Fighting Bioterrorism

The White House is promising to take steps to better protect the nation against bioterrorism, such as the deliberate release of deadly anthrax or the smallpox virus, and to be better prepared to handle public heath emergencies.

“We are launching a new initiative that will give us the capacity to respond faster and more effectively to bioterrorism or an infectious disease—a plan that will counter threats at home and strengthen public health abroad,” President Barack Obama said in his State of the Union address last month.

The speech contained no further details of the initiative, but the White House issued a statement saying that medical contingency plans would be redesigned to ensure the rapid delivery of vaccines and other antidotes in the event of a successful bioterror attack. The strategy would use economic incentives to entice the pharmaceutical and biotechnology industries to develop biodefense medicines.

The U.S. has sought to bolster its capacity to respond to biological attacks since 2001, when anthrax-laced letters were mailed to people across the country. Five people died after exposure to the bacteria and 17 others became ill.

Obama’s pledge came a day after a bipartisan congressional panel concluded that more than eight years after the anthrax attacks, the U.S. is still “woefully unprepared” for a bioterror attack (C&EN, Feb. 1, page 24). The White House strongly disagreed with the assessment.

The Commission on the Prevention of Weapons of Mass Destruction, Proliferation & Terrorism, a panel established by Congress in 2007 to assess the U.S.’s readiness to respond to a terror threat, said in a “report card” that the government’s slow response to the H1N1 flu epidemic last year was evidence of a lack of preparedness for a large-scale crisis.

“With H1N1, we knew it was coming. We had about six months’ notice. If this is a terrorist attack—or most of the forms of natural attack—we aren’t going to have six months’ notice,” former Sen. Bob Graham (D-Fla.), chairman of the commission, remarked at a press conference in Washington, D.C., on Jan. 26.

In its initial report in December 2008, the commission warned that terrorists “more likely than not” will unleash a weapon of mass destruction somewhere in the world by the end of 2013 unless countries take “decisive and urgent” action (C&EN, Dec. 8, 2008, page 6). The analysis found that of all WMD, biological weapons pose the greatest threat because of the widespread availability of deadly pathogens.

The commission also identified a series of recommendations and specific actions that Congress and the Administration should take to change the trajectory of risk.

In an interim report in October 2009, the panel said the White House was making a substantial effort to address concerns about the proliferation of nuclear weapons but concluded that the U.S. still wasn’t prepared for a biological strike (C&EN, Nov. 2, 2009, page 22).

The commission’s final assessment, which measured the government’s performance in 17 areas, gave the Obama team and Congress a grade of F for failing to build a rapid-response capability to deal with bioterror threats.

“Each of the last three Administrations has been slow to recognize and respond to the biothreat,” Graham said. “But we no longer have the luxury of a slow learning curve when we know al-Qaeda is interested in bioweapons.”

Graham said that if al-Qaeda were to recruit skilled bioscientists, the terrorist organization would acquire the capability to develop and use biological weapons. The opportunity to acquire and use WMD is growing exponentially, he noted, because of the global proliferation of nuclear material and biological technologies.

“Al-Qaeda will no doubt look to where it can accomplish its objectives: chaos, mass panic, high level of deaths. And it will use those weapons against targets that it considers to be the least well prepared,” Graham declared.

The commission’s vice chairman, former Sen. Jim Talent (R-Mo.), added that there is ample intelligence showing that “the terrorists are actively trying” to obtain WMD.

“Anybody who studies this will tell you that we are basically nowhere in bioweapons preparation,” Talent said. “Our concern is that this is like Russian roulette—eventually that bullet’s in the chamber.”

The commission’s report was issued a day after a separate study warned that al-Qaeda is pursuing technology to conduct a biological, chemical, or even nuclear attack against the U.S. That study, released on Jan. 25 by Harvard University’s Belfer Center for Science & International Affairs, said al-Qaeda’s “top WMD priority has been to acquire nuclear and strategic biological weapons.”

