December 13, 2022: Pathogen early warning systems to quickly detect and stop the transmission of infectious diseases have advanced significantly over the past few decades—a trend that is accelerating in response to the global COVID-19 pandemic. However, as described in Pathogen Early Warning: A Progress Report & Path Forward, a report released today by the Janne E. Nolan Center at the Council on Strategic Risks (CSR), progress has been strong but remains insufficient for preventing future pandemics, ensuring accidental releases do not trigger major outbreaks, and addressing biological weapons threats. 

In this report, a team of experts recommend that the U.S. government significantly ramp up efforts to enact recent biodefense policy improvements that will advance early warning, including by the following steps:

• The U.S. government must pursue a clear strategy to maximize the Centers for Disease Control and Prevention’s newly-launched Center for Forecasting and Outbreak Analytics, including finalizing plans for how the new center will engage with other government agencies.
• The Department of Defense (DoD) should also pursue and implement a full strategy for advancing its early warning capabilities, including by starting to deploy advanced and pathogen-agnostic systems at high-risk bases and other sites with unique vulnerabilities or continuity-of-operations roles.  

The U.S. government has taken the critical first steps with major policy and institutional advancements over the past year to address deficiencies through a recently-updated National Biodefense Strategy & Implementation Guide, National Security Memorandum -15, and the first annual review of the American Pandemic Prevention Plan. These policies make many specific improvements to U.S. policy, including requiring new annual reporting on investments in early warning and other biosecurity-related capabilities.

However, “Strategies without major resources are illusions,” notes Hon. Andy Weber, CSR Senior Fellow and former Assistant Secretary of Defense for Nuclear, Chemical, and Biological Defense Programs. “In this report, we urge the U.S. President to include major new funding for pathogen early warning in the next budget requests, and the new Congress to support them. We have called on the U.S. government to launch a ten plus ten over ten investment strategy to accelerate and ensure success: an average of $10 billion per year for infectious disease-focused public health and global health security plus $10 billion annually in biodefense investments for the Department of Defense and other security agencies, each sustained for a decade. The world will be a better and safer place if we take bold action.”

In addition to providing recommendations, the report, authored by a team with extensive experience in national security, public health, and laboratory sciences, describes characteristics of ideal early warning systems in order to guide future investments. It also aims to update public understanding of contemporary biosurveillance and pathogen early warning capabilities in the United States government, select regions worldwide, and ongoing efforts towards global pathogen early warning integration—in particular highlighting how public health and biodefense efforts must still come together and the potential benefits that will bring. 

As described by CSR Senior Fellow Dr. Saskia Popescu, who has deep experience in biopreparedness and infectious disease control, “The evolving nature of SARS-CoV-2 has emphasized the importance of not only early warning systems, but that such efforts must be agile, robust, and effectively feed into decision-making. The progress in early warning systems reflects this, but also that we have much work to do in building resilient and responsive biosurveillance efforts. In particular, governments and international institutions need to develop a wider set of pathogen-agnostic tools designed to detect any potential novel or deliberate threat.” The report includes multiple additional details regarding work that remains to be pursued or expanded, for example: 

• Many biosurveillance and early warning efforts lack the resources necessary to be sustainable over the long term. Indeed, some existing capacities may see reduced or halted operations if new funding streams do not arise soon. 
• The absence of a standardized approach to assessing the quality of early-warning systems and biosurveillance coverage.
• Affluent states should extend existing partnerships and develop new programs designed to bolster biosurveillance efforts in resource-limited and remote settings across the globe.

Although these gaps are significant, genuine pathogen early warning systems are not out of reach, and many of the necessary digital and technical tools are already available and beginning to be used. “New ventures at HHS and CDC, such as the Center for Forecasting and Outbreak Analytics, have great potential to enhance U.S. pathogen early warning capabilities if leveraged correctly,” notes Lillian Parr, a co-author of the report and Fellow at CSR.

Now is the time to act in leveraging technologies available today to create the early warning systems the world needs. Infectious disease burdens are not letting up: In the third year of the COVID-19 pandemic, cases of Ebola Sudan are spread in Uganda, the world faces an unprecedented monkeypox (or mpox) outbreak, and diseases such as measles and polio are reemerging. In addition, Russia’s invasion of Ukraine has brought the continuing risk of biological weapons being used back to the fore.  

Dr. Daniel Regan, Fellow at the Janne E. Nolan Center and one of the report authors, noted: “While biodefense policies have progressed over the last year, significant action towards reducing biological risks is at a critical juncture in which it is dangerously close to falling victim to the boom-and-bust cycles of the past. This report offers recommendations on key policies and capabilities to bolster biosurveillance and advance pathogen early warning systems for the modern biological threat landscape.” 

The ability to rapidly detect outbreaks of high consequence pathogens or monitor the emergence of novel variants, such as SARS-CoV-2 Omicron, has improved but is still woefully behind the needs of a responsive and proactive public health infrastructure. There are, however, clear paths to start working on these opportunities for improvement and better response through early warning. With attention on naturally-occurring infectious threats, but also the need for stronger verification and confidence building efforts within the Biological Weapons Convention, there is momentum for such efforts.

In particular, the U.S. Department of Defense (DoD) is expected to soon release its first-ever Biodefense Posture Review. With this effort, “DoD should ensure that its biosurveillance activities and agencies are optimally organized, integrated, and attached to its technology development planning to ensure it provides leaders with timely threat assessments from a variety of sources and evolves ahead of threats,” notes Christine Parthemore, CSR’s CEO and former Pentagon official during an earlier surge in DoD’s early warning efforts, including expansion of its biosurveillance partnership programs in East and Central Asia. “DoD must reverse the decline in resources toward biodefense that it has experienced for years, including a major surge in advancing early warning at U.S. bases and with partners around the world. Early warning has long been a cornerstone of its global biodefense relationships, and it is crucial to reinvigorate this now.”       

This report also highlights the capacity for partnerships across governments, agencies, and the private sector, where labs can serve as a bridge. CSR is releasing this report at a critical juncture for national and international biosecurity efforts. Fatigue from COVID-19 and decreasing interest in biological threat reduction pose a real threat to global efforts to address the outbreaks of today and the dangers of tomorrow.  It is critical now more than ever to invest in robust early warning systems and global partnerships that can help prevent and respond to biological threats regardless of origin. 

As an independent nonprofit, CSR will continue its work to support and encourage stakeholders as they consider the guidance offered throughout this report, and help fill the gaps in efforts to chart actionable steps forward. 

Direct inquiries to: Andrew Facini, afacini@csrisks.org