[Congressional Record Volume 151, Number 38 (Wednesday, April 6, 2005)]
[Senate]
[Pages S3262-S3265]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
THREAT OF BIOLOGICAL ATTACKS
Mr. GREGG. Mr. President, I appreciate the courtesy of the Members
who are in the Chamber and who are dealing with the State Department
authorization bill and allowing me to proceed as in morning business as
they address the issues surrounding that bill.
I wanted to raise an issue which I believe is of very high
significance of how we deal with the threat of biological attacks. This
has been an issue I have been involved in for a considerable amount of
time, having authored the first bioshield bill as the chairman of the
HELP Committee at the time.
Just weeks after September 11, anthrax attacks occurred in Florida,
New York, and Washington. They killed five people, and they crippled
the mail delivery system in several cities and required a cleanup that
cost more than $1 billion. For all that, the President's Commission
which just reported on weapons of mass destruction says we were lucky.
We cannot really know whether we were exclusively lucky or whether
this was the result of responsible effort to prepare ourselves for the
next attack that we have not been attacked again or in a worse way, but
the facts remain that the threat continues. The President's Commission
makes obvious the finding that biological weapons are cheaper and
easier to acquire than nuclear weapons, and they could be even more
deadly.
There is no question that if terrorists are able to get their hands
on a weaponized biological agent, whether it is anthrax, small pox,
botulism, or ebola, they will use it in a place where Americans gather
in their daily lives. Whether it is a subway system as occurred in
Japan or a building as occurred in the Capitol, it is these types of
attacks--biological, chemical, and dirty bombs--that pose the greatest
threat to our Nation.
The President's Commission, which released its report last Thursday,
exposed the stark reality that our intelligence community may have
underestimated the progress of terrorists and others in developing
biological weapons. For example, in Afghanistan, investigators found
evidence that after the war, al-Qaida had the capability to produce a
virulent biological weapon identified only as ``agent X,'' which
documents suggest was anthrax.
Much of the information we have on the development of biological
weapons by terrorist groups and rogue nations is classified; however,
it is no secret that Soviet scientists were working on engineering
biological agents before the fall of the Soviet Union, including
smallpox engineered to be totally lethal, a hybrid plague that is more
resistant to vaccine, and a strain of anthrax resistant to seven
different antibodies. Unfortunately, we have no assurance that all of
these products which they were trying to develop have been destroyed.
We are aware of some rogue countries that developed delivery systems
such as anthrax-laced cigarettes and botulism-contaminated beer.
While the President's Commission finds the threat deeply troubling
today, they foretell that it will be more tomorrow, when genetics
modification techniques will allow creation of even worse biological
weapons. These findings underscore that the threat posed to our
national security from biological, chemical, radiological, and nuclear
weapons is truly real and significant.
Even before the anthrax attacks here, we as a Congress recognized the
need to enhance three critical enterprises or sectors in our country to
better protect our people from attacks by biological agents: No. 1 the
research enterprise, led by NIH and private researchers; No. 2 the
biotechnology development and manufacturing sector, particularly
vaccines but also other countermeasures such as drugs and devices; and
No. 3 the broader health care delivery system, including physicians,
hospitals, and public health departments here and abroad.
The first substantial effort, started before the anthrax attacks and
completed in 2002, was the Bioterrorism Act of 2002, which dramatically
increased funding for the Strategic National Stockpile so that a
national pool of countermeasures, including those to protect against
smallpox, could be maintained. It also dramatically improved our border
protection authorities, particularly for food imports; protected our
water supply; dramatically increased oversight of research labs that
handled agents that could potentially be used in an attack; and
committed substantial new resources to our state public health systems
and hospitals to ensure improved surveillance and surge capacity.
Institutionally, it also created a number of new Federal authorities to
identify and develop and coordinate our response to a threat.
