- At the beginning of the exercise scenario, when faced with an emerging disease outbreak, most participants emphasized the need for qualified experts with a broad range of skills to support an assessment of the outbreak’s source, highlighting trust as an essential component. Participants also acknowledged the need for technical expertise and “soft skills” like media training.
- Many participants called for improvements to international data sharing and surveillance capacities to identify outbreaks, including those with unusual features, earlier.
- Participants emphasized the need to establish strong partnerships and formal collaboration agreements between international organizations—including the World Health Organization, the World Organization for Animal Health, the Food and Agriculture Organization, and the UN Office of Disarmament Affairs—before outbreaks happen. These same participants also underscored the importance of establishing relationships with national authorities in advance.
- Some participants stressed the need to fill gaps in the mandates of the international organizations mentioned above, given the limits of the current fragmented, patchwork international system and the polarized geopolitical environment, but some also cautioned against superseding existing decision mechanisms.
- There was robust discussion about the appropriate criteria for triggering an assessment mechanism for outbreaks of unknown origin. One participant suggested establishing a staggered threshold for activating an assessment to avoid setting the bar too high.
- Participants discussed the value of having the assessment conducted by a standing organization with routine “peacetime” activities, such as regional exercises, to reduce the barrier to activation and stigma associated with an assessment.
- A few participants stressed the importance of sharpening the focus of the assessment mechanism to determining whether an outbreak is deliberate, accidental, or naturally occurring. They felt it was important to avoid politically charged and unproductive terms like “investigation” and underscored the value of combining humanitarian assistance with assessment activities.
- All participants called for improved international coordination during a high-consequence biological event, but they had differing perspectives on how this might be achieved.
- Many participants noted that an international coordinating mechanism would add value but should respect the strengths of partners, avoid encroaching on mandates and duplication of existing work, and fill gaps in existing international response capacities.
- In the face of global spread, participants also reemphasized the importance of pre-established relationships and agreements, as opposed to building new structures during a crisis.
- A few participants also returned to the idea that better data and information sharing should be a priority to improve international response coordination.
- During this move, participants reflected on the strengths and weaknesses of the global response to COVID-19 and lessons that could be applied to the fictional Akhmeta outbreak in the exercise.
- Many participants raised the issue of market failures during the COVID-19 pandemic. Acknowledging that leaders were able to overcome some supply-chain bottlenecks, participants highlighted failures like PPE scarcity, pandemic profiteering, vaccine hoarding, and challenges related to the limited buying power of international organizations versus wealthy states.
- There was a general sentiment that, despite remarkable scientific achievements during the COVID-19 pandemic, global geopolitics hindered an effective response.
- Some participants pointed out the harms caused by inequity during the pandemic response, highlighting global failures to distribute vaccines and insufficient emphasis on getting shots in arms at the community level.
- Some participants expressed a desire for stronger international norms and institutions. Specific suggestions included strengthening and empowering the WHO and ensuring that new structures to prevent pandemics are not funded by voluntary contributions alone.
- Trust was a common theme during the discussion, with most participants assessing that the main risks posed by a cyberattack during an outbreak would be the erosion of trust in the response, as well as the spread of misinformation that would sow discord and undermine social cohesion.
- Participants generally regarded a cyberattack in this type of scenario as a tool of disruption that would likely be used as part of a larger biological attack.
- Many participants discussed the growing cybersecurity vulnerabilities of public health response systems and bioscience infrastructure—including in both the research and development sides of medical countermeasure development. These vulnerabilities include lack of adequate protections against tampering with data or samples, modifying patient health data or pathogen genome sequence data, and disruption of supply chains.
- Many participants also worried about the effect that a sophisticated cyberattack would have on the response to a pandemic, pointing to previous disruptions to pharmaceutical companies and increasingly digitized manufacturing equipment.
- They noted that attacks on manufacturing facilities would hamper both national and international responses.
- Attacks on databases could also undermine efforts to accurately characterize pathogen spread and its continued evolution.
- Some participants offered suggestions for improving cybersecurity within the life sciences, including building in cybersecurity into bioscience infrastructure from the ground up, scaling promising public-private partnerships, and developing cyberbiosecurity standards.
- Most participants felt that biothreat intelligence capabilities are lacking and must be strengthened. They pointed to limited prioritization in traditional intelligence circles and noted opportunities to gather information from social media, bibliometrics, trade data, satellite images, and other newer data streams.
- Some pointed to the need for better baseline data gathered through passive environmental sampling at transit hubs and in wastewater.
- A few participants noted the challenges of assessing bioscience research and development capabilities because of their dual-use nature, which makes biothreat intelligence assessment more difficult than monitoring capabilities in other fields.
- A handful of participants expressed a desire for a global system or clearinghouse for information to improve biothreat intelligence sharing, though there was acknowledgment that governments are often reluctant to share information with UN structures. Some argued that data shared by governments should be validated against independently sourced information whenever possible.
- Intelligence can be challenging to discuss with international partners due to an inadequate shared vocabulary, and some participants called for more structured thinking about this issue. They also noted concerns with framing the issues as either “health” or “security.”
- Some participants expressed a desire for a multilateral system of biological weapons verification, confidence-building measures, and reporting—while acknowledging the gap between what is technically possible and politically feasible.