX, saying it demonstrates the regime’s willingness to use deadly toxins. ‘I think if people paid more attention to the chemical side, they’d be less inclined to talk about preemption and going first against North Korea,’ said Greg Koblentz, a researcher of weapons of mass destruction at George Mason University.” In the event that chemical weapons are deployed, the South Korean capitol of Seoul would surely take a hit, which is home to 25 million people. While details of North Korea’s biological weapons program have given little insight into what is actually going on, there is considerably more knowledge regarding their chemical weapons initiatives. “The exact composition and size of North Korea’s chemical arsenal is unclear, but it’s believed to include everything from antiquated chlorine gas all the way up to sarin, VX, and other highly lethal nerve agents. These weapons are distributed at facilities across the country, often tucked away in underground bunkers or other sites unknown to U.S. and allied intelligence. The weapons are also deployed along the armistice line, which sits just 35 miles north of Seoul.” While there are limits to their chemical weapons capabilities, they surely provide little comfort to South Korean citizens and those living in Seoul.

 Chatting With the WHO
New WHO Director-General Tedros Adhanom Ghebreyesus spoke with Foreign Affairs’ regarding his plans for the future of the WHO and efforts to combat global disease. Tedros notes that epidemics or pandemics keep him up at night, especially something like the 1918 pandemic and the “serious gaps we have”. He comments that “I think the world should unite and focus on strong health systems to prepare the whole world to prevent epidemics—or if there is an outbreak, to manage it quickly—because viruses don’t respect borders, and they don’t need visas.” In regards to irrational beliefs as a public health threat, Tedros highlights the role of governments (and the WHO in supporting them) to communicate with communities and use media as a tool for teaching. Tedros discussed the WHO’s response to Ebola and when asked about hesitancy governments may experience regarding raising the alarm for an outbreak, he noted that “it’s not an issue between the WHO and the member state in question; it’s about the overall implementation of the International Health Regulations [the rules that govern how states respond to outbreaks]. That involves not only the country in question but other countries, as well. For instance, a country may fear the impact on the economy if it reports a certain disease. And if the other countries, instead of banning travel or other measures, could be supportive and implement the IHR, then the country could be encouraged to report immediately.”

Book Review – Barriers to Bioweapons
As the summer winds down, you may find yourself needing a new book to delve into. GMU biodefense professor Sonia Ben Ougrham-Gormley‘s book, Barriers to Bioweapons, is a great addition to any lover of health security and the realities of biological experiments. This latest book review gives a witty and entertaining overview of her work, noting that “Barriers to Bioweapons argues that actually, we’re not all living on borrowed time – that there are real organizational and expertise challenges to successfully creating bioweapons. She then discusses specific historical programs, and their implications for biosecurity in the future.”

Pandemic Preparedness & A Global Catastrophic Biological Risk By Any Other Name Would Smell As Sweet

GMU biodefense PhD student Saskia Popescu tackles the importance of pandemic preparedness and the latest publication from the Center for Health Security regarding global catastrophic biological risks. “We may think written plans and the occasional table-top exercise are making us more prepared to handle a pandemic, but true preparation goes far beyond that. The ability to prevent, detect, respond, and control outbreaks is a hefty investment that countries are still struggling to make, and as a new report recently revealed, a paltry amount of countries may be ready for a pandemic.” She highlights the latest World Bank report that only six countries have truly taken efforts to evaluate their readiness to handle a pandemic. Like many things, the devil is in the details, and often that is as simple as a real name for a problem. A recent publication from the Johns Hopkins Center for Health Security sought to fix this by establishing a working definition for global catastrophic biological risks (GCBR). “What makes this definition unique, aside from it being the first working definition for GCBRs, is that it highlights several components, such as sustained catastrophic damage, and instead of highlighting a specific number of deaths, it looks to a range of negative outcomes, such as infertility. The challenging task of defining such a globally feared, but poorly understood risk was daunting; however, the Center for Health Security has provided us with a working tool that can now be applied to policy, and future preparedness and response efforts.”

H5 Hits the Philippines and Plague in Arizona
The Philippines is reporting its first highly pathogenic H5 avian influenza outbreak. Hitting a commercial poultry farm in Luzon, the outbreak began in July and killed 36,485 of the 190,000 birds. “A report today in the Manila Times, based on a media briefing with Emmanuel Pinol, the country’s agriculture secretary, said the outbreak was confirmed in the city of San Luis and that six poultry farms were affected. Most of the poultry deaths were in layer chickens. Pinol told reporters that the outbreak may have begun as early as April when deaths were reported in quail housed above ducks. He said ducks are the likely source of the outbreak, since they had contact with migratory birds. The Manila Times report said the outbreak site is 37 miles north of Manila and is close to swamps that are stopovers for migratory birds from the Asian mainland.” Public health officials in Arizona have announced that fleas in two counties have tested positive for plague (Yersinia pestis). While plague is endemic in the southwest, public health officials still work to ensure residents are aware that there is an increased risk. Officials are warning residents to be mindful of the potential for exposure via pets. “Fleas can bite rabbits, prairie dogs and other rodents — and anything that may eat them — and transfer the disease to pets, who in turn can infect humans. Cats who get plague transmit it through their cough. Dogs typically carry the fleas on their fur. Health officials cautioned county residents and visitors to keep their pets leashed and to avoid touching dead animals. Evidence of a large die-off could indicate plague is present, they say.”

Strategies for Identifying and Addressing Biodefense Vulnerabilities Posed by Synthetic Biology
Don’t miss out on these events by the National Academies Committee on Strategies for Identifying and Addressing Biodefense Vulnerabilities Posed by Synthetic Biology:

  • August 21 – the committee’s interim report and proposed framework will be released at 11am EDT here
  • August 22 – a public release webinar and report briefing will be held from 11am-12pm EDT. Committee Chair Michael Imperiale and committee members Patrick Boyle and Andrew Ellington will be reviewing the interim report and the proposed framework. This webinar is free to attend and open to the public, but you must register to attend. You can register at the following link:  https://nasevents.webex.com/nasevents/onstage/g.php?MTID=e39277a767b1f0190db4f7ee491c01271  You will be able to submit questions and comments during this webinar through a text-based feature but will not be able to speak directly with the presenters.
  • August 23-24: The meeting will be held at the National Academies of Sciences, Engineering, and Medicine’s Keck Center at 500 5th Street NW, Washington, DC Room 208. You must register to attend the meeting in person; the Keck Center is a secure building and we will need to have your name on the guard’s list to enter the building. You can register by emailing synbiodefense@nas.edu. If you would like to attend via teleconference, you can access the conference by dialing the following: to listen, please dial 1-(866) 668-0721 and use conference code 380 454 1676.

