[Congressional Record Volume 153, Number 103 (Monday, June 25, 2007)]
[Senate]
[Pages S8359-S8361]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. BIDEN (for himself, Mr. Hagel, Mr. Kennedy, and Mr. 
        Casey):
  S. 1687. A bill to provide for global pathogen surveillance and 
response; to the Committee on Foreign Relations.
  Mr. BIDEN. Mr. President, many have called the 20th Century ``the 
American century.'' The 21st Century will be one, too, provided that we 
understand and act on a new reality: that global interactions make each 
country, even the U.S., more dependent upon others. Nowhere is this 
more striking than in our battle against emerging infectious diseases 
and bioterrorism. Whether we like it or not, the very security of our 
Nation depends upon the capability of nations in remote regions to 
contain epidemics before they spread.
  Today, I am introducing the Global Pathogen Surveillance Act of 2007. 
I am very pleased to have as original cosponsors Senator Hagel, who is 
an esteemed colleague on the Foreign Relations Committee, and Senator 
Kennedy, who chairs the HELP Committee. Each of these gentlemen also 
cosponsored earlier versions of this bill. Also cosponsoring this bill 
is one of my fine new colleagues on the Foreign Relations Committee, 
Senator Casey.
  Our action today is timely, as there is still time to prevent 
bioterrorist attacks on the U.S. It is urgent, because the disease 
surveillance capabilities in foreign countries that this act will 
promote are vitally needed to protect our country against not only 
bioterrorism, but also natural diseases such as avian influenza, which 
threatens to become the greatest pandemic since at least 1918. And it 
is long overdue, as this bill was first passed by the Senate in 2001 
and was again passed in 2005. All of us hope that the third time will 
be the charm.
  The purpose of this bill is to bolster the ability of developing 
countries to detect, identify and report disease outbreaks, with 
particular attention to outbreaks that could be the result of terrorist 
activity. My concern, as Chairman of the Senate Foreign Relations 
Committee, is that today, the many deficiencies in the capability of

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developing nations to track and contain disease epidemics are the 
equivalent of cracks in a levee. Right now, when the epidemiological 
``big one'' hits, whether it is a natural outbreak or a terrorist 
attack, the world simply won't be able to respond in time.
  The odds of a major bioterrorism event are very low, but they are 
hardly zero. In 2001, the American news media, the U.S. Postal Service 
and this United States Senate learned first-hand what it is like to 
receive deadly pathogens in the mail. To this day, we do not know 
whether the murderous anthrax letters were just a criminal act or 
actually a bioterrorist attack. But we surely know that neither our 
military power nor our economic wealth or geographical distance affords 
us immunity from the risk that a deranged person or group will visit 
biological destruction upon us.
  The odds of a major outbreak of a new, but natural, disease are much 
higher, and the possible consequences, while variable, are truly 
frightening. At the high end, an avian flu pandemic similar to the 
Spanish flu of 1918 could kill many millions of people and threaten 
social cohesion everywhere, including in the U.S. Viruses and other 
pathogens respect no borders. Increased contact between humans and 
animals, coupled with vastly increased travel of goods and people, has 
made it possible for a new and distant outbreak to become a sudden 
threat to every continent.
  The SARS epidemic was a good example of this. Now the world watches 
nervously as avian flu spreads westward from Asia, occasionally 
striking poultry flocks in Europe and Africa. We wonder when it will 
reach the Western Hemisphere and whether, or when, it will mutate into 
a disease that is readily transmitted between humans, who lack any 
immunity to it.
  Last month, a man with extensively drug-resistant tuberculosis, or 
XDRTB, flew across one ocean, twice, and drove across several national 
borders, reminding us how readily a disease can be spread in the modern 
world. We dodged a bullet this time; XDRTB is especially difficult to 
treat, but does not spread as readily as influenza or some other 
diseases. Authorities knew who the disease vector was, moreover, and 
they knew what he had. The risk with avian flu or a bioterrorism attack 
is heightened by the likelihood that the disease will spread before 
anybody even knows it's here.
  As if that were not enough, recent advances in biotechnology that 
open the door to new cures for diseases could also lead to the 
development of new diseases, or new strains of old ones, with much 
greater virulence than in the past or with the ability to resist our 
current vaccines or medicines. Such man-made diseases have already been 
developed by accident, and there is a clear risk of their being 
developed on purpose.
  The U.S., and this Senate, have acted to address the twin threats of 
bioterrorism and new pathogens. We enacted the Public Health Security 
and Bioterrorism Preparedness and Response Act of 2002, introduced by 
Senators Frist and Kennedy, to buttress the ability of U.S. public 
health institutions to deal with a bioterrorism emergency. In 2004 we 
enacted the Project BioShield Act to spur the development of new 
vaccines and medicines.

