9-10-08 Margaret Hamburg Testimony
Chairman Graham, Vice-chair Talent, other Commissioners and distinguished guests, thank you for the opportunity to participate in this hearing. I have been asked to address the current threat of bioterrorism and how it is likely to evolve in the coming decades, given the rapid advances in the life sciences and the globalization of the biotechnology industry. This is an important, time-urgent and very challenging set of concerns. Now some seven years after the anthrax mail attacks occurred in this city and others, we have seen considerable new efforts and investments to address the ominous potential of bioterrorism, yet in many significant ways our policies and programs have fallen short. We are badly in need of renewed commitment and a stronger focus on the policies and actions vital for protection against this threat. Moreover, much of the focus to date in countering bioterrorism has been on the medical and public health response to an attack. While preparedness is essential, there is a great deal more that can and should be done to reduce the chance of an attack occurring in the first place. Your willingness to grapple with this complex and frightening topic is very welcome.
My name is Margaret (Peggy) Hamburg. I am a physician and a public health professional, currently serving as Senior Scientist at the Nuclear Threat Initiative (NTI), a private foundation co-chaired by Ted Turner and Senator Sam Nunn, whose mission is to reduce the global threat from weapons of mass destruction. I was the founding Vice-President for Biological Programs at NTI. Before joining NTI, I served in government at various levels including Assistant Secretary for Planning and Evaluation in the Department of Health and Human Services in the Clinton Administration, six years as New York City Health Commissioner (under both Mayor Dinkins and Mayor Giuliani), and Assistant Director of the National Institute of Allergy and Infectious Diseases, National Institutes of Health.
I first began working on issues of bioweapons and bioterrorism in the early 1990s. For me, the possibility of domestic terrorism became a harsh reality while serving here as Health Commissioner the first time the World Trade Center was bombed. In those days, not many seemed to take the threat of terrorism in this country very seriously, and especially not the possibility of biological agents being deliberately released to cause widespread panic, disruption, disease and death. Few are so complacent today. The events of 9/11 and the subsequent anthrax letters have forced a new recognition that we cannot count on technical barriers or moral repugnance to protect us from harm. In the near term, “conventional” attacks such as bombs may remain the most likely mode of terrorism, yet there are many reasons to believe that biological agents may be an increasingly attractive approach.
Nature and Urgency of the Bioterror Threat
Biological weapons can produce large numbers of casualties, potentially on a scale to devastate whole cities, regions and possibly the entire nation and beyond. Even without large numbers, attacks with biological agents—especially covert ones—can produce enormous disruption, feelings of vulnerability and possibly panic and terror as people struggle to understand who is at risk and what can be done. This was very much the case with the anthrax exposures in the fall of 2001. While tragic, only five people died, yet the letter attacks were destabilizing in ways that extended far beyond the body count, and far beyond the sites where anthrax-tainted letters actually traveled. These anthrax-containing letters were enormously costly in both human and economic terms, yet it is sobering to recognize that if that same anthrax powder had been introduced into the ventilation system of Rockefeller Center rather than sent in a letter to Mr. Brokaw’s office, it could have produced a far more horrifying scenario. An outbreak caused by a contagious disease agent that spreads person to person would create an even more frightening circumstance.
Truth is, probably no single terrorist attack—no matter how horrifying and catastrophic—could threaten the very stability of our society and institutions in the way that biological weapons could, accept, perhaps, for a nuclear attack. Yet compared to nuclear weapons, biological weapons are relatively inexpensive and easy to produce; significant damage can be done even in the absence of large quantities of material or an elaborate delivery mechanism. What is more, information about how to obtain and prepare bioweapons is increasingly available through the internet, the open scientific literature and other sources. Also, opportunities for access to dangerous pathogens can be fairly routine; certain of these organisms are commonly found in nature, as well as legitimately studied in government, academic and industry labs. Furthermore, bioweapons facilities can be hidden within routine research laboratories or pharmaceutical manufacturing sites. For some, biological agents may have special appeal because the delayed onset of effects may make it more likely that the perpetrator can escape detection, if that is their goal. Adding to the challenge is the fact that while extraordinary advances in modern biology and life sciences research offer great hope to improve health and prevent disease, they also offer the tools--through malevolence, misapplication or sheer inadvertence- to create new and more dangerous organisms, as well as improved mechanisms for delivery. Overall, the reality is that access to the materials and know-how to produce potentially very serious biological threats becomes easier and more sophisticated every day. This has profound implications for both national security and for science.
Brief History of the Use of Biological Weapons
It is often said that there are few past examples of biological weapons use, but in fact history demonstrates that it is not so. In the 1300s, plague-infected bodies were catapulted over city walls during battle. During the French and Indian War in the mid 1700s, smallpox contaminated blankets were used to decimate Native American adversaries. The development of more modern biological weapons dates back to the early decades of the 20th century. In fact, during World War II, every major combatant had a biological weapons program, although Japan is the only country that actually used biological weapons during the course of the conflict. The U.S. bioweapons program began in 1943, but in 1969, President Nixon renounced the use of biological weapons and ordered that our offensive program be ceased and all stockpiles destroyed. This led to the development of the Biological and Toxic Weapons Convention (BWC) treaty which prohibits possession, stockpiling, and transfer of bioweapons. The BWC was concluded in 1972 and subsequently ratified by more than 150 nations.
As we neared the end of the 20th century, several events gave bioweapons greater prominence on the national security agenda. For one thing, in the early 1990s, startling revelations emerged about the enormous bioweapons program undertaken by the former Soviet Union, which went forward full force even as they signed on to the BWC. Concerns were fueled by disclosure of an ambitious bioweapons program mounted by Iraq, and findings that Aum Shinrikyo, the Japanese group that released nerve gas in the Tokyo subway, had also experimented with botulism and anthrax, and sought to obtain Ebola for use as a weapon. Episodes here at home involving extremist groups or individuals who were able to obtain dangerous pathogens such as ricin, anthrax and Yersinia pestis (the organism that causes plague) for dubious purposes added to the growing perception of risk. It was hoped that the destructive and potentially uncontrollable implications of biological weapons might lessen the attractiveness of their use. The events of Sept 11, however, demonstrated that at least for certain groups, a willingness to inflict devastating harm to themselves and others and suggested that if they could get their hands on biological weapons they would use them. The subsequent attacks with anthrax dispelled any lingering doubt that dangerous pathogens could be obtained and used by someone or some group with the intention of doing lethal harm.
Numerous recent government and expert reports confirm that terrorist groups are working hard to get these weapons and/or develop appropriate expertise. Evidence suggests that in the late 1990s, al Qaeda began developing a bioweapons program and constructed a low tech anthrax production facility in Qandahar, Afghanistan. The extent and current circumstances of that program are uncertain, but while operational capacity has certainly been significantly disrupted by U.S. military forces, their intent to pursue biological weapons remains intact. In fact, Osama bin Laden is reported to have described it as “a religious duty.” In 2003, al Qaeda issued a fatwa authorizing the use of biological, chemical, and nuclear weapons against non-Muslims and in 2006, al Qaeda representatives called for scientists to join the jihad to help produce WMD. Strikingly, a recent confidential report by a UN Panel of Experts said that the only thing holding back al Qaeda from using biological weapons is its lack of technical know-how, as the decision to use them in forthcoming attacks has already been taken and they have the funding to continue developing their capabilities. Yet, disturbingly, we know that the knowledge and tools to produce and deliver biological agents as weapons are becoming more and more accessible and available, all over the world. In fact, a Defense Science Board Report published in June 2001 stated that “major impediments to the development of biological weapons—strain availability, weaponization technology, and delivery technology—have been largely eliminated in the last decade by rapid, global spread of biotechnology.”
Agents of Concern
In theory, a wide range of biological agents could be intentionally used to cause harm. Currently, most bioterrorism preparedness efforts have focused on a subset of organisms felt to pose the greatest threat to civilian populations. The so-called “A-list” of concern for bioterrorism includes: anthrax, smallpox, plague, tularemia, viral hemorrhagic fevers and botulism. This list reflects a set of criteria that combines intelligence information about credible threats with public health impact considerations, such as ability to cause significant illness and death, stability and delivery potential of the biological agent and its ability to be produced in large quantities, potential for transmission, and special preparedness concerns like stockpile requirements, enhanced surveillance or diagnostic needs.
No one can predict with much certainty, but many experts believe that an aerosolized anthrax attack is our nation’s greatest threat. Such an attack could take tens or hundreds of thousands of lives. A coordinated attack on multiple targets could rapidly escalate the level of devastation. Other types of possible scenarios include a contagious agent released into the air, within a closed space or outside, or the dissemination of a microbial agent or toxin through the food or water supply. Even without the loss of one human life, it is resoundingly clear that a terrorist could achieve their goals of producing widespread panic, economic damage and the undermining of public confidence in government by an attack on animals or crops.
And while most bioterrorism, especially in the near future, will likely be infectious disease related, the future of the biological weapons threat does not necessarily have to involve infectious agents. Expanding insights into various regulatory and other systems within the human body offer new opportunities for the determined terrorist to develop tools that will disrupt critical functions for life or behavior. For example, we know that the Russians, in their former bioweapons program, were already experimenting with so called neuromodulators.
Emerging Capabilities
With advances in biomedical science, including synthetic biology, recombinant DNA techniques, genomics and the like, the possibilities get much greater. The explosion of knowledge about the fundamental building blocks of life—and how to manipulate them—gives new understandings of staggering and unpredictable power. Along with this comes the global spread of expertise and equipment to support biotechnology and biological manufacturing processes. All of this is changing the research and development landscape in the life sciences, mainly in ways that are constructive and for the good, but it also raises new concerns about the potential for harm—either through deliberate misuse or inadvertence.
When you consider the possibilities for what nefarious things could be achieved with the tools of modern biology to develop new and better bioweapons, now and in the future, the prospects are frightening. Examples include: aerosol technology to deliver infectious agents more efficiently into the lungs for absorption by the body, gene therapy vectors that could cause permanent change in an infected persons genetic make-up, a “stealth” virus that could lie dormant inside the victim until triggered, or biological agents intentionally engineered to be resistant to available antibiotics or evade immune response. An emerging capability is the creation of new forms of life de novo using the techniques of synthetic biology . . . or maybe new classes of pathogens, like chimeras that might combine the most frightening aspects of two organisms (such as smallpox and ebola) or so-called “binary” BW agents that only become effective when two components are combined. A disturbing example involves taking a mild pathogen that when combined with its antidote or treatment, would actually be activated to become highly virulent.
Some of this remains hypothetical, but several fairly recent studies have heightened attention on these issues. The Australian mousepox study is one case often cited of an inadvertent finding that has laid out a potential road map for others to make a pathogen more dangerous. This was a research project to develop a contraceptive vaccine for rodent pest control. A relatively harmless mousepox organism was used as the vector to develop this new vaccine and then a gene involved in the immune system called interleukin 4 (IL-4) was inserted to try to boost the response. What happened was that the IL-4 dramatically increased the lethality of the mousepox; unexpectedly, mice infected with the engineered pathogen died, including some that had been vaccinated against mousepox. Though unintended, this experiment has now provided new information that suggests ways to make other pox viruses—including smallpox—even more dangerous. The creation of poliovirus de novo, and more recently the 1918 pandemic strain flu—literally using DNA fragments and equipment ordered from catalogues --underscores that the capabilities for the intentional creation of new biological agents for potential use as weapons will be increasingly available.
From a security perspective, the natural reaction is to try to figure out how to limit the kinds of research that may be misused or distorted in damaging ways. Yet it is quickly apparent that while the potential for misapplication is resoundingly real, this same research holds great potential for good. In fact, it may be essential to the development of the new medicines, vaccines, and technologies needed to counter bioterrorism, as well as to protect against naturally occurring disease. As it turns out, it is very difficult—if not impossible—to define dangerous science, and it is certainly impossible to monitor all aspects of research that might have destructive applications. So the challenge must be seen, not as how to stop the advance of dangerous science, but how to constrain the misapplication of scientific knowledge and capability without damaging the advancement of science.
