Forum on Microbial Threats: 2018 Annual Report (2019)

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Forum on Microbial Threats Board on Global Health 2018 Annual Report 

Download for free at www.nap.edu 

Contents Message from the Chairs 4 Reflecting Back: Forum Activities in 2018 6 Looking Forward: Forum Activities in 2019 11 One Health Action Collaborative 14 Sponsors and Members 18 Timeline 20 

FORUM ON MICROBIAL THREATS Message from the Chairs  Peter Daszak, Ph.D. Kent E. Kester, M.D. Mary E. Wilson, M.D. The challenge of microbial threats is complex and accelerating. From a microbe’s perspective, our planet shrinks each year as we grow more connected through travel and trade, our food supply becomes more concentrated, and our armory to deal with pathogens is less equipped to meet the challenges. When a pathogen emerges or reemerges, it can have broader and more severe consequences on our health, our economies, and our security in this modified world. During the 2013–2016 West African Ebola outbreak, we saw the rippling effects on global economies, including in the United States, and on agency and private-sector institutions at home and abroad. Effective interventions are frequently thwarted by political instability and war. Microbial threats are diverse—they include the global Since 1996, the forum has burden of neglected tropical diseases, the rise of antimicrobial resistance, diseases that spill over from animals to people, plant diseases, and the often surprising links been committed to providing among infectious agents and chronic diseases. These complex threats shape the a structured opportunity way we conduct science, the way we respond to outbreaks, our clinical toolbox, for discussion and scrutiny our policies and regulations, the pipeline of diagnostic technologies to detect them, of critical, and possibly and the drugs and vaccines to combat them. This complexity is the foundation on which the Forum on Microbial Threats brings together a diverse group of leaders contentious, issues related to from academia, government agencies, the private sector, and public society. Its research on microbial threats. task is to create a platform for cross-disciplinary, flexible, and creative thinking that can keep ahead of rapidly evolving microbes in a rapidly changing planet. Since the Forum on Microbial Threats was formed in 1996, it has provided a structured opportunity for leaders from a wide range of disciplines and industries to debate the most effective ways to understand, anticipate, and “manage” emerging infectious diseases. In the past decade, the forum has gradually coalesced around key themes: a cross-disciplinary One Health approach that brings together our understanding of human, animal, plant, and environmental health; a readiness to work on the full infectious disease landscape that includes the impact on global health security and economies; and a commitment to serving our nation by focusing on improvements to clinical medicine, public health, policy, and the dwindling antimicrobial and vaccine pipeline. 4 

In 2018, the forum continued its evolution. We expanded and diversified our sponsors and membership to better reflect the diversity of microbial threats. Peter Daszak, Ph.D. This includes representation from institutions working on neglected tropical Forum Chair diseases, child health, and global and state-focused public health. We held the workshops Urbanization and Slums: Infectious Diseases in the Built Environment and Understanding the Economics of Microbial Threats. We widened the reach of the forum’s previous work on combating antimicrobial resistance by hosting a side meeting at the Prince Mahidol Award Conference in Bangkok, Thailand. We worked closely with the One Health Action Collaborative to continuously assess the state of One Health in the United States and globally. Throughout these activities, our discussions helped champion a growing approach to infectious agents that is both multidisciplinary and “big picture,” but remains relevant to public health and medicine. As we move into 2019, the forum’s leadership remains committed to confronting Kent E. Kester, M.D. Forum Vice Chair the challenge of evolving microbial threats. The plans include a workshop on the growing convergence of chronic and infectious diseases. This trend has important implications in a society that has unprecedented access to information, but increasing difficulty in assessing proof of causality. It also has implications globally, as populations suffer from the triple threats of poverty, neglected tropical diseases, and disease emergence. Underlying these issues, the forum recognizes that the frequency of novel infectious disease outbreaks is expanding, and the framework to produce new countermeasures and therapies has never been so tested. We look forward to helping identify new strategies to fund and develop the future pipeline, and new ways to bolster global health security in a connected world. Mary E. Wilson, M.D. Forum Vice Chair 5 

