Tom Inglesby, MD, director of the Johns Hopkins Center for Health Security commented today on the National Biodefense Strategy released by the Trump Administration earlier today:

“I am impressed by the scope of the effort. It’s the first national strategy that encompasses natural, deliberate, and accidental biological threats, and that addresses threats to humans, animals, and plants. It divides the work into 5 areas: assessment of threats, prevention, preparedness, response, and recovery – these areas of effort have previously been driven by different documents developed years apart in different Administrations. Quite valuable for this all to be driven by one strategy document now. It’s also new that the National Security Advisor is the lead for the strategy. This is important because Presidential national security priorities are ones that are comparatively likely to get more attention and resources than others. The fact that it is published along with a Presidential Memorandum adds power to it all, including the direction that budgets will need to respond to this strategy.

It’s useful to know that day-to-day coordination and execution will be the responsibility of the Secretary of Health. Having top level accountability and responsibility clearly assigned is a good development. But by same token it will be important and challenging to make sure that the many other agencies of government that need to be involved in preventing and preparing for biological threats stay engaged and bring their full capabilities to bear. HHS has vital capabilities that reside in ASPR, CDC, NIH, and FDA, but there are key roles to play for DOD, DOS, USDA, USAID, DHS EPA, the intel community and other programs. It would not be good if other agencies step back from the biodefense mission because they perceive their roles to be diminished.

The strategy rightly recognizes both the highly beneficial side of biotechnology, and also calls out the need for strengthening biosafety and biosecurity in the life sciences community. It’s particularly important that it calls out the need to promote effective global oversight of research which could have very high consequence, such as with potential pandemic pathogens.  There is no real global dialogue, let alone oversight in most countries, around this realm of research now – having this set forth in the strategy hopefully will motivate real action internationally.

It is very encouraging that the strategy commits to working abroad to strengthen countries capacities to combat infectious diseases and to work multilaterally. I would have liked to see specific mention to the Global Health Security Agenda by name, but it is very heartening to see the international commitment to capacity building for epidemic response. There is a strategy for Global Health Security that is set to be released next month, which will presumably add even more detail on these activities.

Other things that are notable and somewhat novel are the stronger emphasis on risk assessment that has been in past strategies, and the priority given to forecasting and modelling.  What is also new is the focus on secondary impacts and major disruptions to society, economy, and democracy itself– focusing on these major issues is important because these are the kinds of risks that can emerge in a severe pandemic.

DrPH Health Security track at the Johns Hopkins Bloomberg School of Public Health to launch next year

It will be important to understand more deeply how this strategy will be implemented – what are the timelines, who will be responsible for the work, and what resources will be needed and given for it. My assumption is that the kind of detailed planning document will follow.”

In June 2017, the Johns Hopkins Center for Health Security convened a meeting of more than 50 public and private sector biosecurity stakeholders in Washington, D.C., to gather recommendations for what was then the forthcoming National Biodefense Strategy. The Center was not involved in drafting the strategy.