Pandora Report 2.16.2018

 

 White House Budget Hits Public Health
The White House has released their new plan, “Efficient, Effective, Accountable: An American Budget”, which sees an increase in military spending, funds for a U.S.-Mexico border wall, and a 10%  increase in spending from 2017. “The plan also calls for major cuts to Medicare, Medicaid, food stamps and other social programs — reductions that conservatives have long sought. But even with these reductions, which add up to more than $3 trillion in cuts over 10 years, the proposal would not bring the budget into balance because of the lost tax revenue and higher spending on other programs.” The 2019 budget proposal also includes $9.2 billion added after Congress lifted mandatory spending caps. “But the 2019 budget might not be as steady as it seems, because the White House is calling for the creation of three new institutes within the NIH. They include a National Institute for Research on Safety and Quality, which would replace the $324-million Agency for Healthcare Research and Quality within the Department of Health and Human Services (HHS). The Trump plan would also transfer the National Institute of Disability, Independent Living, and Rehabilitation Research from the HHS’s Administration for Community Living, and the National Institute of Occupational Safety and Health (NIOSH) to the NIH from the US Centers for Disease Control and Prevention (CDC).” The plan also includes a cap for how much salary a scientist can draw from an NIH grant (90%), gives NIH an additional $750 million for research towards the opioid crisis ($400 million of which must “be spent on public-private partnerships to develop new treatments”). Unfortunately, this proposed budget significantly weakens public health preparedness and response plans with a 43% reduction in the CDC’s Public Health Preparedness and Response Program. Furthermore, it includes hitting the CDC hard with a 12% reduction and plans to move the strategic national stockpile (SNS) to ASPR. Such plans severely impact global health security as funding for the GHSA is expected to drop. You can read a further overview on the health security outlook by the Johns Hopkins Center for Health Security here. There has also been increasing concern regarding the lack of a nominee for the head of the Office of Science and Technology Policy, especially since the de facto advisor is a 31-year-old political science major from Princeton

GMU Schar School MS Open House
Don’t miss out on our information session next week. This is a great chance to chat with faculty about the GMU Biodefense MS program (both online and in person). “The session will provide an overview of our master’s degree programs, an introduction to our world-class faculty and research, and highlights of the many ways we position our students for success in the classroom and beyond. Our admissions and student services staff will be on hand to answer your questions.” FYI – GMU biodefense students are making headlines for their dedication and passion for health security, come join the nerdom!

Next Generation Global Health Security Mentorship Program
Interested in becoming a mentor  or protege in health security? The NextGen Global Health Security Mentorship Program is a great way to build partnerships and collaborations for those passionate about health security. “The NextGen Global Health Security (NGGHS) Mentorship Program is an annual program aimed at connecting early to mid-career professional and students interested in global health security with experts in the field to enhance professional development. Mentors and Protégés are free to establish a program that suits them best. Meetings can be based on current events, suggested topics and/or other common areas of interest. The pair will maintain correspondence either in person, over the phone or by email, as often as they have decided feasible.” If you’re a GMU biodefense alum, also make sure to update your information in Stay Connected so you’ll get the latest in biodefense program news and opportunities!

The Anniversary of Kim Jong Nam’s VX Assassination
February 13th marked the one-year anniversary of the assassination of Kim Jong Un’s half brother at the Kuala Lumpur airport. Kim Jong Nam was attacked by two women who smeared VX nerve agent on his face. “The women claim they were tricked into believing they were part of a reality show, but the U.S. and South Korea say the murder was orchestrated by Pyongyang. The brazen killing came as North Korea was starting to accelerate its missile tests and countries around the world came under mounting pressure to enforce ever-tightening U.N. sanctions against Pyongyang.” In the wake of the attack, Malaysia is working to distance itself from its previously close relationship with Pyongyang. The murder trial, which started in October of 2017, is set to end in March of this year, with the two women maintaining their innocence. 

