Health Security Intelligence: engaging across disciplines and sectors

ABSTRACT

This article introduces the Special Issue on Global Health Security. It provides an overview of the health security threat spectrum, tracing how perceptions of biological and health security threats have evolved in broad terms over the last century from deliberately introduced disease outbreaks to also incorporate natural disease outbreaks, unintended consequences of research, laboratory accidents, lack of awareness, negligence, and convergence of emerging technologies. This spectrum of threats has led to an expansion of the stakeholders and tools involved in intelligence gathering and threat assessments. The article argues that to strengthen global health security and health intelligence, the traditional state-based intelligence community must actively engage with non-security stakeholders and incorporate space for new sources of intelligence. The aim of the Special Issue is to contribute to the larger effort of developing a multidisciplinary, empirically informed and policy-relevant approach to intelligence-academia engagement in global health security that serves both the intelligence community and scholars from a broad range of disciplines.

As we write, coronavirus disease (COVID-19) is rapidly spreading around the globe, with more new cases of infection now being detected outside China than in it. There are significant concerns not only about the pandemic’s health impacts, but about its socio-economic impacts. Stock markets are tumbling, borders are closing, supply chains are interrupted, international meetings and sports events are cancelled, and there is talk of more severe social distancing measures.

This Special Issue of Intelligence & National Security introduces readers to the world of health security, to threats like COVID-19, but also to the many other incarnations of global health security threats and their implications for intelligence and national security. The Special Issue was conceived and written before COVID-19 emerged and hit our headlines in early 2020. Yet while the individual articles do not engage with the outbreak explicitly, the points they make form valuable reading in these unsettling times. The over-arching message is that to strengthen global health security and health intelligence, we need to engage across disciplines and sectors. This Special Issue is an effort to nurture that debate. By way of introduction, we provide readers with an overview of the health security threat spectrum, and how perceptions of biological and health security threats, as well as the political responses to them, have evolved over the last century. We also provide a brief sketch of intelligence and biological threat assessments, today and in the past. The authors in the Special Issue are briefly introduced along the way; more extensive biographies accompany their individual articles.

Deliberate disease outbreaks

Disease outbreaks like COVID-19 have not historically been considered a national security matter. While disease outbreaks among troops have always been a concern, it was the potential that arose in the twentieth century to systematically design biological weapons (i.e. combine dangerous bacteria or viruses with a delivery mechanism to inflict harm) and then develop these weapons at an industrial scale, that initially drew the attention of security, defence and intelligence communities to biology and medical science.¹ Still reeling from the horrors of gas warfare in World War I, and from the ‘Spanish flu’ that killed over 50 million people towards the end of the war, the ‘civilised world,’ represented by the League of Nations, prohibited the use of asphyxiating, poisonous or other gases in war as well as ‘bacteriological methods of warfare’ under the 1925 Geneva Protocol. Essentially a no-first-use agreement, the Geneva Protocol was not designed to stop the development of biological weapons, and significant programmes to build biowarfare capacities soon ensued in several states. Yet, despite intensive development and testing, which eventually demonstrated that biological weapons could form as great a threat to large populations as nuclear weapons, biological weapons were not assimilated into military thinking and planning, and there has been no known use since 1945.² In a political move that caught American bioweaponeers off-guard, the newly-elected President Richard Nixon unilaterally renounced biological weapons in 1969, paving the way for the multilateral Biological Weapons Convention comprehensively prohibiting biological weapons to be negotiated and agreed at the United Nations in the early 1970s.

Bioterrorism first emerged as a political concept during the early 1990s in the United States.³ As the Cold War faded, the threat of terrorists armed with biological weapons and other ‘weapons of mass destruction’ began to replace the Soviet threat. Different assessments of the importance, urgency and scale of the threat were present in the early political debates on bioterrorism.⁴ ‘Alarmists,’ who included prominent scientific and technical advisers, tended to emphasise the possibility of ‘apocalyptic’ attacks with natural pathogens and genetically engineered hybrids, and the vulnerability of the civilian population. They were less focused on the identities of ‘bioterrorists’ and in their interests in pursuing such attacks or in their capacities to do so. ‘Sceptics,’ on the other hand, tended to have background and training in the history, politics and culture of terrorism, and for them, questions of identity, interests and details of past attackers were the primary questions to ask. Although little credible evidence existed at the time that such states or terrorists would, or even could, resort to biological weapons, alarmism ultimately overcame scepticism, and federal funds poured into new US preparedness and civilian biodefense programmes of considerable institutional proportions.⁵