The committee is also soliciting feedback from the public on the interim report and the associated framework. You can submit questions or comments through September 5, 2017 at the following link:  http://www.surveygizmo.com/s3/3758337/A-Proposed-Framework-For-Identifying-Potential-Biodefense-Vulnerabilities-Posed-By-Synthetic-Biology  Due to the anticipated volume of questions, the committee may not explicitly address every comment received but all comments will be considered and reviewed. PLEASE NOTE: if you submit a question, your question and any associated identifying information you provide will be added to the study’s public access file as per the National Academies’ requirements to comply with FACA.

Stories You May Have Missed:

  • Uganda Ebola-like Illness Demystified- Public health officials in Uganda are sighing with relief as results from the Uganda Virus Research Institute (UVRI) have reported the death of a 20-year-old woman in Luweero was due to carbon monoxide poisoning and not the suspected Ebola virus. “There are currently 3 female cases admitted at Bishop Asili hospital, Luweero. However, results from UVRI indicate that all cases were negative for Ebola, Marburg, Crimean-Congo hemorrhagic fever, Rift Valley fever, and Sosuga viruses. ‘The ministry of health team is working closely with the District Health Team to monitor, review, and manage these cases as well as orienting health workers on management and referral protocols of suspected cases,’ reads the statement.”

Pandora Report 8.4.2017

We all know that kitchen sponges are like little densely populated germ cities, but did you know that cleaning them could make it worse?

Only Six Nations Have Evaluated Pandemic Readiness
A new report from the World Bank is calling out how little work has been done to evaluate and prepare for pandemic readiness. The report notes that only six countries have evaluated their capacity and capabilities for responding to a pandemic. Of these countries, three are wealthy (Finland, Saudi Arabia, and the U.S.) and are were poor (Eritrea, Pakistan, and Tanzania). All six countries had gone under external evaluations and developed funding plans to rectify their inadequacies. “The annual number of disease outbreaks around the globe has more than tripled since 1980, and air travel spreads contagions across oceans far more often. To convince countries that preparedness pays, the report included estimates of the economic damage various epidemics had done. For example, the viral pneumonia SARS — which ultimately killed only 774 people — shrank China’s gross domestic product by 0.5 percent in 2003.” We’re seeing an increasing emphasis on the financial aspect of pandemics and as this report points out, knowledge is power. The report includes an entire section on incentivizing countries to prioritize allocation of funds to preparedness, assessment of economic vulnerability, sovereign credit rating, etc. It was interesting to see that antimicrobial resistance was not considered a pandemic. What would happen if a fully resistant bacteria swept the world?

We Don’t Need Another Biodefense Strategy
Al Mauroni is taking a deep dive into the history of American biodefense strategies and why Thomas Bossert’s recent comments about a new one aren’t exactly promising. White House homeland security advisor Bossert announced this during a security forum in Aspen, noting that until the development of a new plan, the U.S. lacked a comprehensive biodefense strategy. When this was announced there was a collective “um….about that..” from many within the biodefense community. Mauroni points to the three recent biodefense strategies within the last fifteen years, highlighting what we’re all thinking – this won’t be the first comprehensive strategy. First, there was the Homeland Security Presidential Directive 10 in 2005, then the National Strategy for Countering Biological Threats (Presidential Policy Directive 2) in 2009, and most recently, the National Strategy for Biosurveillance in 2012. So, if we’ve had strategies for the better part of two decades, why is there a demand for a new one? Increased outbreaks and concern for biothreats have many calling for further funding of biodefense efforts, like that of the Blue Ribbon Study Panel on Biodefense. Funding is one thing though, but a whole new strategy? “A recent article on the ‘proliferation’ of national strategies suggests that strategic guidance only adds to the confusion, allowing executive agencies to pick and choose what they want to implement.” Mauroni notes that “Going back to Bossert’s statement at the Aspen Security Forum, he referenced the 2001 anthrax-filled letters, pandemic influenza outbreaks, genetic engineering research, and the Global Health Security Agenda. He didn’t reference the protection of US military forces against adversarial use of biological warfare agents. All of these fall under the area of ‘biodefense,’ and there is no one agency that comprehensively addresses all of these threats. Because US government funding, authorities, and capabilities for biodefense reside in different agencies, it is very difficult to articulate objectives and responsibilities in one single strategy. There is no single point of authority to execute the strategy, and very often, no incentive to change given an inability to redirect resources or authorities”. Biodefense is a unique term though as it is often considered in a singular context and while the DoD plays a significant role in countering biological threats, there are other players. Biosafety and biosecurity is a large component, which rests heavily on both the private and public sectors. The DHHS leads in times of public health concerns (even if some of these efforts are duplicated by the DoD) and we can’t forget the role of public health surveillance and health security efforts like that of the GHSA. Mauroni leaves us with several points – “there cannot be one national biodefense strategy because there are at least three distinct policy areas that, while overlapping, are significantly different in execution of their policy objectives.” He notes that “I am not optimistic that the US government will consider a more diverse and complex policy process that articulates these differences. Having one national biodefense strategy offers a façade of simplicity and organization that three separate strategies will not.”

Opening Statements for ASPR Nominee
The nomination hearing for Dr. Robert Kadlec as Assistant Secretary for Preparedness and Response (ASPR) at the U.S. Department of Health and Human Services began on August 1st. You can check out the transcript here, in which Kadlec highlights five priority issues he wishes to pursue if confirmed. His priorities include providing stable leadership and clear policy direction, creating a “national contingency health care” system, supporting the sustainment of robust and reliable public health security capabilities, re-invorgorating and advancing an innovative MCM enterprise, and working to reauthorize the Pandemic and All-Hazards Preparedness Act in 2018. You can watch the nomination hearings here. Reports are pointing to his likely confirmation as his nomination “lacks controversy“.

European Report on Drug Resistance
Is the food we eat helping antimicrobial resistance take over? A new joint report from several European public health agencies notes that “To contain antibiotic resistance we need to fight on three fronts at the same time: human, animal and the environment. This is exactly what we are trying to achieve in the EU and globally with our recently launched EU Action Plan on antimicrobial resistance. This new report confirms the link between antibiotic consumption and antibiotic resistance in both humans and food-producing animals.” The impact of consuming antimicrobial agents is increasingly becoming an area of concern. While there are many factors that contribute to the rise of antimicrobial resistance, it’s not surprising that antibiotic use in food-producing animals would become a topic of interest. “Although consumption is defined differently in humans and animals, to make the comparison as consistent as possible, the report expresses consumption in milligrams of active substance per kilogram of estimated biomass (mg/kg). Human antimicrobial consumption is typically reported as defined daily doses per 1,000 inhabitants. Overall, the report found that average antimicrobial consumption was higher in food-producing animals than in humans, although the difference was largely influenced by a handful of countries with significant animal populations.” Analysis points to a relationship between consumption and antimicrobial resistance (seen in isolates in certain species of bacteria). This latest report underscores the complexity of antimicrobial resistance and the challenges in truly addressing this hydra-like problem. Perhaps we are what we eat?

