World At Risk
Late last year, a group of august legislators and thinkers submitted a report to the White House and Congress regarding weapons of mass destruction proliferation and terrorism. As one of the deliverables of the 9/11 Commission Act, this report was one that folks took notice of.
Okay, sure, Jimmy – yawn – another report by another Commission that sat around in gilded halls spouting off about things they know nothing about. Or maybe they took a junket or two and traveled around dangerous parts of the world outnumbered by bodyguards and munitions. Well, I don’t know anything about the bodyguards afforded them, but I thought it was pretty amazing that the hotel in Islamabad that the Commission members were to be staying in was destroyed by a terrorist’s bomb. They missed being casualties of that disaster by only a few hours. So, maybe the bodyguards were necessary.
The Commission on the Prevention of Weapons of Mass Destruction Proliferation and Terrorism, as they were called, produced the report, World At Risk, which contained 13 recommendations on subjects as diverse as the role of the US citizen in non-proliferation and terrorism and the implementation of a comprehensive policy toward Pakistan.
Of concern to us, though, is the first two recommendations. Listed as such, the Commission members thought that the most important problem facing us was, as they put it, biological proliferation and terrorism—basically what we talk about around these parts. That’s right, Dr. Clark, yet another high profile and highly placed group of risk thinkers feel that bioterrorism is a real threat; enough so to tell the President just that.
The report has been pulled into a quick little book (I got it for about $10), and I encourage you, if you’ve got money jangling around and a few spare minutes to pick up a copy. Today, though, I’d like to focus on those two recommendations that I mentioned above.
RECOMMENDATION 1: The United States should undertake a series of mutually reinforcing domestic measures to prevent bioterrorism: (1)conduct a comprehensive review of the domestic program to secure dangerous pathogens, (2) develop a national strategy for advancing bioforensic capabilities, (3) tighten government oversight of high-containment laboratories, (4) promote a culture of security awareness in the life sciences community, and (5) enhance the nation’s capabilities for rapid response to prevent biological attacks from inflicting mass casualties.
Some of the recommendations make complete sense and really don’t need to be expanded upon. The fact that the Commission feels it is important enough to mention that DHS should look at the Select Agent list is a bit disconcerting, as really, the list should be under constant review by folks from OHA and CDC. The bioforensics thing sounds cool, if anyone has any information on that subject—really just background stuff as I know nothing about it, please feel free to email me. We, and others, have talked about the disaster that is our bio-safety lab network before, so no need to rehash ongoing fights. I will admit, though, that I like the idea of bringing DHS into that process. The security culture thing is interesting, as I’ve worked a smidge in clinical research—nothing dangerous or even that interesting—and am familiar with the culture. I wonder how willing those professors would be to get full FBI background checks. The last one is dead simple, real effort has been made in responding to bio-attacks, but so much more needs to be done. Yet, preparedness is not something to be checked off. We won’t “achieve” preparedness; it’s a process, and one that we’re just getting started. And we’re falling further behind. Note that all public health preparedness funding, even for pandemic influenza was zeroed out in final version of the American Recovery and Reinvestment Act.
RECOMMENDATION 2: The United States should undertake a series of mutually reinforcing measures at the international level to prevent biological weapons proliferation and terrorism: (1) press for an international conference of countries with major biotechnology industries to promote biosecurity, (2) conduct a global assessment of biosecurity risks, (3) strengthen global disease surveillance networks, and (4) propose a new action plan for achieving universal adherence to and effective national implementation of the Biological Weapons Convention, for adoption at the next review conference in 2011.
While I like to toss a lot of blame around at the US government, the fact of the matter is that we live a much bigger world than we like to think. And not everyone outside of our borders is the Universal Adversary (a stupid term if I ever heard one; somebody has spent too much time war-gaming). This recommendation addresses that, and pandemic influenza.
The long and short of this recommendation is “COLLABORATE! Be a world citizen!” I think we’ll see the US moving towards this goal with the new Administration, and hopefully these things acted upon, except of course, the BWC, which Dr. Clarke informed me can be problematic. I’m excited about realization that a real globalized disease surveillance network is a need. We still have problems in the US with that, so you can imagine how difficult it would be to get China to release medical records regarding H5N1 outbreaks, even without the political BS. There are some novel ways that internet technology is being used to supplant the lack of buy-in from health ministries, but these are really just hacks. Until places like Indonesia (???) begin releasing flu sequences to the international community, we might not know if a pandemic strain of flu is spreading until it’s too late. Worldwide surveillance could allow us to target a response while the pandemic is still in its earliest, most easily controlled phase.
All in all, I think this is a valuable addition to the growing body of literature pointing out where are weaknesses are, in the hope that they are addressed. Now we just need the folks at the top to act.
Image credit: Commission on the Prevention of WMD Proliferation and Terrorism