The ‘Amerithrax’ attacks – as the FBI code-named the series of anonymous letters containing anthrax sent to media outlets and the US Senate within weeks of the ‘9/11ʹ terrorist attacks on New York and Washington on September 11^th, 2001 – revealed serious shortcomings in US biosecurity. They also raised fears about the growing potential for bioterrorism on American soil. The threat of bioterrorism became one of the Bush administration’s key security concerns during its two terms in office, and initiated a series of new regulations, policies and programmes to further strengthen US preparedness and defence against a bioweapon attack.

Concern about the threat of international terrorism coupled with WMD proliferation was also exported from the United States to international security forums. The international community’s premier security forum, the United Nations Security Council, decided, for example, in resolution 1540 that all states should refrain from providing any form of support to non-state actors that attempt to obtain biological and other weapons of mass destruction for terrorist purposes. New laws and other non-proliferation measures were implemented in capitals around the world, and counteroffensives materialized in international risk and security strategies.

Global health security

The World Health Organization (WHO), which has traditionally been reluctant to address security-related issues for fear that its public health mission would be compromised, has increasingly been gaining a profile as a key actor in the security world, and it has exerted significant influence on how perceptions of biological threats have evolved. From the outset, its overriding message has been that, whatever the cause of epidemics or emerging infectious diseases, the response to them will initially be the same: ‘In most situations, the public health system will be the first to detect cases and raise the alarm.’⁶ In other words, the threat of deliberate use of biological weapons should be thought of as part of a wider spectrum of threats that also includes the threat of disease from natural outbreaks and accidental releases, and the most effective response to these threats is to bolster public health measures.

Following this lead, the Obama administration ushered in an evolution in US thinking about its response to bioterrorism. The administration’s first major policy initiative on biosecurity was the National Strategy for Countering Biological Threats. While the Bush Administration’s efforts had been focused on biodefence, this strategy was focused on prevention. It emphasised linking deliberate disease outbreaks from bioterrorism attacks with naturally occurring disease outbreaks, to create a more ‘seamless’ and ‘integrated’ link across all types of biological threats – echoing what the WHO had been pushing multilaterally for years. In his 2011 speech to the United Nations General Assembly, President Obama called upon all countries to ‘come together to prevent, and detect, and fight every kind of biological danger – whether it’s a pandemic like H1N1, or a terrorist threat, or a treatable disease.’⁷ In February 2014, the US spearheaded the Global Health Security Agenda to establish global capacity to prevent, detect and rapidly respond to biological threats.

A test case was brewing even as the initiative was getting off the ground. By August 2014, the WHO declared the Ebola epidemic in Western Africa a ‘Public Health Emergency of International Concern.’ But as Margaret Chan, the Director-General of the WHO, explained to the United Nations Security Council, this Ebola epidemic was very different to the many big infectious disease outbreaks managed by the WHO in recent years: ‘This is likely the greatest peacetime challenge that the United Nations and its agencies have ever faced. None of us experienced in containing outbreaks has ever seen, in our lifetimes, an emergency on this scale, with this degree of suffering, and with this magnitude of cascading consequences.’⁸ The Ebola outbreak was characterised not merely as a public health crisis, but as ‘a threat to national security well beyond the outbreak zones.’⁹

Two of the Special Issue contributions focus on the Ebola outbreak and the intelligence gaps that existed in the months before the Ebola outbreak became characterised as a national security concern. Political scientist Robert Ostergard draws on newly declassified material to piece together how US embassy personnel in Conakry, Guinea perceived the early stages of the outbreak and the local government’s response to it, and how they relayed that perception to Washington DC. His contribution demonstrates the significant potential of health intelligence – the concepts, methods, practices and apparatuses assembled to monitor and detect health events – in assessing risks from an emerging infectious disease outbreak. Rose Bernard and Richard Sullivan, who work at the intersection of conflict, health and intelligence, elaborate the role of human intelligence in gathering information on a developing Public Health Emergency of International Concern in their contribution to the Special Issue. They demonstrate how modelling and disease tracking for the Ebola outbreak could have been significantly assisted by a standardised ethnographic and anthropological assessment based on human intelligence. In their own words, ‘An assessment of the social and cultural context could have identified healthcare and burial practices, as well as population movements over common borders and identifying potential cases. Local healthcare workers could have been asked about the healthcare capabilities and the most necessary equipment suited to the immediate context. Similarly, interviews with individuals could have identified attitudes towards the ETUs, and potentially identified any false drop in cases.’ They conclude that the human ecosystem is increasingly the crucial determinate of disease risk and intervention success in complex outbreaks of emerging infectious disease, and that this requires a wide human intelligence perspective that encompasses anthropology, other social sciences, psychology, economics, history and political sciences.

