Dr. David Relman of Stanford University has an article in the new issue of the New England Journal of Medicine entitled “Bioterrorism – Preparing to Fight the Next War,” which argues that the current US strategy places too much emphasis on developing countermeasures for known threats, and not enough on developing flexible capabilities for future and evolving threats:
In devising a robust biodefense strategy, a key challenge will be to define the optimal balance between fixed and flexible defenses. The Maginot Line built by the French in the 1930s serves as a symbol of static defenses designed to protect against known threats. Although these elaborate fortifications bought the French some time, the advancing German army maneuvered around them. Similarly, the creation of static defenses can be justified for clear, imminent, and potentially catastrophic biologic threats â€” including avian influenza virus and prominent drug-resistant bacteria, such as Staphylococcus aureus, as well as anthrax and smallpox.
For the vast array of other potential threats, however, we should invest even more in flexible, dynamic defenses, which will rely on integrative science, new insights into biologic systems, and advancing technology. We need methods and technologies that can generate effective diagnostics, therapeutics, and prophylactics against a new or variant infectious agent within days or weeks after its characterization.
This article makes me wonder if we need a new institution that can focus on developing these long-term capabilities, without the burden of short-term pressures and requirements. I’ve complained previously about the splintered nature of responsibility for bioterrorism in the federal government, but this might be one area where a siloed institution would have some real value. Perhaps the recent Senate proposal to create a Biomedical Advanced Research and Development Agency (BARDA), following the DARPA model, could be the right vehicle for this, although in the current bill language, BARDA has a lot of near-term responsibilities.
If you’re interested in bioterror issues, the article is definitely worth a read.