Biodefense: Coordinating Our Response to Deadly Disease with a Strategy and Policy Memo

The FBI arrested a Navy veteran for sending two letters to a Pentagon distribution center that tested positive for ricin, providing a test run on the effectiveness of interagency response to biological attacks, pandemics, and other bioincidents. The Trump administration has been active in this arena. It trailed release of the congressionally mandated National Biodefense Strategy with a National Security Policy Memorandum on National Biodefense (NSPM-14) on September 18, 2018. Following Judge Alice Hill’s advice in Lawfare, the United States is taking steps to “get serious about biodefense” by developing robust strategies from prevention to recovery, and by providing a clearer chain of command for interagency responses to national bioincidents, rather than employing unilateral agency action. However, questions remain on the funding and execution of the strategy during a crisis.

Congress mandated the National Biodefense Strategy in § 1086 of the FY17 National Defense Authorization Act. The strategy is grounded in Pillar One of the National Security Strategy, which was released by the Trump administration in December 2017, on protecting the American people. The vision of the strategy emphasizes all stages and all forms of biological incidents:

“The United States actively and effectively prevents, prepares for, responds to, recovers from, and mitigates risk from natural, accidental, or deliberate biological threats.”

Like other activities involving varying degrees of danger, the strategy employs layered risk management techniques, driven by objective intelligence assessments, to evaluate and respond to bioincidents. The strategy has five explicit goals:

1) Enable Risk Awareness to Inform Decision-Making Across the Biodefense Enterprise.

2) Ensure Biodefense Enterprise Capabilities to Prevent Bioincidents.

3) Ensure Biodefense Enterprise Preparedness to Reduce the Impacts of Bioincidents.

4) Rapidly Respond to Limit the Impacts of Bioincidents.

5) Facilitate Recovery to Restore the Community, the Economy, and the Environment After a Bioincident.

As a part of the roll out of the document, Department of Homeland Security (DHS) Secretary Kirstjen Nielsen released a statement of support, noting her own experience of streamlining DHS’s Office of Countering Weapons of Mass Destruction, including biological weapons. Health and Human Services (HHS) Assistant Secretary for Preparedness and Response Robert Kadlec also praised the document for embracing a whole-of-government approach to responding to bioincidents. The Department of Defense (DOD) also issued an article reviewing the new documents.

As noted by the NSPM, in addition to the White House statement and press briefing accompanying it, the executive branch sought to implement what worked (and what didn’t) following the 2001 anthrax attacks, the2009 influenza pandemic, and the 2014 West Africa Ebola epidemic. The NSPM restructured the bureaucratic framework by directing the secretary of HHS to take point on coordinating the National Biodefense Strategy. In addition, the NSPM established the Biodefense Steering Committee, chaired by the secretary of HHS, with the participation of the other relevant agency and department heads in attendance (and open to other agency heads by invitation) to protect Americans from diseases and encourage biodefense enterprise. Moreover, the secretary of HHS is required to establish a Biodefense Coordination Team to “assist the Committee in monitoring and coordinating implementation of the Strategy.” Agencies may request a Biodefense Memorandum or Biodefense Assessments from the Biodefense Coordination Team. Finally, the NSPM required the national security advisor to review biodefense annually.

Interestingly, the National Biodefense Strategy and NSPM-14 (and issue of national biodefense as a whole) creates more interagency bureaucratic processes in a Trump administration that tends to promote unilateral agency action. For instance, the Trump administration has encouraged unilateral agency action on cyber matters with noticeable benefits and detriments, as noted by Professors Dakota Rudesill and Bobby Chesney on Lawfare. Perhaps biodefense as a policy area is dominated by professionals in the administrative state and is eschewed until an incident occurs. Moreover, this NSPM echoes the organization of the National Security Council to create buy-in for stakeholders across agencies — granting access to the most resources while preserving bureaucratic turf — while giving HHS a leadership role to increase the probability that coordinated action occurs with an accountable lead agency. For instance, Tom Inglesby of the Johns Hopkins Center for Health Security commented on the interagency process established and turf wars avoided in these documents:

It’s useful to know that day-to-day coordination and execution will be the responsibility of the Secretary of Health. Having top level accountability and responsibility clearly assigned is a good development. But by same token it will be important and challenging to make sure that the many other agencies of government that need to be involved in preventing and preparing for biological threats stay engaged and bring their full capabilities to bear. HHS has vital capabilities that reside in ASPR, CDC, NIH, and FDA, but there are key roles to play for DOD, DOS, USDA, USAID, DHS EPA, the intel community and other programs. It would not be good if other agencies step back from the biodefense mission because they perceive their roles to be diminished.

In addition, the National Biodefense Strategy and NSPM-14 also received praise for reflecting a proactive approach to policy and plans.The Blue Ribbon Study Panel on Biodefense applauded the document, and noted how it “addresses every part of the spectrum of activities that our Panel determined comprise biodefense – from prevention, deterrence, and preparedness, to detection and surveillance, response, attribution, recovery, and mitigation.” The panel will likely discuss the strategy in more detail at a forthcoming meeting on October 8, according to Homeland Preparedness News.

A key remaining aspect, as noted by Politico, will be on the amount of funding that is readily available for executing the strategy, especially for preventative measures, such as vaccines. This critique was also raised by the Global Health Security Agenda Consortium, which challenged the Trump administration to match its words with budgetary action. As former Under Secretary (Acting) and Deputy Under Secretary in the Science & Technology Directorate of the Department of Homeland Security Daniel Gerstein argued on this point for this strategy that “more may be required to fully realize its goals and objectives,” including adequate funding.

Thus, while the National Biodefense Strategy and NSPM-14 answer command and control questions (in theory), demonstrate the benefits (and costs) of interagency processes, and provide a robust plan of action, questions remain on funding and executing responses to bioincidents during a crisis.

Photo: Officials consult on April 16, 2013 in Hyattsville, Maryland after an envelope addressed to U.S. Sen. Roger Wicker (R-MS) tested positive for ricin at the facility where mail bound for the U.S. Capitol is sorted. Photo by Drew Angerer/Getty Images.

 

About the Author(s)

Thomas Rovito

Recent graduate of the Moritz College of Law, selected for a U.S. Army JAG Corps commission. This article reflects his personal views, and not the views of the U.S. Government.