An emerging infectious disease is one that either has appeared and affected a population for the first time or has existed previously but is rapidly spreading in terms of the number of people getting infected or in terms of the new geographical areas affected. Ebola and COVID-19, along with fellow coronavirus diseases Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS), are examples of diseases that have recently emerged. These new infectious diseases are increasing in frequency, due to a variety of factors including: climate change, the increase in world travel, greater movement and displacement of people resulting from war, the global transport of food and intensive food production methods, humans encroaching on the habitat of wild animals, and better detection systems that spot new diseases. Many emerging infectious diseases are zoonotic in origin, which means that the disease has emerged from an animal and crossed the species barrier to infect humans. More often than not, humans have little or no natural immunity to emerging infectious diseases, so their disruptive impacts on health, society and the economy are difficult to predict. This is one of the reasons infectious disease pandemics are often characterised as disrupters with the highest likelihood and most severe impact on national security.

Two contributions to the Special Issue present detailed historical case studies of emerging infectious diseases that demonstrate the role of particular warning signals in monitoring health security threats. Operational health security intelligence specialists James Wilson, Garrett Scalaro and Jodie Powell highlight the role of local media reporting. Using comparative case studies of local media reporting in Philadelphia on the 1918 and 1977/78 influenza pandemics, they argue that warning signals typically appear in local media reporting ahead of reactive public health surveillance. In a second paper James Wilson joins Tracey McNamara, a veterinary pathologist to highlight the critical role of the astute clinician-observer. Drawing on their own significant involvement in responding to the unfolding West Nile virus epidemic that started in New York in 1999, they emphasise the importance of communication between the veterinary and human health communities, as well as the federal and private sectors.

In a final contribution on emerging infectious diseases to the Special Issue, Steven Hatfill, a specialist physician and virologist, analyses a series of emerging infectious disease outbreaks over the past 25 years to explore choke points or major rate-limiting steps in the global pandemic surveillance process to provide timely warning of significant outbreaks. He identifies the challenges of obtaining lab and epidemiological data from affected countries as particularly significant, and argues for establishing independent specialist teams to conduct rapid ‘boots-on-the-ground’ examinations of developing outbreaks posing a possible threat to international security.

Dual use research of concern

Biological threats are today generally thought of as sitting on a spectrum, running from deliberate disease outbreaks at one end, to emerging infectious diseases and natural disease outbreaks at the other. Squeezed in between these two types of threats is a series of linked threats all based on significant scientific advances in capacities to modify genes and organisms.

Innovations in biotechnology are expanding the toolbox to modify genes and organisms at an unprecedented rate, making it easier to produce increasingly dangerous pathogens.¹⁰ Disease-causing organisms can now be modified to increase their virulence, expand their host range, increase their transmissibility, or enhance their resistance to therapeutic interventions. Low-risk pathogens can also potentially be modified to become high-risk pathogens. In addition to modifying existing pathogens, scientific advances are also making it possible to synthetically create known pathogens. Scientific advances are even making it possible to synthetically re-create extinct pathogens like the variola virus which causes smallpox. Entirely new pathogens that have never existed in nature could also potentially be created. These are sometimes referred to as super-pathogens, where characteristics of two, or more, pathogens are combined.

In addition to increased capacities to modify genes and organisms, the global nature of science continues to drive the diffusion of knowledge around the world, with more knowledge hubs and virtual communities, and research occurring in more diverse locations and involving a broader range of actors. Although significant levels of technical skill and tacit knowledge are still required to produce dangerous pathogens, barriers are being reduced, it is becoming easier to misuse the science for a larger group of people, and vulnerabilities are becoming greater.¹¹ There are generally considered to be at least four new types of biological threats arising from these developments: unintended consequences of research, laboratory accidents, lack of awareness, and negligence.

