Introduction
This report summarizes discussions held during a workshop hosted by the Council on Strategic Risks (CSR) on September 26, 2022, focused on ending extreme risks from biological threats. For several years, CSR has convened diverse experts who agree that it is more feasible than ever to halt the spread of infectious disease threats from all sources before they cause significant damage. After several years of virtual discussions during the heights of the COVID-19 pandemic, this in-person, invitation-only event brought together experts from government, academia, industry, and non-profit organizations to discuss how to use technological advances, policy, and other tools to gauge progress, identify open questions and ongoing challenges, and think strategically about what steps must be done next.
Conversations and panels held during “The Summit on Ending Biological Threats” were held under the Chatham House Rule. This report does not represent consensus among participants, nor does it assign specific perspectives to any individual participant. Though many topics were covered throughout the Summit, conversation centered around a few core subject areas: pathogen early warning, public-private collaboration, interagency efforts and collaboration, and strategic communications. This summary report will discuss these central topics and provide a general overview of discussions.
Key Takeaways
This summarizing section captures some of the most important themes, open questions, and opportunities that emerged from the Summit. While much of the material discussed during the Summit has previously been covered extensively by CSR, this section highlights some of the most novel and important ideas and questions that were discussed.
Themes
- Most policymakers and private actors now agree that creating an effective pathogen early warning and response system will enable the global community to prevent naturally emerging and deliberate biological threats from causing mass casualties. Experts have moved beyond debating this vision, and are now focusing more and more on key implementation issues, such as data integration, translating data into action, building political will for sustained funding, and international coordination.
- Pandemic prevention is increasingly seen as a national security issue, which is a promising trend. The presence of National Security Advisor Jake Sullivan at recent bio-related events suggests better integration and a clear recognition of the threat.
- Throughout the COVID-19 pandemic, there has been impressive innovation in biosurveillance efforts, including K-12 school testing, airport testing, and wastewater epidemiology. While continuing to advance technological solutions, it is important to continually improve routine elements of pandemic response—including developing better administrative tools, methods of shoring up the supply chain, and streamlining processes for clinical trials.
- The CDC is making progress in addressing some of the shortcomings that the COVID-19 pandemic exposed. For instance, the agency has shared mpox virus data and technical reports far quicker than it shared similar information about COVID-19. Additionally, the current director has drawn attention to the need to expand CDC’s authorities to quickly deploy experts for on-the-ground responses.. There has also been discussion of how to increase reporting of local data to the CDC to improve situational awareness and disease tracking.
- Currently, biodefense-oriented companies face unreasonable expectations to develop products with both national security and commercial utility, which is not the case for many other defense technologies (e.g., missile defense systems). Security leaders need to understand that this challenge can be addressed like it has with regard to other technology areas and adjust how defense agencies work with companies and academic labs to promote development of biodefense technologies.
- Building sufficient political will is going to be essential to enable continuous funding. For pathogen early warning, for example, it is very challenging to spin surveillance efforts up and down at will—systems must be kept up and running between threats, which necessitates sustained funding.
- Vaccine and medical countermeasure diplomacy will be key avenues to enhancing international trust, which in turn may make countries more likely to quickly report outbreaks without fear of blame.
Open Questions
- Some experts believe that advanced disease early warning coupled with rapid travel restrictions (i.e., shutting down travel and border crossings) can help quash outbreaks before they reach epidemic or pandemic scale. Others strongly disagree, and worry that this punishes nations for openly sharing outbreak-related data.
- To ease public-private cooperation, some participants suggested that there be a central location for coordinating the contracting of biosecurity work, though there was disagreement over whether this hub should be located within the Department of Defense (DoD) or the Department of Health and Human Services (HHS). Others suggested that centralizing contracting doesn’t make sense for an issue set as broad as biosecurity.
- There is currently no consensus on the point at which a warning signal in an early warning system would be sufficient to elicit a response, though this will differ based on specific disease threats and the locations and contexts in which they arise. The fear of a false positive from an early warning system setting off an unnecessary and expensive response is difficult to contend with—the political cost of restrictive lockdowns with few visible illnesses would be severe. Even if early warning systems are successfully developed, choosing benchmarks for action will be a major challenge.
- There was some disagreement among participants over whether to prioritize preventing the most likely biological threats or the most catastrophic biological threats. While there is much overlap, some types of early warning capabilities being developed may not be sufficient to fully protect against a catastrophic biological event. Some participants expressed concern that even leading experts in biosecurity have not fully recognized the scale of damage that a deliberate biological attack could cause.
Opportunities & Recommendations
- Creating a Congressional community of practice dedicated to biosecurity would help ensure more legislative commitment to combating biological threats. To start this process, think tanks, industry leaders, and academics should commit to educating Members of Congress and Congressional staffers on the urgency of biosecurity and work to build a bipartisan coalition.
- Building on the models created to address COVID-19, develop future school testing programs that test for many pathogens at once and potentially extend this to other types of organizations that serve as major collection points.
- UV-C lights—which kill airborne pathogens but are safe for humans—are a promising pathogen-agnostic technology to deploy over the coming years and an example of leveraging existing but less traditional tools for quelling outbreaks.
- Implementing International Classification of Diseases (ICD) codes for animal deaths would be useful for electronically tracking patterns and detecting anomalies, and could serve as a useful input for early warning systems. Additionally, expanding veterinary insurance may help incentivize reporting of deaths and illnesses in livestock.
- For some diseases (e.g., Zika), there are not enough infections to conduct traditional clinical trials despite the potential scale of effects. For these pathogens, human challenge trials may be a useful path. In these trials, healthy people who are not at serious risk volunteer to be deliberately infected and treated. The advancement of countermeasure options resulting from these trials has the potential to save lives and prevent serious illnesses.
- Governmental offices should prioritize hiring individuals who have private sector experience, and should consider implementing programs in which private sector individuals can spend a year or two working on rotation in government.
- Communications experts should be present in the room throughout the policy-making process. Understanding how people will respond to and interpret policy is just as important as getting the science right.
- Non-governmental organizations (NGOs) should be leveraged as a source of innovative messaging techniques, as these methods may help advance public health communication goals.
- The U.S. government should focus more attention on leveraging technologies developed outside of the United States. By focusing solely on domestic technology, the United States is missing out on a great deal of innovation.