Interview
#27 - Dr Tom Inglesby on careers and policies that reduce global catastrophic biological risks
- The Center for Health Security expects to expand its work on global catastrophic risks and pathogen threats following a $16 million grant from the Open Philanthropy Project, while continuing to serve as a resource for the government and public during epidemics.
- Future pandemic risk probability is projected to shift toward natural causes temporarily but will likely change as biotechnology becomes accessible and de-skilled, with capabilities for creating easily controllable pathogens expected to persist indefinitely.
- The Center anticipates a continued minority of professionals with classic security training in public health, though these individuals are deemed highly valuable, while funding for multidisciplinary work is expected to be more difficult from the federal government than from outside foundations.
- A robust, enduring community dedicated solely to global catastrophic biological risks is not expected to emerge; instead, the Center aims to build a community where experts draw from common events to avoid creating parallel, unexercised systems.
- The Center plans to prioritize projects aligning with existing legislation or international bodies like the World Health Assembly and expects to launch a global health security index every two years.
- The Emerging Leaders Fellowship Program is expected to continue selecting 28 fellows annually from approximately 100–110 applicants, with planned sessions in Washington, a summer research symposium, and an autumn retreat in Oxford.
- The U.S. biodefense strategy is expected to be released "sometime soon" to unify plans across organizations, clarify responsibilities, and outline budget allocations.
- Natural pandemics remain the greater risk for any given year, but risks from human behavior are expected to grow annually due to megacities, global travel, and encroachment on natural environments.
- The Global Health Security Agenda, launched in 2014, is considered a success with broad support, though its future funding is undecided and the U.S. Congress must decide on inclusion in the current year's budget.
- A coalition is expected to form around a public health emergency response fund similar to natural disaster relief, yet funding for hospital preparedness and public health systems is projected to face constant downward budget pressure.
- The World Health Organization is expected to consider creating a new office focused on the interface between natural and deliberate events to set norms and reach out to governments.
- Universal safeguards against deliberate misuse are not expected to be possible; instead, protection relies on a mix of safeguards and raised scientific consciousness, with many problems requiring action in areas like vaccine manufacturing.
- The Center for Health Security expects to hire analysts with master's level training in public health, science, or foreign policy, as the field currently lacks many "shovel-ready" projects not situated within existing pandemic prevention frameworks.
- Changing national focus to include global catastrophic risks is expected to take time, requiring a coalition and persuasive arguments similar to post-9/11 responses, as the U.S. government remains committed to urgent, present problems.
- The Center for Health Security expects that avoiding billions of illnesses and deaths is a high priority despite significant uncertainty regarding the likelihood of specific catastrophic scenarios.
- Quantitative probability calculations for pandemics are expected to remain difficult due to insufficient historical sample sizes and a constantly changing situation.
- The CDC and HHS are currently too focused on smaller crises to prioritize large-scale events without external pressure, with progress expected only if outside efforts break down problems to make them feel tractable.
- People interested in regulating gain-of-function research are expected to need government positions to set the right balance, while programs at schools like Johns Hopkins, George Mason, and Harvard are expected to offer pathways for international health governance.
- The EIS at the CDC is expected to remain the flagship program for practical outbreak investigation training, with early deep expertise in science, epidemiology, economics, or law enabling professionals to rise faster in the field.
- The biosecurity community is expected to remain in a stage of risk assessment and strategy scoping rather than advocating for specific policy changes, with an "irreducible uncertainty" regarding emerging natural phenomena and misuse intentions.
- The Center for Health Security expects to continue as a relatively small, compelling field where professionals frequently interact, with a focus on ensuring systems used for clinical medicine and public health can handle catastrophic events.