Interview with: Mike Ryan, Executive Director of the World Health Organization Emergencies Programme and Izumi Nakamitsu, Under-Secretary-General and High Representative for Disarmament Affairs.
What can COVID-19 tell us about the nature of biorisks (whether natural, accidental, or deliberate in origin)?
Natural, accidental or deliberate biological events all fall on the same spectrum of biological risks. Regardless of the source (natural, technological, societal, accidental or deliberate), they all challenge the health systems in similar ways.
In this regard, the COVID-19 pandemic is proving to us that strengthening the international community’s preparedness and response to such events is critical even before their origin is completely determined. Therefore, risk-based decision making, risk assessment/mitigation measures, emergency preparedness, response actions and community recovery activities need to be implemented along, ceteris paribus, relatively similar models, regardless of the cause.
The COVID-19 pandemic also showcases the centrality of the (public) health sector as a (co)guarantor of countries’ security, and the links to animal health issues. Finally, it has shown us that the impact of infectious diseases goes far beyond public health and emergency systems, affecting global socio-economic systems.
If such a disease is deliberately manipulated to be more virulent or is intentionally released in multiple places at once, this could lead to an even greater global crisis.
Therefore, ensuring a comprehensive and holistic approach is pivotal to safeguarding security and guaranteeing safety in all the aspects involving biorisks.
In your opinion, what is the most significant lesson to date that can be drawn from the UN response to the ongoing crisis?
A coordinated and mandate-based approach among and beyond UN agencies to anticipate, assess and mitigate biorisks is critical. Interagency cooperation based on trust and understanding of roles and responsibilities as well as capacities and capabilities are key to success in crisis-response, especially during situations characterized by great uncertainty.
Given the interdisciplinary nature of biorisks, which cut across security, human/animal/plant health, development, humanitarian and other domains, no single organization or expertise can face such events without coordination. When stakeholders from different sectors have to work closely together, a shared understanding and, possibly, the harmonization of procedures, systems, capacities and mechanisms for interoperability becomes essential.
This is true at every stage of an event, for preparedness, prevention, response, mitigation and recovery. Many organizations and nations have acknowledged these challenges and prepared for such contingencies by developing plans and establishing networks.
The decision 2020/59 of the Secretary General of the United Nations on 20 August 2020 established the United Nations Biorisk Working Group (UN-BRWG). In your view, what is the significance/value of a UN working group tasked to address biorisks collectively?
The UN has processes in place to protect human, animal and plant health and conduct investigations if dangerous biological materials or pathogens are released.
There are three main instruments in place: (i) the 1972 Biological Weapons Convention; (ii) the Secretary-General’s Mechanism for Investigation of Alleged Use of Chemical and Biological Weapons; and (iii) Security Council resolution 1540 (2004) regarding the prevention of the proliferation of weapons of mass destruction to non-State actors. Furthermore, the revised International Health Regulations (2005) provide a comprehensive framework for preparedness regarding the public health response to an outbreak of any cause, while the World Organisation for Animal Health (OIE) and the Food and Agriculture Organization (FAO) have similar frameworks in place addressing animal and plant health.
However, the current institutional environment remains fragmented, under-developed and lacking resources, and there are limited processes in place for prevention, prediction and mitigation of biorisks.
In light of this, the United Nations Biorisk Working Group (UN-BRWG) was established to foster coherence and coordination to respond to natural, accidental and deliberate biological events within the UN. Its purpose is not to create a new mechanism/organization but to bring together policy/normative and technical expertise to harmonize and further develop a clear understanding of capacities, mechanisms, and roles and responsibilities within the UN system in order to strengthen the international community’s response to biorisk and improve on the prevention of and preparedness for the deliberate use of biological pathogens.
The UN-BRWG is, therefore, an important step towards defining a common way forward in the field of biorisk. This will contribute to the improvement of health and emergency system capacities as well as interagency interoperability at the national and international levels.
What activities is the UN-BRWG undertaking, and how will these activities help the UN system and Member States be better prepared for future health emergencies?
The UN-BRWG is undertaking five activities to enhance interagency coordination and coherence.
In the context of Activity 1, the working group is conducting a mapping exercise of the existing biorisk related roles, responsibilities, expertise and activities within UN entities. This is an essential exercise to identify the existing resources and possible gaps within the UN system in the area. of biorisk.
In terms of response to a deliberate biological event, Activity 2 is developing the current draft “bio-emergency management framework for deliberate biological events” (being prepared under the Secretary-General’s Disarmament Agenda) into an overarching guidance framework for the UN system. The guidance framework aims at fostering UN coherence and coordination to respond to a major disease outbreak of deliberate origin.
Exploring the establishment of a staff exchange programme could be an excellent tool to share knowledge, implement active networks and lay out the foundation for seamless cooperation as well as building expertise and collaboration on biorisk-related topics within the UN. Activity 3 builds on the need to foster interagency collaboration and strengthen internal expertise in order to contribute to a holistic risk management of biorisk related events (especially deliberate).
