Elevating Biosurveillance in LMICs to Bridge Gaps in Global Biological Catastrophic Risk Preparedness
This was a quick research doc for NTI | bio’s “Poster Session Strengthening Biosecurity Through Next-Generation Perspectives” in the Biological Weapons Conventions 3rd Working Group and 9th Meeting of States Parties, December 2023 in Geneva.
Special thanks to Cameron Angeles, Chelsea Angeles, Maximilian Schons, Brian Tan, Dion Tan, and Ryan Teo for their helpful comments and suggestions.
Summary
This proposal focuses on enhancing biosurveillance in LMICs to address global biosecurity gaps. It advocates leveraging the BWC's Article X for international cooperation, emphasizing collaboration between governments, NGOs, and communities. The proposal highlights successful case studies and recommends resource sharing, utilizing existing health infrastructure, and public-private partnerships. Key actions include initiating biosurveillance pilot projects in LMICs, promoting BWC-facilitated resource transfer and data-sharing, and implementing a BWC-led resource mobilization platform with a formal pledge/reporting system. The goal is to create a dynamic, improved global health biosurveillance system, integrating existing infrastructure for resilience against future biosecurity challenges.
“The States Parties to this Convention undertake to facilitate, and have the right to participate in, the fullest possible exchange of equipment, materials and scientific and technological information for the use of bacteriological (biological) agents and toxins for peaceful purposes. ”
Background
Despite the growing awareness and concern around biosecurity, it remains a generally neglected field in global priorities. This is concerning given the increasing reach and advancements of biotech, the emerging field of cyberbiosecurity, and other exacerbating factors (e.g. global travel and trade, climate change), which increase global biorisk. These developments necessitate a more robust and comprehensive approach to biosecurity to prevent catastrophic biological events. Given this, efforts to enhance biosecurity mustn't overlook a key component: strengthening biosurveillance in LMICs.
Biosurveillance in LMICs
Biosurveillance systems in these regions are inadequately equipped – many LMICs lack basic infrastructure, have limited staff capacity/lack of trained personnel, and rely on external funding, among many other inadequacies (e.g. overlooked occupational safety and health in high-containment laboratory facilities in LMICs; ethical/legal frameworks and challenges in biobanking (a key component of biosurveillance), particularly in public health emergencies). These inadequacies limit the ability for early detection in areas where pathogens can arise and make them potential hotspots for the emergence and spread of infectious diseases.
Global biosecurity
This gap not only heightens the vulnerability of these regions but also poses a significant threat to global health security. Enhancing biosurveillance in these areas is imperative for the safety and well-being of the affected populations and as a strategic measure in the broader global fight against pandemics. A prominent successful example is how many COVID response tools stemmed from global health investments focused on aiding the poor:
Years of robust sequencing lab development in South Africa and Nigeria (for ongoing diseases they were fighting against) proved invaluable to discovering COVID variants of concern;
The Institute for Health Metrics and Evaluation, initiated for insights into causes of death in impoverished nations, played a pivotal role in pandemic modeling;
Global Fund, set up to combat HIV/TB/Malaria, showcased its expansive reach by raising ~$4B for COVID within a year;
Systems established for tackling diseases like HIV expedited COVID vaccine trials;
Prioritizing immunization in nations like India tackled past health concerns and established robust responses for crises like COVID-19.
These points show that investing in health infrastructure consistently yields long-term, broad-ranging benefits. Ignoring the potential of enhancing biosurveillance in LMICs could undermine global biosecurity and the BWC’s efforts, making it essential to integrate the enhancement of LMICs' biosurveillance capabilities into the wider biosecurity strategy.
Relevance to the BWC
The BWC aims to prevent the development, stockpiling, acquisition, and production of biological weapons. Effective biosurveillance is critical to the objectives of the treaty. Relevant to the December 2023 BWC meetings on compliance and verification, the recommendations in this proposal arguably help aid BWC compliance through:
Developing a robust global early warning system to deter and detect any biological research misuse or outbreaks indicative of treaty violations
Enhanced trust and transparency amongst state parties
Fulfilling obligations under Article X
Aligns with the recent cooperation and assistance mechanism that the BWC States Parties have been trying to establish
Methodology
This proposal was done for the Nuclear Threat Initiative | bio’s “Poster Session Strengthening Biosecurity Through Next-Generation Perspectives.” The research was done through a literature review and targeted analysis of biosecurity deficiencies in LMICs, with a specific emphasis on biosurveillance. This proposal evaluates the potential intervention of the BWC through the lens of Article X, considering its emphasis on the peaceful use of biological science and technology and its role in promoting international cooperation in biosafety and biosecurity. The methodology includes reviewing successful case studies to inform potential strategies and actions under the BWC framework.
Strategy
This proposal’s approach focuses on:
Collaboration between governments, NGOs and local communities in LMICs to identify and implement effective strategies for integrating biosurveillance systems.
Encouraging BWC member countries to contribute resources and expertise for biosurveillance in LMICs, including funding, technology sharing, and training. Highlights the importance of leveraging public-private partnerships to support biosurveillance needs in LMICs.