Australian Raid Finds Chemical Weapon Attempts
The Sydney police raids across four properties, which resulted in four arrests, found components for improvised explosive devices (IEDs) and construction on an “improvised chemical dispersion device”. Two men were ultimately charged with building the military-grade device and were reportedly supported by ISIS operatives but their attack plans were foiled. “Police will allege that components for an improvised explosive device (IED) were sent to Australia in air cargo from Turkey via Isis operatives in Syria. Two men, who remained in custody after facing court on Friday, then allegedly assembled the devices with instruction from ‘a senior Isis operative’, according to the Australian federal police deputy commissioner Mike Phelan.” In response to the attempt, intelligence and law enforcement agencies are working to improve screening. Fortunately, the chemical weapon was in the early stages of development.

Biothreat Worries Over Cancer Research
At last week’s DEF CON hacking conference in Las Vegas, Intel’s chief medical officer John Sotos brought forth a somewhat surprising topic – bioweapons. Building on his discussion of the cancer moonshot, Sotos discussed the same technology (DNA manipulation) having the potential for misuse and development into biological weapons. “’The reason you haven’t heard much about bioweapons is that they’ve been held back by a pretty severe limitation, which is the potential for blowback’,” Sotos said. It is hard for any attacker to use weaponised diseases because they spread beyond their initial distribution range: destroy your neighbouring nation and you destroy your own as well. Sotos noted, ‘the cancer moonshot is going to really drive new technologies to manipulate DNA because cancer is a disease of DNA. [And] the same exquisite targeting that allows it to attack only your cancer cells also overcomes the blowback potential for bioweapons’.” While this level of precision medicine isn’t available yet, it draws parallels to gene-editing tools like CRISPR, in which targeted application is becoming more real. Soto hones in on the fear that such genetic engineering capabilities will not only be possible, but used for nefarious purposes like stealing genetic codes or rewriting DNA to tamper with fertility. Soto’s points are valid and it is important to consider the full spectrum of use for biotech developments in the future however, we must not lose sight of the consistent and growing threat that is natural disease.

Stories You May Have Missed:

  • Saliva Secretions & Zika Transmission – A recent study found that rhesus monkeys, when infected with high levels of the virus, could theoretically transmit via saliva. When compared to rhesus monkeys with more common viral loads, it was possible, although extremely unlikely, that the highly infected monkey could spread via saliva “All three monkeys who were exposed to high doses of Zika virus (20-fold higher than that typically found in saliva) applied directly on their tonsils developed the disease. Another group of 7 monkeys were exposed to the virus via the saliva of monkeys who had received subcutaneous infections, representing a typical virus count. None of the monkeys exposed to doses typically found in saliva contracted the disease when their tonsils (5 animals), conjunctivae (1), or nasal passages (1) were exposed. ‘We tried to simulate sneezing, sharing utensils, and other mucosal exposures,’ said Friedrich. ‘But the amount of virus typically founding saliva was not enough to infect a monkey or suggest any seroconversion [development of detectable antibodies]’.”
  • Biodefense World Summit Coverage – Get the latest overview of the Biodefense World Summit here, with a focus on biosurveillance! Topics range from DHS work to enhancing situational awareness for global disease surveillance.

Pandora Report 7.14.2017

Welcome to your weekly dose of all things biodefense! We’ve got a lot of global health security goodies for you this week, so grab a coffee and let’s get our biodefense on!

Canadian Researchers Reconstitute Horsepox With Online DNA Order
Friday was an exciting day in the world of dual-use research of concern (DURC) and biosecurity efforts. News of a Canadian research team and their successful experiment in reconstituting horsepox, brought to light several concerns and gaps within DURC oversight. Led by virologist David Evans, the team was able to synthesize horsepox, a relative of smallpox, which is no longer found in nature. What is really concerning so many about this experiment is that Evans and his team were able to do this with little specialized knowledge, $100,000, and using mail-order DNA fragments. While the study hasn’t been published, it is drawing a lot of attention, not only for the potential that such a process could be applied to smallpox, but also that it failed to trigger more reviews at an institutional level for DURC risks. While the U.S. DURC oversight only applies to federally funded research with fifteen select agents, the Canadian processes cover such research that could disseminate knowledge, regardless of what organism is being used. GMU’s Dr. Gregory Koblentz spoke to Science and discussed DURC oversight, noting, “That should have captured the horsepox synthesis,”. “But as far as I understand, they did not engage in a systematic review of the broader dual-use implications of synthesizing an orthopox virus,” says Koblentz. “I don’t think this experiment should have been done.” Researchers and biosecurity experts around the world are weighing in on this study, especially since its publication is immiment. Tom Inglesby of the Center for Health Security pointed to three serious questions and concerns that this work raises – whether experimental work should be performed for the purpose of demonstrating that a dangerous or destructive  outcome could be created by using biology, how much new detail will be provided in the forthcoming publication regarding the processes for constructing an orthopox virus, and the international biosecurity and biosafety implications regarding the approval process for such experimental work. Perhaps one of the most startling aspects of all the commentary and reports on the horsepox experiment has been Evans own opinion on it all – “Have I increased the risk by showing how to do this? I don’t know,” he says. “Maybe yes. But the reality is that the risk was always there.” Where ever you might stand on the topic of dual-use research, bioethicist Nicholas Evans of the University of Massachusetts (of no relation to David Evans), said it best regarding this debated experiment – “an important milestone, a proof of concept of what can be done with viral synthesis. Aside from the oversight and life science research questions that this experiment brings to light, it also stirs the embers of the fiery debate regarding the destruction of the remaining smallpox stockpiles. The most recent blue ribbon panel review regarding the 2014 NIH variola incident sheds some light on the biosecurity and biosafety challenges of maintaining the stockpiles. You can check out the report of the Blue Ribbon Panel to Review the 2014 Smallpox Virus Incident on the NIH Campus  here. The report goes through the event itself, as well as their findings on the incident, response to the incident, and policy changes. Some of the contributing factors they identified included lack of responsibility for infectious materials in shared space, failure to find all variola samples in the 1980s, lack of complete and regular inventory of potentially hazardous biological materials, lack of policy for abandoned materials, history of NIH lapses following implementation of the Select Agent Regulations, etc.

Summer Workshop – Last Chance to Register!
Our Summer Workshop on Pandemics, Bioterrorism, and Global Health Security starts on Monday, July 17th, which means you still have time to register! Don’t miss out on this wonderful opportunity to discuss everything from Ebola to the concerns surrounding the horsepox dual-use dilemma. This three-day workshop will feature experts across the field of biodefense and will provide participants with a wonderful opportunity for networking and brainstorming!