Biosafety Failures in UK Lab
The Health and Safety Executive (HSE) released findings from their investigations into more than 40 “mishaps” at specialist labs from 2015-2017. The labs were run by hospitals, private companies, and Public Health England (PHE), which reveals an unfortunate trend across many sectors. “One scientist at a PHE laboratory became sick after contracting Shigella, a highly contagious bacterial infection that causes most cases of dysentery in Britain. The incident led the HSE to send the agency an enforcement letter to improve its health and safety practices.” Incidents range from failure to communicate safety requirements for mailing samples to airflow failures and lab workers acquiring illnesses from lab safety mishaps.

Antimicrobial Resistance: Forging A New Strategy Against An Old Threat
GMU Biodefense students love all things health security and that includes antimicrobial resistance. PhD student Saskia Popescu is tackling the woefully insufficient response we’ve had over the years to this growing threat. Pointing to current challenges, initiatives, and research strategies, Popescu discusses current trends and hopeful plans to combat AMR. “What is to be done? There are several initiatives, like the Combating Antibiotic Resistant Bacteria Biopharmaceutical Accelerator (CARB-X), that seek to infuse life into the research and development of new drugs. There is also a push on health care providers and agriculture to reduce the use of antimicrobials. But these are all long-term solutions that may take years or decades to implement. Although long-term plans are critical, if you were hospitalized today with a highly resistant infection, what would be the short-term plan of action your heath care providers would take?”

ABSA Risk Group Database App
Check out the latest Risk Group Database resource (and app!) from the Association for Biosafety and Biosecurity (ABSA) International. “In many countries, including the United States, infectious agents are categorized in risk groups based on their relative risk. Depending on the country and/or organization, this classification system might take the following factors into consideration: pathogenicity of the organism, mode of transmission and host range, availability of effective preventive measures (e.g., vaccines), availability of effective treatment (e.g., antibiotics), and other factors.”

Blue Ribbon Study Panel on Biodefense Receives Grant to Advance Leadership and Reduce Catastrophic Risk
“The Blue Ribbon Study Panel on Biodefense announced today a $2.5 million grant from the Open Philanthropy Project. The grant allows the Panel to continue its leadership role in assessing our nation’s biodefense, issuing recommendations and advocating for their implementation, and identifying viable avenues for needed change to policy. The grant comes amidst heightened global tensions as North Korea and other regimes seek to develop biological weapons. It also arrives on the 100th anniversary of a catastrophic influenza pandemic that took the lives of millions around the world, a stark reminder of the dangers of biological events.”

Stories You May Have Missed:

  • DHS Announces Finalists in $300k Biothreat Prize Competition –  “The Department of Homeland Security (DHS) Science and Technology Directorate (S&T), in collaboration with the Office of Health Affairs National Biosurveillance Integration Center (NBIC), today announced five finalists for Stage 1 of the Hidden Signals Challenge. The challenge calls for the design of an early warning system that uses existing data to uncover emerging biothreats. The announcement was made at the American Society for Microbiology’s 2018 ASM Biothreats meeting.”
  • Seoul Virus Transmission – Have a pet rat at home? Make sure to practice safe rodent handling and hand hygiene as physicians are seeing cases of rodent-to-human transmission of Seoul virus. “After confirming Seoul virus infection in the Wisconsin patients, the CDC and the Wisconsin Department of Health Services investigated the source of the disease. ‘The outbreak spread from sales or trade of infected pet rats between people’s homes or between ratteries’ – places where rats are bred – ‘in 11 states,’ said Kerins, who coauthored the report.”

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

Pandora Report 2.2.2018

The world of health security has been busy this week as news of CDC leadership changes and ongoing flu troubles have caused ripples. A new mouse study is also hinting that West Nile virus may cause Zika-like birth defects. Check out Maryn McKenna’s latest article on changing the market for flu shots and the desperate need for innovation.

