The National Biodefense Strategy

In the United States, the National Biodefense Strategy is a biosecurity strategy that the federal government was directed to adopt by the National Defense Authorization Act for Fiscal Year 2017. Following the congressional directive, in September 2018, President Trump announced and issued the strategy. The strategy placed the U.S. Department of Health and Human Services in charge of leading the federal government's biodefense efforts, and designated HHS to lead a committee of high-level officials from the Defense Department, Agriculture Department, and Homeland Security Departments, to review the biodefense capabilities of the United States Intelligence Community and 15 other executive branch agencies.

The National Academies of Sciences, Engineering, and Medicine was asked to articulate a 5-year strategic vision for international health security programs and provide findings and recommendations on how to optimize the impact of the Department of Defense (DOD) Biological Threat Reduction Program (BTRP) in fulfilling its biosafety and biosecurity mission. Because BTRP is just one of several U.S. government programs conducting international health security engagement, both the strategic vision and the success of the program rely on coordinating actions with the U.S. government as a whole and with its international partners. This report provides several recommendations for optimizing BTRP success in its current mission and the wider-looking strategic vision it proposes.

This Congressionally-mandated report identifies areas for further cooperation with Russia and other states of the former Soviet Union under the Cooperative Threat Reduction (CTR) program of the Department of Defense in the specific area of prevention of proliferation of biological weapons. The report reviews relevant U.S. government programs, and particularly the CTR program, and identifies approaches for overcoming obstacles to cooperation and for increasing the long-term impact of the program. It recommends strong support for continuation of the CTR program.

Scientific advances over the past several decades have accelerated the ability to engineer existing organisms and to potentially create novel ones not found in nature. Synthetic biology, which collectively refers to concepts, approaches, and tools that enable the modification or creation of biological organisms, is being pursued overwhelmingly for beneficial purposes ranging from reducing the burden of disease to improving agricultural yields to remediating pollution. Although the contributions synthetic biology can make in these and other areas hold great promise, it is also possible to imagine malicious uses that could threaten U.S. citizens and military personnel. Making informed decisions about how to address such concerns requires a realistic assessment of the capabilities that could be misused. Biodefense in the Age of Synthetic Biology explores and envisions potential misuses of synthetic biology. This report develops a framework to guide an assessment of the security concerns related to advances in synthetic biology, assesses the levels of concern warranted for such advances, and identifies options that could help mitigate those concerns.

In response to the coronavirus disease 2019 (COVID-19) pandemic and the societal disruption it has brought, national governments and the international community have invested billions of dollars and immense amounts of human resources to develop a safe and effective vaccine in an unprecedented time frame. Vaccination against this novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), offers the possibility of significantly reducing severe morbidity and mortality and transmission when deployed alongside other public health strategies and improved therapies. Health equity is intertwined with the impact of COVID-19 and there are certain populations that are at increased risk of severe illness or death from COVID-19. In the United States and worldwide, the pandemic is having a disproportionate impact on people who are already disadvantaged by virtue of their race and ethnicity, age, health status, residence, occupation, socioeconomic condition, or other contributing factors. Framework for Equitable Allocation of COVID-19 Vaccine offers an overarching framework for vaccine allocation to assist policy makers in the domestic and global health communities. Built on widely accepted foundational principles and recognizing the distinctive characteristics of COVID-19, this report's recommendations address the commitments needed to implement equitable allocation policies for COVID-19 vaccine.

The Cold War phrase “weapons of mass destruction” continues to be used despite significant changes in international political cultures, military concepts of operation, and technology advances. Today, the term “weapons of mass destruction” (WMD) is used to address many things, from grams of ricin and barrels of industrial chemicals to megaton nuclear weapons. As a direct result of the decision to refer to all nuclear, biological, and chemical (NBC) weapons as well as biological, chemical and radiological (CBR) hazards as “WMD,” we have lost the ability to accurately develop, assess, and discuss policy concerns relating to the contemporary use of unconventional weapons on the battlefield and within the homeland. This book uses a public policy framework to examine how the U.S. government, and in particular the U.S. military, should address the potential use of unconventional weapons in the 21st century. It defines the problem, identifies the policy actors and reviews policy options. It discusses past policy efforts before offering a critical review of current strategies and how WMD issues are integrated into the current military Joint Operating Concepts (deterrence, cooperative security, major combat operations, irregular warfare, stability, and homeland security), and proposes new national framework for countering WMD. The aim is to answer such questions as what does counterproliferation mean and whether the U.S. government is adequately prepared to protect U.S. citizens and its armed forces from adversaries developing unconventional weapons.

The attacks of September 11 and the release of anthrax spores revealed enormous vulnerabilities in the U.S. public-health infrastructure and suggested similar vulnerabilities in the agricultural infrastructure as well. The traditional public health response-surveillance (intelligence), prevention, detection, response, recovery, and attribution-is the paradigm for the national response not only to all forms of terrorism but also to emerging infectious diseases. Thus, investments in research on bioterrorism will have enormous potential for application in the detection, prevention, and treatment of emerging infectious diseases that also are unpredictable and against which we must be prepared. The deciphering of the human genome sequence and the complete elucidation of numerous pathogen genomes, our rapidly increasing understanding of the molecular mechanisms of pathogenesis and of immune responses, and new strategies for designing drugs and vaccines all offer unprecedented opportunities to use science to counter bioterrorist threats. But these same developments also allow science to be misused to create new agents of mass destruction. Hence the effort to confront bioterrorism must be a global one. Countering Bioterrorism makes the following recommendations: Recommendation 1: All agencies with responsibility for homeland security should work together to establish stronger and more meaningful working ties between the intelligence, S&T, and public health communities. Recommendation 2: Federal agencies should work cooperatively and in collaboration with industry to develop and evaluate rapid, sensitive, and specific early-detection technologies. Recommendation 3: Create a global network for detection and surveillance, making use of computerized methods for real-time reporting and analysis to rapidly detect new patterns of disease locally, nationally, and ultimately- internationally. The use of high-throughput methodologies that are being increasingly utilized in modern biological research should be an important component of this expanded and highly automated surveillance strategy. Recommendation 4: Use knowledge of complex biological patterns and high-throughput laboratory automation to classify and diagnose infections in patients in primary care settings. Recommendation 5: USDA should create an agency for control and prevention of plant disease. This agency should have the capabilities necessary to deal effectively with biothreats.