The Pentagon Weighs the Threat of Synthetic Bioweapons 
While the topic of synbio and DURC is still fresh in our minds, how is the Pentagon considering gene-editing as a potential threat? Sure, we prepare for natural outbreaks and acts of bioterrorism, but how does CRISPR come into the mix? “Pentagon planners are starting to wonder what happens if the next deadly flu bug or hemorrhagic fever doesn’t come from a mosquito-infested jungle or bat-crowded cave. With new gene editing tools like Crispr-Cas9, state enemies could, theoretically, create unique organisms by mixing-and-matching bits of genetic information.” In response to these questions and potential scenarios, deputy assistant secretary of defense for chemical and biological defense, Christian Hassell, is working to get some answers. Hassell and other Pentagon colleages funded a year-long review by the National Academies of Sciences to evaluate the health security threats of synbio. While the review is still going on, a preliminary report is undergoing “classified review” before it can be publicly released. This review will be vital to consider the future of gain-of-function research and other dual-use research of concern in the context of biodefense. “Scientists at the meeting expressed a range of ideas about how the military could best defend against biological threats. Sriram Kosuri runs a synthetic biology lab at UCLA that has developed libraries of DNA sequences that can be developed into new kinds of organisms. While he understands the possibility of a lab-engineered threat, he believes the Pentagon and federal health officials should focus on responding to emerging public health menaces rather than monitoring academic labs that use genetic manipulation tools. ‘There’s a legitimate threat of emerging viruses and we need to be prepared for those things,’ Kosuri said during a break in the meeting. ‘The tiny threat of engineered viruses is miniscule compared to that’.” The challenging part in all of this is that there’s no precedent – this is a new field of threat and risk analysis where historical examples are lacking. Hypothetical situations and response scenarios are the best we can offer, but some of the most valuable tools are the ones we already have, like surveillance or early-stage review processes.

Trump Appoints A Key Bioterrorism Position But Still Leaves Dozens Open
Biological threats aren’t just acts of bioterrorism, but also natural outbreaks or laboratory accidents. If the latest horsepox experiment hasn’t convinced you already, we live in a time of quite unique and diverse biothreats. The spectrum of threats requires an array of agencies and personnel with the skills and resources to prevent and respond to such an event. Unfortunately, we’re currently at a national disadvantage in terms of biodefense. If we look at just one small facet of biothreats (bioterrorism), the U.S. has twenty-six (now twenty-five with the nomination of Kadlec) major and vital roles that are vacant and have not been filled by the Trump administration. While some are awaiting confirmation, there are vacancies without even a nominee like the White House position of Director, Office of Science and Technology Policy. The Department of Health and Human Services is missing a surgeon general and assistant secretary for health (awaiting confirmation), while the U.S. Agency For International Development lacks a nominee for the assistant administrator for global health. There are just a few of the vital positions we rely upon for preventing and responding to acts of bioterrorism. In the wider context of all biological threats, it may not seem like much, but the truth is that these vacancies leave the U.S. in a dangerously vulnerable position. Fortunately, President Trump announced on Monday his plans to nominate Robert P. Kadlec of New York to be the Assistant Secretary of Health and Human Services for Preparedness and Response. “Currently, Dr. Kadlec is the Deputy Staff Director for the Senate Select Committee on Intelligence. Previously, he served as a Special Assistant to the President for Biodefense Policy for President George W. Bush. Dr. Kadlec holds a B.S. from the U.S. Air Force Academy; a M.D. from the Uniformed Services University of the Health Sciences, and a M.A. in National Security Studies, Georgetown University.” He was also the Director for the Biodefense Preparedness on the Homeland Security Council and aided in drafting the Pandemic and All-Hazard Preparedness Act, as well as conducting the biodefense end-to-end assessment (culminating in the National Biodefense Policy for the 21st Century). You can even watch Dr. Kadlec speak on C-SPAN at the Bipartisan Policy Center & Kansas State University forum on biodefense in October of 2016. Dr. Kadlec also directed the Blue Ribbon Study Panel on Biodefense during their efforts to establish guidance during critical biothreats.

Public Health Preparedness and Response National Snapshot 2017
The CDC just released their 2017 snapshot regarding U.S. public health preparedness and response, noting that “this year has shown us, once again, that we can’t predict the next disaster. But it has also shown us clearly how being prepared protects health and saves lives. Emergencies can devastate a single area, as we saw with Hurricane Matthew, or span the globe, like Zika virus. Disasters from 9/11 to Ebola have demonstrated that we absolutely must have people, strategies, and resources in place before an emergency happens.” Within the snapshot, there are four main sections- Prepare, Respond, Connect, and Looking Forward. Within these sections, you can look at Zika, laboratories as the front lines of America’s health, global training programs, delivering results through partnership, etc. I found the section on Health Security: How Is The U.S. Doing, quite interesting. They note that “as part of the Global Health Security Agenda, teams of international experts travel to countries to report on how well public health systems are working to prevent, detect, and respond to outbreaks. This process is known as the Joint External Evaluation.” The CDC and Office of the Assistant Secretary for Preparedness and Response (ASPR) work together to establish evaluators , etc. Thankfully, this position is in the process of being filled so that these efforts can move forward. While this snapshot captures the range of issues that must be covered in public health preparedness, it also draws attention to how vital the roles in each agency are, which makes the vacancies that much more impacting.

Summary of Key Recommendations – Meeting to Solicit Stakeholder Input on Forthcoming 2017 National Biodefense Strategy
The Johns Hopkins Center for Health Security, supported by the Open Philanthropy Project, recently held a meeting to discuss and consider the landscape of biological threats to the United States and what response measures, programs, and policies are in place, etc. Featuring members from across academia, industry, and government, these subject matter experts weighed in on this honest and frank discussion about U.S. biodefense strengths and weaknesses. There were several recommendations and topics that were discussed but some of the highlights include improving biosurveillance capabilities and laboratory network, performing risk assessments and characterizing threats, strengthening emergency response capabilities including decontamination efforts, prevention-related efforts, building global capacities for bio-threat preparedness and response, etc. They noted several components to improving U.S. biodefense – “internationally, laboratory and surveillance systems for early detection of new outbreaks will be most effective when they serve the needs of countries where they are housed. It will not work for the US to create systems to gather and export data that the US needs from countries if those countries do not get the information themselves and find it to be valuable.” In regards to healthcare system response and strengthening the workforce, the group pointed out that “national and international preparedness for biological threats requires a strong workforce, including public health experts and animal and plant disease scientists. To some degree, success at controlling infectious diseases in the US may have inadvertently resulted in workforce attrition in these fields. Federal support for developing the workforce in these fields is important”.

Strategies for Effective Biological Detection Systems: A Workshop
Don’t miss this workshop put on by the National Academies of Sciences on Monday, September 18th – Tuesday, September 19th. “The National Academies of Sciences, Engineering, and Medicine will host a two-day public workshop on strategies for effectively updating biological detection systems. The workshop will explore alternative effective systems that would meet requirements for the Department of Homeland Security’s BioWatch Program as a biological detection system for aerosolized agents. There will be a focus on systems or strategies that could be deployed by 2027, and enable indoor surveillance and dual-use with day-to-day environmental surveillance that would be of value to the public health and medical communities. There will also be a focus on the integration of improvements and new technologies into the existing biological detection architecture.”