 CDC’s Plans to Scale Back Global Health Security Activity 
A recent article brought attention to CDC plans that would reduce efforts to prevent and respond to outbreaks on a global scale through the global health security agenda (GHSA). “In an email to U.S. and overseas leaders in its global health center, the CDC said it anticipates that if its funding situation remains the same, it will have to narrow activities to 10 ‘priority countries’ starting in October 2019. The email was reviewed by The Wall Street Journal.” The 10 countries include Vietnam, India, Nigeria, etc. “Reductions now would halt critical work midstream and result in a loss of newly trained local experts, said Tom Frieden, the former CDC director who led the effort until a year ago and is now president and chief executive of Resolve to Save Lives, an initiative working on strengthening epidemic preparedness.” In response to this alarming plan, the Global Health Security Agenda Consortium, Global Health Council, Next Generation Global Health Security Network, and Global Health Technologies Coalition, have drafted a letter to newly appointed HHS Secretary Alex Azar, regarding the serious implications of such actions. Sent to HHS, CDC, OMB, State and NSC leadership, they underline the funding ramifications of scaling back on CDC’s efforts regarding the GHSA. “US investments in global health security and deployed CDC personnel are making America safer today. For example, US investments in surveillance capacity in Cameroon have decreased the disease outbreak response time from 8 weeks to just 24 hours.” The letter highlights the recent Ebola and Marburg outbreaks as prime examples of work within the GHSA, but also what occurs when global efforts are not available or lacking. “As the United States and the world begin to reap the benefits of our investments in better disease preparedness, now is not the time to step back. The ongoing danger that biological threats pose to American health, economic, and national security interests demands dedicated and steady funding for global health security. Congress and the Administration must invest in our deployed global biodefense capability.” Nothing short of serendipitous, the National Academies have also released their report from a workshop on Exploring Partnership Governance in Global Health. “In global health, collaboration frequently occurs through public–private partnerships (PPPs), with public and private parties sharing risks, responsibilities, and decision-making processes with the objective of collectively and more effectively addressing a common goal. PPPs include government and industry as well as partners from a range of other sectors. The workshop examined what role governance assumes in global health PPPs through presentations and discussion on transparency and accountability, operational challenges, legal considerations, barriers and strategies for engagement, examples of governance structures and lessons learned, and measurement. This publication briefly summarizes the presentations and discussions from the workshop”

Antimicrobial Resistance Surveillance Efforts and Needs
While the outcome is not surprising, this first release of the WHO’s surveillance data on AMR isn’t pretty. Surveillance data is revealing high levels of antibiotic resistance are in fact, found worldwide. “WHO’s new Global Antimicrobial Surveillance System (GLASS) reveals widespread occurrence of antibiotic resistance among 500 000 people with suspected bacterial infections across 22 countries. The most commonly reported resistant bacteria were Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus, and Streptococcus pneumoniae, followed by Salmonella spp. The system does not include data on resistance of Mycobacterium tuberculosis, which causes tuberculosis (TB), as WHO has been tracking it since 1994 and providing annual updates in the Global tuberculosis report.” The GLASS program includes 52 countries (25 high-income, 20 middle-income, and 7 low-income countries) and was launched in 2015 as a way to better track and understand the complexities of AMR. Wellcome Trust has also just announced a new strategy to combat AMR on an international scale. SEDRIC (Surveillance and Epidemiology of Drug-Resistant Infections Consortium) will work to strengthen country capacity for AMR surveillance and detection. “We need to better understand where patients acquire bacteria that cause infections – are they acquiring bacteria from other patients, from healthcare settings, water or food or the general environment? Drug-resistant infections are, like us, international travellers. We need to track which borders they cross, and how quickly. Without detailed and up-to-date information we cannot effectively intervene.” SEDRIC will work to fix surveillance gaps across countries by focusing on improving global coordination, identifying critical gaps and barriers, and helping countries to adopt sustainable best practice and strategies. These surveillance efforts and strategies are desperately needed to understand the AMR problem at a global level, especially as it was reported that India’s farmed chickens are dosed with colistin (the antibiotic of last resort). 

CDC Director Steps Down
Dr. Brenda Fitzgerald has stepped down from her role as director of the CDC due to conflicts of interest. “Politico reported on Tuesday that Fitzgerald, a physician and former commissioner of the Georgia Department of Public Health, bought shares in a tobacco company a month into her leadership of CDC, an agency charged with safeguarding public health, including reducing rates of smoking. She took over leadership at CDC in July. After advising the HHS secretary of the status of her financial interests and the way in which it limited her ability to do her job, Azar accepted her resignation, HHS said in a statement.” Dr. Fitzgerald began her role in July and is the second of top health positions appointed by the Trump Administration to resign. Dr. Anne Schuchat is now the Acting Director for the CDC. 