Reflecting Back: Forum Activities in 2018 In 2018, the forum held three workshops, two closed meetings, and one international dissemination event; published two Proceedings of a Workshop and two peer- reviewed papers; and produced an Outbreak exhibit. These activities covered a variety of topics, including antimicrobial resistance, One Health, economic and social Forum meetings convene drivers of microbial threats, and global health security. domestic and international experts and leaders in the January 30: A One Health Approach for Tackling Antimicrobial infectious disease field to explore Resistance: Moving from Knowledge to Action—A Side Event for the Prince Mahidol Award Conference (PMAC) 2018 | Bangkok, Thailand complex issues and work toward a Building on the June 2017 forum workshop Combating Antimicrobial Resistance: shared understanding. A One Health Approach to a Global Threat and the PMAC 2016 and 2017 side meetings on antimicrobial resistance, this closed meeting at PMAC 2018 gathered international experts—scientists, delegates from ministries of health and agriculture, and decision makers from the United Nations—to galvanize policy action to counter antimicrobial resistance from the local to regional to global levels. Discussions touched on cross-cutting topics: (1) surveillance under a One Health approach; (2) rational use of antimicrobials; and (3) global policy and coordination. This event was organized in collaboration with the U.S. Agency for International Development and Wellcome Trust. June 12–13: Understanding the Economics of Microbial Threats— A Workshop | Washington, DC Available: Archived videos | Proceedings Chaired by forum member Peter Sands (The Global Fund) with opening remarks from Lawrence H. Summers (Harvard University), this workshop convened more than 100 domestic and international stakeholders with expertise on economic risks, models, and cost issues across the spectrum of endemic and emerging infections 6 

Reflecting Back: Forum Activities in 2018 Panelists David Fidler, Anthony Fauci, Yoshihiro Kawaoka, and Suzet McKinney discussed global progress to prepare for the next influenza pandemic at a workshop reflecting on the 100th anniversary of the 1918 influenza pandemic. and antimicrobial resistance. The event allowed for experts who often work in silos to share best practices, discover new ideas to develop interventions, and spur novel areas of research, such as on the economics of fear from outbreaks—an often neglected but critical area to understand when countering epidemics. Within only 2 months, the Proceedings of the Workshop was downloaded more than 2,000 times in 100 countries, already placing it as one of most downloaded National Academies Press products. November 26: A Century After the 1918 Influenza Pandemic— Why Are We Still Concerned?—A Workshop | Washington, DC Available: Archived videos | Proceedings to be released by June 2019 Reflecting upon the 100th anniversary of the 1918 influenza pandemic, the forum (in collaboration with the National Academy of Medicine) hosted a public awareness event to highlight the global progress and benefits of driving science, global governance, and cross-sectoral alliances for pandemic influenza preparedness. The event included an exhibit of 10 educational panels that illuminated the building blocks of strengthening global health security. The event drew nearly 300 people via in-person and online attendance. 7 

November 27–28: Readiness for Microbial Threats 2030: Exploring Lessons Learned Since the 1918 Influenza Pandemic— A Workshop | Washington, DC Available: Archived videos | Proceedings to be released by June 2019 Under the leadership of forum member Keiji Fukuda (The University of Hong Kong), the forum convened multisectoral stakeholders, including former ambassadors; current and former policy makers from multilaterals and governments worldwide such as Indonesia, Saudi Arabia, and the United States; community outbreak responders; and representatives from pharmaceuticals and nonprofits. Drawing on lessons learned, participants discussed strategies to build the business case and incite action among decision makers to overcome critical impediments to achieve greater preparedness through an intimate and candid dialogue. What makes a Forum on Microbial Threats workshop different from other activities on similar topics? “The practical applications focus [of the workshop] was given a well-grounded base.” – Academic participant, Readiness for Microbial Threats 2030—A Workshop, November 2018 A public Outbreak exhibit highlights themes in building national public health capacities, community engagement, global coordination, and research and development to enhance global health security. 8 