Laboratory Biosecurity
A similar challenge exists with respect to reducing access to dangerous pathogens and strengthening laboratory biosecurity. It used to be that laboratories focused almost exclusively on biosafety—making sure that people working in labs and their neighbors did not get infected by organisms being studied. In today’s world, there are a broader set of worries; there must also be adequate measures to guard against the possibility of inappropriate acquisition and/or deliberate release of dangerous pathogens for malicious purposes. The recent charge that a government biodefense scientist was responsible for the deadly 2001 anthrax mailings has brought new attention to these concerns.
In the aftermath of the terror events of autumn 2001, the U.S. Government moved rapidly to try to shore up security at biological laboratories and suppliers. Two significant pieces of legislature were passed, the Public Health Security and Bioterrorism Preparedness Act of 2002 and the USA PATRIOT Act, putting in place measures to control agents with potential uses as biological weapons. New regulations and requirements tightened access to biological materials from culture collections in the United States and strengthened the government’s ability to monitor the shipping and receipt of a discrete set of dangerous pathogens through a registration process, which also requires disclosure of the intended use for these agents (CDC Select Agent Program). These steps have value, but the anthrax situation demonstrates that these safeguards do not ensure that we have an adequate handle on whether dangerous pathogens are adequately secured, who is using them, and why.
In my view, more can and should be done, but it must be done carefully and with the full input of those most familiar with how research is done. Government must work closely with the scientific community to reduce risks in ways that will be meaningful but not overly cumbersome to legitimate research. There must be clearly defined and followed guidelines for biosafety and security, training and monitoring of personnel, and transparency of laboratory research activities and policies. Caution must be taken to ensure that procedures undertaken actually enhance safety and security and support the responsible, productive work by scientists, rather than creating punitive systems that both make it difficult to conduct good science and serve to drive scientists away from work in the biodefense area.
These issues have become even more pressing with the rapid expansion of biodefense research that has occurred since the events of 9/11 and the anthrax letters. For example, to pursue research related to potential bioterror threats, the National Institutes of Health (NIH) received its largest budget increase in history, expanding from $53 million in 2001 to more than $1.6 billion in 2008. During this same timeframe, The Department of Defense (DOD) more than doubled its investment in biodefense research to a spending level of over $1 billion. Correspondingly, a rapid expansion of laboratories working on dangerous pathogens research is underway, representing over a 10-fold increase in the number of labs requiring the highest level of containment, biosafety level 4 (BSL-4), for work on lethal agents for which there is no vaccine or therapy available, such as Marburg or Ebola virus. Some 13 new regional BSL-3 labs are being built for work on potential bioterror agents requiring less stringent, though still significant levels of biocontainment. Since its inception in 2003, the Department of Homeland Security (DHS) has been developing a significant biodefense research enterprise centered around the National Biodefense Analysis and Countermeasures Center (NBACC), which includes a large BSL-4 laboratory for biological threat characterization and bioforensic research, at least some of which will operate at the secret level. Many new research grants and contracts have been awarded for researchers to pursue biodefense/emerging infections research in existing academic and industry labs across the country. Though estimates vary, a 2005 DHS/DHHS report estimates that there are more than 600 BSL-3 labs in the U.S. suitable for such microbiological research. With all of these new research activities, thousands of scientists and workers have entered the biodefense arena, many working with select agents for the first time.
It is not surprising that there is a growing sense of unease about whether our current biodefense research policies and programs are creating new vulnerabilities. By increasing the numbers of facilities and people working with dangerous pathogens, it is almost inevitable that the risks for malfeasance or accident will enlarge. In this regard, it is important to underscore how vital, in fact, such research is to further our understanding of these microbes, how they cause disease, and how to develop new diagnostics, treatments, protections and cures. Today’s investment in research will be the foundation of future preparedness and protection capabilities. A strong, well-funded and carefully developed research agenda could provide us with the tools and countermeasures to reduce the attractiveness of biological terrorism, perhaps even eliminate biological agents as weapons of mass destruction or disruption. Yet it is not unreasonable that questions are being asked about the scope of current activities and the adequacy of oversight measures.
Concerns have also been raised about possible other unintended consequences of this rapid expansion of biodefense research programs. By devoting such substantial new resources to biodefense research and the study of potential bioterror agents, could this work be misperceived by other nations as an indicator of a broader bioweapons program or a signal that we are developing capabilities that could rapidly be used in an adversarial manner? Might we inadvertently stimulate an arms race dynamic that could escalate in unexpected and undesirable ways? I think it is fair to say that our country would almost certainly raise questions if similar activities were being pursued so intensively and systematically by certain other countries.