In 2003 and 2004, following the President's call and leadership, we
passed the bipartisan Project BioShield Act to confront weaknesses in
our ability to have the research enterprise speed results to us and to
have FDA speed products to potential victims. Notably, we pre-funded a
$5.6 billion account to assure the developers of countermeasures that
if they delivered a product that protected this country from a
biological attack then the Government would in fact have the resources
to purchase that product and recognize their work.
Project BioShield recognized that we had very little on hand to
address even
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the handful of agents that pose the greatest threat, such as smallpox,
anthrax, botulism and plague. As a result, we have made valuable
progress.
Our smallpox stockpile has grown from 90,000 doses of smallpox
vaccine ready for use in 2001 to 300 million doses today. We have
modified vaccinia Ankara, a next-generation smallpox vaccine that
promises greater safety, in clinical testing and others in
predevelopment. In addition, we have a new oral form of an antiviral
drug cidofovir in advanced product development for use in the event of
a smallpox attack and to treat the rare complications from the smallpox
vaccine.
To combat anthrax, a new recombinant vaccine is in clinical testing
and may need fewer doses than the classic vaccine, and the Department
of Health and Human Services has contracted with VaxGen to purchase 75
million vaccine doses under BioShield. New anthrax therapies that can
neutralize the anthrax toxin are also being developed, such as
monoclonal and polyclonal antibodies.
To combat botulism, treatments for the toxin and a vaccine to prevent
the disease are in development. And finally for Ebola a new vaccine is
in development.
Project BioShield was a good start, but we must do more. As the
authors of the Center for Biosecurity report note: The legislation
represents a significant step for the government and demonstrates [its]
seriousness [but] is only a necessary first step.
We have identified dozens of agents that could be used against our
people, yet we still lack vaccines and treatments for some of the
gravest biological and chemical threats, such as ricin, plague, and
viral hemorrhagic fever. We still lack an antidote to sulfur mustard
and nitrogen mustard--and those available for sarin and VX have
significant limitations in their practical utility given the speed with
which they need to be applied.
We are also not prepared to fight naturally occurring infectious
diseases--such as avian flu--that could be equally as deadly and could
be weaponized in the future. And experts in HELP testimony, as well as
those responding to a comprehensive survey by the University of
Pittsburgh Center for Biosecurity, note the increasing threat of new
bio-engineered and genetically modified pathogens. A 2003 CIA review
confirms that these strains could be ``worse than any disease known to
man.'' Many have observed that we in fact need to move beyond the
product-by-product and bug-by-bug approach of BioShield and address
solutions more comprehensively and innovatively.
And we have seen a very anemic response within the research and
manufacturing sectors to engage in biodefense work. Fewer than 100
companies have come forward with even a modest interest in developing
countermeasures for bioterrorism and other agents. The profile of these
companies is in many ways positive--they are entrepreneurial, often
have crucial insights into a bioterrorism agent or product, can move
quickly, and many have strong venture capital connections. However, in
other critical ways they lack the ability in our current environment to
deliver a finished, effective product to potential victims. These same
companies tend to be small, often work on only a single product, rarely
have the capital required to bring a product to market, and typically
have limited ability to manufacture a product at the level and with the
speed required to respond fully to an emergency. BioShield has done
little to address these latter concerns.
The President's Commission stated that to combat this continuing
threat, the Intelligence community, and the government as a whole,
needs to approach the problem with a new urgency and new strategies. We
are in fact pushing our luck.
This is precisely why BioShield II--a bill that I introduced as part
of S. 3--is critical to our efforts in the war against terrorism. S. 3
clearly indicates that the Senate Republican leadership puts a very
high priority on invigorating our biodefense capability. The people and
10 organizations that will be on the front lines of national defense
will no longer be just traditional defense industries--providing arms
and artillery--but will now include biomedical research and
biotechnology manufacturing sectors, as well as health care delivery
systems.