Reflecting Back: Forum Activities in 2018 “Speakers and forum members are extraordinary world experts. Interactive nature of workshop, small meeting, it’s a gem.” – Academic participant, Understanding the Economics of Microbial Threats— A Workshop, June 2018 “ Excellent presentations from the knowledgeable and well-spoken presenters, as well as the Q&A and discussion…. I think the fact that some of the participants are truly ‘in the thick’ of the efforts at the national and international levels, their comments were particularly significant.” – Public sector participant, Readiness for Microbial Threats 2030—A Workshop, November 2018 Engaging with the Smithsonian Outbreak project is one of many ways that the forum seeks to broaden its reach with members of the public. 9 



Looking Forward: Forum Activities in 2019 Looking Forward: Forum Activities in 2019 The forum continually identifies priority topics to convene public workshops several times per year, with the goals of influencing new ways of thinking, fostering cross-sectoral collaborations and new professional relationships, and inspiring research and action to shape the field of infectious diseases. Furthering the conversations in 2018, the forum will hold workshops in 2019 that channel our evolving understanding of microbes into new approaches and innovation, focusing on the convergence of infectious diseases and noncommunicable diseases and the broader development of cutting-edge public health tools and methods. June 11–12: Breaking Down Silos: The Convergence of Infectious Diseases and Noncommunicable Diseases—A Workshop | New York City A 1.5-day public workshop will explore the growing understanding of how microbes interact with and affect humans in multiple ways, ranging from effects on normal physiological functions to chronic diseases. The workshop will allow participants to gain a deeper understanding of how the distinction between infectious diseases and noncommunicable diseases is blurring, and how this is extending to new approaches, such as the use of vaccination to treat certain cancers. 11 

June 11–12: Workshop continued Specifically, this workshop will feature invited presentations and discussions including the following: . Current knowledge on the known and suspected associations between micro-organisms and chronic diseases and conditions, as well as associated issues, such as possible linkages between antibiotic use at an early age and obesity; . The evolving understanding of how the microbiome affects the normal physiological functioning in humans and how it may differ depending on the population, geographic location, and other biological or environmental factors; . Research needed to further understand the relationship between micro-organisms and chronic diseases and physiological functions; . Opportunities for developing new approaches to prevent, detect, and mitigate chronic diseases and to reduce their public health impact and burden; . Cutting-edge methods and tools and study designs being used to explore links between chronic diseases and infectious diseases; and . Mechanisms to leverage cross-sectoral collaborations and break down silos among various stakeholders from research to practice. December 4–5: Exploring the Frontiers of Innovation for Tackling Microbial Threats—A Workshop | Washington, DC This workshop will examine cutting-edge methods and tools such as advances in predictive modeling, digital platforms, and precision public health that can counter microbial threats and will assess approaches to leverage data insights that are useful for people on the ground. Stay tuned for developments on the Statement of Task for this workshop! 12 

Looking Forward: Forum Activities in 2019 Forum workshops are often hosted at the National Academies in Washington, DC, and involve breakout groups and table discussions among forum members, speakers, and public participants to brainstorm priority next steps to bring research into action. 13 

One Health Action Collaborative The One Health Action Collaborative (OHAC)1 associated with the forum is an opportunity to engage a community of participants who are interested in collectively exploring the current status, successes, and challenges of deploying the One Health approach and to catalyze efficient and effective implementation. Chaired by forum member Jonna Mazet (University of California, Davis), OHAC is comprised of both forum members and stakeholders external to the forum. Through ongoing dialogue and information sharing, OHAC’s objectives are to: Jonna A. K. Mazet, Ph.D., . Discuss the current understanding of high-risk interfaces for pathogen D.V.M., M.P.V.M. spillover from animals into people; OHAC Chair . Review best practices and valuable lessons in integrating the One Health approach in outbreak preparedness and response; . Develop ideas for expanding and linking One Health efforts to plant and environmental health; . Identify priorities, effective strategies, and creative solutions for preventing and controlling emerging disease threats; and Action collaboratives are . Inspire policy decisions and encourage global and local health capacity structured, action-oriented investments that would advance One Health efforts. entities that bring together experts from multiple disciplines. 1 The work of the action collaborative does not necessarily represent the views of any one organization, the forum, or the National Academies and is not subjected to the review procedures of, nor are they a publication or product of, the National Academies. 14 