GMU Master’s Open House – February 21st
We’re just a few weeks out from the GMU Schar School MS Open House on February 21st and you won’t want to miss this opportunity to talk to faculty about our biodefense graduate degrees. Whether you’re looking to attend in person or online, this is a great opportunity to discuss the application process, curriculum, and how students are supported in their academic and career goals.

 Hawaii’s False Missile Alert and The Woeful State of US Preparedness
For 38 minutes, residents of Hawaii were alerted that a ballistic missile was approaching the island. A deep-dive of this mishap has found that the “emergency worker who sent a false public safety alert on Jan. 13 warning of an imminent  ballistic missile attack on Hawaii believed that a ballistic missile was truly bound for the state after mishearing a recorded message as part of an unscheduled drill,”. A mix-up in communication between shift supervisors regarding when the drill would run led to a trickle-down of confusion as the day-shift workers were notified of a missile threat (as part of the drill). “Following standard procedures, the night-shift supervisor posing as Pacific Command played a recorded message to the emergency workers warning them of the fake threat. The message included the phrase ‘Exercise, exercise, exercise.’ But the message inaccurately included the phrase ‘This is not a drill.’ The worker who then sent the emergency alert failed to hear the ‘exercise’ portion of the message and acted upon the ‘This is not a drill’ part of the message that should not have been included, according to the report.” Furthermore, the computer systems in place that should’ve been a stop-gap did not detect the difference between test alerts and actual alerts. This event is a prime example of the traditional failure in emergency preparedness exercises (and real events) – communication. Such an event, while frustrating, should be utilized as a teaching tool to truly fix the communication gaps. Sometimes it’s the “did that seriously just happen?” events that teach us the most about the fissures in our preparedness.

Flu Wreaking Havoc on Hospitals, Infection Control Practices Struggling
GMU Biodefense PhD student and infection preventionist Saskia Popescu is looking at the current flu situation from the perspective of infection control and healthcare response. “Hospitals are being hit hard by a rapid influx of individuals who are requiring isolation, treatment, and manpower during a time where health care institutions are already suffering from an intravenous (IV) bag shortage. I’ve seen some hospitals go on diversion because they are so inundated with patients that they are unable to accept any more. Hospitals are experiencing shortages of influenza testing kits, conference rooms and outside tents are being set up as triage/waiting areas, personal protective equipment (PPE) stores are being strained. Furthermore, infection prevention and control practices are being stressed against the influx of patients and staff calling in sick. All the while, clinicians are trying to maintain proper isolation precautions. To add insult to injury, a recent study on the transmissibility of aerosols and the role they play in spreading influenza has uncovered some disheartening results.”

Tests Link Syrian Government Stockpile to Largest Sarin Attack
Laboratories performing analysis for the Organisation for the Prohibition of Chemical Weapons (OCPW) have confirmed linkage between the Syrian government’s chemical weapons stockpile and the largest sarin attack of the civil war. “The tests found ‘markers’ in samples taken at Ghouta and at the sites of two other nerve agent attacks, in the towns of Khan Sheikhoun in Idlib governorate on April 4, 2017 and Khan al-Assal, Aleppo, in March 2013, two people involved in the process said. ‘We compared Khan Sheikhoun, Khan al-Assal, Ghouta,’ said one source who asked not to be named because of the sensitivity of the findings. ‘There were signatures in all three of them that matched’.” The test results further reinforce the widespread belief that the Assad regime has not destroyed their chemical weapons supply (and continues to use them), which would violate not only the Chemical Weapons Convention, but also several UNSC resolutions. Russia continues to maintain that the Syrian government has not carried out such attacks and that the OCPW inquiries aren’t reliable, but inspectors continue to find evidence of chemical weapons in Syria. “Independent experts, however, said the findings are the strongest scientific evidence to date that the Syrian government was behind Ghouta, the deadliest chemical weapons attack since the Halabja massacres of 1988 during the Iran-Iraq war.” “A match of samples from the 2013 Ghouta attacks to tests of chemicals in the Syrian stockpile is the equivalent of DNA evidence: definitive proof,” said Amy Smithson, a U.S. nonproliferation expert. “The hexamine finding ‘is a particularly significant match,’ Smithson said, because it is a chemical identified as a unique hallmark of the Syrian military’s process to make sarin. ‘This match adds to the mountain of physical evidence that points conclusively, without a shadow of doubt, to the Syrian government,’ she said.” Furthermore, experts are dispelling the notion that the attacks could have been carried out by rebels, noting that it would be impossible for them to achieve such a coordinated, large-scale attack.