Building this biodefense sector is the first step in winning what
could be the arms race of the 21st century. We must be secure in the
ability of this sector to prevent and defend the United States against
biological weapons. If we are capable of developing a vaccine or some
other treatment that will neutralize the effect of these types of
biological agents, including genetically modified pathogens, then they
are less likely to be used against us. This same sector must also be
positioned to fight new natural threats, such as a pandemic of avian
flu. And, as highlighted by a recent GAO report on Anthrax Detection,
we need improved detection and testing methods to accurately determine
when an agent has been released and when an area has been
decontaminated and is safe. Similarly, as the Washington Post helped
uncover, BioWatch style technologies need to be dramatically improved,
so that we have confidence in the detection of airborne pathogens
affecting our key cities. Currently, lab analysis, even when it is
correct, requires days to return results on only 10 agents to date.
A range of experts, including researchers, government officials, and
manufacturers, told us in hearings that they need greater Federal
assistance for them to bear the risk of developing products to counter
biological threats or infectious disease that also divert capital away
from the development of other important and often more profitable
drugs. Many of the measures in BioShield II legislation, including
financial incentives, intellectual property protection, and liability
protection were recommended during those hearings.
A key point here is that we need to ensure the participation in this
enterprise of not just small, fleet, and innovative biotechnology
companies. We need to broaden our attention to large, experienced
companies, with multiple sources of financing, the ability to
manufacture, license, and bring to market a product, and do so on a
large scale in an emergency. Additional measures are needed to
encourage potential research, manufacturing, and health care delivery
partners to commit substantial resources and take the risks necessary
to bring innovative new products to market.
The number-one threat cited by experts in our hearings and experts in
a range of forums and publications is the almost boundless liability
exposure associated with developing these products--and the resulting
massive cost of product liability law suits. The unfortunate liability
experience of Bayer, manufacturer of Cipro, bears witness to the
exposure a biodefense manufacturer faces--and the litigation costs that
will be incurred even when, as in the Bayer case, the manufacturer is
eventually absolved.
Manufacturers of biodefense countermeasures typically risk exposure
to devastating product liability lawsuits to a far greater degree than
typical drug companies and for this reason are unlikely to get
commercial liability insurance for countermeasure products. There are a
number of reasons. For example, as Project BioShield specifically
contemplates, such countermeasures may be made available without the
usual battery of clinical trials required for other FDA-approved
products. Safety and efficacy data often must be derived, for the most
part, from animal trials because healthy humans cannot be exposed to
toxic agents during testing for obvious reasons.
Further, the scope of distribution of biodefense products and their
method of distribution heightens the risk of a lawsuit--even if the
product is otherwise safe and effective. For example, when distributed
to large numbers of potential victims, perhaps millions of Americans in
an emergency, there will inevitably be harm or injuries that occur
around the time of the use of the product but that are in fact
associated with the inevitable pre-existing health conditions in that
large population. Determining the cause of the harm and distinguishing
between the product and other factors will be nearly impossible--and
yet liability exposure is evident. Methods of distribution in an
emergency, perhaps using less trained persons as a last resort, also
increase risk of liability.
Large, responsible, successful companies are--without liability
protection--
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the most likely to remain on the sidelines for fear of risking
corporate assets in defending lawsuits. And with other sources of
revenue, other successful products, and products generally with higher
profit margins, these same companies in fact act prudently in
protecting their general corporate assets from unnecessary litigation
associated with lower-margin biodefense products.
Even as Government has begun to purchase BioShield countermeasures,
the Government's ability to limit liability has significant
limitations. Under current law there are only two legal authorities
that allow the Federal Government to mitigate the liability concerns of
producers of countermeasures other than small pox vaccine.
The first is through Federal indemnification under Public Law 85-804.
The second is through designation/certification under the SAFETY Act.
Both of these measures are woefully inadequate to address the practical
realities of potential litigation facing providers of countermeasures
and the fiscal realities facing the Federal Government.
