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Biosurveillance, Medical Countermeasures and Global Health: Addressing Complex Challenges October 16, 2013 Irene Anne Jillson, PhD Assistant Professor.

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Presentation on theme: "Biosurveillance, Medical Countermeasures and Global Health: Addressing Complex Challenges October 16, 2013 Irene Anne Jillson, PhD Assistant Professor."— Presentation transcript:

1 Biosurveillance, Medical Countermeasures and Global Health: Addressing Complex Challenges October 16, 2013 Irene Anne Jillson, PhD Assistant Professor School of Nursing and Health Studies

2 DEFINING THREATS What do you consider threats to global health and security today? What do you believe they were 40 years ago or so (1970s)?

3 VARYING DEFINITIONS By USG Agency By international agencies By other countries

4 Defining global health threats DOD: a public health emergency is an occurrence or imminent threat of an illness or health condition that may be caused by: Biological incident, naturally occurring or intentionally introduced Appearance of a novel, previously controlled or eradicated infectious agent or biological toxin Natural disaster Chemical attack or accident High-yield explosive detonation Zoonotic disease National Intelligence Council (2000) -- broadened the scope to include HIV/AIDS, chronic NCDs Neglected tropical diseases Sanitation and access to clean water DHHS (NIST SP )– the potential for a person or think to exercise (accidentally trigger or intentionally exploit) a specific vulnerability Natural Threats: may include floods, earthquakes, tornadoes, and landslides Human threats: enabled or caused by humans and may include international (e.g., network and computer based attacks, malicious software upload, and unauthorized access to EPHI) or unintentional (e.g., inadvertent data entry of deletion and inaccurate data entry) actions. Environmental threats: may include power failures, pollution, chemicals and liquid leakage

5 Threats: chemical, biological, radiological, or nuclear (CBRN) threat agents naturally-occurring infectious disease outbreaks transboundary zoonotic diseases Other?

6 DEFINING BIOSAFETY AND BIOSECURITY Biosafety and biosecurity widely used and of increasing concern Joint statement by the Federation of American Societies for Experimental Biology and the Association of Medical Colleges The news media and policymakers often use the terms biosafety and biosecurity interchangeably, when distinct differences from a policy and regulatory point of view may exist. (2)

7 BIOSAFETY application of knowledge, techniques and equipment to prevent personal and environmental exposure to potentially infectious agents or biohazards. Biosafety defines the containment conditions under which laboratory workers can safety manipulate infectious agents. The objective of containment is to confine biohazards and to reduce the potential exposure of the laboratory worker, people outside of the laboratory, and the environment to potentially infectious agents. (3) SEMP (2003)

8 BIOSECURITY First used in the fifth edition of CDCs Biosafety in Microbiological and Biomedical Laboratories, fifth edition Still no consensus on a definition Described as an objective rather than a term The objective of biosecurity is to prevent loss, theft or misuse of microorganisms, biological materials, and research-related information. This is accomplished by limiting access to facilities, research materials and information. (4) No final SEMP definition for biosecurity, but one option: …application of knowledge, techniques and equipment to prevent or mitigate community and environmental exposure to potentially infectious agents or biohazards resulting from loss, theft or misuse of microorganisms, biological materials, and research-related information. This is accomplished by limiting access to facilities, research materials and information. (8)

9 DISTINCT CONCEPTS: Biosafety the goal of biosafety is to protect individual laboratory workers from exposure to the microorganisms they handle. By contrast, the goal of biosecurity is to protect dangerous biological materials from inadvertent or deliberate release to the community or environment. (4) …inherent to the concept of biosafety is protecting the individual handling the agent, whereas inherent to the concept of biosecurity is protecting populations of humans, animals and plants, as well as the environment. (1)

10 Distinct Concepts: Biosecurity Biosecurity differs from biosafety in terms of its focus on populations and the environment, rather than on individuals the fact that its risk classification system is based on the inherent capability of a microorganism to be used as a weapon against humans, animals, plants, and the environment, rather than (as with biosafety) to cause disease in humans, animals, and plants. (1)

11 Contextual factors for threats U.S. Other countries Low-resource countries Conflict and post-conflict settings

12 Defining Medical Countermeasures MCMs Drugs, biologics (including vaccines), devices (including diagnostic tests and personal protective equipment), and other equipment and supplies for response to public health emergencies involving chemical, biological, radiological, or nuclear (CBRN) threat agents or naturally-occurring infectious disease outbreaks.

13 Improvements over a decade Common methodologies for assessing threats and risks Improved interaction between health and safety sectors Improved interaction between human and animal health sectors High-safety laboratories Generating best practices in detection, diagnosis and transportation

14 Global Health Security Initiative GHS: term used to describe preparedness for and response to serious health incidents that are cross-border in nature and that post a risk to security, destabilize economies, disrupt social cohesion, and affect the critical business of government. GHSI members: Canada, France, Italy, Japan, Mexico, UK, US, EU, WHO

15 Incidents that influenced GHS focus: Sarin gas attack in Tokyo (1995) Mailing of Anthrax spores in the US (2001) SARS (2003) H1N1 Pandemic (2009) Fukushima accident (2011)

16 Issues to Consider Impact of non-medical technologies on transfer of diseases (and our ability to apply principles of regulatory science) Transportation Information and communication technology The politics of regulatory science Domestic (U.S.) U.S. foreign policy International politics

17 Back to the Future AIDS as a national security threat Food/water-borne contamination Drug-resistant gonorrhea Middle East Respiratory Syndrome (MERS-CoV) (Re) defining global health threats and countermeasures

18 Capacity-building and Harmonization U.S. DHHS DoS DoD USDA EU UNESCO WHO

19 REFERENCES 1. Suburban Urban Management Project 2. Letter from Federation of American Societies for Experimental Biology and the Association of Medical Colleges to the U.S. Working Group on Strengthening the Biosecurity of the United States, dated May 29, Available at Accessed from: 3. SEMP Dictionary. Available at Accessed from: 4. Biosafety in Microbiological and Biomedical Laboratories. U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention and National Institutes of Health, Fifth Edition, 2007, U. S. Government Printing Office, Washington: Available at Accessed from: Biosafety, Biosecurity, and Biological Weapons. The Sunshine Project, October Available at Accessed from: M. OLeary, cited in: 7. White House Office of Science and Technology Policy. Access April 17 at: 8. National Science Advisory Board on Biosecurity 9. USDHHS (2010) The Public Health Emergency Medical Countermeasures Enterprise Review 10. Groopman, J (2012) Sex and the superbug: the rise of drug-resistant gonorrhea. New Yorker Digital Edition: Oct. 01, 2012, pp


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