Strengthening Biosecurity
There are no easy or complete solutions to ensure adequate and appropriate oversight of biosecurity, including the responsible stewardship of research activities, knowledge and materials, but there are ways to approach this problem. Strategies will not mirror traditional approaches to arms control and non-proliferation. Success will require new systems of governance, and it will require individual, community and government driven strategies. Science is at once the practice and product of individual scientists, and the outgrowth of scientist-to scientist collaborations. Important life sciences research today is as likely to occur in a private biotech company or in an academic lab, as in a government facility. An effective approach cannot reflect a model based solely on top down government regulations and legal requirements. Meaningful solutions will require the full engagement of the scientific community, and will require a mix of strategies including legal regulations, professional standards and codes of conduct, international guidelines and agreements, and a fundamental shift in awareness and accountability about how science is done, the so-called ethos of science.
Several recent reports from the National Research Council (NRC) and Institute of Medicine (IOM) of the National Academies have offered valuable insights and recommendations on these matters, along with important work from professional societies such as the American Association for the Advancement of Science (AAAS), the American Society of Microbiology (ASM), and the Federation of American Scientists (FAS). Editors of scientific journals have come together to examine strategies to reduce the possibility that legitimate life sciences research could be misused for nefarious purposes. The government has sought additional expertise, including the creation of the National Science Advisory Board for Biosecurity (NSABB) to advise the government on “dual-use” research, monitor projects, and provide guidance on issues such as codes of conduct, publication of potentially sensitive research information and the development of guidelines for biosecurity oversight and research monitoring.
International Dimensions
Despite considerable new activity, most would agree that the international dimension of the problem remains under-addressed. It must be emphasized strongly that none of the measures aimed at strengthening biosecurity and restraining the potential for misapplication of science will be successful if not taken on an international basis. In today’s world, science is an inherently global enterprise, spanning sectors as well as nations. Scientific knowledge is rapidly disseminated, materials are widely available, and scientists train, conduct research and collaborate across national boundaries. The equipment and technologies needed for life sciences research and biotechnology are intrinsically dual-use and hard to limit or track. Many of the dangerous pathogens themselves are endemic in numerous countries and are potentially available outside research laboratories, either in clinical settings or in nature; they can be directly isolated, they can spontaneously proliferate, and they can cross borders without respect to national laws or regulations. Several countries including the United States have passed legislation or established guidelines to address the problems of biosecurity and research oversight. Such national initiatives have value, but the lack of coordinated, uniform international standards and guidelines produce gaps and vulnerabilities that undermine those efforts. A fragmented approach enables those seeking to do harm to still identify where facilities are unprotected, oversight procedures are lax, or where particular items can be readily obtained without additional requirements. There is also a real concern that when national programs exist in isolation they may actually inhibit scientific progress in that country by creating cumbersome rules and procedures that make the conduct of research more difficult, stifle collaboration and innovation, and ultimately may serve as a disincentive to pursue important work with certain biological agents or technologies.
The issues surrounding the potential threat of bioterrorism are felt most profoundly in the United States, where our experience of the deliberate exposure of innocent victims to anthrax powder dramatically heightened attention and concern, especially coming immediately after the 9/11 attacks of 2001. However, not all countries share our same level of alarm, and because the U.S. track record with respect to international agreements, including the Biological Weapons Convention, has been less than stellar, we are in a weak position to argue that other countries should follow our lead in instituting controls on pathogens and technology. Moreover, many countries, especially those with fewer resources, have little inducement to invest in biosecurity regimes when they do not feel targeted by the threat of bioterrorism, but rather suffer the daily burden of naturally occurring infectious disease.
Nonetheless, there is a strong and growing need to seek full international cooperation and a harmonized approach. In our rapidly transforming world, biotechnology is becoming an increasingly globalized field of endeavor. Major new investments to strengthen and extend life sciences research and development capabilities are being taken around the globe, in both the developed and developing world. Clearly investments in these fields will be vital to address some of the most pressing challenges of disease in their countries and beyond, but at least as significantly, these investments are seen as critical drivers of their economic development strategies. With this has come an explosion in the numbers of high-containment laboratories, both those in existence and those planned. For example, China is reported to have 34 BSL-3 labs, Singapore 11, and India started up 16 in 2006 alone.