One Health Action Collaborative Action Collaborative Members (through December 31, 2018) Jonna A. K. Mazet, Ph.D., D.V.M., M.P.V.M. (Chair) University of California, Davis Kevin Anderson, Ph.D.* U.S. Department of Homeland Security Casey Barton Behravesh, D.V.M., Dr.P.H., M.S. U.S. Centers for Disease Control and Prevention Peter Daszak, Ph.D. EcoHealth Alliance Jennifer L. Gardy, Ph.D. University of British Columbia, Canada Gail R. Hansen, D.V.M., M.P.H. Hansen Consulting, LLC Elizabeth D. Hermsen, Pharm.D., M.B.A. Merck & Co., Inc. James M. Hughes, M.D. Emory University Lonnie J. King, D.V.M. The Ohio State University Sally A. Miller, Ph.D.* The Ohio State University George H. Poste, D.V.M., Ph.D. Arizona State University David M. Rizzo, Ph.D. University of California, Davis Mary E. Wilson, M.D. University of California, San Francisco 15 *New member in 2018. 

Core Competencies in One Health Deliverables Education: What Are We Missing? *By Eri Togami, Jennifer L. Gardy, Gail R. Core Competencies in One Health Education Hansen, George H. Poste, David M. Rizzo, For their first deliverable, OHAC members assessed the evolution of existing Mary E. Wilson, and Jonna A. K. Mazet One Health core competencies, explored how they are being applied in academic June 4, 2018 programs, and identified gaps that could be filled through their recommendations. Today’s public health challenges are complex The resulting publication was disseminated widely, including at the International One and cross-cutting, such as antimicrobial Health Congress held in June in Saskatoon, Canada, and continues to receive positive resistance, food insecurity, and outbreaks of feedback and invite opportunities for OHAC to gain visibility with both domestic and emerging infectious diseases. An important step toward synergistically addressing these international audiences. issues would be to apply consistent One Health core competencies in education to optimally prepare future One Health leaders. It is unclear if and how core competencies are currently being employed in One Health education. This paper discusses the unique challenges facing the incorporation of One Health core competencies in educational programs and provides recommendations to advance their visibility and use. *The views expressed in this paper are those of the authors and not necessarily of the authors’ organizations, the National Academy of Medicine (NAM), or the National Academies of Sciences, Engineering, and Medicine (the National Academies). The paper is intended to help inform and stimulate discussion. It is not a publication of the NAM or the National Academies. Copyright by the National Academy of Sciences. All rights reserved. One Health Workers Complementing the core competencies in One Health education publication, OHAC members developed a survey designed to shed light on the usefulness and benefits of a One Health education and the potentially unique challenges that One Health workers face. The objectives were to characterize students, graduates, workers, and employers in the One Health arena; understand the benefits of One Health education; elucidate unique challenges that One Health workers face; and assess whether employers are satisfied with the skill sets of employees who have 16 

One Health Action Collaborative received training in the One Health arena. The survey has been disseminated to more than 500 stakeholders worldwide and closed in January 2019 for the data analysis phase. Findings of this survey will be discussed and shared with the public through a manuscript authored by OHAC members, which will offer recommendations on strengthening the One Health workforce. Plant Health and Food Security OHAC members have discussed the importance of elevating the role of plant health in the One Health approach and have begun to develop a concept for a third deliverable on “Plant Health, Food Security, Climate Change, and One Health.” This deliverable will be an editorial-style paper that will include case studies and help promote the United Nations’ Declaration of 2020 as the International Year of Plant Health. Other Activities In addition to these deliverables, OHAC discussed or provided input on other One Health efforts, including forum workshops on antimicrobial resistance, urbanization, and economics, as well as the World Bank’s activities on the economics of One Health and One Health in conflict-afflicted countries. OHAC also continues to monitor and support One Health progress in the United States, such as the follow-on activities of the first “One Health Zoonotic Disease Prioritization Workshop in the U.S.” 17 

