Panel revisits anthrax attacks: "Are we better prepared today?"

The Center for American Progress hosted an event on Thursday to commemorate the 10 year anniversary of the anthrax attacks.

The event, "Anthrax Revisited: The Outlook for Biopreparedness," featured a panel of experts on biosecurity discussing improvements in the country's preparedness and response capabilities. The panel featured James H. Davis, the executive vice president of Human Genome Sciences, Thomas V. Inglesby, the chief executive officer and director of the Center for Biosecurity at the University of Pittsburgh Medical Center, and Jeff Levi, the executive director of the Trust for America's Health. The panelists provided their views on the central question "Are we better prepared today?"

Dr. Inglesby said that the stockpiling of medical countermeasures is important and that huge capital investments need to be made to maintain the stockpile. Currently, there are vaccines for anthrax and smallpox, but the focus needs to be on those threats for which countermeasures are not yet stockpiled.

"It's been 10 years, we are better today," Dr. Inglesby said. "We have a Strategic National Stockpile, we have government agencies committed to supporting research development of new countermeasures, we have a method to procure these. We are in serious danger of losing focus of continuing to keep the stockpile full, and adding new things to the stockpile. While we have made progress, we are at a crossroads, if we continue to develop and be prepared, we have a lot of work still to do."

The government recently announced a contract to acquire an additional 44.75 million doses of anthrax vaccines for the stockpile. Emergent BioSolutions manufactures BioThrax, the only anthrax vaccine licensed by the Food and Drug Administration, which has been administered to over 2.6 million military personnel.

"Research...takes a great deal of time to develop some of these products," Dr. Davis said. "Most of the products that are very pathogen specific tend to be biological products and the manufacturing cost of biological products is very high even after you have the product. It takes a long time to manufacture them, it takes fairly sophisticated equipment, it takes highly skilled technicians to run the equipment. It's not something you can turn on or off."

Anthrax is the top biological threat because it is easy to weaponize and disseminate, and inhalation anthrax is lethal if not treated immediately. To protect against this threat, the strategic national stockpile has FDA-licensed vaccines, anti-toxins and antibiotics. Progress has been made on this front and, with the limited resources, the panelists suggest that other threats be addressed as well.

"At this point, where we are today, I'm more interested in having more solutions to different organisms how ever it comes about," Dr. Davis said. "I'm less concerned about the market risk because I don't think that's a major risk in comparison to all the other risks we are facing today. So I think we need to find the best solution - sometimes it is going to be big companies, sometimes small companies, I think it's good to have more than one source of addressing an issue but I don't think we should be driven by the market concern. We need to be concerned about how we get solutions on the market that the government can use in a crisis."

All panelists agreed that the government should recommit to preparedness and response effort even when times are difficult.

"The real difference is we have a much better idea of what the threat is and what we need to be doing," Dr. Levi said. "Do we have the political will to invest in it?"

The motivation to invest in preparedness measures and the response system especially by the states, has helped with the recent cantaloupe and the Listeria outbreak.

"Nature is the most effective bioterrorist,"Dr. Levi said. "Every time we do or do not respond effectively to something like the Listeria outbreak is a demonstration of our preparedness capacity. The kind of surveillance we need for that outbreak is the same we need for a bioterrorist event. That is a symbol of why we need to continue to invest. The preparedness function runs a spectrum - whether we use (food) safety as a reason to do it or bioterrorism as the reason to do it, a lot of that is overlapping."