There is no wall against infectious diseases

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 vaccineon 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 single-country 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 ever-evolving 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.

Rachel Evans (revans46@jhmi.edu) is a PhD 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.

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