The good old days of the threat are gone. What I mean is that we used
to have a list of classical threat agents. We would just
proceed down the list and try to develop countermeasures against each
one. If I did not like the list I would go to my colleagues in the
intelligence community and ask them to work a little harder on it and
improve the definitions.
Today, however, we face a wide variety of new kinds of biological warfare
agents. Some may have developed accidentally,
because these agents are constantly changing in nature. Unfortunately,
they may also be getting a helping hand from some clever scientists
who are genetically engineering them to defeat the defenses that we
might be trying to put in place.
The science and technology community is essentially developing our
defenses
independently of what the bad guy might actually use. So we are not
threat specific. The bottom line is that technology is part of the
solution to countering bioterrorism, and we have a few elements that
will contribute significantly.
There is an explosion in the scientific community today; almost every
discipline is making tremendous strides compared to the advances made over the
last 50 years. Despite this, I am very
pessimistic that we will find a silver bullet that will solve all our problems.
Instead, we need a balanced approach that combines several stages. We need protection
before an event happens, a detection system so that we know very quickly that
we have come under attack, and a way to treat people so that we can reduce casualties.
Let us look at these different stages.
First, we are trying to improve people’s acquired immunity by using
vaccines before a crisis erupts. Once we vaccinate people, they are protected
against a particular pathogen for life. We have a variety of new vaccines in
the pipeline and I am very optimistic that they will show good promise. In addition,
we are going one step further to multi-agent vaccines, such as those
routinely used in fighting childhood
diseases, which provide cover against a variety of different pathogens. Unfortunately,
there is a general reluctance
to vaccinate people before an attack,
because the risk/benefit ratio is not quite good enough.
Next, let us suppose we are in a heightened threat status and we have
intelligence data indicating an attack may be imminent. In this case, we may
go to “innate immunity,” which essentially means energizing the immune
system that protects you every day. Boosting your immune system may help protect
you against several generic pathogens, which may be nonspecific. Whatever the
kind of attack, your body will naturally protect itself. We have
several very promising developments in this area.
Then, if we do come under attack, how will we know? There may not be an explosion,
or a big event that says the
attack has occurred, so we are putting a very high premium on detection capability.
The classic approach is to put
detectors in place, but another possibility might be to use a medical surveillance
system, in which every one of us is the detector. If people come down with certain
symptoms, they would be
reported through the medical system and we would know immediately that an outbreak
had occurred in a particular area. That is important because the
majority of our treatments are most
effective if they are used quickly.
Once it is known that we are under attack, people will be clamoring for help,
so administering treatment must be relatively easy. Our current approach is
essentially one pathogen, one therapy, or in a commonly used phrase, “one
bug, one drug.” The big challenge, however, is to reduce the time between
the introduction of a new bug and the development of a countermeasure. Unfortunately,
for the foreseeable future, it is unlikely that we will be able to find a countermeasure
quickly enough to work in a crisis, so we are pursuing our work on this front
in a routine manner, without regard to crises.
There are other developments that are starting to show promise. We are also,
for instance, investigating countermeasures against classes of known pathogens.
We understand the signatures of those pathogens and we can make comparisons,
so that we can develop a countermeasure against an entire class. The ultimate
aim is to protect ourselves against any kind of unspecified threat, no matter
what it is.
In order to do that, we have to change the way we think about this
entire problem. Hitherto, we have tried to understand how each pathogen
attacks human beings and prevent it from doing so. Now, however, we are changing
the whole paradigm. We are studying the human body to understand all the pathways
through which something can get inside, and then trying to build defenses to
cut off those pathways. Whatever the pathogen may be, we are simply closing the
doors so that it cannot get in.
From a scientific perspective, however, we need a balanced approach to medical
countermeasures that includes pretreatments, as well as therapeutics. We are
at the dawn of a new age of scientific advances, and it will take time to harness
these new developments to work for us. Nevertheless, some very talented people
are working hard to find new
biological defenses, and there is no doubt that, in the end, technological
advances will provide part of the solution to countering bioterrorism.
Dr. Charles Gallaway is Director of the Chemical and Biological Defense Directorate
at the
Defense Threat Reduction Agency (DTRA) of the U.S. Department of Defense. He
was previously Director of Advanced Systems and Concepts Office; Chief of Arms
Control Technology Division and Chief of Systems Applications Division at DTRA.
Before that, he worked for the Defense
Intelligence Agency and the Central Intelligence Agency.
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