SPONSORS (through December 31, 2018) The forum membership strives to be reflective of the diversity of microbial threats and the multidisciplinary, cross-sectoral collaboration necessary to address emerging challenges. Forum sponsors and members include a range of stakeholders from government agencies, pharmaceutical industry, nonprofit organizations, and The Forum on Microbial Threats academia across human, animal, and plant health. greatly appreciates its sponsors Uniformed Services University of the Health Sciences that make intellectual and U.S. Agency for International Development financial contributions to the U.S. Army Medical Research and Materiel Command U.S. Centers for Disease Control and Prevention forum’s work. U.S. Department of Homeland Security U.S. Department of Veterans Affairs U.S. Food and Drug Administration U.S. National Institutes of Health EcoHealth Alliance* Infectious Diseases Society of America Johnson & Johnson Merck & Co., Inc. Sanofi Pasteur The University of Hong Kong* *New sponsor in 2018. 18 

Sponsors and Members MEMBERS (through December 31, 2018)  Peter Daszak, Ph.D. (Chair) Michael Mair, M.P.H. EcoHealth Alliance U.S. Food and Drug Administration Kent E. Kester, M.D. (Vice Chair) Jonna A. K. Mazet, Ph.D., D.V.M., Sanofi Pasteur M.P.V.M. University of California, Davis Sponsors by Sector Mary E. Wilson, M.D. (Vice Chair) University of California, San Francisco Sally A. Miller, Ph.D. Academia The Ohio State University 7% Kevin Anderson, Ph.D. U.S. Department of Homeland Security Suerie Moon, Ph.D., M.P.A. The Graduate Institute, Geneva Industry Timothy Burgess, M.D., M.P.H. 22% Uniformed Services University of David Nabarro, B.M.B.Ch., MFPHM, the Health Sciences FRCP 4SD–Skills, Systems & Synergies for Dennis Carroll, Ph.D. Sustainable Development U.S. Agency for International Development Rafael Obregon, Ph.D., M.A.* Emily J. Erbelding, M.D., M.P.H. United Nations Children’s Fund U.S. National Institutes of Health Kumanan Rasanathan, M.B.Ch.B., Marcos A. Espinal, M.D., Dr.P.H., M.P.H. M.P.H. Pan American Health Organization Professional Government Health Systems Global Societies 57% Keiji Fukuda, M.D., M.P.H.* and Gary A. Roselle, M.D. The University of Hong Kong Nonprofits U.S. Department of Veterans Affairs 14% Jennifer L. Gardy, Ph.D. Peter A. Sands, M.P.A. University of British Columbia, Canada The Global Fund to Fight AIDS, Jesse L. Goodman, M.D., M.P.H. Tuberculosis and Malaria Georgetown University Thomas W. Scott, Ph.D. Eva Harris, Ph.D. University of California, Davis University of California, Berkeley Jay P. Siegel, M.D. Caroline S. Harwood, Ph.D. Retired At-Large Member University of Washington Paige E. Waterman, M.D. Elizabeth D. Hermsen, Pharm.D., M.B.A. Walter Reed Army Institute of Research Merck & Co., Inc. Matthew Zahn, M.D.* Rima F. Khabbaz, M.D. Orange County Health Care Agency U.S. Centers for Disease Control and Prevention *New member in 2018. 19 

