Milestones :: Perspectives
[U.S.] National Biodefense Strategy: Protect the Nation Against all Biological Threats
September 18, 2018
By: Robert P. Kadlec, MD, MTM&H, MS, HHS Assistant Secretary for Preparedness and Response
Summary:
As a nation, public and private partners must work closely together to plan adaptively for current and emerging biothreats.
Today, the White House and four federal departments unveiled a comprehensive National Biodefense Strategy to make America safer against modern biological threats to the United States. In the 21st century, biological threats are increasingly complex and dangerous, and that demands that we act with urgency and singular effort to save lives and protect Americans.
Whether a natural outbreak, an accidental release, or a deliberate attack, biological threats are among the most serious we face, with the potential for significant health, economic and national security impacts. Therefore, promoting our health security is a national security imperative.
The strategy released today not only establishes the U.S. government vision for biodefense, it prioritizes and coordinates federal biodefense activities and budgets. In meeting the aggressive demands of the National Biodefense Strategy – PDF as directed by President Trump’s National Security Presidential Memorandum, we will improve the nation’s readiness and response capabilities to combat 21st century biological threats to humans, animals, agriculture and the environment.
Combating 21st century biothreats requires a whole-of-nation approach
Biodefense entails a range of coordinated actions to counter biothreats, reduce risks, and prepare for, respond to, and recover from incidents. As biothreats continue to evolve, so must our biodefense capabilities.
Coordination of such complex actions requires a sound strategy, commitment, and governance structure. As an initial step in implementing the strategy, leaders from every federal department involved in biodefense formed a steering committee, led by Secretary Azar, that provides strategic guidance in preparing for, countering, and responding to biological threats. I am honored that Secretary Azar asked me to lead the day-to-day coordination team that supports this committee in improving biodefense readiness. As the assistant secretary for preparedness and response, my office routinely coordinates federal preparedness, response and recovery efforts to address the healthcare and public health impacts of public health emergencies and other disasters, including bioincidents.
The National Biodefense Strategy’s coordination team also will engage state, local, tribal and territorial governments, as well as private and international partners as appropriate, because while coordinating federal activities and budgets across the full spectrum of biodefense sectors and activities represents a monumental step forward; being truly successful will require a whole-of-nation approach with government agencies at all levels and non-government stakeholders playing important roles in providing support and guidance. As a nation, public and private partners must work closely together to plan adaptively for current and emerging biothreats, whether they stem from terrorist groups, pandemics, natural disasters, or even rouge nation states.
Seventeen years ago today, our nation experienced a biological attack with anthrax mailed in letters, killing five people and injuring 17, and costing an estimated $6 billion in clean up and lost revenue. Those historic attacks, the more recent Ebola outbreaks and the emergence of potentially deadly influenza viruses demonstrate how severe biological threats continue to evolve, both man-made and from nature, can be. By meeting the call to action in the National Biodefense Strategy, we become better equipped to protect this nation against all biothreats.
National Biodefense Strategy [U.S.]
U.S. Department of Health & Human Services
2018 :: 36 pages
FOREWORD
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. Outbreaks of disease can cause catastrophic harm to the United States. They can cause death, sicken, and disable on a massive scale, and they can also inflict psychological trauma and economic and social disruption. Natural or accidental outbreaks, as well as deliberate attacks, can originate in one country and spread to many others, with potentially far-reaching international consequences. Advances in science promise better and faster cures, economic advances, a cleaner environment, and improved quality of life, but they also bring new security risks. In this rapidly changing landscape, the United States must be prepared to manage the risks posed by natural outbreaks of disease, accidents with high consequence pathogens, or adversaries who wish to do harm with biological agents.
Health security means taking care of the American people in the face of biological threats to our homeland and to our interests abroad. The significant infectious disease outbreaks of recent decades, including Severe Acute Respiratory Syndrome (SARS), pandemic influenza, Ebola virus disease, and Zika virus disease, have revealed the extent to which individual countries and international communities need to improve their preparedness and biosurveillance systems to detect and respond to the next health crisis. 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.
The National Biodefense Strategy is aligned with the 2018 National Security Strategy of the United States. Pillar One of the 2018 National Security Strategy explicitly calls for protecting “the American people, the homeland, and the American way of life.” One component of this goal is achieved by detecting and containing biothreats at their source, supporting and promoting the responsible conduct of biomedical innovation, and improving emergency response. Pillar Two calls for “promot[ing] American prosperity,” which increasingly will depend on a vibrant life sciences and biotechnology enterprise.
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.
[Excerpts from Goals summary which reference vaccines; Editor’s selection and text bolding]
[p.12] GOAL 2: ENSURE BIODEFENSE ENTERPRISE CAPABILITIES TO PREVENT BIOINCIDENTS.
2.1 Promote measures to prevent or reduce the spread of naturally occurring infectious diseases.
2.1.1 Strengthen Infection Prevention Measures Domestically and Internationally.
:: Using a multidisciplinary approach, strengthen medical, public health, animal health, and plant health capacities to improve infection prevention and control.
:: Strengthen vaccination and other health intervention activities.
2.1.2 Reduce the Emergence and Spread of Antimicrobial-resistant Pathogens Domestically and Internationally.
:: Strengthen awareness of drug-resistant pathogens and their associated diseases, and improve stewardship of medically important drugs.
:: Strengthen understanding of the drivers of drug resistance and improve the development and adoption of effective mitigation measures.
:: Promote the use of preventive and therapeutic options other than antimicrobial drugs.
:: Accelerate basic and applied research and development of new antimicrobials, novel preventatives and therapeutics, vaccines, and diagnostic tests.
[p.22] GOAL 4: RAPIDLY RESPOND TO LIMIT THE IMPACTS OF BIOINCIDENTS.
4.2 Conduct federal response operations and activities in coordination with relevant non-federal actors to contain, control, and to rapidly mitigate impacts of biothreats or bioincidents.
4.2.2 Deploy MCMs and Implement CMMs.
:: Rapidly identify potentially exposed populations to begin triage, preventive healthcare activities, and treatment.
:: Ensure that access and functional needs of at-risk individuals are integrated into rapid deployment.
:: Implement CMMs and other multidisciplinary bioincident control measures, to include addressing service animal and wildlife concerns, animal vaccination, and agricultural depopulation.
4.2.3 Conduct Real-time Research.
:: Conduct real-time research during response to characterize emerging biothreat agents and develop response tools in order to improve response and recovery capacity, capability, and future preparedness.
:: Rapidly identify and disseminate guidelines and clinical approaches during a bioincident for the purpose of decreasing transmission, morbidity, and mortality; and rapidly identify and disseminate analogous approaches for animals and plants.
:: Conduct real-time clinical research to evaluate promising investigational MCMs, and identify potential novel diagnostics, treatments, and vaccines.
vaccines and global health :: ethics and policy 
