As a founding director of the nation’s first bioterrorism preparedness program at the Centers for Disease Control and Prevention in 1999, Dr. Scott Lillibridge didn’t realize then what would emerge as the almost surreal scope of biothreats now challenging the United States.
But now he knows, said Lillibridge, director of the Center for Global Health and Innovation, as a panelist who spoke during an Oct. 9 panel meeting at the Hudson Institute in Washington, D.C., held by the Blue Ribbon Study Panel on Biodefense.
“We face different biological threats today than we understood in 1999,” Lillibridge said. “They are more complex, they are larger in scale, they are more global and strategic than we were thinking 20 years ago.”
“We were thinking about vulnerabilities, not specific agents,” said the medical doctor and former special assistant for national security and emergency management at the U.S. Department of Health and Human Services. “We weren’t thinking of national scope, synthetic biology, genetic sequencing, manipulation of resistance patterns, and so forth. This has gotten much more complex.”
Lillibridge, who experienced firsthand the anthrax events of 2001, addressed these and other future biological challenges during one of several panels held during Tuesday’s Blue Ribbon Study Panel on Biodefense meeting to review the state of biodefense. The Blue Ribbon panel also just released a new special report on biodefense preparedness at the local level.
“Most threats we face are global in nature,” said Lillibridge. “They’re emerging diseases in far-away places. They are nation-state actors. And we have this new phenomenon of manipulation of synthetic biology that can pop up virtually anywhere.”
To address such challenges, he said intermittent or one-year federal funding for biodefense “won’t do the trick.”
“This is a large-scale operation so five- or 10-year programs are going to be needed,” Lillibridge said.
He also thinks the federal government hasn’t sufficiently engaged with private industry on biodefense nor invested enough resources to attract the industry’s best and brightest to work for Uncle Sam. A hybrid of academia, private industry and other key stakeholders should be involved in the nation’s biodefense preparedness and response efforts.
“Many of these companies in the private sector … are multinational and have the vaccines and antidotes and countermeasures we need,” Lillibridge told the Blue Ribbon panel members. “The key is we need the political will and sufficient funding to get them involved.”
Members of the Blue Ribbon Study Panel on Biodefense agreed with that assessment.
“I don’t think we’ve done anywhere near the amount of work necessary to create the medical understanding, the psychological understanding, and maybe even the genetic understanding of what happens to people who are exposed,” said Blue Ribbon Study Panel member Tom Daschle, a former majority leader in the U.S. Senate.
“This is not something that’s history; this is happening now,” Daschle said, referring to recent bioterrorism and naturally occurring biothreat events. “And our ability to deal with the issues of those who are exposed, need more research.”
That costs money. And although billions have been authorized by Congress during the last decade, he said, more federal funds are needed. “While there’s no opposition to that idea,” added Daschle, “there’s no energy to propel it forward. We need a champion.”
Former U.S. Sen. Joseph Lieberman, co-chairman of the Blue Ribbon Study Panel on Biodefense, noted that the recently released national biodefense strategy by the Trump administration took “a while longer than we hoped,” but is a strong document and a significant step forward that the panel would like to build on.
A bioterrorism attack is coming, Lieberman added, and so too is another infectious disease pandemic, “but we don’t know when, even though we can say with reasonable certainty that both awful events will occur.”
“We have a tendency in this country to react to things after they occur,” said Blue Ribbon panel co-chairman Tom Ridge, former governor of Pennsylvania.
The anthrax attack 17 years ago on Capitol Hill, for instance, found the federal government semi-prepared. “That incident shook up the nation,” which learned it could have done a better job in preparing to respond to such bioterrorism, Ridge said.
“The bottom line is we don’t think we’re ready,” Lieberman said. “We have to get ahead of the threat rather than be reactionary.”
Hence, the title of Tuesday’s meeting by the Blue Ribbon Study Panel on Biodefense meeting — Fits and Starts: Reactionary Biodefense, he said.
Ironically, the global response to the deadly Ebola virus in the Democratic Republic of Congo has been just that.
Two days ago, the World Health Organization reported that the Ebola virus disease has sickened 188 people and killed 118 in the northeastern region of the Democratic Republic of Congo. Lillibridge noted that Ebola continues to spread in what is considered a conflict zone, making it nearly impossible for the U.S. to sufficiently access the stricken population there.
“It’s the harbinger of a perfect storm,” he said.
The national security of the U.S. has a vested interest in containing the virus in Africa, but the U.S. lacks a coordinated team, a central structure to meet such biodefense goals, Lillibridge said. And while leadership on the issue is needed, he thinks the solution is organization rather than whomever mans it.
Building and funding the proper organization, said Lillibridge, is critical. He noted that such an organization should be “more corporate and scientific in origin rather than civil service or military. It needs to run on an informational background like Amazon, IBM or Microsoft, that’s capable of computational biology or artificial intelligence, that’s also able to use blockchain technology.”
The size and scope of the organization also needs “to be more like the Manhattan Project rather than a small program in a discreet agency or department; it should be over-arching,” he said.
A step toward making a difference, said Lillibridge, would be to consolidate biodefense budgets across all federal agencies and departments, which he thinks would resolve 90 percent of the country’s coordination issues. “You can’t build the pizza if you hand out the slices,” he said, referring to the government’s disparate biodefense budgets and operations.
Lillibridge also suggested that the United States take a second look at revitalizing components of the United Nations. “We need more neutral ways to get into regions of the world,” he said.
In the Democratic Republic of Congo, for instance, the UN is supervising the overall response to the Ebola crisis, the first time Lillibridge said he’s seen it become operational. U.S. investment in such responses would benefit the nation, he said.
The current Ebola outbreak harkens back to the anthrax attack in the nation’s capital, said Daschle, who pointed out that “people died and became seriously ill back in 2001, but the biological threat is obviously still with us.”
Daschle said that his “mounting frustration over the inaction in Washington on this issue” is one of the reasons he decided to serve on the bipartisan Blue Ribbon Study Panel on Biodefense.
“Today’s intelligence reports confirm that there are nation-states and terrorist organizations who are actively seeking to weaponize biological agents and attack the United States and its interests overseas,” said Daschle. “The biological threat is real. Despite this fact, we have done far too little to coordinate our response and take meaningful action.”