Digital Version of November/December 2014 Print Edition
It’s time to get serious about chemical and biological preparedness
Dr. Robert Kadlec
In Washington, attention has shifted from the daily grind towards a hyper-partisan presidential campaign. Battle lines are sharply cast between Republican challenger, Governor Mitt Romney, and the incumbent, President Barack Obama.
While all eyes are on the economy, national security challenges abound. Obama’s killing of Bin Laden and targeting terrorists with Predator strikes argues his prowess on terrorism. Iran’s nuclear weapon pursuits are hindered by cyber-sabotage.
Growing Syrian violence raises the specter of civil war, but a UN mandate is needed to enable U.S. action. Civil war, however, is not the only risk. Concerns percolate about Bashar al-Assad’s chemical and biological weapons. The State Department quietly warned our allies in February. In March, Defense Secretary Leon Panetta and the Joint Chiefs Chairman, Army General Martin Dempsey, publicly and ominously warned that these weapons could fall into the hands of Hezbollah and Al Qaeda.
Panetta recently mentioned that planning is underway for “any contingency.” DoD’s imperative will be to secure and deny terrorists these weapons, destroy a stockpile that Panetta describes as “100 times” larger than Libya’s, and prepare for the consequences should these efforts fail.
Meanwhile, Congress is working through minor differences between bills co-authored by Senators Burr (R-NC), Harkin (D-IA) Enzi (R-WY) and Casey (D-PA) and Representatives Rogers (R-MI), Myrick (R-NC) and Green (D-TX) reauthorizing the Pandemic and All-Hazards Preparedness Act. This legislation renews -- but provides no funding for -- key Department of Health and Human Services (HHS) authorities for the development and stockpiling of life-saving medical countermeasures to protect Americans from chemical, biological and radio-nuclear (CBRN) threat agents. These bi-partisan efforts will improve bio-preparedness, but excessive bureaucracy and funding cuts threaten progress and may nullify these advances.
Congress created the Biomedical Advanced Research and Development Authority (BARDA) to be solely responsible for development and procurement of civilian medical countermeasures. However, BARDA is not the final word on such matters. It is part of a larger Public Health Emergency Medical Countermeasure Enterprise (PHEMCE). PHEMCE is a series of committees representing other HHS stakeholders that coordinates, validates and decides on which countermeasures -- and how much -- to buy.
Surprisingly, funding concerns are not behind the long-delayed procurement of anthrax and radiological treatments and next-generation smallpox vaccines. In 2004, Congress wisely provided 10 years of procurement monies to ensure our nation’s preparedness would not be held hostage to political whims. The PHEMCE nullifies that advantage by engaging in a process that has multiple layers of review, each requiring internal approvals by unanimous consent.
For companies accustomed to streamlined business practices, which have candidate products involved in the PHEMCE process, the extensive bureaucracy resembles the Politburo. Delays not only cost companies money, but they also result in not having countermeasures available in the event of an emergency.
Further compromising the nation’s bio-preparedness is the decline of the Strategic National Stockpile. Countermeasures that have already been bought and stockpiled are at risk of being eliminated because the Centers of Disease Control’s bioterrorism funds have been cut. Many of the expiring vaccines, antibiotics and chemical antidotes will not be replaced and funds are inadequate to maintain what is at the ready. The money spent to prepare us over the last 10 years -- upwards of $5 billion -- may be wasted and protect no one because of insufficient funding. The White House and Congress must ensure this does not happen.
At a time when we worry about the risk of terrorists obtaining Syria’s chemical and biological weapons, the means to protect Americans in case those weapons are used appears to be declining. Deputy Secretary of Defense Ashton Carter said recently at the American Enterprise Institute, that these kinds of weapons "will be used in war. They will be used in terrorism."
While DoD is preparing for near-term worse case scenarios, HHS is “business as usual.” Whether this represents cognitive dissonance or dereliction of duty will depend on what ultimately happens.
Dr. Robert Kadlec, a former career officer and physician in the U.S. Air Force, served as the Biodefense Special Assistant to President George W. Bush. He can be reached at: