Biosecurity Threats in the Asia-Pacific Region
8-11 August 2005 Honolulu HI
The purpose of this executive summary is to briefly describe the highlights of the Biosecurity Threats Conference. A more detailed and in-depth report will be forthcoming from the Center of Excellence.
The Asia-Pacific Center for Security Studies and The Center of Excellence in Disaster Relief and Humanitarian Assistance conducted a conference titled “Biosecurity Threats in the Asia-Pacific,” from 8-11 August 2005 at the Asia-Pacific Center. Participation in this conference included over 40 civilian and military representation from the World Health Organization, the Center for Disease Control, the National Institute of Allergy and Infectious Diseases, Armed Forces Research Institute of Medical Science, Department of Health and Human Services, U.S. Army Medical Research and Material Command, Walter Reed Army Institute of Research, Office of Security and Emergency Preparedness, Center for the Study of Weapons of Mass Destruction, and personnel from both APCSS and COE. Additionally, medical personnel from PACOM and component commands, academics and researchers from the University of California, Davis, University of Washington, and the University of Hawaii, the State of Hawaii, and foreign medical practitioners from Singapore, Vietnam, and Hong Kong participated and contributed significantly to discussions. (See attached agenda and attendee list).
This conference focused on natural and man-made medical threats facing the Asia-Pacific in the near term, especially pandemic diseases such as avian flu, SARs, and other naturally occurring diseases. The goals of the conference were (1) to allow participants to share their perspectives on biosecurity threats; (2) discuss issues and challenges facing the United States and its Asian partners in responding to these threats, (3) examine policy planning and coordination, and (4) recommend improvements that could be effectively implemented to mitigate future outbreaks. The format of the conference was principally lectures for the first half of the day to educate each other on different perspectives and challenges, followed by working groups where prioritizing challenges and actions, opportunities for cooperation, and recommendations for international responses were addressed.
Key conference insights included:
- Global Threat. Potential pandemic diseases, such as avian flu, SARS, AIDS, and other diseases, due to the rapidity of dissemination, are global threats. As such, these diseases require a global response. Global organizations, such as the World Health Organization, and national organizations, such as CDC, need to strengthen their surveillance network and capabilities to monitor and quickly respond to disease outbreaks.
- Coordination. There is a lack of formal coordination mechanisms, both at the national and international level. Thought should be given to strengthening organizations, such as WHO and CDC, to act as more robust coordinating agencies to bring together both civilian and military organizations in resolving responses. At present, responses are too decentralized and uncoordinated.
- Communication. The number of forums, conferences and workshops should be increased to bring national and international policy makers, health scientists, and medical personnel together to meet and discuss health issues. Focusing on the pandemic avian influenza could be a rally point to create this multi-sector approach to synchronize responses to pandemic threats. To further improve communication, a central databank needs to be created, possibly at WHO, on lessons learned, contingency plans, and common language, and this should be made available to all in the Asia-Pacific.
- Prevention. Governments must concentrate on prevention rather than response to these threats. This involves a paradigm shift and reallocation of public health investments which now centers on response. Prevention will minimize mortality and morbidity and reduce economic losses. One of the best preventive measures is timely surveillance. Countries must report outbreaks of infectious diseases in a timely manner, despite the effect on tourism or trade. Significant improvements to surveillance and communications have been made, but there is much work to be done.
- Response. Local agencies are in responsible for initial responses to an outbreak. If they are unable to manage the response, due to a lack of capabilities, it is essential that requests for assistance and support are forwarded quickly so that assets can be energized to respond in a timely manner. Local agencies must develop plans and exercise those plans on a regular basis so the effects of pandemic outbreaks can be controlled.
- Military Capabilities. Militaries, with their large, organized forces, ability to mobilize quickly, and surge capabilities, will be employed to assist in responding to pandemic outbreaks. However, while most militaries have trained to deal with radiological and chemical threats, their utilization in dealing with pandemic biological threats has not been defined. Most militaries are neither equipped nor organized for this contingency. Furthermore, operations plans need to be written and exercises, such as CPXs with other militaries and civilian agencies, need to be conducted to ensure be ready to respond to these outbreaks. Information about military response capabilities of Asia-Pacific nations should be collected.
- Health Care Systems. Most health care systems, including the US, are ill-prepared for pandemic outbreaks of disease, and improvements must be made now to cope with these diseases that will soon emerge. Vaccines need to be developed, medications need to be stockpiled, and training and education, especially for first responders, as well as for the general public, should be expanded.
- Economic Effects.The effects of outbreaks on trade and the economy need to be examined. If government and businesses are aware of the detrimental effects that pandemic disease outbreaks can have on the bottom line, they will be more inclined to support response and mitigation efforts. The devastating economic effects of SARS of 2003 would pale in comparison to a pandemic avian flu outbreak.
In conclusion, conference participants engaged in lively and frank discussions about the challenges associated with responding to biosecurity threats in the Asia-Pacific region. All emphasized there was no need to create new organizations but emphasized providing capacity to those organizations that are in place. This will require a greater political will on the part of policy makers, and a greater allocation of resources to contend with these pandemics that will surely come in the near future. This conference was the first in what both organizations see as a series in addressing biosecurity threats facing the Asia-Pacific. All participants believed that this conference was a very necessary first step in bringing medical practitioners, policy makers, academics, and military personnel together to build bridges and discuss holistic responses to these challenges. This collaborative effort between APCSS and COE should be continued in future areas of common concern.