T I M E LI NE For more than two decades, the forum has grappled with Selected Activities (2003–present) issues as diverse as influenza virus vaccines, antimicrobial 2003 | The forum changes its name to the Forum on Microbial resistance, climate change, the human microbiome, big data, Threats and continues to provide a structured opportunity to effective scientific communication, and fungal diseases. Its facilitate discussion and inquiry into the most challenging and publications have been cited widely and are regularly used complex science, technology, and public policy issues and in debates about critical issues affecting policy, industry, to foster collaborations across private and public sectors and and science. human, animal, and plant health communities. 1992 | The Institute of Medicine (IOM) releases the seminal • Ensuring an Infectious Disease Workforce: Education report Emerging Infections: Microbial Threats to Health in the and Training Needs for the 21st Century—A Workshop United States, which identifies major challenges in detecting (June 12–13) and managing infectious disease outbreaks and monitoring • Learning from SARS: Preparing for the Next Disease endemic diseases. Outbreak—A Workshop (September 30–October 1) 1996 | At the request of the U.S. Centers for Disease Control 2004 and Prevention and the U.S. National Institutes of Health, the IOM • Pandemic Influenza: Assessing Capabilities for Prevention convenes a Forum on Emerging Infections as part of developing and Response—A Workshop (June 16–17) a national strategy to address those challenges. 2005 1996–2002 | In its early years, the forum convened 10 meetings • Ending the War Metaphor: The Future Agenda for that considered topics both broad and narrow, including Unraveling the Host–Microbe Relationship—A Workshop managed care systems for emerging infections, biological (March 16–17) threats and terrorism in the wake of 9/11, and a case study on the Children’s Vaccine Institute. Already, the forum was recognizing • Protecting Against Foodborne Threats to Health: The critical concerns about antimicrobial resistance, the importance Practice and Policies of Surveillance, Proactive Prevention, of leveraging cross-sector collaboration to tackle public health Outbreak Investigations, and International Coordination— issues, and the links between human and animal health with the A Workshop (October 25–26) emergence of zoonotic diseases—and the forum has reexamined lessons across these key areas throughout the years. 20 

2006 2010 • Ethical and Legal Considerations in Mitigating Pandemic • Antimicrobial Resistance: Implications for Global Health and Disease—A Workshop (September 19–20) Novel Intervention Strategies—A Workshop (April 6–7) • Infectious Disease Surveillance and Detection: Assessing • The Causes and Impacts of Neglected Tropical and the Challenges—Finding Solutions—A Workshop Zoonotic Diseases—Implications for Global Health and (December 12–13) Opportunities for Novel Intervention Strategies—A Workshop (September 21–22) 2007 • Fungal Diseases: An Emerging Challenge to Human, • Vector-Borne Diseases: Understanding the Environmental, Animal, and Plant Health—A Workshop (December 14–15) Human Health, and Ecological Connections—A Workshop (June 19–20) 2011 • Global Climate Change and Extreme Weather Events: • Improving Food Safety Through One Health—A Workshop Understanding the Potential Contributions to the (December 13–14) Emergence, Reemergence, and Spread of Infectious Disease—A Workshop (December 4–5) 2012 • The Social Biology of Microbial Communities—A Workshop 2008 (March 6–7) • Microbial Evolution and Co-Adaptation: A Workshop in • The Science and Applications of Microbial Genomics— Honor of Joshua Lederberg (May 20–21) A Workshop (June 12–13) • Global Issues in Water, Sanitation, and Health—A Workshop • Sustaining Public Health Capacity in an Age of Austerity— (September 23–24) A Workshop (September 10–11) • Emerging Infections, Microbial Threats to Health, and the 2009 Microbiome Anniversary Symposium (December 11–12) • Influenza H1N1 Pandemic—A Workshop (September 15–16) 21 

