The Brief

To grasp the threat of bioterrorism — and in recent years, the United States has received strategic warnings of biological weapons use from dozens of government reports and expert panels — you may want to consider this: one recent study from the intelligence community projected that a one- to two-kilogram release of anthrax spores from a crop duster plane could kill more Americans than died in the Second World War. Clean-up and other economic costs could exceed $1.8 trillion. Let us repeat: We are talking about one- to two-kilograms of anthrax pores.

It is thus puzzling – and disturbing – that the U.S. level of preparedness for dealing with the threat of bioterrorism remains far lower than that of the nuclear threat. It is time to change this imbalance.

Central to any U.S. biosecurity strategy is the recognition that biological weapons are distinct from nuclear weapons and require a unique approach:

• On the bad side: Unlike nuclear weapons, which require highly advanced technology, massive infrastructure, and rare materials that can be closely monitored and secured, biological weapons materials occur naturally, require no significant infrastructure to produce, and can be found in nearly every part of the world. What is more, as technology advances, the ability to prevent biological attacks diminishes.

• On the “good” side: With nuclear weapons, once a bomb goes off, there is little that can be done to mitigate the consequences. There is, however, an opportunity to decrease the impact of a biological weapons attack by improving the U.S. capabilities for rapid recognition, response, and recovery.

These capabilities, unfortunately, have not been adequately embraced in a national bioweapons prevention strategy. Most egregiously, two programs set up to develop and purchase medicines to prevent and respond to biological, radiological, or nuclear attacks have been inadequately funded, and have also had to weather attempts to raid their funding. One is the Department of HHS Biomedical Advanced Research and Development Authority (BARDA), which leads an integrated, systematic approach to the development and purchase of the necessary vaccines, drugs, therapies, and diagnostic tools for public health medical emergencies. The other is Project BioShield, which funds medical countermeasures against biological, chemical, radiological, and nuclear agents.

The outgoing Bush administration requested $969 million in additional funding for BARDA. That funding could and should have been included in the stimulus package but was not. Not only was it not, but the Obama administration, inexplicably, request only was only $305 million for BARDA in FY 2010. The commission says this is insufficient by a factor of 10.

The paltry sum the Obama administration requested for biodefense is especially disturbing since funding allocations for clinical development of biodefense medical countermeasures (MCMs) have direct impacts on the probability of successfully satisfying all of these requirements. The Center for Biosecurity at the University of Pittsburgh Medical Center recently estimated that $3.39 billion per year in medical countermeasure development support would be required to achieve a 90 percent probability of developing an FDA-licensed countermeasure for each of those requirements. The cost estimates of developing these pharmaceuticals were based on in-depth surveys of historical vaccine and drug development data, and reflect the high failure rate of biopharmaceutical development.

It now falls to the U.S. government to fund the development of medical countermeasures based upon the level of risk that is deemed tolerable. The commission says that an amount of $1.7 billion per year would meet roughly half the estimated need to provide a significant and necessary down-payment on the U.S. preparedness. “Given the threat, $1.7 billion per year for prevention and consequence management is a reasonable and comparatively sound investment, the commission argues.

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