WHO Officials Assail U.S. On Bioterrorism Planning
November 6, 2003
By SHANKAR VEDANTAM
THE WASHINGTON POST
GENEVA -- A severe lack of funding for surveillance and front-line defenses has left the World Health Organization unprepared to deal with a global bioterrorist attack involving an agent such as smallpox, according to a senior official who monitors disease outbreaks for the agency.
The concerns were underscored by a recent exercise involving a simulated bioterrorist attack in which WHO observers unexpectedly had to be called in to broker breakdowns in coordination among the eight nations taking part.
Several WHO officials also said they believe that U.S. bioterrorism defenses that mainly focus on domestic preparations could be ineffective against an attack involving a pathogen that emerges, or is released, in a remote part of the world and spreads internationally.
More than 100 nations have no surveillance capabilities to detect such an outbreak, several WHO officials said. In an attack, they added, a welter of conflicting national protocols could undermine a swift global response.
Although the U.S. has sought to vaccinate domestic health workers against smallpox, for instance, no comparable program has been offered to WHO employees who may be the first to respond, said Patrick Drury, project manager of WHO's Global Outbreak Alert and Response Network.
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A spokesman for the U.S. Department of Health and Human Services defended the level of support for WHO and said the U.S. is aiming for an optimal balance among unilateral, bilateral and multilateral biodefense strategies.
The recently concluded global bioterrorism exercise, called Global Mercury, was based on a scenario involving a group of terrorists who deliberately infect themselves with smallpox and then travel to various countries, using their bodies to spread the infection on public transportation systems and at car shows and by distributing contaminated business cards.
Drawbacks of Defense
The exercise underscored the drawbacks of defending against bioterrorism threats on a nation-by-nation basis, said Mr. Drury and other WHO officials. Results of the exercise will be discussed this week by officials of the U.S. and several other industrialized countries at a meeting in Berlin.
"We'd like to see the United States engage in this as a multilateral effort," Mr. Drury said. "They seem to be unilateral or bilateral in what they are doing."
WHO, which was supposed to play only an observer role in the exercise, had to be called in to negotiate coordination among the players, Mr. Drury said. The countries participating were the U.S., the U.K., France, Germany, Canada, Italy, Japan and Mexico. By the end of the exercise, he said, victims had been infected with smallpox in Chicago and the U.S. West Coast.
"If you have problems between democratic countries, you can imagine what will happen if you put Iran and North Korea in the picture," said Diego Buriot, director of WHO's Department of Communicable Disease Surveillance and Response in Lyon, France.
Bill Pierce, spokesman for the U.S. Department of Health and Human Services, said the U.S. played a key role in conducting Global Mercury, which he described as an initial step in developing multinational protocols to deal with bioweapons.
Some WHO officials said they were satisfied with the level of U.S. involvement. David Heymann, an American infectious-diseases expert working on polio eradication, said U.S. surveillance systems would complement WHO's multilateral efforts. "The U.S. has been a strong supporter of WHO," he said.
But other U.S. experts said America needs to do more. "The U.S. has not made an investment in global public health and the World Health Organization that anywhere matches the magnitude of the global health need," said Margaret Hamburg, a physician who is vice president at the nonprofit Nuclear Threat Initiative in Washington, which studies biological, chemical and nuclear security threats. "We cannot address this problem by going it alone or by developing relationships on a one-on-one and ad hoc basis."
SARS Example
Several officials at WHO pointed out that the recent outbreak of severe acute respiratory syndrome, or SARS, began in rural China but rapidly spread to industrialized countries. More than 100 countries don't have the laboratory expertise to spot even common diseases, making it unlikely they would detect a new agent until it had claimed many lives or spread to other countries, said Bradford Kay, an American who is helping WHO build laboratory capabilities in developing countries.
WHO officials readily acknowledged that the U.S. is a top funder and that American specialists often provide the backbone for international investigations of disease outbreaks. But they said $10 million promised to WHO this year to boost surveillance hasn't been forthcoming, leaving the agency with too few resources to thoroughly investigate the outbreak reports that pour in every day.
"It's understandable for them to say we'll do it ourselves instead of relying on a bunch of U.N. pinkos," Mr. Drury said of U.S. biodefense planners. But instead of trying to build a "Great Wall" around the U.S., he said, it would be cheaper and more effective to build global networks that could spot and contain outbreaks where they begin.
U.S. Funding Plan
Mr. Pierce rejected that criticism and said the U.S. wants funds set aside for WHO after details of programs have been worked out. "This is a hollow complaint," he said. "I don't know why they are complaining. Maybe they are covering up for some of their shortcomings."
The Global Mercury bioterrorism exercise, described by Mr. Drury and another official, laid out a hypothetical scenario that involved a couple who arrived in western Canada on a plane from Tokyo. Authorities eventually concluded that members of a terrorist cell had deliberately infected themselves and were flying to various countries to start an epidemic of a lethal form of smallpox.
As the game played out, Messrs. Drury and Buriot said, WHO had to be called in as a neutral broker. "The practicality of ongoing teleconferences with eight different countries and different cultural backgrounds and different languages and different priorities" were enormous, Mr. Drury said.
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