Emmanuelle Tuerlings Biorisk reduction for dangerous pathogens

Department of Epidemic and Pandemic Alert and Response

World Health Organization

Biorisk reduction: A WHO approach

ESRC Seminar, 8-9 January 2007University of Sussex, Brighton

HealthHealth

WHO Constitution"a sate of complete physical, mental and social well-being and not

merely the absence of diseases or infirmity"

"the health of all peoples is fundamental to the attainment of peace and security and is dependent upon the fullest co-operation of individuals and States".

Human security (1)Human security (1)

Background– evolution of threats and insecurities– seminal reports – 1994 UNDP and 2003 Human Security Now

What is new? What is the added value?

Human security (2)Human security (2)

Definition of the Commission on Human Security– the protection of "the vital core of all human lives in ways that

enhance human freedoms and human fulfillment"– addresses both "freedom from fear" and "freedom from want"– link human rights, development, security together– people-centred

Criticisms– E.g. too broad, health being securitized

Global health securityGlobal health security

Global Health security at WHO– Global Alert and Response Operations (WHA54.14, 2001) (with

GOARN: Global outbreak and response network) – Preparedness for the unexpected (WHA55.16, 2002)– International Health Regulations (WHA58.3, 2005)– Laboratory biosafety (WHA58.29, 2005)

So what?So what?

Health, human security and global health security

So one advantage of a global health security framework is that it broadens the traditional national security approach to allow theemphasis to be placed on the public health approach.

Biorisk Reduction Management

Safety of staff and environment Protecting valuable biological materials

Promote responsible biomedical research

Specific pathogens expertise

Outbreak response coordination

Surge response capacity

Deliberate threat response preparedness

Map global laboratory resources

Laboratory biosafety and biosecurity

Deliberate useNatural infection

Accidentalexposure

Laboratory Resource MappingLaboratory Resource Mapping

ExpertInternational reference labPrivate lab

National lab network

Regional lab network

National reference lab

Agent-specific lab network

Regional public health instituteWHOCC

NGOAcademic institute

Building the Network Directory, brick by brick

GLaDNet GLaDNet is the is the ““mortarmortar”” part of the wallpart of the wall

•Get to “know your neighbors” in advance of event response•Harmonization of basic operations(protocols, logistics, communication)•Serve to implement

International Health Regulations

BACTERIA– Anthrax– Brucellosis– Glanders– Melioidosis– Tularaemia– Plague– Q Fever– Typhus Fever

FUNGI– Coccidioidomycosis

VIRUSES– Venezuelan equine

encephalomyelitis– Smallpox

Disease specific Disease specific (selected BW agents, 2nd ed. WHO publication)(selected BW agents, 2nd ed. WHO publication)

Name of laboratory Address

City

Postal code

Country

Telephone

Fax EmailWeb site

Name of director of the laboratory

Title

Telephone

Fax

Email

Name of person responsible for anthrax activities

Title

Telephone

Fax

Email

World Health Organization

Disease-Specific Networks: AnthraxQuestionnaire for Laboratories

Communicable Disease Surveillance and Response Global Alert and Response

1. Contact details

2. Your laboratory is affiliated to:Ministry of Health

Ministry of Agriculture

Other ministries (please specify)

Universities

Private laboratories

Other (please specify)

World Health OrganizationGlobal Alert and Response

Communicable Disease Surveillance and Response

Disease-Specific Networks: AnthraxQuestionnaire for Laboratories

1. Contact detailsName of laboratory ______________________________________________________

Address ________________________________________________________________

City ________________________ Post code ________________________________

Country ________________________________________________________________

Telephone ________________________ Fax ________________________________

Email ____________________________ Web site ___________________________

Director of the laboratory ________________________________________________

Title (Prof., Dr, Mr, Mrs, Miss) ___________________________________________

Telephone _______________ Fax _______________ Email ____________________

Person responsible for anthrax activities ____________________________________

Title (Prof., Dr, Mr, Mrs, Miss) ___________________________________________

Telephone _______________ Fax _______________ Email ____________________

2. Your laboratory is affiliated to: Ministry of Health Ministry of Agriculture Other ministries (please specify) ______________________________________ Universities Private laboratories Other (please specify) _______________________________________________

Disease-specific networks:

improving public healthpreparedness forand response to

the threat of epidemics

Mission statementTo strengthen global disease-specific networks

of experts and laboratories able toprovide technical support to response activities

in Member States, particularly developing countries, related to the natural occurrence, accidental release,

or deliberate use of biological agentsthat affect health.

