Course Description

This three-day, non-credit short-course is designed to introduce participants to the challenges facing the world at the intersection of biodefense and public health. Private and public organizations face a number of challenges in the biosecurity domain. A bioterrorist attack is both a public health emergency and a criminal act whose perpetrators need to be apprehended. Likewise, pandemics can affect not just public health, but also public safety and national security. The causes and consequences of these risks extend far beyond any one nation’s borders. Pandemics and bioterrorist attacks will also confront government agencies and the private sector with the need to make high-impact decisions with limited information during a rapidly evolving situation. Further complicating this domain is the dual-use nature of biology: the knowledge and skills developed for legitimate scientific and commercial purposes can be misused by those with hostile intent. Research with dangerous pathogens and the development of dual-use biotechnologies poses a dilemma for policy-makers and researchers who seek to maximize the benefits of such research while minimizing the risks. Thus, public health, law enforcement and national security agencies, pharmaceutical and biotech industries, and the academic life sciences community need to establish new priorities, such as developing new types of expertise, adopting new types of risk assessment and risk management strategies, and learning to collaborate with each other.

Implementing these new priorities will require substantial organizational learning and change. But large organizations have deeply embedded professional norms and organizational culture that make them resistant to change, even during times of crisis. Each organization responds with its own routines, and its own distinctive view of “the threat,” which dilutes new initiatives, encourages stovepiping, and impedes effective collaboration. These organizational tendencies grow even more pronounced during times of declining budgets. Thus, while the need for collaboration is great, the potential for differing organizational styles to produce conflict is high.

The 1976 swine flu scare, 2001 anthrax letter attacks, 2003 smallpox immunization campaign, SARS and avian influenza outbreaks, and 2009 influenza pandemic provide rich case studies of how elite organizations have struggled to address novel biological threats, make high-impact decisions with limited information, and work effectively with new partners. The lessons from these cases are broadly applicable to both public and private organizations seeking to address current and emerging biosecurity risks.

Topic Highlights

Among the specific course topics that will be included are:

Learning from SARS & Avian Flu
The SARS epidemic and the threat of H5N1 avian influenza are striking reminders of how infectious diseases can spread in unexpected ways. What can we learn from these experiences about the problems of disease surveillance, accurate diagnosis, effective treatments, and the detection of novel viruses? How would the SARS outbreak have been different if it had been a deliberate release? What are the potential global health consequences if avian flu became easily transmitted person-to-person?

The 1976 Swine Flu Scare: Lessons for Decision-Making
In 1976, the Centers for Disease Control (CDC) mounted a national immunization campaign against a projected new influenza virus that was feared to be unusually virulent. However, the virus never arrived. Instead 25 people died from unexpected side effects from the vaccine itself. What can we learn from this program about decision making with fragmentary evidence; about probing medical assumptions; and about accurate public communication?

Impediments to Organizational Change: Professional Norms, Organizational Routines and Culture
What are the impediments to organizational change? Is reorganization an effective response to these issues? What are effective strategies for changing an organization’s priorities?

Case Study: The 2001 Anthrax Letter Attacks
The 2001 anthrax letters caught public health and law enforcement agencies off guard. What are the lessons for diagnosis and treatment; for interagency cooperation; and especially for clear, consistent risk communication to the public?

Dual-Use Research: Balancing Benefits and Risks
Advances in the life sciences and the revolution in biotechnology are frequently referred to as being dual-use. The recent controversy over experiments with H5N1 is only the latest example of this dual-use dilemma. What is dual-use dilemma? What are the risks posed by dual-use research? How feasible and desirable are proposed measures to regulate dual-use research? What are the potential costs of such proposals? What is the proper balance to be struck between science and security?

Expanding the Law Enforcement Approach
The standard law enforcement approach stresses careful examination of the crime scene and a search for the perpetrators of the crime. However law officers are not trained in the identification of biological agents, nor in the capabilities needed to make or spread biological agents. How do we expand law enforcement routines to respond to bioterrorism? How do we organize law enforcement and scientific capabilities to work in harness? What role should law enforcement agencies like the FBI play in preventing bioterrorism?

Biological Weapons and National Security
Biological weapons are the least well-understood of the so-called weapons of mass destruction. What unique features of biological weapons differentiate them from chemical and nuclear weapons? Why have states and terrorists groups sought biological weapons? What national and international strategies can be adopted to reduce the proliferation of these weapons?

Barriers to Bioweapons: The Case of Filoviruses
Filoviruses, including Marburg and Ebola viruses, are feared and lethal viruses on an individual level, but they are not very communicable and have never killed more than a few hundred people per outbreak. How realistic is it that aggressors could modify these viruses by genetic engineering to become more effective bioweapons? Are the resources and expertise needed for this within the likely reach of terrorist groups?

Developing Medical Countermeasures
The 2001 anthrax letter attacks and 2009 influenza pandemic revealed a lack of effective medical countermeasures against traditional and emerging biological threats. The new national medical countermeasure initiative foresees an increased federal role in the development and purchase of the next generation of vaccines and therapeutics. What are the political, technical, regulatory and financial obstacles to this new initiative? Who should manage this ambitious effort? What should be the roles of public health agencies, national security agencies, and the private sector?

Courses Objectives