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Remarks to the National Biodefense Summit

Alex M. Azar II
National Biodefense Summit
April 17, 2019
Washington, D.C.

“[Biodefense] isn’t a topic that crosses the minds of most Americans every day—thankfully. In order to keep it that way, we need to continuously improve our preparedness work, which is why the biodefense strategy is a blueprint for action.”

As Delivered

Good morning, everyone, and thank you for joining us here today. I'm here to help kick off this summit because, as HHS Secretary, I was appointed by President Trump to oversee the implementation of the National Biodefense Strategy, and that effort will benefit greatly from your input.

From the start, the national strategy was designed to be a highly collaborative effort. Engaging the public and all key stakeholders is vital to successful work on a complex issue like biodefense.

I want to particularly thank the National Biodefense Science Board, the federal advisory committee that advises HHS on biodefense, for recognizing the importance of outreach and for making recommendations about stakeholder engagement.

Today's summit will allow the federal government to obtain valuable individual input from members of the public and the scientific community on important aspects of our shared work.

So first of all, why do we have a biodefense strategy that needs your input?

The simple answer is that biological threats, of a manmade, accidental, or naturally occurring nature, are real and they are growing.

There are several factors driving these trends: as the world grows more urbanized and interconnected, infectious threats can spread more rapidly and easily than ever before.

We also face accidental and manmade threats. Today's rapid technological advances have great potential to improve human health, but they also create the opportunity for new kinds of threats, and for small-scale actors or even individuals to make use of biological weapons.

These trends are not new, so our national strategy is the culmination of a long series of steps taken by HHS and the entire U.S. government to build up our biodefense capabilities.

You're going to hear more of that history from Dr. Kadlec in a moment, but I want to give you a sense of the perspective I've brought to my role at HHS and the personal interest that I have in biodefense.

Over the last two decades, the growing complexity of biodefense threats have demanded the involvement of more and more of the biomedical and public health expertise we have at HHS, as well as more and more coordination across the government and with the private sector.

It was back in the 1990s, before I'd arrived at HHS, that my predecessor, Secretary Donna Shalala, declared HHS to be a national-security agency, detailing a Public Health Service Commissioned Corps officer to the National Security Council for the first time.

I think the recognition of the importance of HHS's role in biodefense and national defense grew during the years I was at the department in the previous administration from 2001-2007.

I was confirmed in August, 2001—one month before 9/11, when everything changed.

But everything progressed from what we had already been seeing in terms of chem, bio, radiological, and nuclear defense programs. The day of 9/11, we got to see the need of coordination and the need to think of ourselves as a genuine national security agency and a genuine part of that establishment.

That can be as simple as the creation of the command center that we have that keeps us linked across the government and provides a simple portal of information and situational awareness. It allows us to be tightly connected—whereas on 9/11 our connectivity with other agencies was on my personal cellphone. Because the main system had gone down, we had no phones.

I'm sure there are a lot of people in this room who, on 9/11, were in D.C. and experienced the same and were in government agencies on that day.

That day, Secretary Thompson declared what I think was the first Section 319 public health emergency. I think that's the first one.

Back then, of course, that really tapped into access of funds that weren't funded, so there was some symbolism in that. We since wrote and passed various statutes that actually put meat behind Section 319. But it was an important recognition of what we were facing that day, what we mobilized that day with the Red Cross, tragically, to try to get blood to the World Trade Center because we thought there would be survivors. That proved to not really be necessary.

We very quickly suffered the anthrax attacks, and had to face our first very real bioterrorism attack on this country. We had to come up with countermeasures, like Cipro. We did procurements and development of anthrax vaccine. We had to worry about smallpox. We had to vaccinate our troops and vaccinate our first responders. We had to secure the supplies of dryvax and see how we could maximize the remaining supplies of dryvax that we had here in the United States. We also had to develop next-generation smallpox vaccines.

And then it goes from that to sometimes the almost comical. I remember waking up and seeing The New York Times one morning was talking about monkey-pox getting into the United States. How were they getting into the United States? Through the importation of giant Gambian rats by collectors. And how was it spreading? It was spreading by prairie dogs, and people who collect prairie dogs. So, we banned the importation and inter-state sale of giant Gambian rats and prairie dogs. Just so you know, there is and remains a very active prairie dog lobby in the United States. I think it was probably the most death threats and hate mail I ever got.