The 19-page report by the Graham-Talent panel says the U.S. lacks the technical and operational capabilities required for an “adequate” response to a bioterror attack. “Especially troubling is the lack of priority given to the development of medical countermeasures—the vaccines and medicines that would be required to mitigate the consequences of an attack,” the report asserts.

“We don’t have in place the mechanisms which will tell us an attack has occurred,” Talent said. “We don’t have plans for surge capabilities. We don’t have stockpiles. There’s just not enough being done on a consistent and urgent basis.”

Talent said no one in the Obama Administration has taken the lead in protecting the country against bioterrorism. “It isn’t that there isn’t a desire to do this. It’s just that the way we’ve set this up, it just constantly gets pushed to a lower priority. And that’s what’s so frustrating,” he remarked.

The commission also gave the government low marks for failing to recruit a new generation of national security experts and for failing to improve congressional oversight of intelligence and homeland security agencies.

The Department of Homeland Security “can’t do its job if it is responding to more than 80 congressional committees and subcommittees,” Talent said. “This fragmentation guarantees that much of what Congress does is duplicative and disjointed.”

In addition, the government needs to tighten its oversight of high-containment laboratories, where researchers work to develop countermeasures to the most dangerous biological agents. “There are too many agencies at the federal, state, and local levels that regulate pathogens, in sometimes conflicting ways,” the report says.

The White House dismissed the commission’s criticisms and insisted that much progress has been made in the past year to protect the U.S. from biological threats.

“Since coming to office, the Obama Administration has undertaken a comprehensive review of our national preparedness policy, including an evaluation of how to best integrate planning at all levels of government and build the key capabilities needed,” White House spokesman Nick Shapiro said in a statement.

He noted that in November 2009, the Administration rolled out a national strategy to counter biological threats and has taken “significant steps to enhance the nation’s capabilities for rapid response to prevent biological attacks from inflicting mass casualties.”

Shapiro cited an executive order signed by Obama on Dec. 30, 2009, that establishes a “federal capability to rapidly provide medical countermeasures to supplement state and local response in the event of a large-scale biological attack.”

The order directs government agencies, local law enforcement, and the U.S. Postal Service to work on a model for drug distribution in the wake of an attack. “The U.S. Postal Service has the capacity for rapid residential delivery of medical countermeasures for self-administration across all communities in the U.S.,” the order says.

Shapiro acknowledged that despite years of effort, the government’s approach to developing antidotes against emerging pandemics and biological threats “has not produced the results we demand.”

“Our results reflect in part the state of the pharmaceutical industry as a whole,” he said. “As a nation, we are spending more time and money in research and development of pharmaceuticals, but fewer licensed products are emerging from the pipeline.”

The President’s new initiative is aimed at responding “faster and more effectively” to public health threats, including bioterrorism, Shapiro said. The goal, he added, is to enhance the U.S.’s ability to produce vaccines and other antidotes that could be distributed to save lives in the case of another pandemic flu, anthrax attack, or other crisis.

The U.S. has not been able to successfully develop, license, and acquire the countermeasures it needs against threats such as anthrax and smallpox because market forces drive private industry toward more profitable products, Shapiro explained.

“Our new approach will turn this around. We will pursue a business model that leverages market forces and reduces risk to attract pharmaceutical and biotechnology industry collaboration with the U.S. government,” he said.

The Department of Health & Human Services has taken a first step by initiating a review of medical countermeasure development and procurement efforts. “We want to have more promising discoveries, more advanced development, more robust manufacturing, better stockpiling, and more effective distribution practices,” HHS Secretary Kathleen Sebelius said earlier this month.

“Our ultimate goal is to have the kind of biodefense system that is so dependable and robust that potential terrorists give up and say, ‘It’s not worth the effort,’ and when Mother Nature strikes we are ready to respond,” Sebelius remarked. The evaluation is expected to be complete by the end of the first quarter of 2010.

Some defense groups contend that the bioterrorist threat has been exaggerated. The Center for Arms Control & Non-Proliferation, a research organization, argues that “improving the capability to respond to natural disease outbreaks, which currently present the major problem,” would “provide much greater public health benefit and ... significantly strengthen resistance to bioterrorism.”