How concerned should we be about the potential of bioterrorism, in general, and viral gain-of- function research, specifically? This has been an area of great interest to me, espe- cially since 9/11. Since then, it has become easier for those not part of an organized government effort to conduct research on bioterror agents. How do we regulate this area while not holding back on potential positive scientific gains from this research? We don’t have a good handle on this yet. Gain-of-function re- search will be a challenge, but there is an appropriate role for it. For example, it could be applied in learn - ing how Ebola could be modified to lead to airborne transmission. However, this research must be done in the most secure laboratory location possible with redundancies in the system to limit inadvertent es- cape or release. What value does CIDRAP provide for its leadership forum members such as RGA? We offer daily information few other sources can. By 8 a.m. each weekday, we have prepared a comprehen - sive summary of what’s going on around the world, which is made available to our members. Second, we can bring together multiple groups which can share and learn from each other. We operate in a Chatham House Rules Forum, which creates an optimal envi - ronment. CIDRAP also offers members a “front row” seat, as we did in the very early days of the pandemic, with examples of actionable information. What is your hope for the future? I’ve been in this business for 50 years. I can’t imag - ine retiring right now. I have six grandchildren, and they’re coming into a challenged world. I do believe we can do better. I believe the improved technologies will be reality one day. We have more vaccines than we’ve ever had. From a public health standpoint, I’d like to see prevention of chronic disease and expansion of the healthspan. Quality of life is very important. Are there any other points you would like to make which you feel are important, but were not ad - dressed thus far? I think we covered a lot, but as I look back on our conversation, I see clear challenges in science and technology, in policy and politics, and in public ac- ceptance of recommendations and technology tools.
NIH. I also worry about the elimination of PEPFAR (President’s Emergency Plan for AIDS Relief). This worry is real. What is the current state of technology when it comes to the development of a universal flu vaccine? The technology is clearly moving forward. Part of the challenge we have right now is that Operation Warp Speed (to develop COVID vaccines) gave people the perception that in 1 year we can come up with magic. mRNA vaccines were already in development for 2 decades. All the money in the world can’t accelerate development. Also, we are not seeing significant pri - vate sector investing at this point. Thus, it will mostly be supported by government investment. We are still 5 to 10 years from having these game-changing vaccines that would provide broad protection with efficacy over an extended period of time. How concerned should we be with the current global avian influenza outbreak? Is its risk of jump - ing to humans still low? I have been involved with H5N1 since the late 1990s in Hong Kong. At that time, it posed substantial risk to humans, but we’ve seen it change over time. In 2015, it spread to Africa, the Nile River Valley, and we saw a concerning level of human transmission. However, the receptor sites on the current circulating virus have changed substantially. This is why the WHO and CDC list it as a low risk for humans but high risk for birds. I feel more comfortable that we are at lower risk for humans at this point, but clearly the impact on animal species around the world will be dramatic. To what extent will climate change drive changes in the patterns of transmission and distribution of infectious diseases? I think it’s going to be huge, in two areas in particu - lar. One is the availability of safe, potable water for people to drink around the world. Climate change is affecting water availability. Glacier and snowmelt are rapidly being depleted, as well as groundwater. The other is on vector-borne diseases. For example, temperature and precipitation patterns are changing to favor certain mosquito species in areas that never had this as an issue. In parts of South America, we are also seeing mosquito habitat gaining almost 2,000 feet in elevation.
ON THE RISK vol.40 n.3 (2024)
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