Written evidence submitted by Dr Beyza Unal and Benjamin Wakefield
Royal Institute of International Affairs, Chatham House

Resilience and Biosecurity: Lessons from African Cities

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 biosecurity issues over the last decade. This submission draws on the two-year project: Strengthening Urban Preparedness and Resilience against Biological Threats. The main aim of the project was to ascertain the required capacity building activities that would strengthen urban resilience to biological threats in key African cities.

 

Section 1: The main drivers of biosecurity risks to human health in the UK, including from pandemics and emerging infectious diseases

The 2018 Biological Security Strategy rightly recognises that the impacts of animal and plant diseases are far reaching and that the risk of related outbreaks is high. It is also accurate in its recognition that most new and emerging diseases are zoonotic diseases and COVID-19 is the latest example of this. A ‘One Health’ approach, considering the human-animal-environmental interface, is key to understanding, preparing for and responding to the main biosecurity risks to human health in the UK.

Main areas of biosecurity risks include:

At the international level, there are concerns over the use of biological agents by state and non-state actors. The Biological Weapons Convention (BWC) does not have an effective compliance system; there is a lack of measures to prevent non-state actors’ possession, transfer, transport, or use of bio agents and bioweapons; and problems exist with the implementation of the BWC and United Nations Security Council Resolution 1540 in different parts of the world. Preparedness and city resilience as part of a bottom-up approach plays a key role in strengthening and supporting the BWC.

Driver #1: ill-preparedness not only at the national level but also at the local levels

The capacity of states to contain and respond to biological threats varies considerably across the world. Prior to COVID-19, there has been a wide-belief that low-and-medium income countries lack the infrastructure, including for example the laboratory standards, regulatory capacity and resources needed to efficiently and effectively manage an incident involving biological agents.[1]  It was also believed that countries in the developed world were better prepared in detecting, responding and containing outbreaks and emerging infectious diseases. COVID-19 revealed areas of vulnerabilities and gaps in the current biosecurity plans across the globe. The spread of COVID-19 has shown quite clearly how quickly a natural disease outbreak can spread and intensify in densely populated urban centres throughout the world. The success of a response and the ability to control an outbreak are largely determined by the efficacy and preparedness of national and local health systems, this is the case whether an outbreak is natural, deliberate or accidental.

In this regard, one of the main drivers of biosecurity risks to human health is the ill-preparedness of cities against biosecurity risks. As the world becomes more urbanized and interconnected, and cities and towns grow, localised forms of governance have become critically important in managing numerous global security challenges: terrorism, climate change, health security among others.

Local authorities have the power to leverage existing local infrastructures, accelerate policy responders, foster resource mobilization, detect, assess and notify national authorities, and engage local stakeholders to prevent a crisis from escalating. Emergency responders such as ambulance, police and fire services, all operate at a local level, enabling them to work quickly and effectively in chaotic situations. It is therefore critically important that urban centres are resilient in the face of emergencies and are prepared to handle threats that emerge both domestically and internationally. Strengthening health systems and building capacity in lower income countries are fundamental to this end. Urban resilience in the context of biological threats means being able to deliver basic needs, protect human life and infrastructure, and function efficiently while absorbing the knock-on effects of bioweapons use, natural outbreaks, or accidents.

Recently, Chatham House conducted a two-year project that focused on city-resilience against biological threats in developing countries and found that:

Driver #2: Lack of law enforcement / Multi-agency coordination plans

In the early stages of an outbreak it is difficult to determine whether an outbreak is natural or deliberate and there may be disagreement on the matter between a country’s security services and health ministries and on who leads the response. It is therefore important to establish and communicate the roles and responsibilities of each organization prior to an outbreak occurring. The immediate public health response and timely control of an outbreak is crucial, as is collecting and preserving evidence (forensics) for law enforcement and security purposes. Given that the responsibilities of each organization may differ, clarification of roles in the emergency response protocols would be helpful in minimizing the potential for conflicting interests at a time of crisis.

The appropriate management of biological threats requires the development and implementation of legislative frameworks. Most importantly, legal frameworks provide the necessary legitimacy for local emergency response teams to act in the event of a threat.

Driver #3: Disease surveillance capacities and surge capacity

At the start of the COVID-19 outbreak in the UK, the government focused early on scientific modelling techniques and delayed conducting mass testing – this has raised concerns from parts of the UK scientific community and from WHO.[2] Similarly, the NHS contact tracing app, which has faced major technical challenges (e.g. failed to detect 96% of contacts in Apple phones in the Isle of Wight trial) and privacy concerns over centralized data collection, has currently been put on hold.[3]

Findings from our research demonstrate that effective disease surveillance systems are critical for city-level preparedness and resilience efforts. They can, for example: help to identify an outbreak; provide insights as to which populations are most affected; monitor geographic spread of disease and determine key risk factors; and inform appropriate public messaging and prevention measures. Given the ease with which outbreaks can spread, surveillance networks need to be activated at local, national and regional levels.

Section 2: Resilience strategies

Several countries in the developing and developed world mitigated the first wave of the COVID-19 pandemic and adapt better to the “new normal”. Lessons learnt from these countries and from preparedness and response strategies to other biological disease outbreaks (such as Ebola), can point to areas for building and measuring resilience:

Future Recommendations:

Based on Chatham House’s research on biological risks, Chatham House recommends:

  1. A comprehensive analysis of city resilience in the UK, which will allow a dynamic risk and resilience assessment and reveal levels of preparedness across the UK in mitigating biosecurity risks.
  2. A broader learning from infectious disease outbreaks across the world. It is important to learn lessons not only from the COVID-19 pandemic and the UK response, but also from other infectious disease outbreaks. Limiting lessons learnt to COVID-19 has the potential to underestimate the range of bio threats in the world.
  3. Improve public-private sector engagement, creating incentives for organizations in the private sector to be proactive in this space. This engagement should not be limited to the health sector but extended to sectors including telecommunications. Domestic technology start-ups, working with tech giants (e.g. Google, Apple etc) should be considered for developing contact tracing applications.

Acknowledgement

The authors welcome any views and opinions on the subject and are ready to respond to further questions. They would also like to thank to Dr Patricia Lewis and Prof David Harper for their involvement and support in the abovementioned project on strengthening city resilience against biological threats.

Dr Beyza Unal, PhD – Senior Research Fellow, International Security Programme, Royal Institute of International (Chatham House) – BUnal@ChathamHouse.org

Ben Wakefield, MSc – Research Associate, Centre for Universal Health, Global Health Programme, Royal Institute of International Affairs (Chatham House) and Emerging Leader in Biosecurity (ELBI) Fellow, Center for Health Security, Johns Hopkins University – BWakefield@ChathamHouse.org

22 June 2020

 


[1] Dickmann, P., Emami, S., Santhakumar, A., Mildenberger, C. and Lightfoot, N. (2014), Safe and Secure Biomaterials: A Risk- Based Alternative Approach, Research Paper: Royal Institute of International Affairs, https://www.chathamhouse.org/publication/safe-and-secure-biomaterials-risk-based-alternative-approach

 

[2] Devlin Hannah, 19 April 2020, Scientists raise concerns about quality of UK Covid-19 tests, https://www.theguardian.com/world/2020/apr/19/scientists-raise-concerns-about-quality-of-uk-covid-19-tests

[3] Rory Cellan-Jones, 19 June 2020, Coronavirus: What went wrong with the UK's contact tracing app?, https://www.bbc.co.uk/news/technology-53114251

[4] https://www.chathamhouse.org/about/structure/global-health-security/sustainable-laboratories-initiative