A set of high profile scientific experiments in the early 2000s, which made mousepox more deadly, chemically synthesised poliovirus from scratch in the lab, and reconstructed the extinct ‘Spanish flu’ virus from the end of World War I, first drew attention to these threats.¹² Responding to the experiments and the novel threats they represented, a US National Academies of Sciences committee identified a broader set of seven illustrative experiments that raised concern.¹³ In the Committee’s view, these were the sorts of experiments that should necessitate further review before they are conducted or published. They include those that: (1) demonstrate how to render a vaccine ineffective, (2) confer resistance to therapeutically useful antibiotics or antiviral agents, (3) enhance the virulence of a pathogen or render a non-pathogen virulent, (4) increase the transmissibility of a pathogen, (5) alter the host range of a pathogen, (6) enable the evasion of diagnostic/detection modalities, and (7) enable the weaponisation of a biological agent or toxin. The Committee also recommended the creation of a new National Science Advisory Board for Biosecurity to provide guidance for the review and oversight of such experiments and other dual-use research concerns.

The National Science Advisory Board on Biosecurity (NSABB) was chartered in 2004 by the Executive Office of the President to provide advice to the US Government regarding the review and oversight of dual-use research. In the first years of its existence, the NSABB focused on defining and providing oversight recommendations for dual use research.¹⁴ The Board proposed a split between two kinds of science. ‘Dual use research’ was used to refer in general to legitimate life sciences research with potential to yield information that could be misused to threaten public health and safety and other aspects of national security. Since nearly all science could be used in this manner, NSABB offered another category: ‘Dual use research of concern’ (DURC). This denoted ‘research that, based on current understanding, can be reasonably anticipated to provide knowledge, products or technologies that could be directly misapplied by others to pose a threat to public health and safety’.¹⁵

Another set of high-profile experiments attracted attention in 2011. The ‘gain-of-function’ experiments, which resulted in the creation of laboratory-modified H5N1 ‘bird flu’ viruses that could spread not just between birds but now also between mammals, and, if accidentally or deliberately released, could result in a deadly pandemic, were considered archetype DURC. The gain-of-function research prompted a moratorium, followed by the release of the US Government’s Policy for Oversight of Life Sciences Dual Use Research of Concern in March 2012, and later the Policy for Institutional Oversight of Life Sciences Dual Use Research of Concern in September 2014. The policies built on the criteria for establishing DURC proposed by the National Academies of Sciences and the NSABB, but the US Government limited review to research carried out with one of 15 pathogens deemed to pose the greatest risk of deliberate misuse with most significant potential for mass casualties or for devastating effects to the economy, critical infrastructure or public confidence.¹⁶

Very few, if any, other countries have to date developed guidance or practices like the US to address the potential for terrorist or criminal use of information based on biology and biomedical research. While the focus of the political response has been on unintended consequences of research, laboratory accidents, lack of awareness and negligence, DURC research would of course also have implications for the threat of deliberately developed biological weapons, where scientific advances could, for instance, be used to enlarge the target of traditional biological weapons from causing disease to directly targeting the immune system, nervous system, genome or microbiome.

Convergence

Technological change is accelerating, not just in the biological sciences but also in other emerging technologies, and this acceleration is impacting biological threats across the spectrum.¹⁷

Of particular note is the convergence between biology and chemistry, spurred on by advances in neuroscience and toxicology. New pharmaceutical based agents are being developed that share characteristics of both traditional chemical and biological agents. These agents mostly comprise chemicals that have been designed for medical pharmaceutical use but which in overdose, or certain exposure contexts, can cause either incapacitation, permanent injury or death. David Heslop and Peter Blain analyse this convergence in their contribution to the Special Issue. Experienced physicians working at the intersection of medicine, academia and defence, they present a risk assessment of pharmaceutical based agents and approaches to threat prevention or mitigation. They highlight in particular fentanyl analogues, now widely available in illicit drug markets, as the major threat potential of pharmaceutical based agents, and urge both law enforcement officers and emergency planners and responders to factor in accidental exposure to, or deliberate use of, these agents into emergency preparedness, resilience, response and recovery plans, as well as training programmes.