Stories You May Have Missed:

  • South Korea Works to Eradicate Avian Flu Before Olympics – “With the PyeongChang Winter Olympics set to begin on Feb. 9, the South Korean Ministry of Agriculture, Food and Rural Affairs announced Monday that it had confirmed the presence of a highly pathogenic strain of the H5N6 avian influenza virus at two chicken farms south of Seoul, Korea JoongAng Daily reportsThe two farms both are approximately 80 miles to the west of PyeongChang. The government has culled 190,000 chickens at the farm in Hwaseong and another 144,000 at the farm in Pyeongtaek. It also has ordered that 430,000 chickens on farms in a 500-meter radius of the Pyeongtaek farm be slaughtered and has destroyed nearly 500,000 eggs at the Hwaseong farm as a precautionary measure. The government also will inspect and disinfect other farms in the area.”
  • Yellow Fever in Brazil – Cases of yellow fever have jumped in Brazil, based upon data from the Ministry of Health data. “In 1 week, the number of recorded deaths from yellow fever rose from 20 to 53, reported cases rose from 470 to 601, while confirmed cases jumped from 35 to 130, O Globo reported yesterday. All deaths have occurred in Minas Gerais, Sao Paulo, and Rio de Janeiro states. Ministry of Health data lag behind data from state officials, Brazilian media reported. The state health data for Minas Gerais notes 24 deaths (1 more than the federal government count), and Rio de Janeiro recorded 8 deaths (also 1 more than the federal total for that state.)  All reports indicate that Sao Paulo has 21 deaths.”

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 1.5.2018

Welcome to our first Pandora Report of 2018! While things may have been relatively quiet over the holidays, we still have some health security gems for you to start the new year right.

 An Infection Preventionist’s Take on the 2017 Biological Weapons Convention
GMU Biodefense Phd student and infection preventionist Saskia Popescu recently attended the BWC Meeting of States Parties and is discussing the importance of civil society and why even the most unlikely participants are important for the future of the BWC. “It seems an unlikely story that an infection prevention (IP) epidemiologist would attend a Meeting of the States Parties (MSP) at the United Nations (UN), but here’s why civil society has an important role in the work that IPs do.” Highlighting the Confidence Building Measures (CBMs) and the role of NGOs, she uses communicable disease reporting as an example of how so many of us play an unsuspecting role. “In fact, I feel that there are 2 things that should underline the importance of NGOs and civil society being involved in international treaties such as the BWC: 1.) Inherently, our work plays into the CBMs. Who does communicable disease reporting at a county level? Yours truly, and that feeds into the state health departments and then up through the Centers for Disease Control and Prevention (CDC), which goes into the CBM. 2.) With the rapid pace of advancements in the life sciences—such as gain-of-function research or genome editing like CRISPR—it is critical that treaties like the BWC be modernized to maintain relevancy. This requires experts from civil society who can work across international borders.”

