Congress needs to act now to prevent another biodisaster like anthrax, Zika
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In December, the president signed into law the 2017 National Defense Authorization Act (NDAA). Each year, the NDAA authorizes activities at the Department of Defense and for other national defense programs. Tucked among the nearly 1,000 pages of this year’s bill is a critical provision that implements a major recommendation of the bipartisan Blue Ribbon Study Panel on Biodefense: the development of a strategy and implementation plan for national biodefense.

In September 2001, letters containing anthrax spores were mailed via post to federal offices and news outlets; in addition to their intended targets, they contaminated postal facilities and private homes along their way. Twenty-two people contracted anthrax, and five of them died.

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The extraordinary events that fall, which included the closure of contaminated House and Senate office buildings, the preventive administration of antibiotics to 10,000 people, and a years-long criminal investigation stymied by insufficient microbial bioforensics science, revealed weaknesses in our national capacity for handling major biological events.

 

A flood of legislative and policy activity in the decade hence put in place statutes, programs and policies designed to support prevention, detection, mitigation, response and recovery from biological disasters. Billions of national security dollars were spent on programs for biosurveillance, medical countermeasures, forensics, hospital preparedness, and many others.

There is no question that we are better prepared today than we were in 2001. Yet the emergence of the Ebola and Zika viruses a little more than a decade later startled lawmakers into the knowledge that we are still structurally and legislatively underprepared for biothreats. 

Bio-intelligence failures, inadequate guidance to hospitals, a well-intentioned but inadequate global response capability, and political wrangling over where to find money: these outbreaks revealed cracks — fissures even — in our capability level. 

The Blue Ribbon Study Panel assessed that one of the major drivers of this is a lack of centralized biodefense leadership, along with a fragmented proliferation of strategies, laws and programs implemented across some dozen agencies.

The panel’s foremost recommendations were to institutionalize White House biodefense leadership over this policy area and for that leadership to drive the consolidation and updating of a comprehensive national strategy for biothreats. The NDAA brings us a step closer to achieving this goal.

The NDAA requires the secretaries of Defense, Health and Human Services, Homeland Security, and Agriculture to jointly develop a strategy and implementation plan that includes: 

  • a full inventory of all interagency activities related to biodefense;
  • a description of the biological threats we face, including intentional, emerging and accidental exposure to pathogens;
  • a description of current efforts and authorities to prevent these threats;
  • a full accounting of the roles and responsibilities across executive agencies;
  • an articulation of the interagency activities required to do defend against biological threats; and
  • recommendations for improving biodefense capabilities, authorities and coordination nationally.

The legislation requires submission of a report to Congress within 275 days of the enactment of the law, with briefings to the relevant committees no later than March 1, 2017, and annually through 2019.

This law undoubtedly puts pressure on an incoming administration and Cabinet with many competing priorities; however, nature and terrorists continually remind us that when it comes to biodefense, these actions cannot be delayed.

Anthrax, Ebola and Zika are the highest profile bio-incidents in the United States this new century; it is only a matter of time before we are confronted with an event whose impact exceeds the relatively limited effects of these events on the homeland. Animal threats like highly pathogenic avian influenza and foot-and-mouth disease further demonstrate that biothreats are not isolated to human populations, and a whole of government strategy is needed to address them.

A strategy is but one element of what is needed to protect Americans from biological threats. First, a full capabilities gap analysis is requisite, and the Office of Science and Technology Policy has taken the initial step toward this assessment. It is up to the new Congress and new administration — along with partners from the private sector and other levels of government — to address those gaps through the strategy and implementation plan the NDAA now requires. 

To achieve the intent of this law and the vision of the Blue Ribbon Study Panel, the strategy and implementation plan must be developed with input from across the interagency, from other levels of government, and from the private and academic sectors where the capacity for innovation is strongest. It must also be tied to a strategic biodefense budgeting process and clear authorities to translate it into meaningful and sustainable action.

For the new administration and Congress, the NDAA provides an opportunity for a fresh look at our biodefense challenges. It can serve as a catalyst for a clear roadmap for interagency collaboration as well as better leveraging of the private sector, where most of our innovations and technological solutions will come from.

We should all pay close attention to the report that comes from this legislation and the briefings that that accompany this process. Congress and the new administration have an opportunity to accomplish what other administrations have been striving to do: to create a comprehensive national biodefense system that harnesses private sector ingenuity and government leadership to protect all Americans from 21st Century biothreats.

 

Jeff Schlegelmilch, MPH, MBA, (@jeffschlegel) is the deputy director of the National Center for Disaster Preparedness at Columbia University’s Earth Institute (@columbia_ncdp). He has served as a local public health planner and an epidemiologist as well as a consultant to local, state and federal health agencies. He has developed and evaluated numerous programs related to biodefense including those related to bioterrorism detection systems, countermeasures distribution programs, and interagency epidemiological modeling processes. 

Ellen P. Carlin, DVM, is senior health and policy adviser for EcoHealth Alliance (@EcoHealthNYC). She supports science and policy programs there that advance the ecological health mission of the organization, including co-directing the Blue Ribbon Study Panel on Biodefense (@BiodefenseStudy). She handled the biodefense and medical preparedness portfolios for the House Committee on Homeland Security for more than five years. She is an adjunct research scientist with the National Center for Disaster Preparedness, and also practices small animal clinical medicine.

 


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