Another significant area of convergence is that of genomic technologies with artificial intelligence (AI), automation, robotics and cloud computing.¹⁸ Genomic technologies are driving a vast expansion in genomic data, from gene sequences and entire genomes to data that links genes to specific functions and other types of metadata for humans, animals, plants and microbes. This data is becoming increasingly digitised, and computational power is significantly changing how genomic data is analysed.¹⁹ This integration of AI computation into biology opens up new possibilities for understanding how genetic differences shape the development of living organisms including ourselves, and how these differences make us and the living world susceptible to diseases and disorders, as well as responsive to drugs and treatments.

But the interface of bioinformatics and AI also open up new possibilities for harm. Developments in advanced AI and machine learning could speed up identification of harmful genes or DNA sequences. Advanced AI and machine learning could also potentially enable much more targeted biological weapons that would harm specific individuals or groups of individuals based on their genes, prior exposure to vaccines, or known vulnerabilities in their immune system. Big Data and ‘cloud labs’ (completely robotized laboratories for hire) facilitate this process by enabling massively scaled-up experimentation and testing, significantly shortening ‘design-test-build’ timeframes, and improving the likelihood of obtaining specificity or producing desired biological functionality.²⁰

There are also traditional cyber risks at the interface of bioinformatics and AI, particularly for the healthcare sector. In their contribution to the Special Issue, Kim Offner, Elena Sitnikova, Keith Joiner and Raina MacIntyre review the literature on global cyberattacks against the healthcare sector and examine recent trends in cybersecurity breaches, focusing especially on their own country, Australia. They argue that a culture of cybersecurity maturity must be proactively developed within healthcare systems to help mitigate cyber threats, limit disruption to essential services, and protect patient safety and privacy.

In addition to traditional cyber risks, there are also what have been termed ‘cyber-biosecurity’ risks, focused on the bioeconomy. These risks include waging adversarial attacks on automated bio-computing systems, biotech supply chains, or strategic cyber-biosecurity infrastructure.²¹ Malicious actors could, for example, use AI malware to co-opt networks of sensors and impact control decisions on biotech supply chains with the intent to damage, destroy or contaminate vital stocks of vaccines, antibiotics, cell or immune therapies. In another scenario, AI malware could be used to automate data manipulation with the intent to falsify, erase or steal intelligence within large curations of genomics data. Such data poisoning could affect how pathogens are detected and analysed. It could also affect biointelligence on complex diseases in subpopulations collected over many years.

Intelligence-gathering and biological threat assessments

State-based intelligence activity has traditionally formed the bulk of biological threat assessments. Yet, obtaining accurate intelligence on biological threats from both state and non-state actors is challenging, as highlighted by Patrick Walsh, a former intelligence analyst, in his contribution to the Special Issue. His account of ‘Five Eyes’ health security capabilities emphasises gaps in three core intelligence processes: tasking and coordination, collection and analysis.

Capability gaps have certainly been apparent historically. In terms of state threats, for instance, the size, scope and sophistication of the extensive Soviet biological weapons programme took Western intelligence communities completely by surprise when it began to be uncovered at the end of the Cold War. Western intelligence communities also had to re-evaluate assessments made in the 1990s and early 2000s that Libya and Cuba had active biological weapons programmes, retroactively concluding that earlier judgements were incorrect. The most remarkable failure, however, was the incorrect assessment of Iraq’s biological weapons programme before the US invasion of Iraq in 2003. Scholars have demonstrated how the ‘anticipatory frame’ CIA analysts used in their assessment of the programme fixated the analysts on particular technical pieces of information rather than integrating the more complex social, political and economic dynamics shaping Iraq’s biological weapons development: ‘factors which ultimately proved to be decisive.’

Today, there is limited public information on possible illicit state-based biological weapons activity. There is no public reporting that any country is maintaining a biological weapons programme. In the US State Department’s annual compliance report on arms control, non-proliferation and disarmament treaties – the only publication of its kind – concerns are expressed that the Russian Federation has not ‘satisfactorily documented whether [its inherited Soviet offensive] program was completely destroyed or diverted to peaceful purposes.’²² Three key military institutes involved in the Soviet programme remain closed to outsiders, and it is these that are of particular interest to the USA. Bilateral discussions and confidence-building measures under the Biological Weapons Convention have not clarified the situation and, as a result, the US position is that it cannot confirm the elimination of past illegal biological weapons activities in Russia.²³ Russia’s official position is that no offensive biological weapon programme ever existed in the Soviet Union.