Advocating for BWC-specific actions to enhance biosurveillance infrastructure in LMICs, leveraging on Article X. This includes facilitating the transfer of scientific knowledge and resources, developing data-sharing mechanisms, providing technical assistance, and mobilizing strategic resources for biosurveillance.
Recommendations
A. For member countries and LMICs
LMIC member countries should pilot projects that engage relevant biosecurity stakeholders (i.e., governments, NGOs, research institutions, and local communities) to pinpoint the weakest gaps in the country’s biosecurity landscape and determine the most effective strategies for integrating surveillance systems.
Examples:
Personal LMIC case study: Philippine research initiative Project SHIELD PH engaged with Philippine biosecurity stakeholders, resulting in mapping the biosecurity system of the Philippines and its leverage points for intervention
This project discovered that the most important leverage points to strengthen biosecurity in the Philippines were creating more comprehensive relevant legislation and programs and projects, increasing funding, and addressing siloed agency work and slow information exchange.
LMIC members can also leverage public-private partnerships in their countries to provide both resource allocation and technical support tailored for biosurveillance needs.
Member countries should implement concrete actions contributing resources and expertise specifically for the most important biosurveillance gaps in LMICs.
This can include allocating funds, sharing technological advancements, and offering training programs.
This could be implemented from the BWC sending out an annual survey to all states parties and their scientific community, asking LMICs to submit their research/evidenced needs, and disseminating it to relevant member parties. (Must be considered with caution, as sharing biosurveillance gaps may be an information hazard.)
Member countries should support research that investigates existing health infrastructure and how they can be adapted and optimized for broader biosecurity applications.
This considers investigating existing health systems like those designed for HIV/TB/Malaria (or other diseases that can come from LMICs) for broader biosecurity measures. The aforementioned are examples that indicate how measures that LMICs use to counter biothreats in their regions help broader biosecurity measures.
B. BWC-specific actions
These actions specifically advocate for the BWC to intensify its focus on enhancing biosurveillance infrastructure in LMICs, specifically leveraging on Article X, which emphasizes the peaceful use of biological science and technology and promotes international cooperation in the field of peaceful biological activities, and where the BWC acts as a facilitator of international cooperation.
These recommendations propose that the BWC should action integrated health surveillance initiatives in LMICs to be backed by member countries, focusing on comprehensive monitoring and response strategies. In essence, the BWC should act as a facilitator for the transfer of scientific and technological knowledge, equipment, and resources necessary for effective biosurveillance in LMICs.
To catalyze the implementation of these suggestions, the BWC can consider allocating these responsibilities under one/more of the Implementation Support Unit staff if possible. Potentially, all these recommendations can be implemented under one umbrella program.
The BWC Meetings should propose developing an alternative to a BWC-managed fund, with the BWC facilitating partnerships for funding and technical support.
Given the BWC's constraints regarding financial resources, the BWC meetings can propose an alternative strategy where the BWC can act as a facilitator or broker to connect LMICs with potential funders and technical experts. This can involve the BWC actively coordinating with international donors, NGOs, and private sector partners to secure funding and resources for biosurveillance in LMICs.
The BWC Meetings should encourage member parties to develop and adopt a BWC-sanctioned data-sharing mechanism to enhance biosurveillance.
Currently, the BWC doesn’t have a formal mechanism for data-sharing. Member states should advocate for such a mechanism, which can be used as a platform for sharing biosecurity standards, surveillance data, research findings, and best practices in biosafety and biosecurity, focusing on aiding LMICs.
The BWC can facilitate this by providing guidelines and a secure online platform for data exchange, ensuring that all shared information adheres to agreed-upon confidentiality and security standards.
The BWC Meetings can propose a BWC technical assistance program for LMICs focusing on biosurveillance.
This technical assistance program can manifest in the BWC facilitating collaboration between countries, such as joint research projects like the Working Papers.
Member parties (especially of more developed countries) can set up capacity-building workshops and host dialogues outside of the annual meetings or as side events in the annual meetings.
An example of an essential dialogue being conducted is what the Johns Hopkins Center for Health Security is doing with the Southeast Asia Strategic Biosecurity Dialogue.
The BWC should develop and lead a resource mobilization platform and formal pledge/reporting system to efficiently match member states' contributions with the biosurveillance needs of LMICs.
The BWC can assist LMICs in mobilizing strategic resources, focusing on establishing and enhancing biosurveillance capabilities. This can be done by:
Implementing a formal pledge/reporting system where member states pledge support and report on contributions
Establishing a BWC resource mobilization platform for coordinating and matching member states' pledges of financial, technological, and human resources with the specific biosurveillance needs of LMICs
Listing a set of relevant and curated bachelor and master theses on their website that would allow people from all respective countries to work on meaningful topics for their respective country. This can be implemented by sending out an annual survey to all member states and their scientific community and publishing these topics on the BWC’s website or through another platform.
Outcomes
These actions ultimately aim to establish a reinforced global health biosurveillance system. A crucial point is making this system dynamic, capable of continuous improvement and updates, ensuring it remains at the forefront of biosecurity technology and strategy. Moreover, it will intelligently integrate and enhance existing infrastructure, creating a network that is stronger, more resilient, and adaptable to future challenges in biosecurity and public health.
Presenting at the BWC
Talking with the BWC Philippine delegate; photo by Jaime Yassif