World Health OrganizationGlobal Alert and Response

Communicable Disease Surveillance and Response

ACTIVITIES

Global network of anthrax experts and laboratories

Anthrax guidelines 4th edition (coming soon)

Report on 2003 survey on anthrax (being finalized)

Second survey on anthrax being drafted

Laboratory Laboratory BiosafetyBiosafety and and BiosecurityBiosecurity

Laboratory Accidents and BioLaboratory Accidents and Bio--RisksRisksSelected examples of laboratory acquired infections in “well-equipped and trained”laboratories:

SARS: Singapore, 2003

SARS: Taiwan, 2003

SARS: China, 2004

Tularemia: USA, 2004

Ebola: Russia, 2004

Potential exposure (high consequence):

Anthrax: Soviet Union, 1979; USA, 2005

H2N2: USA, 2005

WHO Biosafety To promote the use of safe practices in the handling of pathogenic microorganisms

•in the laboratory •during transportation •in field investigations •in manufacturing facilities •in health-care facilities

WHO Laboratory Biosafety EFSPChRu

"Laboratory biosafety" describes containment principles, technologies and practices implemented to prevent unintentional exposure to pathogens and toxins, or their accidental release.

EFSPChRu

EFSPChRu

“Laboratory biosecurity” describes the concept, process and objective of managing biorisks associated, in laboratories, with valuable biological materials, increasing its protection, control and accountability in order to prevent their unauthorized access, their loss, theft, misuse, diversion or intentional release.

WHO Laboratory Biosecurity

1

WORLD HEALTH ORGANIZATION

Biorisk management:

Laboratory Biosecurity

WORLD HEALTH ORGANIZATION DEPARTMENT OF EPIDEMIC PREPAREDNESS AND RESPONSE

WHO BiosecurityTo promote the protection of valuable biological materials and their safekeeping in the laboratory

•public health laboratories•animal and food laboratories•academic and research institutions• field investigation station •Industrial and manufacturing facilities •health-care facilities

Preparedness for Deliberate Preparedness for Deliberate EpidemicsEpidemics

Managing the health risks of the deliberate use of biological and chemical agents or

radioactive material:Guidance on capacity

assessmentbeing finalized

Guidance for public health preparedness

BiorisksBiorisks from deliberate usefrom deliberate use

Low probability, high consequence

New science and technology

Life science research and global Life science research and global health security projecthealth security project

Objectives1. engage dialogue2. raise awareness

Importance of health research

Health and researchHealth and research

Globalization of life science research and technologies– Global dispersion – Pace of discovery

10/90 gap in health research– Link with development– Lack of investments, inappropriate priorities, capacity

development and retention

Life science research and global health Life science research and global health security projectsecurity project

Measures to address the risks– self-governance (code of conducts, responsibility)– regulatory approaches (legislation on access to labs)

Impact on public health

Public confidence in science

Information vary among Member States

Life science research and global health Life science research and global health security project security project

Outcomes of Phase I:

1. Raising awareness document

2. Internal and external networks

3. Collaboration

Life science research and global health Life science research and global health security project security project

Objectives of Phase II:– Engage dialogue and listen through regional activities– Verify the added value of the public health approach– Explore the needs and perceptions in developing countries– Assess the need for WHO further actions

Scientific Working Group (16-18 October 2006)Electronic platform (January-February 2007)Regional activities Review of the process

Thank you