Biological Threats: A Matter Of Balance
By Scientists Working Group on Biological and Chemical Weapons
Bulletin of the Atomic Scientists
2 February 2010
http://www.thebulletin.org/web-edition/op-eds/biological-threats-matter-of-balance
Article Highlights
* Last week, the Graham-Talent WMD Commission
asserted that a life-altering bioterrorist attack is
highly likely to take place within the next four
years. * As such, it called on the
to urgently expand its biodefense measures. * This
call, however, is misplaced. Instead,
should put greater focus on improving public health
capabilities applicable to all infectious disease threats.
The Graham-Talent WMD Commission asserted again last
week that a bioterrorism attack that "will fundamentally
change the character of life for the world's
democracies" is highly likely to occur within the next
four years. The commission argues that the
must urgently expand its efforts to develop vaccines and
other medical countermeasures against potential
bioterrorism agents.
We disagree with the commission on both points. It
exaggerates the bioterrorist threat and proposes
solutions that won't produce the comprehensive approach
needed to strengthen public health security.
The bioterrorist threat must be kept in perspective.
Although many fictional "tabletop" scenarios and
exercises have predicted bioterrorism catastrophes,
these scenarios often have used unrealistic values for
critical disease parameters and have routinely ignored
the organizational and technical difficulties that
terrorists would have in organizing, and successfully
carrying out, a bioweapons attack. The history of both
state-operated bioweapons programs and unsuccessful
terrorist attempts to develop and use such weapons
(e.g., the Japanese cult Aum Shinrikyo) have
demonstrated, again and again, the significant
difficulties that confront making and disseminating a
biological weapon. The 2001 anthrax letter attacks,
which were seen as validating the catastrophic
scenarios, appear to have been executed with anthrax
developed in a
capabilities vastly superior in scale and quality to
anything a terrorist could achieve.
Advances in the life sciences may gradually put
bioweapon capabilities closer within terrorist reach,
but scientific and technological progress alone doesn't
warrant exaggeration of the bioterrorist threat. Rather
than basing policy on worst-case scenarios, the United
States should develop and conduct more plausible,
sophisticated threat assessments that take into account
the complex set of political, social, and technical
factors that would affect bioweapons development and use.
Since the 2001 anthrax attacks, the federal government
has spent nearly $60 billion responding to the perceived
threat of bioterrorism. Roughly one-half of that money
has funded detection systems, dramatically expanded
research on bioweapon agents, and the development,
procurement, and stockpiling of vaccines and other
medical countermeasures against these agents.
As bioterrorism has commanded policy and funding
attention over the last decade, domestic influenza-
related deaths have likely exceed 300,000 people. The
growing problem of multi-drug resistant tuberculosis,
the lack of progress on reducing food-borne infections
and disease outbreaks, and annual
from AIDS (14,000 deaths) and opportunistic infections
such as MRSA (19,000 deaths) all speak to significant
ongoing public health needs. Policy and funding
decisions must be based on more than just mortality
statistics. For instance, government is expected to
respond effectively to acute disease outbreaks.
Nonetheless, these figures underscore that continuing to
emphasize and spend billions of dollars on measures to
specifically counter exaggerated bioterrorist threats
diverts attention and resources from other pressing
natural disease threats and public health concerns.
Moreover, all the money and effort spent on biodefense
hasn't produced demonstrably better overall health
security for the country. Detection systems remain
unreliable triggers for immediate responses. Expansion
of biodefense research has increased the number of
people with access to dangerous pathogens and toxins,
which increases the risk of accidents, infiltration by
outside groups, or attack by a rogue insider. Programs
to develop stockpiles of vaccines against bioweapon
agents continue to face questions relating to efficacy,
safety, shelf life, and timely distribution. Many other
bioweapon-specific countermeasures will be useless
against serious infectious disease problems, other acute
public health threats, or even bioterrorist attacks that
differ from the threat predicted. Despite promises of
broad-based "synergies," most of these efforts haven't
produced benefits for public health, as illustrated by
the problems experienced in the responses to pandemic
influenza A (H1N1).
Nonetheless, the Graham-Talent Commission wants
policy makers to continue down this questionable path
with more urgency, more money, and more intense focus on
bioterrorist threats. Such an approach will exacerbate
the political and funding gaps between defense against
bioterrorism and protection of the
naturally occurring infectious diseases. Strangely, the
Commission points to the H1N1 pandemic as evidence that
the
biodefense, when the proper conclusion to draw from the
troubles experienced with H1N1 is that
paying enough attention to public health capabilities in
its efforts to strengthen national health security.
Rather than continuing to argue, despite accumulated
evidence to the contrary, that bioterrorism-centric
policy and spending will produce meaningful and
sustainable positive "spillover" effects for public
health, a better, more comprehensive approach to
national health security would focus on improving public
health capabilities to respond to any kind of infectious
disease threat. As the recently released
Health Security Strategy states, "Investments should
focus, to the extent possible, on new technologies and
countermeasures that could also have uses in non-public
health emergency situations."
This more comprehensive approach would focus political
attention and fiscal resources on addressing important
public health and national health security needs,
including:
* Ensuring that the nation's public health system is
capable of addressing all public health needs,
including infectious disease outbreaks. Only by
ensuring adequate staffing and resources in all
program areas will the
sustainable public health system that can strengthen
individual resistance to disease, improve early
detection and treatment, and contain disease
outbreaks, whether natural, deliberate or accidental.
* Increasing support for the basic tools necessary
for public health surveillance and epidemiology,
including skilled personnel, public health
laboratories, and data collection, management,
analytic, and information-sharing systems. In this
respect, the roughly $15 billion in biodefense
spending to strengthen state and local public health
capacity and fund other public health efforts has
been important and needs to be maintained and even enhanced.
* Enhancing animal disease surveillance and response
capabilities and their integration with public
health systems, which would improve the ability to
rapidly detect and diagnose both animal and zoonotic
infections and disease outbreaks, whether natural or deliberate.
* Improving disaster preparedness and response
capabilities, especially medical surge capacity. The
capabilities needed to respond quickly and
effectively to an event that produces a large number
of casualties are similar whether the event is a
natural disease outbreak, a bioterrorism event, or a
natural disaster such as an earthquake or tsunami.
* Strengthening research on new diagnostics,
antibiotics, and antivirals for emerging or
established diseases that cause significant
mortality or morbidity. An ability to more rapidly
develop, test, and verify the safety of new vaccines
after an epidemic or pandemic is also important.
However, emergency-response strategies shouldn't
overly focus on vaccination because vaccines usually
need to be given prior to exposure. New vaccines
will continue to take time to produce, and
stockpiled vaccines are highly disease-specific
(often even strain-specific) and often have a
limited shelf life.
Public health in the
challenges; bioterrorism is just one. Policies need to
be crafted to respond to the full range of infectious
disease threats and critical public health challenges
rather than be disproportionately weighted in favor of
defense against an exaggerated threat of bioterrorism.
Nine years after the anthrax letters, we know better
than to expect narrowly construed biodefense policies to
produce comprehensive health security for the
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