Protection under Public Law 85-804 and its executive order extension
to biodefense products is not frequently granted. When it is, the
primary limitation is that the administration typically will not
address indemnification prior to award of a contract for a
countermeasure--unlike the Department of Defense, which typically does
address liability earlier in the process. As a result, potential
providers must expend resources to compete for a contract that they may
have to refuse due to the lack of liability protection. More often
companies simply refuse to bid at all due to lack of certainty on the
issue of liability. Numerous technical and definitional limitations on
the scope of the indemnification also exist--Is the product inherently
dangerous? Is it involved in national defense?--not to mention the
nature of indemnification may expose the Federal Government to enormous
liability exposure as awards and liability is not structured or limited
in any way.
The practical utility of SAFETY Act protections to biodefense
products is limited. For example, the potential liability of a provider
of a vaccine that is administered prior to a bioterror attack is not
addressed--leaving producers of vaccines in particular, as they are
typically dispensed prior to an attack, at great risk of liability
exposure. Protection also requires a burdensome pre-certification
process that has not resulted yet in designation of any biotechnology
products. Clearly dramatic improvements on this model are required.
The net impact of this atmosphere results in needed countermeasures
not being developed and deployed, thereby exposing the economy, and the
Nation as a whole, to far greater potential liability due to the lack
of available effective countermeasures in the event of attack. Either
way, the Federal Government is likely to bear both the human and
financial cost of such an attack as it did on September 11th. But by
failing to account for these costs before an attack, countermeasures
will not be developed and the Nation will be more exposed to attack,
costing America both lives and economic stability.
S. 3, which contains liability protections based on the SAFETY Act,
attempts to address these liability concerns not only for terrorism,
but also countermeasures developed and deployed to protect the Nation
against naturally occurring epidemics such as SARS and pandemics such
as Avian influenza. Further, liability protections would be extended to
ensure that those delivering health care in an emergency, including
biodefense products, receive due protection for 19 stepping up and
protecting our country when it is under attack. Further, S. 3 puts some
limits on the almost boundless liability exposure.
The second most significant barrier to investment in biodefense
technology, according to experts testifying before the HELP committee
and other public documents is the failure of current intellectual
property law to adequately recognize and protect a researcher or
manufacturer's investment in a technology.
The current law mechanism for this involves a combination of patent
term extensions and grants of market exclusivity for a product, which
permit a patent term essentially to be extended to compensate for
periods of time while a countermeasure is in the regulatory review or
other process.
Under current law, there are several arbitrary limits placed on the
duration and nature of the patent extensions that may be granted on a
pharmaceutical product. First, the total effective period of the patent
from the date the drug is approved until the patent expires cannot
exceed 14 years. Second, no patent extension can exceed 5 years. In
addition, only partial credit for a patent extension is granted for the
lengthy time the product undergoes research and development before an
application is reviewed by the FDA. S. 3 would create a patent term
extension authority that is not subject to these arbitrary limits. This
type of incentive is also important to recoup some of the innovator or
manufacturer's investment in developing the product and for diverting
resources from manufacturing other more profitable drugs.
As an alternative, S. 3 provides a second type of patent provision to
permit the Government to reward manufacturers who work to develop a new
countermeasure use from an existing product or technology during an
emergency. This provision could, for example, have been useful with the
drug Cipro, used as a therapeutic for a number of reasons, but at that
time not otherwise studied for use as a treatment for anthrax exposure.
During the anthrax attacks, the government asked the company to step
forward--the company responded by researching and developing
considerable evidence that their product was indeed safe and effective
for treatment following anthrax exposure. Under current law, Americans
can only rely on the unselfish generosity of a company to expend these
resources to provide the safety and effectiveness data we need. Under
my legislation, depending on circumstances, additional incentives
involving market exclusivity could be granted for up to two years for
the product that was used as a countermeasure. This is an important
distinction from the so-called ``wild card'' exclusivity idea, which
would allow a company to extend the patent protection of a different
product as a reward for stepping forward. Again, this type of incentive
will encourage manufacturers to step forward in a crisis and will help
them recoup their losses from diverting their research and
manufacturing efforts from more profitable products.