MRSA Screening – Healthcare Prevention Methods for Resistant Germs & Swabbing Our Way To A Solution for Antibiotic Resistance
Antibiotic resistance is a growing global issue and one of the hotspots for transmission of resistant germs is in hospitals. Given that MRSA (Methicillin-resistant Staphylococcus aureus) is now a common bacteria in the community and healthcare world, hospitals are working to screen patients to ensure those with MRSA are isolated appropriately and they can stop the spread of infection. GMU biodefense PhD student and infection preventionist Saskia Popescu looks at MRSA screening practices within hospital intensive care units (ICUs) and the cost analysis that can make or break a program. Most hospitals utilize one of two approaches – preemptive universal precautions (isolate all ICU patients until microbiology labs can prove they are negative for MRSA) or targeted isolation (wait until labs come back and then isolate). Each tactic has benefits and weaknesses. Delays in isolation can translate to further spread of MRSA, while longer periods in isolation mean additional costs associated with isolation. A recent study evaluated these very two strategies and the “researchers found that the total cost of preemptive isolation ‘was minimized when a PCR screen was used ($82.51 per patient). Costs were $207.60 more per patient when a conventional culture was used due to the longer turnaround time.’ For ICUs that used targeted isolation, the researchers found that costs would be lowest when chromogenic agar 24-testing was used and not PCR.” What this study highlights is that there is inherently no best practice and that depending on laboratory capability, hospitals may have to plan their MRSA screening and isolation protocols off their microbiology department and cost centers. While hospitals are working to screen patients as a means of responding to microbial resistance, researchers are working against the clock to find solutions. Dr. Adam Roberts is one such innovative microbiologist in the UK who is using an old-school approach to respond to a new problem. Popescu was able to interview him regarding his Swab and Send program, which utilizes citizen scientists from around the world to collect samples that may help produce new antimicrobials from the environment. Roberts is working to utilize environmental samples that hold microorganisms which produce compounds that can help build new antibiotics. “The initiative also helps create a microbial database. For £30, Dr. Roberts’ team will send anyone a handful of sample tubes, a mailing envelope, and directions for what to swab (for example: a nutritious area bacteria would likely grow, likely something unsanitary). After you send back your swabs, you can check out Swab and Send’s Facebook page and see what microbes grew from the samples.” Check out Dr. Roberts’ comments on trends he’s seeing and how even GMU biodefense students are getting in on the swabbing!

Naval Research Lab Find High Prevalence of Antibiotic Resistance in Kenya
Microbial resistance has a way of popping up in even the most unexpected places and projects. The U.S. Navy Research Laboratory (NRL), U.S. Army Medical Research Directorate-Kenya (USAMRD-K), Kenya Medical Research Institute (KEMRI), and University of Washington, led a joint effort to evaluate intestinal tract bacteria and its resistance in patients across Kenya. The NRL-developed microarray they used is capable of detecting over 200 difference antimicrobial resistant genes. “These results suggest that there is selective pressure for the establishment and maintenance of resistant strains,” said Dr. Chris Taitt, research biologist, NRL Center for Bio/Molecular Science and Engineering. “This is potentially due to agriculture and prophylactic use of antibiotics and further suggests the need for more effective public health policies and infection control measures than those currently implemented.” “Specific to Kenya, widespread use of tetracycline in livestock production, use of trimethoprim/sulfamethoxazole (SXT) and chloramphenicol as first line therapeutics for typhoid, and prophylactic use of SXT in persons exposed to or infected with human immunodeficiency virus (HIV) might have contributed to the high prevalence of resistance.” Surveillance of antimicrobial resistance has been a struggle on an international level however, joint efforts like this are vital to not only establishing global standards and processes, but also highlighting the importance it has for military personnel abroad.

Stories You May Have Missed:

  • Agroterrorism Bill – a new bill was recently introduced by U.S. Rep. David Young (R-IA) and Sen. Pat Roberts (R-KS) regarding the preparedness of the U.S. agriculture, food, and veterinary systems. “The Securing Our Agriculture and Food Act requires the DHS Secretary, through the Assistant Secretary for Health Affairs, to ensure food, agriculture, animal, and human health sectors receive appropriate attention and are also integrated into the DHS’s domestic preparedness policy initiatives. The legislation specifically addresses issues seen after the 2015 avian influenza outbreak, which killed millions of turkeys, backyard flocks, and layer hens. It was the deadliest outbreak of avian influenza in Iowa’s history.”
  • What The G-20 Needs To Do To Fight The Next Ebola– The G-20 summit occurred last week in Hamburg and many were hoping for a renewed passion surrounding biological threats. While much attention was focused on climate change, there is also a call for efforts to prevent the next outbreak that will produce a pandemic. “Ultimately, strong health systems depend on communities, health workers, managers, researchers and other local stakeholders being empowered to respond to the inevitable, future waves of change we all face. At Health Systems Global, our members represent these multiple groups. Strengthening everyday resilience demands that we all — governments, donors, researchers, communities, health professionals — work with the resources that health systems already have — their people and relationships. This must be done as we take wider action to confront inequality at all levels. If we do not do that, then efforts to safeguard disease outbreaks will be meaningless.”

Pandora Report 6.2.2017

Good news – the early registration discount for the Pandemics, Bioterrorism, & Global Health Security Summer Workshop has been extended to July 1st! We’ve got a full Pandora Report for you this week, so buckle up, it’s going to be quite a ride!

Worries, Woes, and Realities of Global Health Security
Novel diseases are a near certainty in life (perhaps the saying should be death, taxes, and disease?). Whether it be a natural event, an accidental lab exposure, or by the hand of a bioterrorist, the threat of a pandemic is real. Five infectious disease experts recently convened to discuss the threat of pandemics and what worries them most about future outbreaks. From this meeting they found five issues that truly worry them. First, the lack of trust in scientists and experts. Second, learning lessons from the past. “Tom Frieden said he’s concerned that people won’t study responses to recent pandemics enough to improve responses to future ones. ‘The world has a unique opportunity following Ebola to close gaps, to address blind spots around the world and to become much safer. If we don’t take action very quickly to close the gaps that are being identified, we will lose that opportunity,’ he said.” Third, antibiotic resistance and the continuous spread of resistant bacteria. Fourth, destruction of species and environments that might hold the key to future medical breakthroughs (we’ll be talking more about this one in a bit…). Lastly, they worry about funding for public health workers and that they have the resources needed when fighting epidemics on the front lines. Sadly, a newly established score card on global health found the U.S. lacking. This new measurement tool uses the Global Burden of Disease, Injuries, and Risk Factors Study (GBD) to establish a healthcare access and quality index. Countries that improved in deaths avoidable due to healthcare at their economic level over the last twenty-five years were China, Ethiopia, the Maldive Islands, Peru, etc. “By that standard, the United States improved slightly over the same period, 1990 to 2015. But the American ranking is still so low that it’s ‘an embarrassment, especially considering the U.S. spends $9,000 per person on health care annually,’ said the report’s chief author, Dr. Christopher J. L. Murray, director of the University of Washington’s Institute for Health Metrics and Evaluation, created by the Bill and Melinda Gates Foundation.”