In light of these many concerns, there have been several recent efforts by international organizations to develop biosecurity initiatives on a regional or more global basis. For example, the World Federation for Culture Collections has spearheaded an initiative to tighten storage and accesss controls. The Organization for Economic Development (OECD) has developed best practice guidelines for controlling access to pathogens with dual-use capacity. The Group of Eight (G8) has developed policy agreements concerning non-proliferation principles that include physical protection, control, and accounting for biological agents and other materials that could be used for attack purposes. The European Union has also undertaken efforts to strengthen biosecurity by developing a select agent priority list, agent inventories, and guidelines for work with biological agents, including transfer and processing. The Australia group represents an export control coordinating group comprising 33 member states plus the European Commission, providing guidelines on transfer and exchange of certain pathogens and toxins, as well as equipment and other material that might be needed for weaponization. The World Health Organization has also attempted to respond to the needs of the international community by articulating guidelines for laboratory biosecurity. Other less formal groups, such as the InterAcademy Medical Panel, a group representing academies of medicine from around the world, has also begun to seriously focus on issues of biosecurity and the dual-use dilemma posed by advances in biomedical research and technology.
Need for Strengthened Global Biosecurity Framework
While it is very necessary and useful to have a range of groups and organizations working to enhance global biosecurity standards, there is a continuing need to have a framework of laws and policies that are agreed to by governments and reflected in harmonized national policies and legislation. Most likely, essential components should comprise some level of enforceable controls on: (1) access and accountability for dangerous pathogens in laboratories, including requirements for safe acquisition, storage, transfer and use; (2) registration and licensing of facilities that are working with dangerous pathogens; (3) standards for both personnel screening and physical biosafety and security measures at these facilities. Clear guidelines and standards should be accompanied by technical assistance and other support as needed, especially for developing countries. Ongoing efforts to raise awareness and achieve a common understanding of threats and concerns among the scientific and security communities would greatly support these efforts as well. As a general rule, there should be requirements for transparency in biodefense programs and information sharing to the greatest degree possible. Clearly, all of this will be no easy task, as differing expectations and concerns, differing legal systems and differing structures for the conduct and support of scientific research will have to be reconciled in some way. Under whose auspices these activities should be undertaken and overseen is another challenging question.
It is difficult to talk about efforts to prevent the development and use of biological weapons without raising the role of the Biological Weapons Convention (BWC. Entered into force in 1975, the BWC represents a multilateral agreement to ban the development, production, stockpiling or acquisition of biological and toxin weapons, along with destruction or conversion of such weapons or delivery means. At present the BWC has 153 states parties and another 16 have signed but not ratified the treaty. The signing of the Biological Weapons Convention (BWC) stands as an important commitment by nations to abandon pursuit of biological agents as weapons, but it does not contain explicit monitoring, inspection or enforcement requirements. In the late 1990s, efforts were made to develop a protocol which would strengthen the BWC through on-site inspections, mandatory declarations of agents and equipment, and investigations of suspected weapons research and development as well as suspicious outbreaks. However, in 2001 the Bush Administration indicated that it would not support the protocol because of concerns that the inspections would be ineffectual in their verification goals, and might compromise sensitive information and disrupt legitimate commercial and biodefense activity. No alternative has yet been proposed. While reasonable arguments can be made on both sides, the issues are too important to completely abandon efforts to devise a meaningful and non-disruptive approach to compliance. It is in all our interests to pursue ways to meaningfully strengthen and enforce the Biological Weapons Convention.
Strengthening Intelligence
If we hope to block the proliferation and use of biological weapons, we must significantly bolster our intelligence about the threat—where it may come from and what it may be. But while the benefits of having good intelligence is clear, gathering that intelligence is particularly difficult. Traditional methods of intelligence collection are of much less value in the context of biological agents and the potential misuse: biological agents and related equipment can be obtained on the open market, biological weapons can be produced in legitimate looking lab, pharmaceutical sites and even breweries, and it is hard to track the movement of biological materials by satellite or detectors. Human intelligence becomes vitally important, but opportunities to obtain meaningful information are limited by the difficulty of successfully penetrating the groups of concern. In addition, at least in recent times, there have been few people with backgrounds in the life sciences to gather and analyze intelligence on the biolological threat.
