Biodefense

From the Executive Summary: "The COVID-19 [coronavirus disease 2019] pandemic is a stark wake-up call for the United States to take biological threats seriously. The virus has taken the lives of more than 400,000 Americans and cost our economy trillions of dollars in just a year. The risks of future pandemics are increasing as technological progress eases barriers to modifying pathogens, raising the specter of novel biological agents causing diseases much worse than humanity has ever faced. Meanwhile, U.S. vulnerabilities to biological attacks have never been clearer to our adversaries. However, there is a path forward. 'The Apollo Program for Biodefense' would provide the United States the opportunity to mobilize the nation and lead the world to meet these challenges: a world where we detect and continually trace any new pathogen from the source; where we can distribute rapid point-of-person tests to every household in the country within days of that detection; where effective treatments are already in-hand; where vaccine development and rollout occur in weeks rather than years; and where pandemics will never again threaten the lives and livelihoods of Americans and people around the world."

From the Executive Summary: "The exploitation of wildlife through hunting and trade facilitates opportunities for animal-human interactions and zoonotic disease transmission. Furthermore, advances in DNA sequencing, gene-editing, and synthetic biology (among others) hold the promise of profound advances in healthcare, crop and environmental sustainability, and economic growth. Unfortunately, these are dual-use technologies that could yield accidental, unintended, and deliberate misuse by creating deadly pathogens or disrupting ecological balances. [...] 'The Athena Agenda: Advancing The Apollo Program for Biodefense' contains additional recommendations to execute The Apollo Program, building on the Commission's previous work and taking into consideration the efforts of current and former Administrations and Congresses. This report provides the following specific governance and technology recommendations to implement The Apollo Program for Biodefense and identifies the US government organizations responsible for leadership and accountability, though certain actions may require or benefit from public-private partnerships."

From the Highlights: "The COVID-19 [coronavirus disease 2019] pandemic shows how catastrophic biological incidents can cause substantial loss of life, economic damage, and require a whole-of-nation response involving multiple federal and nonfederal entities. The 2018 National Biodefense Strategy outlines specific goals and objectives to help prepare for and respond to such incidents. The CARES [Coronavirus Aid, Relief, and Economic Security Act] Act includes a provision for GAO [Government Accountability Office] to conduct monitoring and oversight of federal efforts to prepare for, respond to, and recover from COVID-19. This report addresses: (1) interagency plans key federal agencies developed, and exercises they conducted, to help prepare for biological incidents; and (2) the extent to which exercises and real-world incidents revealed opportunities to better achieve National Biodefense Strategy objectives. GAO reviewed biological incident plans and after-action reports from exercises and real-world incidents from calendar years 2009 through 2019, including a non-generalizable sample of 19 reports selected based on threat scenario and other factors. GAO interviewed federal and state officials to obtain their perspectives on plans, exercises, and the COVID-19 response."

From the Highlights: "Early detection of a biological attack can help reduce illness and loss of life, but DHS has faced challenges in acquiring biodetection capabilities to replace BioWatch, the current system used to detect aerosolized biological attacks. According to DHS, it is exploring the use of a new anomaly detection capability that, if developed successfully, could reduce the time to detection. GAO [Government Accountability Office] was asked to examine the BD21 [Biological Detection for the 21st Century] acquisition and assess technical maturity. This report (1) describes BD21 and the extent to which the program has followed DHS's acquisition policy, and (2) examines potential technical challenges to successful BD21 development, and actions to mitigate acquisition risks."

From the Highlights: "Biological threats, such as the COVID-19 [coronavirus disease 2019] pandemic, can cause catastrophic loss of life and damage to the economy. The 2018 National Biodefense Strategy outlines goals and objectives to help prepare for and respond to such threats. However, DHS has long faced challenges implementing its biodefense responsibilities, including acquiring biodetection capabilities. This statement discusses GAO [Government Accountability Office] reports issued from December 2009 through August 2021 on efforts to implement the National Biodefense Strategy and strengthen biodefense preparedness, as well as ongoing challenges to DHS's biosurveillance and biodetection efforts. The statement also includes recommendation follow-up work conducted through January 2022."

From the Recommendations: "The United States is just beginning to identify key lessons learned from the COVID-19 [coronavirus disease 2019] pandemic as they relate to strengths and gaps in our country's disaster preparedness and response system, which are of central concern to ASPR [Office of the Assistant Secretary for Preparedness and Response], HHS [Department of Health and Human Services], and the country as a whole. One overarching lesson that is abundantly clear and of pressing importance from the perspective of the NBSB [National Biodefense Science Board] is the need to ensure that the United States is always prepared to implement an immediate, effective, and coordinated public health response 'that is guided by scientific knowledge and protected from undue political influence.' Similar to the Congressional Budget Office or the Federal Reserve Bank, HHS should consider how to develop a centralized, core public health emergency communication and coordination function that is inherently insulated from political considerations, with the ability to independently develop, directly distribute, and frequently update public health messages with scientific principles in mind, guided by analysis of available data, with inputs from the nation's leading experts. [This document includes] more specific recommendations to enhance the country's disaster preparedness and response."

"It is a vital interest of the United States to manage the risk of biological incidents. In today's interconnected world, biological incidents have the potential to cost thousands of American lives, cause significant anxiety, and greatly impact travel and trade. [...] Biological threats--whether naturally occurring, accidental, or deliberate in origin--are among the most serious threats facing the United States and the international community. [...] Health security means taking care of the American people in the face of biological threats to our homeland and to our interests abroad. [...] The health of the American people depends on our ability to stem infectious disease outbreaks at their source, wherever and however they occur. America's biodefense enterprise needs to be nimble enough to address emerging infectious disease threats, the risks associated with the accelerating pace of biotechnology, and threats posed by terrorist groups or adversaries seeking to use biological weapons. [...] This National Biodefense Strategy highlights the President's commitment to protect the American people and our way of life, laying out a clear pathway and set of objectives to effectively counter threats from naturally occurring, accidental, and deliberate biological events. It is broader than a Federal Government strategy. It is a call to action for state, local, territorial, and tribal (SLTT) entities, other governments, practitioners, physicians, scientists, educators, and industry."

"The 2019-2022 NHSS [National Health Security Strategy] is focused on three overarching objectives. As health security threats continue to emerge and evolve, these objectives are intended to be flexible and adaptable. 1. Prepare, mobilize, and coordinate the Whole-of-Government to bring the full spectrum of federal medical and public health capabilities to support SLTT [state, local, tribal, and territorial] authorities in the event of a public health emergency, disaster, or attack. [...] 2. Protect the nation from the health effects of emerging and pandemic infectious diseases and chemical, biological, radiological, and nuclear (CBRN) threats. [...] 3. Leverage the capabilities of the private sector."