Digital-to-Biological Converter  
Synthetic Genomics Inc. is bringing a bit of excitement to the world of synbio via their announcement within a peer-reviewed Nature article describing this new technology. The development of the digital-to-biological converter (DBC) marks a huge step in synthetic biology. The DBC produces biological compounds on-demand and without any human intervention. The unit is fully automated and allows the “user to create complex synthetic DNA in a single process. To demonstrate feasibility, researchers digitally transmitted a file with DNA sequence information to the DBC. The DBC converted that digital sequence into oligonucleotides, and utilized synthetic biology tools developed by Synthetic Genomics such as gene synthesis, error correction, and Gibson Assembly™ methods to create large and complex DNA constructs with high fidelity. Utilizing this DNA as a template, the DBC further produced a series of biological materials without any human intervention, such as RNA, proteins, and viral particles.Biological products created on the DBC included DNA templates for an influenza vaccine, an RNA-based vaccine, antibody polypeptides, and a bacteriophage.” Co-founder J. Craig Venter noted that the DBC is also the first machine of its kind and can receive digital biology in the form of DNA sequences via the internet or radio wave! “The DBC prototype fully integrates and automates processes from oligonucleotide design and synthesis to the production of biopolymers. Development of a smaller and portable DBC could enable reliable production at the point of demand and potentially reduce costs and increase access to bio-production in research laboratories. Finally, with the incorporation of large-scale synthesis technologies, one can envision the DBC being used in industrial settings to enable high-volume production of biologics such as proteins and RNA vaccines.”

ISIS & CRISPR Article Critique Writing Competition
Calling all GMU biodefense students! A recent article came out in Foreign Affairs that made some rather interesting comments regarding CRISPR, bioterrorism, and the threat of synthetic biology. We’re holding a competition for biodefense students (past and present) to write a critique on the article (700-1,000 words) and the winner (selected by Dr. Koblentz) will be featured in Global Biodefense. Please email me with any further questions and submissions (spopesc2@gmu.edu). The due date for this is June 17th. We look forward to reading your thoughts!

Pandemics, Bioterrorism, & Global Health Security Workshop Instructor Spotlight 
If you’re hoping to learn from a USAMRIID commander, NSABB member, UN Special Commission chief inspector, and veterinarian for the 10th Special Forces Group (Airborne), look no further than Dr. David R. Franz! He’s our spotlight instructor this week and will be teaching at our summer workshop in July. Dr. Franz has current standing committee appointments including the Department of Health and Human Services National Science Advisory Board for Biosecurity (NSABB), the National Academy of Sciences Committee on International Security and Arms Control, the National Research Council Board on Life Sciences, and the Senior Technical Advisory Committee of the National Biodefense Countermeasures Analysis Center. Dr. Franz was the chief inspector on three United Nations Special Commission biological warfare inspection missions to Iraq and served as technical advisor on long-term monitoring. He also served as a member of the first two US-UK teams that visited Russia in support of the Trilateral Joint Statement on Biological Weapons and as a member of the Trilateral Experts’ Committee for biological weapons negotiations. Dr. Franz was technical editor for the Textbook of Military Medicine on Medical Aspects of Chemical and Biological Warfare released in 1997. He serves as a Senior Mentor to the Program for Emerging Leaders at the National Defense University. He also serves on the Board of Integrated Nano-Technologies, LLC. Dr. Franz holds an adjunct appointment as Professor for the department of Diagnostic Medicine and Pathobiology at the College of Veterinary Medicine, Kansas State University. The current focus of his activities relates to the role of international engagement in the life sciences as a component of national security policy. Dr. Franz holds a DVM from Kansas State University and a PhD in physiology from Baylor College of Medicine. Even better, he’ll be lecturing on dual-use research at the workshop, so make sure to register!

Financial Cuts to Biodefense – Are We Digging Our Own Grave?
Despite a stark outlook painted from the looming threat of pandemics and the realities of American public health inadequacies, things are being further compounded by proposed budgetary hits to biodefense. A 10% increase in military spending means that other government agencies will take a hit, of which many are involved in biosecurity and biodefense. “The Office of Public Health Preparedness and Response, which tracks outbreaks of disease, would be cut by $136 million, or 9.7 percent. The National Center for Emerging and Zoonotic Infectious Diseases — a branch of the Centers for Disease Control and Prevention that fights threats like anthrax and Ebola — would be cut by $65 million, or 11 percent. The CDC’s Center for Global Health would lose $76 million, or 18 percent. Its Emergency Operations Center, which conducts real-time monitoring of outbreak responses, and its Select Agents Program, which sets regulations in lethal toxin labs and helps researchers stay ahead of bioterrorists, face unspecified cuts as well.” Fear is flourishing as there are substantial gaps in the appointment of positions within key federal agencies that are responsible for outbreak response and global health security. The 700 vacancies at the CDC alone is troubling as cases of Ebola continue to bubble up in the DRC and China fights back against a deadly outbreak of avian influenza. Many experts, like J. Stephen Morrison, the director of the Global Health Policy Center at the Center for Strategic and International Studies, are horrified and note that these drastic cuts will surely impact health security. A recent op-ed by faculty from the Johns Hopkins Center for Health Security highlights the proposed budget and how it makes the U.S. vulnerable to bioterrorism. In the event of such an attack, there are several links in the response chain that will invariably lose capacity and capability following such budgetary cuts- first responders, hospital staff, public health professionals, MCM research, decontamination efforts, etc.  In fact, the recent announcement of the expected closure of  NBACC, the Fort Detrick research lab only fuels concern. “While the overall spending for the Department of Homeland Security increases in Trump’s budget request, that department also zeroes out funding for the National Biodefense Analysis and Countermeasures Center (NBACC) at Fort Detrick.” NBACC is barely seven years old and is the government’s leading organization for forensic epidemiology in the event of a biocrime or bioterrorism. It is a world class facility for biodefense, collaborates with NIH and the DoD to conduct research gaps, and maintains several partnerships to strengthen U.S. biodefense and global health security. “’President Trump’s budget undermines important work being done in Frederick County to protect our troops and our national security. It guts federal investment in scientific research that saves lives, keeps our nation safe, and supports good-paying jobs in our state. The National Biodefense Analysis and Countermeasures Center at Fort Detrick, which helps protect America from biological threats, is doing critical work and I will fight these cuts and this ill-conceived budget in the U.S. Senate,’ said Sen. Chris Van Hollen (D), who is a member of the Senate’s budget and appropriations committees.” Governor John K. Delaney (MD) recently voiced his concern for the potential closure of NBACC, noting that he is “100% opposed to the closing of the National Biodefense Analysis and Countermeasures Center in Frederick and will fight this deeply misguided move by the Trump Administration. While DHS may be moving forward with plans to close the facility based on the assumption that the President’s request will be enacted, I want to stress that President Trump’s budget proposal is not law yet, that all funding and appropriations matters must go through Congress and that Trump’s budget overall has very little support in the House and Senate.” Unfortunately, as the threat of infectious diseases only grows, these cuts and closures will severely impact global health security. As the faculty from the Johns Hopkins Center for Health Security noted, “We urge Congress to reject the severe cuts proposed by the Trump administration and to support the continuation of these and other critical national biopreparedness and response assets, which protect the health and safety of all Americans.” On top of the budgetary impact to biodefense efforts, Thursday brought forth the troubling news that President Trump will end U.S. involvement in the Paris Climate Agreement . Many experts are highlighting the untold damage that will come from this move by way of climate change and international relations, but also the unintended consequence that is so easily forgotten – the spread of infectious diseases.

