Southeast Asia Strategic Dialogue on Biosecurity

Co-Hosts from the Johns Hopkins Center for Health Security
Tom INGLESBY, Director
Anita CICERO, Deputy Director

Co-Hosts from the Philippines
Irma MAKALINAO, Professor & Special Assistant to the Dean, Department of Pharmacology & Toxicology, College of Medicine, University of the Philippines Manila
Camilo Pancratius CASCOLAN, Undersecretary of Health for Field Implementation and Coordination Teams

Each participant will introduce herself/himself, including their current position and organization, the principal focus of their work, and the biosecurity challenge they are most concerned about.

Please limit introductions to 90 seconds each.

For this dialogue, we define “biosecurity” as the policies, programs, and actions taken to prevent, prepare for, and respond to biological threats, whether they are natural, accidental, or deliberate.

Dialogue Session One: Building on COVID-19 Lessons

The COVID-19 pandemic is a seminal event in global health security, and it will serve as the foundation for decades of future research, capacity-building efforts, and other preparedness activities, reaching far beyond health care and public health. Over the course of the pandemic, countries implemented policies, expanded capacities, and developed new collaborations to improve their emergency responses. As the world moves toward the endemic stage of COVID-19 and returns attention to future threats, it is critical to identify key lessons from this pandemic experience and apply them to the broad and expanding scope of health security.

• Looking back, more than 3 years into the COVID-19 pandemic, what was the biggest challenge your has country faced?
• What are the most important lessons you have taken away from your country's COVID-19 experience?
• What disease surveillance, preparedness, response, or recovery systems or programs that your country established to combat COVID-19 will be sustained after the pandemic?
• What new steps is your country taking now to improve pandemic resilience?
• Has the COVID-19 experience made it more likely or less likely that your country will invest additional resources, personnel, and planning efforts for health emergency preparedness in the future?

Opening Remarks (3-5 minutes each): Janette GARIN, Soawapak HINJOY & Marc HO

Dialogue Session Two: Critical Multisectoral Partnerships to Address Biological Threats

During the COVID-19 pandemic, the military, law enforcement, and emergency management sectors coordinated with and assisted civilian public health agencies in some countries. For example, uniformed personnel in the Philippines played a vital role in the partnership between the health and security sectors. And the US Department of Defense was central to the “Operation Warp Speed” effort to accelerate vaccine development, manufacturing, and distribution. Essential workers assumed non-traditional roles in outbreak response, when necessary.

• Did these types of collaborative responses occur in your country, and what are the lessons from these experiences?
• What were the most important contributions of the military? Law enforcement? Emergency management?
• How does your country plan to maintain these types of coordination for health emergency preparedness in the future?
• To what extent was the security sector involved in vaccine rollout or other elements of the response, including in conflict areas?
• What roles did the media, academia, or other private actors play in terms of sharing vital information or epidemiological data during the COVID-19 pandemic?
• How would these sectors respond to deliberate biological events?

Short Brief by Benjamin WAKEFIELD (JHCHS): Early findings from study on national civilian-military collaboration for health emergency preparedness

Opening Remarks (3-5 minutes): Endy BAYUNI, José EMBANG, Jr. & Mohd Arshil bin MOIDEEN

Presentations: New Initiatives in the ASEAN Region

Improving Coordination on Pandemic Preparedness & Response
Ferdinal FERNANDO, Assistant Director & Head, Health Division, ASEN

Mitigating Biothreats in ASEAN Region
CHONG Chee Kheong, Senior Health Advisor, Mitigation of Biological Threats Programme, ASEAN

Presentations will be followed by a group discussion.

Dialogue Session Three: Managing Biosecurity & Biosafety Risks Related to Advanced Life Sciences Research

Following the emergence of SARS-CoV-2, some countries have increased investments in developing new high-containment laboratory capacity. The biosafety and biosecurity risks associated with increases in advanced biological research have garnered elevated attention and scrutiny since the COVID-19 pandemic began. This focus has been amplified by questions related to the origins of SARS-CoV-2.

• What is your country’s strategy for investing in new laboratory capacity, including virology laboratories? What threats is this new capacity intended to address?
• To what extent are you concerned about research intended to increase the lethality or transmissibility of pathogens—commonly referred to as “gain-of-function”—in your country or other countries?
• To what extent are you concerned about the field of viral discovery from wild animals and its associated practices and management (eg, proactively gathering specimens from bat caves in order to sequence them or experiment with them)?
• How is your country addressing oversight and governance of Dual-Use Research of Concern (DURC), generally defined as research that could be misused? Are there national-level laws or regulations related to DURC? If not, is the governance of DURC issues viewed as a priority in your country, and will your country’s governance approach be sufficient to address current or future emerging risks?
• Is your country addressing cyberbiosecurity threats, particularly those related to laboratories, genomic databases, or the production of life science-related materials?

Opening Remarks (3-5 minutes): Poh Lian LIM, Gerald PARKER & Amin SOEBANDRIO

Presentations: WHO Global Governance Framework for the Responsible Use of the Life Sciences / Developing a Biorisk Management Tool to Implement the Framework Nationally

Anna Laura ROSS
Head of Emerging Technologies, Research Prioritisation & Support, WHO

Emmanuelle TUERLINGS
Technical Officer, Emerging Technologies, Research Prioritisation & Support, WHO

Anita CICERO
Deputy Director, Johns Hopkins Center for Health Security

Presentations will be followed by Q&A and group discussion.