The US intelligence community has been most explicit in expressing concerns that an adversary might be harnessing techniques for sequencing, synthesizing and manipulating genetic material for offensive use, and the government is investing heavily in defensive capabilities. The Defense Advanced Research Projects Agency (DARPA), the US military’s research wing, asserts that: ‘The application of biotechnologies by an adversary is an area where the United States could be most surprised as a nation, but it is also a source of great potential, where the United States could develop a host of new surprises of its own.’²⁴ The goal to ‘harness biology as technology’ is one of four main areas of focus for DARPA’s strategic investments in ‘overmatch’ capabilities, according to its website. In Congressional testimony from March 2017, Arthur T. Hopkins, Acting Assistant Secretary of Defense for nuclear, chemical and biological defence programmes, stated that: ‘The same tools of synthetic biology that we’re concerned about as being capable of being used against us, we are also using in the laboratories to help develop countermeasures.’²⁵

This build-up of biodefence infrastructure and capacities, not just in the United States but taking place around the world, means that states are moving closer to being in a position to threaten or perpetrate a biological attack.²⁶ This situation is worrying from an international security perspective. While states building their biodefence and civil emergency response capacities are not deliberately developing offensive capabilities, states observing the build-ups might feel the need to prepare for a sudden change of mind or change of intent by the leadership of the state building its capacities, and observer states might then begin to investigate the offensive capabilities they fear. Russia, for instance, claims that the US military is establishing a chain of dual-use laboratories on its border, that it is secretly collecting Russian biological material, and that the USA is conducting biological experiments near Russia’s borders.²⁷ Like the USA, Russia is probably preparing for the eventuality that sophisticated biology might be used against its people, animals or crops. Russia’s claims that it is aiming to develop ‘genetic weapons’ suggests the country might even aspire to go beyond defensive measures.²⁸ A build-up of capabilities would lead to more offensive know-how all round and to more danger of biological attacks against more states.

The focus in the ‘non-state actor’ category has traditionally been on terrorists. There is, however, relatively little evidence of past terrorist interest in biological agents.²⁹ Terrorists tend to be conservative and use weapons that are readily available and have a proven track record, not unconventional weapons that are more difficult to develop and deploy.

There are few instances of intent to develop mass casualty capabilities.³⁰ In one of the earliest incidents, in the 1970s in the USA, a group of teenagers calling themselves RISE fantasized about killing large parts of the world population and then regenerating humankind. They obtained several pathogens and learned how to grow them, but they failed to carry out their planned attacks before being arrested. In the 1980s, also in the USA, the Rajneeshees cult deliberately contaminated salad bars with Salmonella to sicken diners to make them stay away from voting booths during local elections in Oregon. Salmonella rarely kills, and no one died in this attack, but more than 750 people were infected, some of them quite severely. In the 1990s in Japan, the Aum Shinrikyo cult tried to cause mass casualties by developing and disseminating Bacillus anthracis, but the cult’s attempts failed and no one was infected with anthrax. The Aum had more success with chemicals. In 1995, the same cult carried out the sarin attack on the Tokyo underground.

The most lethal bioterrorism attack was the 2001 anthrax letters. Codenamed Amerithrax by the FBI, the attack killed five and sickened another 17 people. Five anonymous letters containing a deadly strain of Bacillus anthracis were sent to media outlets and the US Senate within weeks of the 9/11 terrorist attacks on New York and Washington. The letters overtly linked the two attacks, with its messages of ‘09-11-01 you cannot stop us’ and ‘this is next’, but the attacks were in fact not connected.

During the invasion of Afghanistan in late 2001, US soldiers captured a primitive laboratory known to be used by al-Qaeda operatives. As Vogel notes: ‘Although crude and not yet operational, the lab findings suggested that al-Qaeda had acquired an avirulent strain of anthrax bacteria, limited biotech equipment, and some scientific articles. US officials determined that one PhD-level microbiologist from Pakistan was in charge of planning the design and work of the laboratory; he had also visited biotechnology companies and conferences. … Declassified US government reports about this Afghani makeshift laboratory have indicated that al-Qaeda was unable to obtain a pathogenic culture of the anthrax bacteria, and that there was no evidence of any technical work done at this site, suggesting that al-Qaeda’s 2001 bioweapons capabilities never went beyond trivial (Vogel 2013).’³¹

Interrogations of a captured Malaysian biological technician who was seeking to acquire bioweapons materials and equipment for al-Qaeda revealed that the group faced similar hurdles to developing biological weapons as the Aum Shinrikyo cult.