T I M E LI NE 2013 2016 • Microbial Ecology in States of Health and Disease— • Big Data and Analytics for Infectious Disease Research, A Workshop (March 18–19) Operations, and Policy—A Workshop (May 10–11) • The Influence of Global Environmental Change on Infectious • Building Communication Capacity to Counter Infectious Disease Dynamics—A Workshop (September 24–25) Disease Threats—A Workshop (December 13–14) 2014 2017 • Emerging Viral Diseases: The One Health Connection— • Combating Antimicrobial Resistance: A One Health A Workshop (March 18–19) Approach to a Global Threat—A Workshop (June 20–21) • Vector-Borne Diseases: Exploring the Environmental, • Urbanization and Slums: New Transmission Pathways of Ecological, and Health Connections—A Workshop Infectious Diseases in the Built Environment—A Workshop (September 16–17) (December 12–13) • Symposium on Phylogenetic Approaches to Innate Immunity (December 2–3) 2018 • Understanding the Economics of Microbial Threats— A Workshop (June 12–13) 2015 • The Ebola Epidemic in West Africa—A Workshop • Readiness for Microbial Threats 2030: Exploring Lessons (March 24–25) Learned Since the 1918 Influenza Pandemic—A Workshop (November 27–28) • Enabling Rapid Response and Sustained Capability with Medical Countermeasures to Mitigate Risk of Emerging Infectious Diseases—A Workshop (March 26–27) • Global Health Risk Framework: Governance for Global Health—A Workshop (September 1–2) 22 

FORUM STAFF Cecilia Mundaca Shah, M.D., Dr.P.H. Forum Director and Senior Program Officer V. Ayano Ogawa, S.M. Program Officer T. Anh Tran Research Assistant BOARD ON GLOBAL HEALTH Julie Pavlin, M.D., Ph.D., M.P.H. Director 3 

ABOUT THE FORUM ABOUT THE NATIONAL ACADEMIES OF SCIENCES, ENGINEERING, AND MEDICINE The Forum on Microbial Threats of the National Academies of Sciences, Engineering, and Medicine was created in 1996 at the request of the The National Academy of Sciences was established in 1863 by an Act of U.S. Centers for Disease Control and Prevention and the U.S. National Congress, signed by President Lincoln, as a private, nongovernmental institution Institutes of Health to provide a structured opportunity for discussion to advise the nation on issues related to science and technology. Members and scrutiny of critical, and possibly contentious, scientific and policy are elected by their peers for outstanding contributions to research. Dr. Marcia issues related to research on and the prevention, detection, surveillance, McNutt is president. and responses to emerging and reemerging infectious diseases in The National Academy of Engineering was established in 1964 under the humans, plants, and animals, as well as the microbiome in health and charter of the National Academy of Sciences to bring the practices of engineering disease. The forum brings together leaders from government agencies, to advising the nation. Members are elected by their peers for extraordinary industry, academia, and nonprofit and philanthropic organizations to contributions to engineering. Dr. C. D. Mote, Jr., is president. facilitate cross-sector dialogue and collaboration through public debate and private consultation to stimulate original thinking about the most The National Academy of Medicine (formerly the Institute of Medicine) was pressing issues across the spectrum of microbial threats. established in 1970 under the charter of the National Academy of Sciences to advise the nation on medical and health issues. Members are elected by their Despite decades of progress, the need for the Forum on Microbial peers for distinguished contributions to medicine and health. Dr. Victor J. Dzau Threats remains. Problems such as Middle East respiratory is president. syndrome, Ebola, Chikungunya, Zika, yellow fever, and antibiotic resistance demonstrate how the issue of emerging infections is The three Academies work together as the National Academies of Sciences, global and unrelenting. The drivers are ever more pervasive, and the Engineering, and Medicine to provide independent, objective analysis and consequences—human, social, and economic—loom larger than ever. advice to the nation and conduct other activities to solve complex problems and inform public policy decisions. The National Academies also encourage education The forum convenes several times each year to identify and discuss key and research, recognize outstanding contributions to knowledge, and increase problems and strategies in the area of microbial threats. To supplement public understanding in matters of science, engineering, and medicine. the perspectives and expertise of its members, the forum also holds public workshops to engage a wide range of experts, members of the Learn more about the National Academies of Sciences, Engineering, and public, and the policy community. All workshops are summarized in Medicine at www.nationalacademies.org. high-quality scholarly proceedings that are available for free download from the National Academies Press. The Forum on Microbial Threats is part of the National Academies’ Board on Global Health. For more information about the forum, please visit our website: www.nationalacademies.org/microbialthreats.