National Biosafety and Biocontainment Training Program (NBBTP)
Don’t miss the July 5th deadline for this amazing opportunity! “The NBBTP was conceived as a partnership between the National Institute of Allergy and Infectious Diseases (NIAID) and the Division of Occupational Health and Safety (DOHS) at the National Institutes of Health in Bethesda, Maryland. The program is administered by CDIC, Inc. The NBBTP Fellowship is a two-year program designed to train Fellows specifically to support high containment research environments by acquiring knowledge and skills necessary to meet the scientific, regulatory, biocontainment, biosafety, engineering, communications, management, and public relations challenges associated with the conduct of research in these facilities. NBBTP Fellows do not engage in any primary patient care activities. The mission of the NBBTP is to prepare biosafety and biocontainment professionals of the highest caliber to meet the needs of the biomedical emerging disease and civilian biodefense research communities through the 21st century.”

Outbreak Insurance
Instead of a tiny gecko or duck, perhaps the mascot would be a friendly looking microbe? Metabiota has a new CEO and a plan for outbreak response that involves insurance. Bill Rossi thinks that this could be the key to stopping outbreaks and Metabiota plans to help by providing the monitoring tools that would facilitate its success. “The company’s chief executive said that the new policies will provide financing in the wake of deadly pandemics and encourage multi-national corporations and nation-states to invest in preventing the spread of disease. Metabiota launched its insurance product last month and has been pitching its services to insurers, nations, and companies ever since. Indeed, Metabiota is partnering with the African Risk Capacity (ARC) agency, an agency of the  African Union (AU) to help nations respond to threats.” Rossi points to the growing interest in pandemic insurance since the 2014 Ebola outbreak and acknowledges that there will have to be work to avoid potential abuse of such policies that would result in perverse incentives (i.e. profitable insurance payouts should a country be afflicted by an epidemic). Regardless of insurance, early detection systems are a necessary investment and that’s where Rossi and his Metabiota team come in. Metabiota is working with “sovereign nations and also the insurers who have the financial wherewithal to ensure that policies are put in place to prevent the spread of disease.” Epidemic insurance is looking better every day, especially after the World Bank revealed that most nations aren’t ready for a pandemic. Recently, a working group was tasked with evaluating the world’s pandemic readiness and sadly, they found that most countries simple aren’t prepared. “Recent economic estimates suggest the global total for a moderately severe to severe pandemic could be $570 billion, or 0.7% of the world’s income. The 131-page report said many countries chronically underinvest in critical public health tasks that help with early identification and containment of infectious diseases: surveillance, diagnostic labs, and emergency operations centers. It also spells out 12 recommendations to ensure adequate financial support and infrastructure”. The recommendations include preparing a detailed financial proposal to support implementation of the plan to improve preparedness, developing partners and building on existing collective and bilateral commitments to help finance preparedness in countries needing support, etc.

Unexpected Mutations Following CRISPR           
I guess what happens in CRISPR doesn’t stay in CRISPR, eh? A recent letter published in Nature notes that despite the hopes many had for the gene editing technology as a means of solving disease-causing mutations, a new study found that there were some unintended changes to other genes. “When correcting blindness in mice, researchers at Columbia University found that though CRISPR did manage to successfully edit the particular gene responsible for blindness, it also caused mutations to more than a thousand other unintended genes. The off-target effects of CRISPR have long been known, but this new research highlights just how extensive they can be, and highlights the importance of research to understand them.” Shortly after the letter was published in Nature, investments in genome-editing companies took a hit and stock prices dropped.

Ebola in the DRC
This week the DRC approved the use of the experimental Ebola vaccine rVSV-ZEBOV. The WHO plans to use a ring vaccination method to roll out the new vaccine. “The situation report also said that several cases of suspected Ebola have now been ruled out, meaning the outbreak appears to be not as extensive as once feared. As of Sunday, there were 2 confirmed, 3 probable, and 14 suspected cases. No new possible cases have been identified since May 11.” You can read the latest WHO situation reports here for updated case counts and geographic distribution.

Virus Hunters
Researchers are currently hunting for the next lethal virus in the Democratic Republic of the Congo (DRC). The team is in the DRC with the PREDICT project, which is part of USAID’s Emerging Pandemics Threat program to create a database of zoonotic pathogens that are the most likely emerging pandemic threats. “If scientists can detail the places where lethal viruses simmer in wait, the thinking goes, they can head off a swelling pandemic and better manage outbreaks while they are still small and local. Researchers and other outbreak responders could consult this database to begin mapping the source of an emerging disease, for example, and quickly get to work on minimizing transmission and developing potential new vaccines that could save countless lives. ‘We have a job to do,’ Dr. Prime Mulembakani explains. ‘We also have the opportunity to be in contact, in close contact, with people who are on the front line—the communities who are really at risk for a virus spillover from animals into people.’ The irony of potentially disease-carrying bats hanging from the rafters of the local health center is not lost on Mulembakani, an epidemiologist by training, and he pauses for emphasis: ‘We need to stop these events from getting out of control’.”

Stories You May Have Missed:

  • Pale Rider – The Spanish Flu of 1918 and How It Changed the World – Laura Spinney’s new book, Pale Rider, is coming out this fall, which details the history of the 1918 pandemic. Spinney takes the reader through a journey of the influenza virus history and how the pandemic was quickly forgotten after it took as many as 100 million lives. “By early 1920, nearly two years after the end of the first world war and the first outbreak of Spanish flu, the disease had killed as many as 100m people— more than both world wars combined. Yet few would name it as the biggest disaster of the 20th century. Some call it the ‘forgotten flu’. Almost a century on, Pale Rider, a scientific and historic account of Spanish flu, addresses this collective amnesia”.
  • Salmonella Outbreak in 47 States – Nearly 400 have been sickened following a salmonella outbreak tied to live poultry. “Since early January and through May 13 the outbreaks have sickened 372 people in 47 states. So far, 71 people have been hospitalized but no deaths have been reported. Just over a third (36%) of the sick patients are children. During the investigations, interviews revealed that 83% (190) of 228 sick people had contact with live poultry the week before they got sick. People bought live baby poultry from a variety of sources, including feed supply stores, Web sites, hatcheries, and relatives.”