Enhancing BioWatch Capabilities Through Technology and Collaboration
The latest proceedings of a workshop report from the National Academies are now available online. “The Department of Homeland Security’s (DHS’s) BioWatch program aims to provide an early indication of an aerosolized biological weapon attack. The first generation of BioWatch air samplers were deployed in 2003. The current version of this technology, referred to as Generation 2 (Gen-2), uses daily manual collection and testing of air filters from each monitor, a process that can take 12 to 36 hours to detect the presence of biological pathogens. Until April 2014, DHS pursued a next-generation autonomous detection technology that aimed to shorten the time from sample collection to detection to less than 6 hours, reduce the cost of analysis, and increase the number of detectable biological pathogens. Because of concerns about the cost and effectiveness of the proposed Generation 3 system (Gen-3), DHS cancelled its acquisition plans for the next-generation surveillance system.” Within the report, you can find an overview of BioWatch priorities, collaborative planning, recommendations from the GAO and DHS responses, and future opportunities at the state and local level. Some of the GAO’s findings included failure by DHS to develop performance requirements that would allow for conclusions about Gen-2’s ability to detect attacks, and that the modeling and simulation studies that DHS commissioned had not directly and comprehensively assessed Gen-2’s capabilities.

 GMU Biodefense MS Open House
Mark your calendars for the February 21st Master’s Open House at GMU’s Arlington campus! The session will provide an overview of our master’s degree programs, an introduction to our world-class faculty and research, and highlights of the many ways we position our students for success in the classroom and beyond. Our admissions and student services staff will be on hand to answer your questions. This is a great chance to speak with biodefense faculty, learn about some of the awesome classes our students get to take, and find out why we study health security threats from anthrax to Zika.

Winter 2018 Mid-Atlantic Microbiome Meetup Biodefense and Pathogen Detection
Don’t miss out on this January 10th event at the University of Maryland College Park. The University of Maryland Institute for Advanced Computer Studies (UMIACS) is hosting this regional conference next week, the Winter 2018 Mid-Atlantic Microbiome Meetup, with a focus on biodefense and pathogen detection. The workshop is a great way to learn about the latest in synthetic biology, biodefense, and pathogen detection. Several federal agencies are sending experts, and the conference will include a keynote talk from Tara O’Toole, executive vice president of In-Q-Tel.

Three Global Health Issues To Watch in 2018
What are the biggest stories health reporters are looking to follow this year? STAT polled their reporters and predicted that the three big stories in public health would be the final push to end polio, how the WHO will do with a new Director General amidst shaken confidence, and vulnerability to pandemics as we march into the centennial of the 1918 Pandemic. “This year marks the centenary of the Spanish Flu, the influenza pandemic of 1918, which killed somewhere between 50 million and 100 million people as the H1N1 flu virus swept the globe. Many of the people who died were in the prime of life. There are unsettling reports of people who were well at breakfast and dead by dinner. This uniquely fatal outbreak haunts influenza scientists and emergency response planners to this day. The latter know health systems don’t have the capacity to cope with the huge upsurges in illness that would accompany a major disease outbreak. A regular old bad flu season can severely tax hospitals. Those who worry about these issues will use the anniversary to focus attention on the risk of ‘the next Big One’.” What do you think the big pubic health topics will be this year? Tweet us @PandoraReport and we’ll report back on what the biodefense community is saying!

Three Children Hospitalized With Dengue Following Vaccination
Three Filipino children have been hospitalized with suspected dengue infections following their immunization with Dengvaxia, the latest Sanofi Pasteur dengue vaccine. “The hospitalizations come 1 month after Sanofi recommended Dengvaxia not be used in anyone who is dengue-naive. In recipients without previous dengue infections, the vaccine can lead to more severe illness.”

Stories You May Have Missed:

  • Raw Water” Trend Sparks Public Health Concern – This is both hysterical and deadly – a new Silicon Valley obsession with untreated and unfiltered “raw” water. “When food-safety expert Bill Marler saw The New York Times’ trend piece on Silicon Valley’s recent obsession with raw water, he thought he was reading a headline from The Onion. According to The Times, demand for unfiltered water is skyrocketing as tech-industry insiders develop a taste for water that hasn’t been treated, to prevent the spread of bacteria or other contaminants.”

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

Pandora Report 12.15.2017

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

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

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

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

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

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

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

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

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

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

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

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

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

Stories You May Have Missed:

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

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

Pandora Report 12.1.2017

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

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

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

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

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

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

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

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

Stories You May Have Missed:

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

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

Pandora Report 11.10.2017

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

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

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

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

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

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

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

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

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

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

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

Stories You May Have Missed:

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

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

Pandora Report 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.”