Written evidence submitted by Dr Patricia Lewis

Legal Provision for Biosecurity Preparedness

Introduction:

The Royal Institute of International Affairs (Chatham House) conducts independent and rigorous analysis of critical global, regional and country-specific challenges and opportunities, examining the changing nature of geopolitics through the lens of our core research themes - sustainable and equitable growth, preventing conflict, and improving the rules-based order. For over a decade, Chatham House has conducted research on high impact, low probability events, preparing for the new normal and addressing high impact, unknown probability security risks. This work is finding a new resonance during the Covid-19 pandemic. This submission builds on the work that Chatham House is currently carrying out looking at resilience planning as a major part of security, defence and international governance.

 

Background:
The first onslaught of the 2020 COVID-19 pandemic illuminated significant regional and global discrepancies in regard to the state of biosecurity readiness in areas such as testing provisions, personal protective equipment (PPE), and the speed of decision-making.

President Macron in a speech to the nation admitted French medical workers did not have enough PPE and that mistakes had been made: ‘Were we prepared for this crisis? We have to say that no, we weren’t, but we have to admit our errors … and we will learn from this’.

In reality few governments were fully prepared and, in years to come, almost all governments and health systems – even those that were well prepared – will ask: ‘how could we have been better prepared, what did we do wrong, and what can we learn?’. After every crisis, governments ask these same questions. Most countries have put in place national risk assessments and established processes and systems to monitor and stress-test crisis-preparedness. But some were more agile and better prepared than others for the first wave of Covid-19.

Some countries had more time to prepare and were able to watch the spread of the disease, learning from those countries that were first hit by the disease. Others took their own routes, and there will be much to learn from comparing these different approaches in the longer run.

Governments in Asia were strongly influenced by the experience of the SARS epidemic in 2002-3 and - South Korea in particular[1] - the MERS-CoV outbreak in 2015 which was the largest outside the Middle East. Several carried out preparatory work in terms of risk assessment, preparedness measures and resilience planning for a wide range of threats.

The US had adapted the 2019 Pandemic and All-Hazards Preparedness and Advancing Innovation Act, creating the post of Assistant Secretary for Preparedness and Response (ASPR) in the Department for Health and Human Services (HHS). The Act authorised the development and acquisitions of medical countermeasures and a quadrennial National Health Security Strategy. The 2019 Act also set in place a number of measures including the requirement for the US government to re-evaluate several important metrics of the Public Health Emergency Preparedness cooperative agreement, the Hospital Preparedness Program, and a requirement for a report on the states of preparedness and response in US healthcare facilities[2].

As part of the undertakings laid out in the National Security Strategy, the UK regularly updates the National Risk Register for Civil Emergencies which analyses the risks of major emergencies that could affect the UK in the next five years and provide resilience advice and guidance. The UK also published its Biological Security Strategy in 2018.

At the international level, there are frameworks for preparedness for pandemics. The International Health Regulations (IHR) - adopted at the 2005 World Health Assembly and binding on member states - require countries to report certain disease outbreaks and public health events to the World Health Organization (WHO) and ‘prevent, protect against, control and provide a public health response to the international spread of disease in ways that are commensurate with and restricted to public health risks, and which avoid unnecessary interference with international traffic and trade’.

Under IHR, governments committed to a programme of building core capacities including coordination, surveillance, response and preparedness. The UN Sendai Framework for Disaster Risk highlights disaster preparedness for effective response as one of its main purposes and has already incorporated these measures into the Sustainable Development Goals (SDGs) and other Agenda 2030 initiatives. UN Secretary-General António Guterres has said COVID-19 ‘poses a significant threat to the maintenance of international peace and security’ and that ‘a signal of unity and resolve from the Council would count for a lot at this anxious time’.

As the global impact of the Covid-191 pandemic unfurls, we need to seize this opportunity to prepare for future pandemics – whether another type of coronavirus or a new influenza virus or one of a type that we have yet to meet and whether coming from nature or through a human-manipulated pathogen released either inadvertently or deliberately. Our species and economies will be threatened again, we just don’t know when.

Other disasters too will befall us – we already see the impacts of climate change arriving on our doorsteps characterised by increased numbers and intensity of floods, hurricanes, fires, crop failure and other manifestations of a warming, increasingly turbulent atmosphere and we will continue to suffer major volcanic eruptions, earthquakes and tsunamis. All high impact, unknown probability events.

Recommendations:
Preparedness for an unknown future is expensive and requires a great deal of effort for events that may not happen within the preparers’ lifetimes. It is hard to imagine now, but people will forget the Covid-19 crisis, and revert to their imagined projections of the future where such crises don’t occur, and progress follows progress. But history shows us otherwise.  Preparations for future crises tend to fall prey to financial cuts and austerity measures in lean times unless there are mechanisms to prevent that. Cost-benefit analyses will understandably prioritise the urgent over the long-term. One way to address this natural tendency is to put in place legislation – or strengthen existing legislation – to ensure that the country is as prepared as possible for whatever crisis is looming. Other governments should be encouraged to likewise – we are all connected and a national epidemic faraway can very quickly escalate to a pandemic.

Such a legal requirement would require the government to report back to Parliament every year on the state of national preparations detailing such measures as:

At the international level, the UK could lead or co-lead on a set of initiatives that could enhance international biosecurity:

COVID-19 has been referred to as the 9/11 of crisis preparedness and response. Just as that shocking terrorist attack shifted the world and created a series of measures to address terrorism, we now recognise our security frameworks need far more emphasis on being prepared and being resilient.

Dr Patricia Lewis

Royal Institute of International Affairs, Chatham House
Research Director, Conflict, Science & Transformation;

Director, International Security Programme 

22 June 2020

 

 


[1] By 2007, South Korea had established the Division of Public Health Crisis Response in Korea Centers for Disease Control and Prevention(KCDC) and, in 2016, the KCDC Center for Public Health Emergency Preparedness and Response had established a round-the-clock Emergency Operations Center with rapid response teams. KCDC is responsible for the distribution of antiviral stockpiles to 16 cities and provinces that are required by law to hold and manage antiviral stockpiles.

 

[2] The 2019 Act built on the 2006 Pandemic and All-Hazards Preparedness Act, which required research to ‘improve federal, state, local, and tribal public health preparedness and response systems’ and required the National Institutes of Health (NIH) and the Center for Disease Control (CDC) to establish PERRC – the Preparedness for Emergency Response Research Centers.