 

Week in DC: Events July 11-15, 2016

Monday, July 11, 2016
How To Defeat Terrorism In Iraq– Institute of World Politics
Time: 1-2:30pm
Location: The Institute of World Politics1521 16th St NW, Washington, DC 20036, USA (map)
Sheikh Jamal al-Dhari will share his vision for his country: a political re-crafting of the existing government structure away from sectarianism and towards a new consitution based on Iraqi national citizenship and inclusive of participation from all sectarian communities. HE Sheikh Jamal al-Dhari is the Chairman of the Iraq National Project and President of Peace Ambassadors for Iraq (PAFI). One of the leaders of the al-Zoba tribe in Iraq, he is the nephew of the late Islamic scholar and religious leader Sheikh Harith al-Dhari. Jamal was born in the Abu Ghraib district of Iraq on July 16, 1965. He grew up within the al-Zoba tribe and in the 1970s he attended the Hafsa School. In the 1980s, Jamal was conscripted into the Iraqi Army to fight in the Iran- Iraq War.  During his time on the frontline, he fought alongside both Sunni and Shia officers and friends, in the Iraqi Republican Guard. Following the 2003 invasion of Iraq by coalition forces, Jamal was a strong proponent of Iraqi nationalism and self-rule.  In 2005, he and his family fought against al-Qaeda’s occupation of Iraqi territory and, as a consequence, Jamal lost 70 members of his family in the struggle. In 2014, Jamal helped to establish the nonprofit think tank Peace Ambassadors for Iraq, whose purpose is to advocate for a renewed system of government in Iraq, to determine the best policies to fully eliminate ISIS/Daesh and other terrorist forces from Iraq, and to build international support for an all-inclusive Iraq. Presently, Jamal is working for a renewal in Iraq by forging a non-sectarian and inclusive settlement for all Iraqis.

Tuesday, July 12, 2016
Opportunities And Challenges In Implementing The Iran Nuclear Deal– Bipartisan Policy Center
Time: 10am-noon
Location: Bipartisan Policy Center1225 I Street, NW Suite 1000, Washington, D.C. 20005 (map)
On July 14, 2015, President Obama announced that international negotiators had reached agreement on the Joint Comprehensive Plan of Action (JCPOA), “a comprehensive, long-term deal with Iran that will prevent it from obtaining a nuclear weapon.” Robust debate followed, with supporters of the deal arguing that it would put in place verifiable restrictions on Iran’s nuclear program and critics worried that it would do too little to prevent Iranian cheating while leaving other issues—Iran’s ballistic missiles and its support for terrorism, for example—off the table. As the first anniversary of the JCPOA approaches, it is possible to assess how the deal has fared thus far and what challenges or opportunities its implementation might present going forward. Please join the Bipartisan Policy Center for a keynote address by Ambassador Stephen Mull, the State Department’s lead coordinator for Iran nuclear implementation, and an expert panel discussion. The event will be streamed live on this page. Join the discussion on Twitter: @BPC_Bipartisan#BPClive

Wednesday, July 13, 2016
Russia’s AIDS Epidemic: Truths, Policies, And Future Outlook– Center on Global Interests
Time: 10:30-noon
Location: Human Rights Council 1640 Rhode Island Ave NW, Washington DC, 20036 (map)
Russia is home to one of Europe’s largest and fastest growing HIV/AIDS infected populations. As of 2016, more than 1 million people are registered on the country’s official HIV-positive list. What factors led to Russia’s AIDS epidemic, and will it continue to grow? How have policymakers responded to the crisis? And what do these responses say about Russia’s current political, social, and economic environment? As the world’s public health leaders prepare to meet in South Africa for the AIDS 2016 summit, the Center on Global Interests is pleased to invite you to this timely discussion with Robert Heimer, Professor of Epidemiology and Pharmacology at the Yale School of Public Health and Olga Levina, Development Director at Stellit, a St. Petersburg-based public health NGO. Judyth Twigg, Professor of Political Science and senior fellow (non-resident) at the Center for Strategic and International Studies will moderate the conversation. Continue reading “Week in DC: Events July 11-15, 2016”

Week in DC: Events 6.27-7.1.2016

Monday, June 27, 2016
Leaders Speak: National Security Advisors– National Committee on U.S.-China Relations
Time: 5:30-7pm
Location: Omni Shoreham Hotel2500 Calvert St NW, Washington, DC 20008, USA (map)
Every morning, the national security advisor briefs the president of the United States on the world’s most pressing security threats, from ISIS to the Zika virus. Our collective security is increasingly reliant upon cooperation between the United States and China, whether it is minimizing the risk of conflict in the South China Sea, dealing with North Korea’s nuclear weapons program, or responding to climate change. Join us for a program on these issues and more, featuring former National Security Advisors Stephen J. HadleyRobert “Bud” McFarlane, and Richard V. Allen in conversation with National Committee President Steve Orlins.

Tuesday, June 28, 2016
Trading Up: A Critical Perspective On Jobs, Governance & Security In U.S. Trade Policy– Institute for Policy Studies
Time: 9am-5pm
Location: nstitute for Policy Studies815 16th St. NW Washington, DC United States (map)
We are delighted to invite you to“Trading Up: A Critical Perspective on Jobs, Governance & Security in U.S. Trade Policy,”  A program that includes continental breakfast, lunch and an evening reception. U.S.  trade policy is at a crossroads. With progress at the WTO seemingly halted, the global business community has turned to alternative strategies, including the Trans-Pacific Partnership (TPP). The Administration continues to work to advance the TPP this year, but its unpopularity with all remaining presidential candidates and their primary voters has made that goal tenuous. We encourage you to R.S.V.P. as soon as possible, as space is limited for this free event. Check out the Trading Up conference agenda in full.

Expand Social Security Now– Economic Policy Institute
Time: 11am-12:20pm
Location: Economic Policy Institute1225 Eye Street, N.W. Washington, DC (map)
Suite 600 Wellstone Room
Join Social Security Works at the Economic Policy Institute for a panel on expanding Social Security. As seen in the New York Times, Social Security expansion is part of a strong and growing movement in America and will play a crucial role in the 2016 election. This movement has allowed defenders of Social Security to shift the conversation and have a serious discussion about how we can expand Social Security to solve the retirement security crisis. On June 28, 2016, we will be joined by author Steven Hill to talk about his new book Expand Social Security Now! How to Ensure Americans Get the Retirement They Deserve, as well as Nancy Altman, co-author of Social Security Works! Why Social Security Isn’t Going Broke and How Expanding It Will Help Us All. The panel will be moderated by the President and CEO of the Center for Global Policy Solutions and author of Plan for a New Future: The Impact of Social Security Reform on People of ColorMaya Rockeymoore, and joined by EPI President Lawrence Mishel. This panel will explore Social Security expansion and discuss how we can continue to make expansion the only option for lawmakers. Continue reading “Week in DC: Events 6.27-7.1.2016”