While there are few datapoints, past incidents show that even in the small number of cases where terrorists have actually made a serious effort at bioterrorism, pathogens have been difficult to acquire and use as weapons. The skills required to undertake even the most basic of bioterrorism attacks are often greater than assumed. The incidents also illustrate that bioterrorism can take many forms. Motivations differ significantly. RISE, the Aum Shinrikyo cult and al-Qaeda were motivated by a desire to cause mass casualties. The Rajneeshes were aiming to disrupt an election and focused on incapacitation. The Amerithrax case seems to have been motivated by a desire to make a political statement, drawing attention to the importance of anthrax research and the need to continue to fund it. Another takeaway from past bioterrorism incidents is that it is difficult to predict which pathogens terrorists might employ. It is often assumed that terrorists will use the same agents as were developed in state weapons programmes, but bioterrorists have acquired and used agents of little or no value as weapons of war.

The unique characteristics of biological agents make bioterrorism fundamentally different from other forms of terrorism. Not only are biological agents radically different from other weapons available to the terrorist, but biological weapons are also substantially different from the other weapons of mass destruction: chemical and nuclear weapons. To develop an effective biological weapon, it is necessary to obtain a pathogen suitable for weaponization. That pathogen must be weaponized and then disseminated without itself being affected by exposure to the environment. The pathogen must be capable of infecting the target, causing illness and/or death despite the efforts of the authorities to provide medical treatment, vaccination, quarantine, and so on. While case studies of terrorists evaluating the use of biological weapons are scare, there is one prominent example. The Norwegian right wing extremist, Anders Behring Breivik, who carried out a bomb attack in Oslo and a massacre on the island of Utøya in 2011, stated in a manifesto that he had considered using biological warfare agents, in particular anthrax, but concluded that he did not have the necessary expertise. Instead, he carried out a conventional attack with explosives and firearms.

Today, there is no public reporting that any current terrorist group has the capabilities to inflict mass casualties using biological agents. The characteristics of bioterrorism drawn out from previous incidents – technical barriers, range of motivations, uncertain pathogens/nature of the attack – are likely to remain in the short to medium term.

Fostering engagement between intelligence and academia

State-based intelligence activity is struggling to keep pace with the rate of societal transformation. Intelligence has traditionally been concerned with the assessments of threats which influence tactical and strategic responses, embedded within national security postures. Technological advances, and political and economic upheaval, have at once both undermined and strengthened the state’s capacity to observe and analyse, the capacity for secrecy, and the capacity to act at a distance. This represents a fundamental challenge not just for the state and the intelligence community, but for broader conceptions of national security and intelligence and their functions within statecraft.

A significant component in meeting this challenge is the acquisition of outside expertise to gain new insights and mitigate against intelligence failures.³² In the US, for instance, a National Research Council report, sponsored by the Office of the Director of National Intelligence, recommended that the intelligence community ‘should expand opportunities for continuous learning that will enhance collaboration, innovation, and growth in the application of [social and behavioural science] analytical skills.’³³ In Britain, the Chief of MI6 has recently commented on the ‘danger of group think’ and the requirement to ‘stimulate a contrary view’. Lord Butler’s report Review of Intelligence on Weapons of Mass Destruction identified the need for ‘challenge’ to the government – a need that is still unmet.³⁴ The Blackett Review of High Impact Low Probability Risks, commissioned by the Cabinet Office and the Ministry of Defence, argued that greater use ought to be made of ‘external experts to inform risk assumptions, judgments and analysis’.³⁵ In January 2018, the British Government’s ‘Areas of Research Interest’ identified the need to ‘align scientific and research evidence from academia with policy development and decision-making.’³⁶ The growing emphasis on intelligence outreach provides an unparalleled opportunity for scholars from a broad range of disciplines to consider the role they might play in these efforts, as well as the various opportunities and difficulties that can shape these relationships.

