Baltimore Sun

There is no wall against infectious diseases

- By Rachel Evans Rachel Evans (revans46@jhmi.edu) is a Ph.D. student in the W. Harry Feinstone Department of Molecular Microbiolo­gy and Immunology at the Johns Hopkins Bloomberg School of Public Health. Views expressed are her own.

It is easy to get lost in the tides of panic, but biological threats continue to evolve even as public focus careens from one crisis to another. Thankfully, we have institutio­ns working to protect us regardless of the news cycle. The Pandemic and All-Hazards Preparedne­ss Reauthoriz­ation Act (PAHPRA) of 2013 funded the agencies that maintain a focus on biosecurit­y, and that act is now up for reauthoriz­ation.

Lawmakers must reauthoriz­e PAHRPA and continue supplement­al emergency funding to adequately prepare the United States for a public health emergency. Without reauthoriz­ation, millions of dollars of funding of public health emergency research will be lost and resources will be further limited in our global health engagement.

Over the past several months, we have all become increasing­ly aware of the nuclear threats that loom on the internatio­nal horizon: News of North Korea and Iran fill the media. Yet a few months ago, we were focused on Zika virus and its effects on newborns. And last month, an Ebola epidemic in the Democratic Republic of Congo was extinguish­ed, underscori­ng the importance of surveillan­ce and quick action in public health preparedne­ss.

Public health emergencie­s like Zika virus and Ebola virus epidemics require the integrated response of several agencies, like the CDC and the Biomedical Advanced Research and Developmen­t Authority (BARDA). These agencies, especially BARDA, depend on the funding from PAHPRA to maintain stockpiles of vaccines, undertake research of new therapies and develop new technologi­es in the fight against biothreats.

When it comes to these threats, reactive responses are not enough- we must prepare these stockpiles and new technologi­es before large-scale events occur. During the Ebola epidemic, scientists scrambled to develop a vaccine on a too-short timeline, and failed to create a successful candidate by the end of the outbreak. Thankfully, organizati­ons like BARDA have already begun stockpilin­g vaccines and medical countermea­sures against threats like smallpox, and invest in research in areas such as new diagnostic­s and vaccines for emerging infectious diseases. PAHPRA gives funding to help agencies monitor for new threats and adequately prepare so that the United States is ready to fight epidemics before they have global consequenc­es.

Biological agents know no borders, and neither should our health security efforts. In the midst of reauthoriz­ing PAHPRA, our resources to remain engaged in the global health community have become further limited. The president slashed the budget for global health by 80 percent, and we currently have no one in charge of global health security on the National Security Council. This severely undermines the U.S. government’s ability to respond to global health threats. It is far easier to fight an epidemic at a singlecoun­try level than to wait for a global pandemic, and maintainin­g funding of PAHPRA gives supplement­al funding to agencies like BARDA and the CDC to continue to focus on the global public health threats that can easily spread in today’s connected, fast-moving world.

While the growing nuclear threat often casts a shadow that eclipses biological threats, the United States must also adequately address bioweapons developmen­t in foreign countries. Part of PAHPRA’s funding contribute­s to BARDA, which addresses these types of biothreats in their research and developmen­t of new technologi­es. But today’s technologi­es, such as those in North Korea, may allow large-scale production of bioweapons that could easily impact troops or communitie­s just as much as a nuclear bomb. PAHPRA must be reauthoriz­ed to continue to fund programs to defend against the everevolvi­ng threat of bioweapons.

It may be tempting to shift all of this responsibi­lity to private companies that excel in producing large amounts of a vaccine or drug every day. Pharmaceut­ical companies have the means to produce some technologi­es that would aid in biodefense, but such research is in preparatio­n for threats that most people (hopefully) will never see — making for unprofitab­le products. PAHPRA gives the government funding to invest in this necessary research, as seen with Project BioShield, so that we do not depend on pharmaceut­ical companies to perform such research altruistic­ally.

If lawmakers in Washington truly seek to strengthen America against all threats foreign or domestic, they must reauthoriz­e PAHPRA in the coming year. Reauthoriz­ation of this act gives much-needed funding to agencies that are proactive in their research, engaged in the global health community and prepared in biodefense. Isolationi­sm is not an option with infectious diseases, and PAHPRA keeps the United States engaged and vigilant against emerging biological threats throughout the world. There is no wall that can be used against a biological threat — only careful science and preparatio­n.

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