We had SARS. I remember being out at Home Depot on a Sunday, and we had a ship coming in to Seattle. For us to quarantine, we had to have, in an Executive Order, a disease definition. We had to get the actual Executive Order up to Camp David to get President Bush to add SARS to the list of diseases to which we had been quarantined so we could yellow-flag a vessel that was out in the harbor in Seattle.

The thing that people often ask is: "What keeps you most up at night in the biodefense world?" Pandemic flu, of course.

Everyone in this room probably shares that concern. Working with Secretary Levitt, President Bush, and Congress to create the pandemic flu preparedness work that we did really helped rejuvenate the domestic pandemic flu vaccine capability here in the United States. We're not there yet, but we revolutionized our capabilities and capacities around flu production in the U.S. to minimize shortages so that we don't again go through what we did in 2004 on the Chiron shortage. Now we've got capacity, but we still need to improve our speed and production of pan-flu vaccine at our capacities.

Then, of course, the Obama administration in 2014 and 2015 dealt with the Ebola crisis in West Africa—which has sadly come back on our watch in the DRC. But such advances have happened in just those years.

Think about it: in the spring of 2018, the Democratic Republic of Congo had, through PEPFAR and the Global Health Security Agenda, so advanced their public health capabilities that they identified the first outbreak of Ebola, they came to the world community transparently with information on that and brought the WHO, HHS, and other international partners in.

Now we're dealing with the current outbreak in the Eastern DRC, a very difficult area in which to try to operate. But we have tools. The miraculous thing is that, just a couple years after the 2014 outbreak, we have experimental vaccines, we have experimental therapeutics, and we're running clinical trials right now on therapeutics for Ebola there.

Such change has happened, and a lot of that is because of two really important innovations that we got started, which is Project Bioshield and then BARDA, to enable the research, and the development, and the procurement of countermeasures which we, in the government, would be uniquely the purchaser. We would be a stable partner to ensure that development, and it's really proven very valuable. Forty-three FDA-approved countermeasures and products for CVR and pandemic flu—most recently, the first anti-viral for smallpox, which has been approved for going into the Strategic National Stockpile.

And, of course, central to all of that is the creation of the Assistant Secretary for Preparedness and Response. Dr. Bob Kadlec currently occupies that role, and I cannot tell you how delighted we are to have someone with such deep expertise in this field sitting in that chair.

All of these experiences—both what I've learned personally and what so many of our dedicated professionals at HHS have seen—inform the work that we do on the biodefense strategy.

These lessons of history led to the decision to place accountability in one place, the Secretary of HHS, as chairman of a steering committee. This is a cooperative effort, with expertise from many domains, including the private sector. Many of you have been through this same journey that we have.

But it's a cardinal rule of leadership that you have to have accountability, which means picking a leader. That's a leadership lesson well understood by President Trump, who has a particular interest not just in our national security but in preparedness for biodefense in particular.

This isn't a topic that crosses the minds of most Americans every day—thankfully. In order to keep it that way, we need to continuously improve our preparedness work, which is why the biodefense strategy is a blueprint for action. Since we officially launched the strategy at the White House back in September, we've begun implementing on a number of fronts.

First, we established the Biodefense Coordination Team, a group of leaders that is chaired by Dr. Bob Kadlec that began meeting regularly to begin implementation.

We've been extremely pleased with the buy-in of leadership across the federal government so far, both members of the coordination team and as well as my fellow cabinet secretaries.

We also launched an internal request for information, across the federal government, to support the development of an overall biodefense assessment of our capabilities and capacities.

Responses from agencies are due at the end of May, and then we'll be analyzing this information to understand our current set of activities, where the gaps lie, and what our priorities need to be.

But we need to know the lay of the land not just inside government, but also outside of it. That's why we've engaged stakeholders, including many of you, to begin understanding your current activities and priorities and identifying opportunities to improve and increase coordination.

That's why we're here today. We are now at a point where the federal government is in particular need of your advice to inform our efforts.

We want to come away from this meeting with individual perspectives from all stakeholders, to inform our assessment of the biodefense enterprise and policy priorities.

This will not be the only opportunity for public input. We plan to engage the public further as we move forward, and many of you will play a critical role in the activities that fall under the strategy.

So thank you all for joining us here today, at this important time for America's biodefense enterprise and the national strategy. I am honored that HHS is helping to lead this work, and I hope you all are honored to play a crucial role in that as well.

Thanks again for being here today, and I look forward to years of continued partnership with all of you, and I'll turn things back now to Dr. Kadlec. Thank you very much.

Content created by Assistant Secretary for Public Affairs (ASPA)
Content last reviewed on April 17, 2019