Activity 4 consists of a high-level UN table-top exercise to test the overarching guidance framework for the UN system developed in the context of Activity 2. The lessons identified from this table-top exercise could be stepping stones towards future exercises focusing on interagency interoperability. This exercise will be critical in order to show the relevance of a guidance framework for the UN system for responding to a deliberate biological event.
Finally, Activity 5 aims to develop a UN system strategy and associated implementation plan for greater multi-stakeholder engagement in biorisk mitigation. There is indeed a wide recognition among, inter alia, many States, civil society, researchers, biotechnology companies, and among UN experts that regular and coordinated engagement across the UN system and between stakeholder groups on biorisk related issues would improve preparedness, coordination, cooperation, and response.
These activities are critical as they directly enhance the capability of the UN family to respond to health emergencies in a comprehensive manner and thus to better assist Member States in strengthening their preparedness and response to biorisk related events.
In your opinion, what is the most urgent action the UN system and Member States can take to better prepare themselves for future health emergencies?
Sustained investment in prevention and preparedness, as well as enhancing robust global governance to develop predictive mechanisms for coordination are needed in order to realize better preparedness for future health emergencies.
The best defense against disease outbreaks and other health threats is preparedness, which includes investing in building strong health systems and primary healthcare. Health systems and health security are two sides of the same coin. If we don’t invest in both, we will face not just health consequences but the social, economic, and political fall-out that we are already experiencing in this pandemic. Additionally, developing robust mechanisms at the global level for assessing multisectoral/ multi-stakeholder preparedness is critical for addressing gaps and advancing coordination for health emergency preparedness and health security. Finally, strong national health systems can help to discourage potential perpetrators from considering the use of biological weapons in the first place, demonstrating the strong linkages between the health and security sectors.
The next pandemic could be more severe than COVID-19. Therefore, we need to leverage lesson-learned and learning from COVID-19 to improve future preparedness, secure the necessary commitments and resources to strengthen our existing tools and capacities, and explore where improvements need to be made.
Dr Michael Ryan, Executive Director, WHO Health Emergencies Programme
Mike Ryan has been at the forefront of managing acute risks to global health for nearly 25 years. He served as Assistant Director-General for Emergency Preparedness and Response in WHO’s Health Emergencies Programme from 2017 to 2019.
Dr Ryan first joined WHO in 1996, with the newly established unit to respond to emerging and epidemic disease threats. He has worked in conflict-affected countries and led many responses to high-impact epidemics. He is a founding member of the Global Outbreak Alert and Response Network (GOARN), which has aided the response to hundreds of disease outbreaks around the world. He served as Coordinator of Epidemic Response (2000-2003), Operational Coordinator of WHO’s response to the SARS outbreak (2003), and as WHO’s Director of Global Alert and Response (2005-2011),
He was a Senior Advisor on Polio Eradication for the Global Polio Eradication Initiative from 2013 to 2017, deploying to countries in the Middle East.
He completed medical training at the National University of Ireland, Galway, a Master’s in Public Health at University College Dublin, and specialist training in communicable disease control at the Health Protection Agency in London and the European Programme for Intervention Epidemiology Training.
Izumi Nakamitsu assumed her position as Under-Secretary-General and High Representative for Disarmament Affairs on 1 May 2017. Prior to taking on this post, Ms. Nakamitsu served as Assistant Administrator of the Crisis Response Unit at the United Nations Development Programme (UNDP) since 2014.
She has many years of experience within and outside the United Nations system, most recently as Special Adviser Ad Interim on Follow-up to the Summit on Addressing Large Movements of Refugees and Migrants between 2016 and 2017. She was previously Director of the Asia and the Middle East Division of the United Nations Department of Peacekeeping Operations between 2012 and 2014, and Director of the Department’s Division of Policy, Evaluation and Training, from 2008 to 2012.
Between 2005 and 2008, Ms. Nakamitsu was Professor of International Relations at Hitotsubashi University in Tokyo, where she also served as a member of the Foreign Exchange Council to Japan’s Foreign Minister, and as a visiting senior adviser on peacebuilding at the Japan International Cooperation Agency. Between 1998 and 2004, she was the Chef de Cabinet and Director of Planning and Coordination at the International Institute for Democracy and Electoral Assistance, based in Stockholm, Sweden.
Earlier in her career, Ms. Nakamitsu was a member of the United Nations Reform Team of former Secretary-General Kofi Annan. She also held positions with the Office of the United Nations High Commissioner for Refugees (UNHCR), including within the office of Assistant High Commissioner for Policy and Operations Sergio Vieira de Mello, and in UNHCR field operations in the former Yugoslavia, Turkey and northern Iraq.
Born in 1963, Ms. Nakamitsu holds a Master of Science degree in Foreign Service from Georgetown University in Washington, D.C., and a Bachelor of Law degree from Waseda University in Tokyo.