Forewarned is Forearmed — Thoughts on the Looming Threat of Pandemic and What We Can Do About It

11 Feb

The deadly influenza outbreak of 1918 swept across the globe, claiming tens of millions of lives. The more conservative estimates place the death toll at around fifty million people though the number may have been far greater. My grandmother lost her older sister during that outbreak, but with the advent of more advanced medical technologies and increased understanding of how pandemics spread, my generation has so far experienced these deadly global outbreaks largely through the study of history. However, as the flu virus continues to mutate and scientists push the boundaries of experimental manipulation of pathogens, I wonder if we are adequately prepared to meet the biological security threats of tomorrow.

A recent article in Foreign Affairs by Laurie Garrett, “The Next Pandemic”, offers a comprehensive look at how the evolution of pathogens may shape our future and highlights the lack of governmental capacity for dealing with this urgent security threat. Due to several mergers in the 1990s and the high risk associated with investment in vaccines, there are now only a few companies that produce an influenza vaccine. Furthermore, as of 2003, the entire market for all vaccines accounted for less than two percent of the global pharmaceutical market. Thus if disaster strikes, manufacturers will have trouble ramping up production sufficient to meet dramatically increased demand. Garrett notes that “manufacturers have never produced more than 300 million doses of flu vaccine in a single year”, a disturbing figure given that in order to inoculate the entire population in the event of a global pandemic, the US alone would require roughly 300 million doses.

Should a pandemic strike now, given our current level of preparedness, tragic consequences seem inevitable. The world would be thrown into turmoil – widespread panic and drastically reduced law enforcement make for a bad mix. Peacekeeping operations would be weakened by loss of personnel, leading to a worldwide rise in conflict potential. Inter- and intrastate tensions would be further exacerbated by a severely limited supply of lifesaving vaccines and medication. In addition, a vastly reduced workforce, as well as an almost inevitable global stock market meltdown would lead to major economic troubles throughout the world. The combined effects of these outcomes would lead to global chaos and discord, exactly what security experts around the world spend their lives working to prevent.

In addition to formulating a response to the natural evolution of pathogens, we must also decide how to deal with the challenges that manmade pathogens pose to global security. Laurie Garrett offered some thoughts on this issue in “Biology’s Brave New World: The Promise and Perils of the Synbio Revolution.” She notes that “[i]n May 2010…J. Craig Venter and his private-company team started with DNA and constructed a novel genetic sequence of more than one million coded bits of information known as nucleotides.” This heralded the beginning of a new era where scientists could both manipulate the genetic code of existing organisms and create new ones. This is the age in which my peers and I will experience our adulthoods, and it has the potential to be a time of exciting innovations – everything from “smart” materials to artificially grown organs. However, this new era brings with it the potential for frightening innovations in the realm of biological warfare, as well as warfare triggered by biological catastrophe.

It is vital that we ask ourselves what the boundaries of exploration are and whether there are experiments that simply should not be conducted. In 2011, Ron Fouchier of the Erasmus Medical Center in Rotterdam announced that he had “mutated the hell out of H5N1”, turning it from a disease confined mainly to birds and transmissible only to humans who had direct contact with infected animals, into a possible human-to-human flu. Initially, he created a virus that could infect ferrets – ferret flu susceptibility is similar to that of humans, and thus they are often used as human stand-ins in labs. Fouchier then did what he described as “something really, really stupid” – he swabbed the nose of infected ferrets and then used the gathered virus to infect more of the animals, repeating the process until he had produced a strain of H5N1 that spread through the air. Fouchier defended his actions, arguing that the experiment served to alert that world that H5N1 could become airborne. However, the experiment set off a debate about what should and should not be allowed in the lab, with people raising concerns about what would happen if such a virus fell into the hands of terrorists.

Certainly, one way we can learn about these potential killers is by experimenting with them. However, Garrett raises an interesting point noting: “When HIV emerged in the early 1980s, nobody was sure just how the virus was transmitted…Had it been technically possible to do so, would it have been wise to deliberately alter the virus then, giving it the capacity to spread through the air or through casual contact?” In all fairness, although both are infectious, flu is very different from HIV, and the chance of H5N1 naturally mutating to become airborne and human-to-human transmissible is significantly higher. However, there is also a very real risk that the blueprints of experiments like Fouchier’s could fall into the wrong hands, with catastrophic consequences.

Perhaps the endless predictions of the coming storm have deafened us to the far off thunder. So far we have avoided a pandemic, but it is likely that eventually a highly contagious, deadly strain of influenza will emerge on a large scale. Whether that influenza kills hundreds of millions of people or not depends on how well we prepare for it. Stockpiling enough vaccines to inoculate the global population is not a viable option, but perhaps policymakers can offer companies incentives to enter the vaccine market and increase production capacity. Furthermore, by augmenting controls on and monitoring of scientific experimentation and weapons development, world leaders can help assure that no manmade biological weapon is ever unleashed. Our world is full of threats as well as opportunities. For the moment, we might well be missing the opportunity to proactively prepare for the threat of a pandemic, natural or otherwise. Through conducting a global dialogue on this potential danger to all humanity, we can share ideas on how to prepare and hopefully both prevent the malevolent use of biological agents and also mitigate the effects of a naturally occurring pandemic.

My generation is eager to add our brainpower and our voices to this discussion as we take on the mantle of tomorrow’s innovators. For now we must still rely on those at higher policy and scientific levels to take the lead on such initiatives and protect all our futures. I would urge those in authority to consider the consequences of failure to take proactive action. As Cervantes once noted, “to be prepared is half the victory.”

Carly Millenson, Student and WIIS New York Coordinator

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