  The Centers for Disease Control has a program to put electronic 
surveillance systems in 8 American cities as the cornerstone of an 
eventual national network. Delaware is developing the first State-wide, 
electronic reporting system for infectious diseases, which will serve 
as a prototype for other States. And the Department of Health and Human 
Services funded a 3-year, $5.4 million program, early warning 
infectious disease surveillance, to assist the Government of Mexico to 
improve its disease surveillance capabilities near the U.S. border. 
Other funds were provided to U.S. States on the Mexican border.
  But these efforts, as vital as they are, address the threats of 
disease and bioterrorism only when they are inside our house or on our 
doorstep. We must lift our eyes and look farther, to the places around 
the world where diseases and terrorism so often breed. We must battle 
bioterrorism not just at home, but also in those countries where lax 
governance and the lack of public health resources could permit both 
strange groups and stranger diseases to get a foothold and to get out 
of hand. We must not treat the threat of a massive biological pandemic 
the way we treated the threat of a category 5 hurricane striking New 
Orleans. If we do not prepare to combat realistic, once-in-a-century 
threats, then we will be left again to pick up the pieces after 
enduring massive physical and social harm.
  There are precedents in current programs, moreover, for promoting 
disease surveillance as a means to lessen the risk of bioterrorism. For 
example, our programs to find useful careers for former Soviet 
biological weapons scientists, under the leadership of the State 
Department's Office of Cooperative Threat Reduction, currently fund the 
disease surveillance activities of anti-plague institutes in six states 
of the former Soviet Union, which had a major pathogen surveillance 
program ever since tsarist days. The Department of Defense also has 
programs with former Soviet scientists, as well as overseas 
laboratories that work with doctors in developing countries.
  We need to build on those programs. We must create a world-wide 
disease surveillance capability that matches that of the old anti-
plague institutes. We must help the rest of the world gain the 
capability to detect, contain, and report on disease outbreaks in a 
timely manner, and especially to spot outbreaks that may be the result 
of biological terrorism.
  Part of the answer to the threat of new natural diseases is to 
stockpile vaccines and medicines, and the means to deliver them 
quickly. But rapid detection and identification of an outbreak is 
equally necessary, wherever it occurs. Only disease surveillance can 
give us the lead time to manufacture vaccines and enable the world 
community to help control a disease outbreak where it initially occurs.
  In 2005, two sets of researchers reported in the journals Nature and 
Science that, based on computer simulations, if an outbreak of human-
to-human-transmitted avian flu occurred in a rural part of Southeast 
Asia, it might be possible to stem that dangerous epidemic by using 
anti-viral drugs to treat the tens of thousands of people who might 
have been exposed in the initial outbreak. One key requirement, 
however, was that the outbreak would have to be discovered, identified 
and reported very quickly; in one study, the assumption was that 
countermeasures were instituted when only 30 people had observable 
symptoms. That is a tall order for any country's disease surveillance 
system, let alone a poorly equipped one.
  The National Intelligence Council, NIC, reported in January 2000 that 
developing nations in Africa and Asia have only rudimentary systems, at 
best, for disease surveillance. They lack sufficient trained personnel 
and laboratory equipment, and especially the modern communications 
equipment that is needed for speedy analysis and reporting of disease 
outbreaks. The NIC estimated that it would take at least a decade to 
create an effective world-wide disease surveillance system.
  According to an August 2001 report by the General Accounting Office, 
World Health Organization officials said that more than 60 percent of 
laboratory equipment in developing countries was either outdated or 
nonfunctioning, and that the vast majority of national personnel were 
not familiar with quality assurance principles for handling and 
analyzing biological samples. Deficiencies in training and equipment 
meant that many public health units in Africa and Asia were simply 
unable to perform accurate and timely disease surveillance.
  The poor sanitary conditions, poverty, close contact between people 
and animals, and weak medical infrastructure make developing countries 
ideal breeding grounds for epidemics.
  So it is vital to give these countries the capability to track 
epidemics and to feed that information into international surveillance 
networks. Disease surveillance is a systematic approach that requires 
trained public health personnel, proper diagnostic equipment to 
identify viruses and pathogens, and prompt transmission of data from 
the doctor or clinic level all the way to national governments and the 
World Health Organization, Who.
  The Global Pathogen Surveillance Act will offer such help to those 
countries that agree to give the United