• How might the WHO framework be useful in your country?
• Who would be the critical stakeholders for framework implementation in your country?
• How could framework implementation be tailored to the Southeast Asia region? To the US context?
• What would it take to operationalize the framework in your country?

Dialogue Session Four: The Future of Medical Countermeasures Research, Development & Manufacturing

The COVID-19 pandemic illustrated the role of new research, development, and manufacturing capabilities for novel medical countermeasures (MCMs), building on decades of advancements in biotechnology. Yet, even with a historically short timeline from the emergence of SARS-CoV-2 to the authorization of vaccines, there were tremendous inequities in the access to these products around the world. As we look ahead to future biological threats, we need to define the capabilities, capacities, and frameworks necessary to ensure the rapid and equitable availability of novel MCMs—including vaccines, therapeutics, and diagnostics—during public health emergencies.

• What research and development approaches are needed to improve capabilities to make MCMs rapidly available in future emergencies?
• What is the potential for COVAX to meet MCM needs during a future epidemic or pandemic?
• Does your country have a national strategy for stockpiling MCMs? If so, has that strategy changed based on your country’s COVID-19 experience?
• Is it possible—and practical—to establish distributed manufacturing capacity in the Southeast Asia region, including from a technical, financial, regulatory, and legal standpoint? What would it take to ensure this capacity is sustainable?
• How can public-private partnerships, including with the pharmaceutical industry and research institutions, promote MCM development for novel threats?

Opening Remarks (3-5 minutes): Sazaly ABU BAKAR, Phyllis ARTHUR & Wisit TANGKEANGSIRISIN

Dialogue Session Five: Mitigating Deliberate Biological Threats

The COVID-19 pandemic has demonstrated the significant economic, social, and political impacts that infectious disease outbreaks can have around the world. While this has led to increased political attention, providing a short window to improve preparedness for future health emergencies, it may also inspire malicious state or non-state actors to pursue the development and use of biological weapons. Renewed focus and attention are needed to mitigate deliberate biological threats, alongside improving public health preparedness for natural or accidental biological events.

• What concerns are there in your country with regard to deliberate biological threats? What programs are in place to detect or deter the development or use of biological weapons?
• What programs does your country have in place to promote the responsible use of biology and mitigate deliberate biological threats, such as a select agent program, personnel reliability program, insider threat program, and research codes of conduct?
• What challenges exist for implementing the Biological & Toxin Weapons Convention (BWC), UNSCR 1540, and other international instruments in your country?
• What partnerships or initiatives exist for countries to collaborate on tackling these issues? Globally? Regionally?

Opening Remarks: Irma MAKALINAO, May ONG & Kathleen STEVENS

Dialogue Session Six: Epidemic Containment, Data Systems & Disease Surveillance

Early detection and quality data are critical to the ability to rapidly identify and contain emerging outbreaks and epidemics. The COVID-19 pandemic illustrated that countries around the world—independent of geography, government, and resources—continue to struggle in establishing and maintaining disease surveillance systems and integrating them at the regional and global levels. Highly effective emergency operations for epidemic containment are also critical. The pandemic stressed those systems, and personnel managing them may not have had the training or experience to do this work for the prolonged period of time required for COVID-19 containment efforts.

• What are the strengths and weaknesses of your country’s disease surveillance systems, including to detect the emergence of novel pathogens?
• What information and data systems does your country use for disease surveillance? Is there local, national, or regional integration of disease surveillance data?
• What is the public health and emergency operations capacity in your country to prepare for and respond to emerging outbreaks and epidemics, including for novel pathogens?
• Do personnel responsible for leading and conducting epidemic containment operations in your country have the training, experience, and support they need for this challenging work?
• How have national and regional disease surveillance systems and capacities changed since the emergence of COVID-19?

Opening Remarks: Fatima Claire NAVARRO, Tanarak PLIPAT & Daniel TJEN

Dialogue Session Seven: Global Health Security

The COVID-19 pandemic highlighted long-standing gaps in global collaboration and leadership on health security threats, including pandemic preparedness and response. Numerous efforts are underway to close these gaps at the global level, including through the launch of the WHO Pandemic Hub in Berlin as well as discussions on opportunities to increase WHO capacities (eg, establish a pandemic response corps), update the IHRs, or develop a pandemic treaty. Regional efforts are also underway around the world, including within ASEAN, to establish preparedness and response capacity for future large-scale health security threats.

• How do you view these ongoing efforts? What needs to be done in order to improve international coordination on pandemics and other large-scale health emergencies?
• What do you view as WHO’s current role? Should WHO evolve beyond that role to expand its responsibilities, capacities, and authorities?
• Do you think there are useful ways for international organizations to facilitate collaboration between national-level governments—before and during future large-scale health emergencies—including to improve communications, data sharing, and equitable access to MCMs?
• In addition to naturally occurring epidemics, what should national-level governments, UN agencies, and other partners be doing now to ensure effective coordination in a response to an accidental or deliberate biological event?

Opening Remarks: Julie FISCHER, Tikki PANGESTU & Suwit WIBULPOLPRASERT

Roundtable Discussion & Final Thoughts

This closing discussion invites participants to convey valuable take-aways or insights from this meeting. It also encourages participants to consider and propose future work this dialogue group can do together. What should be the foci of future dialogue meetings? What topics, threats, or capabilities would you like to see included in future dialogue discussions? What opportunities do you see for this group in terms of collaborating outside of dialogue meetings? How could JHCHS or DTRA provide assistance to meet these goals?

Dialogue Adjourns

Lunch available at Tides Restaurant.