Perceptions of biological and health security threats have evolved in broad terms over the last century from deliberately introduced disease outbreaks to also incorporate natural disease outbreaks, unintended consequences of research, laboratory accidents, lack of awareness, negligence, and convergence of emerging technologies. This spectrum of threats has led to an expansion of the stakeholders and tools involved in intelligence gathering and threat assessments. Initially limited to groups associated with war, defence, international order and strategy, the field has expanded to also involve groups associated with medicine, health care and the life sciences, as well as groups associated with crime, internal security, public order and police investigations. To strengthen global health security and health intelligence, the traditional state-based intelligence community must actively engage with non-security stakeholders and incorporate space for new sources of intelligence. It is our hope that this Special Issue will contribute to the larger effort of developing a multidisciplinary, empirically informed and policy-relevant approach to intelligence-academia engagement in global health security that serves both the intelligence community and scholars from a broad range of disciplines.³⁷

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Notes on contributors

Filippa Lentzos

Filippa Lentzos is a Senior Research Fellow at King’s College London, jointly appointed to the Department of Global Health & Social Medicine and the Department of War Studies. She is also an Associate Senior Researcher at the Stockholm International Peace Research Institute (SIPRI), a columnist at the Bulletin of Atomic Scientists, and the NGO Coordinator for the Biological Weapons Convention. For more about her work see www.filippalentzos.com or follow her on twitter: @FilippaLentzos

Michael S. Goodman

Michael S. Goodman is Professor of Intelligence and International Affairs, Head of the Department of War Studies and Dean of Research Impact, King’s College London. He is also a Visiting Professor at the Norwegian Defence Intelligence School and at Sciences Po in Paris. Goodman has recently finished a secondment to the Cabinet Office where he has been the Official Historian of The Joint Intelligence Committee: Volume II which will be published in 2020.

James M. Wilson

James M. Wilson is the CEO of M2 Medical Intelligence, Inc. He is a board-certified, practicing pediatrician who specializes in operational health security intelligence, with a focus on the anticipation, detection, and warning of infectious disease crises. Wilson led the private intelligence teams that provided tracking of H5N1 avian influenza as it spread from Asia to Europe and Africa, detection of vaccine drifted H3N2 influenza in 2007, warning of the 2009 H1N1 influenza pandemic, discovery of the United Nations as the source of the 2010 cholera disaster in Haiti, and several investigations of alleged and confirmed laboratory accidents and biological weapon deployments. Wilson is a strong advocate for effective and accountable global health security intelligence and the need for credible and balanced threat assessments.

Notes

1. Lentzos, Biological Threats.

2. Carus, “A century.”

3. Guillemin, Biological Weapons; and Wright, “Terrorists and biological weapons”.

4. Wright, “Terrorists and biological weapons”.

5. See note 3 above.

6. WHO, “Preparedness for Deliberate Use”.

7. White House, “Remarks by President Obama”.

8. WHO, “Director-General”.

9. Ibid.

10. NASEM, Biodefense.

11. IAP, Biological and Toxin Weapons.

12. NRC, Biotechnology Research.

13. Ibid.

14. NSABB, Proposed Framework.

15. Ibid.

16. NASEM, Dual Use Research.

17. Brockman, Bauer and Boulanin, Bio plus X.

18. Dunlap and Pauwels, Intelligent and Connected; and Pauwels, New Geopolitics.

19. Bajema et al., Digitization of Biology.

20. Lentzos and Invernizzi, “Laboratories in Clouds”.

21. See note 18 above.

22. US Department of State, Report on Adherence.

23. Ibid.

24. DARPA, DARPA: 1958–2018.

25. Pellerin, “DOD Officials”.

26. Lentzos and Littlewood, “DARPA’s Prepare Program”.

27. Lentzos, “Russian Disinformation Attack”.

28. Hoffman, “Genetic Weapons You Say”.

29. Carus, Bioterrorism and Biocrimes.

30. Carus, “RISE, The Rajneeshees”.

31. Vogel, Phantom Menace, 47.

32. Dover and Goodman, “Impactful scholarship”; Dover, Goodman and White, “Two Worlds”.

33. NRC, Intelligence Analysis.

34. Butler, Review of Intelligence.

35. Government Office for Science, Blackett Review.

36. HM Government, “Areas of Research Interest”.

37. Vogel and Balmer, “Secrecy and Intelligence”; Vogel and Knight, “Analytic Outreach”; and Nolan, “Ethnographic Research”.