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States or the World Health Organization prompt access to disease 
outbreaks, so that we can help determine their origin. Recipients of 
this training will also be able to learn to spot diseases that might be 
used in a bioterrorist attack.
  In drafting this bill, we worked closely with the Department of 
Defense and others, which have all supported the underlying goals of 
the bill. We also accepted several suggestions for improving the bill 
from the State Department and, in 2005, from the HELP Committee, all of 
which contributed to making this a better bill.
  This bill targets U.S. assistance to developing nations in the 
following areas: Training of public health personnel in epidemiology; 
aquisition of laboratory and diagnostic equipment; Acquisition of 
communications technology to quickly transmit data on disease patterns 
and pathogen diagnoses to national public health authorities and to 
international institutions like the WHO; expansion of overseas CDC and 
Department of Defense laboratories engaged in infectious disease 
research and disease surveillance, which expansion could take the form 
of additional laboratories, enlargement of existing facilities, 
increases in the number of personnel, and/or expanding the scope of 
their activities; and expanded assistance to WHO and regional disease 
surveillance efforts, including expansion of U.S.-administered foreign 
epidemiology training programs.
  Two years ago the Secretary of State, Dr. Condoleezza Rice, expressed 
her strong backing for this legislation:

       We believe that the Global Pathogen Surveillance Act will 
     indeed help strengthen developing countries' abilities to 
     identify and track pathogens that could be indicators of 
     dangerous disease outbreaks--either naturally-occurring or 
     deliberately-released. Improved disease surveillance and 
     communication among nations are critical defenses against 
     both bioterrorism and natural outbreaks. We look forward to 
     working with you in support of the Global Pathogen 
     Surveillance Act.

  Secretary Rice went on to make clear that she shares the sense of 
urgency that Senators Hagel, Kennedy, Casey and I feel on this subject:

       One of the true ``nightmare'' scenarios--of a bioterrorist 
     attack or a naturally-occurring disease--involves a 
     contagious biological agent moving swiftly through a crowded 
     urban area of a densely populated developing nation. Thus, we 
     believe that it is critical to increase efforts to strengthen 
     the public health and scientific infrastructure necessary to 
     identify and quickly respond to infectious disease 
     outbreaks--and that the Global Pathogen Surveillance Act will 
     provide valuable support in these efforts.

  The WHO also shares our concern. During the SARS epidemic, Dr. 
Michael Heymann, who was the highest-ranking American in the WHO, 
stated: ``it is clear that the best defense against the spread of 
emerging infections such as SARS is strong national public health, 
national disease detection and response capacities that can identify 
new diseases and contain them before they spread internationally.'' He 
went on to highlight the important role that disease surveillance plays 
in combating both natural and terrorist outbreaks:

       Global partnerships to combat global microbial threats make 
     good sense as a defense strategy that brings immediate 
     benefits in terms of strengthened pubic health and 
     surveillance systems. The resulting infectious disease 
     intelligence brings dual benefits in terms of protecting 
     populations against both naturally occurring and potentially 
     deliberately caused outbreaks. As SARS has so vividly 
     demonstrated, the need is urgent and of critical importance 
     to the health of economies as well as populations.
       Support to developing countries such as proposed in the 
     Global Pathogen Surveillance Act . . . will help strengthen 
     capacity of public health professionals and epidemiologists, 
     laboratory and other disease detection systems, and outbreak 
     response mechanisms for naturally occurring infectious 
     diseases such as SARS. This in turn will strengthen WHO and 
     the world's safety net for outbreak detection and response, 
     of which the United States is a major partner. And finally, 
     strengthening this global safety net to detect and contain 
     naturally occurring infectious diseases will strengthen the 
     world's capacity to detect and respond to infectious diseases 
     that may be deliberately caused.

  The purpose of the Global Pathogen Surveillance Act is precisely to 
build these partnerships. And today, with the global war on terrorism 
an ever-present concern and with the threat of avian flu on the 
horizon, we have no time to waste. I urge my Senate colleagues to once 
again pass this bill and, with new leadership in the other body and 
with the support of Secretary Rice, I look forward to its speedy 
enactment.
                                 ______