There is an urgent need for greater biomedical and scientific expertise to enhance the quality of data collection and analysis; this could enhance the sources and types of information available as well. As mentioned earlier, members of the scientific community may yield new knowledge about threats through routine scientific activities and collaborations, as well as understanding of what information is available in the open scientific literature, including what could be potentially misused or misapplied by those who want to do harm. Similarly, public health professionals may have important insights into infectious disease outbreaks or events of potential significance. As such, these scientists may be crucial to building new knowledge and expertise in this complex area within the intelligence community. Strengthening intelligence about the biothreat will require greater partnership and trust between the intelligence, public health and biomedical science communities. These disciplines do not routinely work together and their professional cultures and practices are not easily merged. Nonetheless, greater coordination of effort is very important to our national defense and must be an element of our nation’s evolving security strategy.
Reduce Conditions that Foster Terrorism
At the most fundamental level, efforts to prevent or reduce the threat of bioterrorism must endeavor to understand the context of terrorism and the motivations and intent of terrorists. In addressing the threat of terrorism, the 9/11 Commission and others have looked at the causes and conditions that may foster terrorism and allow it to take hold. An array of factors have been cited. The 9/11 Commission outlined an “Agenda of Opportunity” to make a difference in changing the environment in which terrorism breeds, noting such things as education, social programs, and institution building. However, to my eye, health programs were strikingly absent.
We should recognize that health—both the health status of individuals and populations-- is a key building block to well-being, prosperity and productivity in any society. International, collaborative health programs can serve as a valuable pathway to new optimism and opportunity in communities impoverished of hope, as well as a bridge to new trust and partnership among communities or nations formerly at odds. We can and should use health programs as a vehicle to improve the common good and to demonstrate-- building on our countries enormous strengths in science and medicine--our goodwill and concern for others around the world.
Conclusions
To conclude, I want to stress that the menace of bioterrorism is unlike that posed by threats from conventional terrorism, military strikes, or chemical, radiological or nuclear attack. By its very nature, the bioweapons threat – with its close links to naturally occurring infectious agents and biological disease – requires a different paradigm. Countering bioterrorism will depend on understanding it within this broader context. We must recognize the dynamic nature of biology and the influence of advances in medicine and science. Effective strategies will require different priorities, expertise and partnerships, along with a deeper understanding of our adversaries, both human and microbial. And, of course, we must be global in both our perspective and our actions.
Many of the special concerns raised by the nature of the bioweapons threat defy traditional ways of thinking about prevention, deterrence and non-proliferation. In this regard, as we think about the important steps necessary to reduce or prevent the threat of bioterrorism, it is essential to recognize that preparedness is, in fact, an important element of prevention. For a determined terrorist, limiting access to the tools of bioterrorism may prove a near impossible task. Thus we need a multi-faceted approach to countering bioterrorism. We must begin before an event occurs, doing everything we can to reduce the likelihood and opportunity for an attack. But even if we cannot prevent an attack, we can prevent catastrophe through well designed and funded programs to enhance surveillance, detection and early warning, research and medical countermeasure development and stockpiling, mobilization of response, including public health control and medical care, and recovery. The more effectively we are prepared to respond should an attack occur, the greater the likelihood that we can limit damage, save lives, control panic and re-establish normalcy. This will reassure the public, reduce terror and send a powerful deterrent message to those who wish to use biological agents as weapons of mass terror or destruction.
As we meet here in New York City almost seven years after the devastating attack on the World Trade Center and the dissemination of anthrax as a weapon through the mail, we are reminded of the reality of the world we live in and recognize just how vulnerable we are to acts of great malevolence and harm. The determination of this Commission to examine strategies to prevent the proliferation of biological weapons and its deadly conjunction with terrorism is a worthy but extremely difficult challenge.
Thank you very much for the opportunity to speak with you today. I will be happy to answer your questions and am eager to assist you in any way I can as you pursue this important mission.
