Interview, Podcast
#27 - Dr Tom Inglesby on careers and policies that reduce global catastrophic biological risks
- Most subscribers are expected to find the conversation engaging and extract general lessons applicable to their own work, regardless of whether their field is health-related.
- A convergence is anticipated between public health and national security fields, driven by a growing recognition of epidemics' broader impacts on governance, politics, and security.
- Annual uncertainties regarding influenza will persist concerning peak timing, severity, hospital and ICU occupancy, child infection rates, and vaccine effectiveness.
- The accessible, de-skilled nature of biotechnology is expected to continue advancing, necessitating a recalibration of risk calculations for deliberate misuse and accidents.
- A new US Biodefense Strategy is expected to be released soon, legally mandated to cover natural, deliberate, and accidental threats across human, animal, plant, domestic, and international domains to unify disparate agency goals.
- Government funding for multidisciplinary biodefense work is expected to remain less accessible than for monoculture fields despite federal encouragement.
- Quantitative risk calculations for biological threats are expected to remain difficult due to a lack of sufficient historical data and the dynamic nature of threats, while adversarial intentions are noted as particularly hard to quantify.
- Resources are expected to be dedicated more heavily to Global Catastrophic Biological Risks (GCBRs) because worst-case scenarios are possible, though a robust, enduring community dedicated solely to biological risks is considered unlikely.
- Catastrophic risks are expected to emerge from the continuum of ordinary infectious diseases, leading to heavy overlap between communities working on natural epidemics and GCBRs.
- Creating a separate, zero-sum field for GCBRs is expected to face pushback, and alienating the biology community by framing them solely as risk sources rather than solution-creators is viewed as counterproductive.
- Governments are expected to remain focused on urgent problems, meaning a shift toward GCBRs will require a coalition, persuasive arguments, and time, as viewing such risks as insurmountable could lead to disengagement.
- Modern conditions including dense urbanization, increased global travel, and encroachment into natural environments are expected to increase the probability of substantial epidemics compared to the past.
- The Global Health Security Agenda (GHSA) is expected to be viewed as a successful principle-based effort, though its future funding depends on US budget inclusion and congressional decisions on organization and level.
- A public health emergency response fund similar to FEMA is expected to be considered to accelerate funding access during epidemics, as current budget pressures view preparedness as redundant.
- No concerted budget currently exists within US agencies specifically for extraordinary, low-probability events, with the CDC and ASPR expected to remain focused on day-to-day crises.
- Progress on catastrophic problems is expected to be facilitated by external efforts that make these issues feel tractable before government action is taken.
- The Center for Health Security is expected to continue experiencing personnel flux and hiring analyst positions, with potential recruitment starting in the summer.
- The Global Health Security Index project is expected to evolve into a biennial, worldwide assessment tool.
- The Emerging Leaders Fellowship program is expected to remain highly competitive with approximately 100 to 110 applicants for 28 spots, continuing to include participants from the UK and Canada, and hosting a third session in Oxford in the fall.
- Biotechnology tools are expected to become increasingly powerful, with the strong market forces driving advancements like CRISPR-Cas9 rendering external efforts to stop such technological drivers virtually impossible.
- Biology is expected to remain international and uncontrollable like nuclear weapons, relying instead on scientific norms, self-governance, and international screening consortiums, though current screening systems are not foolproof.
- The Biological Weapons Convention is expected to remain under-resourced compared to other treaties, with UN Security Council Resolution 1540 addressing non-state actors while the BWC focuses on state actors.
- Long-range health security goals include dramatically accelerating the development of medicines, vaccines, and diagnostics, with the capacity to manufacture these in multiple global locations simultaneously.
- The GHSA is expected to face a fragile, generational trajectory with potential forward and backward slips, while the WHO leads efforts for national response teams and CEPI develops vaccines for high-priority diseases lacking a market.
- GCBR is currently a nascent acronym unrecognized by many government officials working on emerging infectious diseases, and few "shovel-ready" projects exist outside of existing pandemic prevention frameworks.
- DNA transcript checking technologies are expected to prevent accidents but will not stop hostile actors, necessitating a mix of safeguards, raised consciousness, and norms rather than a single technological fix.
- Increased numbers of individuals with life science backgrounds in government are expected to be beneficial, with the AAAS Fellowship and Emerging Leaders Fellowship serving as key pathways for policy exploration and leadership connection.
- Health security is expected to be viewed as a marathon requiring deep expert training early in a career, rather than a sprint.