We've heard resoundingly that our research, manufacturing, and health
care delivery sectors need reasonable assurances that a market for
these products will in fact exist should they invest the resources
necessary to fully develop them. Under the BioShield approach the
manufacturer takes the gamble for product development--the government
as the sole purchaser needs to be a reliable partner. I look forward to
continuing to discuss viable approaches in this area. In my view,
however, it is not politically viable to have that basket of options or
incentives include ``wild-card'' exclusivity--or the ability to apply a
patent extension or market exclusivity to any product in a company's
portfolio, regardless of whether it has any use for biodefense
purposes. Today, politically, the reality is that this approach is not
sustainable--even if it would serve as a powerful incentive to
companies to step up and deliver much-needed biodefense products.
The role of the government in facilitating research, development, and
delivery of biodefense products can be great. Unfortunately, all too
often, government gets in the way. Accordingly, S. 3 also contains
important regulatory reform initiatives for protecting Americans
against bioterrorism. First, it has provisions that will improve the
international harmonization of U.S. Food and Drug Administration
regulations with those of the regulatory bodies of our allies in
Europe, Canada, and other developed countries. This will help
facilitate the development and approval of biodefense products, and
will reduce the costs of regulation by the United States and these
countries of biodefense countermeasures such as drugs, vaccines and
medical devices. Streamlining and making truly effective the regulatory
approaches from these developed countries will also assure the
continued safety and effectiveness of these medical countermeasures. S.
3
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also requires additional reviews by experts on how to improve
regulation of these products.
Second, the bill includes important provisions to assure uniformity
throughout the United States of biodefense product labeling and other
FDA-regulatory requirements. We urgently need this provision to respond
in a uniform and united way to a potential bioterrorist attack or other
deadly epidemic.
Dramatically conflicting or confusing state and local labeling and
composition requirements will limit the ability of Americans across the
country to respond adequately and quickly. It is important to note that
the provision includes language for exempting purely local matters such
as pharmacy practice laws from national uniformity requirements and
unique local conditions.
The Bioterror Act of 2002 took significant steps forward to address
public health infrastructure needs of the country. BioShield II builds
on these authorities in an effort to prioritize resources to those
areas faced with the greatest threat--to build the technical expertise
of the federal workforce, particularly at our premier biomedical and
health organizations at NIH, FDA, and CDC--and to build private sector
response capacity in various private-public arrangements designed to
have credentialed, expert, and trained teams on hand to respond quickly
to a crisis. Surveillance authorities here and abroad also need to be
strengthened and developed--using innovative private sector analysis of
prescription drug, hospital emergency room and doctor visits and other
``leading indicators.'' In short, as Richard Falkenrath of the
Brookings Institution notes, ``there's no area of homeland security in
which the administration has made more progress than bioterrorism, and
none where we have further to go. But, it is critical to agree with
Elin Gursky with the Anser Institute for Homeland Security, ``This
problem won't be solved by money alone.''
We have an obligation to be prepared for the worst threat. Maybe that
``next'' attack will never come. Or maybe it will come tomorrow.
We can't know where or when it will come or what our enemies will try
to do. We have to be prepared for all possibilities. Therefore, we have
to have a vibrant and strong biotechnical industry, a biomedical
industry, and an atmosphere here in the Federal Government which
encourages the development of the vaccines and other antibodies which
will allow us to address these type of threats.
I yield the floor.
I suggest the absence of a quorum.
The PRESIDING OFFICER. The clerk will call the roll.
The assistant legislative clerk proceeded to call the roll.
Ms. STABENOW. Mr. President, I ask unanimous consent that the order
for the quorum call be dispensed with.
The PRESIDING OFFICER. Without objection, it is so ordered.
____________________