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3 Preparedness as an Issue of National Security
Pages 17-30

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From page 17...
... In this chapter, experts representing a variety of sectors (e.g., national security, biosecurity, defense, economics, risk, industry, and ethics) discuss their perspectives, focusing on what can be done during interepidemic periods to envision MCM availability through a lens of national security, fill the gaps in preparedness, and enhance MCM capabilities.
From page 18...
... This kind of event, however, has distributional effects. Following the events of September 11, 2001, for example, Lower Manhattan real estate values fell, but those in Midtown rose; hotels and airlines suffered temporarily, but consumers instead spent their money on televisions and recreational vehicles; the federal government cut interest rates, boosting interest rate-sensitive industries.
From page 19...
... This could be accompanied by a new tax incentive for pharmaceutical firms to establish facilities that could quickly produce vaccines and treatments for emerging infectious disease outbreaks. GLOBAL RISK ANALYSIS What is needed now, according to Suresh Kumar, senior partner at Oliver Wyman Public Sector and Health and Life Sciences Practice, Marsh & McLennan Companies, is an objective, outside-in global health security strategy for the future.
From page 20...
... Unlike risk, trends occur with certainty and can have positive or negative -- Suresh Kumar, senior partner consequences. Global health security at Oliver Wyman Public Sector concerns will be exacerbated by trends and Health and Life Sciences Practice, Marsh & McLennan toward rapid and unplanned urban- Companies ization, particularly in developing countries; inadequate infrastructure associated with water, electricity, and sanitation; increasing resistance to antibiotics and antiviral drugs; and growing human mobility, which compounds the risk of transmission.
From page 21...
... Applications to the Civilian Sector Because biological threats range from common infectious diseases to the potential for complex engineered organisms, the DoD program uses an integrated layered approach, seeking holistic solutions, not just for individual agents, but potentially for classes of agents, that protect the warfighter both from the inside and the outside (e.g., personal protective equipment, decontamination, MCM)
From page 22...
... . DoD also encourages the development of broadspectrum MCMs that address both current clinical needs and emerging infectious diseases.
From page 23...
... Within DoD, the strategy is to develop broad solutions that may have application to multiple threats. Moving forward, she said, DoD's international and interagency partnerships will be critical to ensuring that multiple potential threats are addressed by the defense and health sectors with countermeasures to ensure a world safe and secure from infectious disease threats.
From page 24...
... . ENGAGING INDUSTRY Daniel Abdun-Nabi, president and chief executive officer of Emergent BioSolutions, shared his perspective based on more than 15 years of acquiring and developing MCMs for biological and chemical threats for governments across the globe.
From page 25...
... He agreed with others that a more streamlined and simplified contracting process would help to enable pharmaceutical companies and others to enter the MCM space. A few participants noted that it has been very challenging to induce credible leaders in industry to speak openly to Congress about what they would need to invest in the MCM enterprise.
From page 26...
... Invoking a predominantly national security rationale to address public health problems can be very effective in contributing to policy and programs that strengthen the public health infrastructure, but there are unintended consequences with ethical dimensions and direct practical implications for preparedness. The Ebola epidemic and other recent disease outbreaks have demonstrated that prevention continues to be undervalued and underfunded, Lee said.
From page 27...
... This perception can result in stigma, discrimination, and inattention to health problems that are unlikely to affect high-income countries. There is often an emphasis on short-term solutions to control acute infectious diseases when they emerge, rather than long-term efforts to build health infrastructure and address the underlying issues that contribute to the likelihood of such outbreaks (e.g., war, poverty)
From page 28...
... Efforts are under way in the private sector to develop three promising vaccine candidates that are currently in Phase II and Phase III clinical trials in West Africa. Preparing the world to prevent and respond to future epidemics requires capitalizing on this extraordinary global effort and international goodwill.
From page 29...
... PREPAREDNESS AS AN ISSUE OF NATIONAL SECURITY 29 the planned actions clear," Venkayya said. This entails communicating how government and industry partners are going to share risk and cost in addressing defined targets.


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