Indo-U.S. Workshop on
Challenges of Emerging Infections
and Global Health Safety
Summary of a Workshop
Rita S. Guenther and Micah D. Lowenthal, Rapporteurs
Committee on India-United States Cooperation on Challenges of
Emerging Infections and Global Health Safety
Policy and Global Affairs
NATIONAL ACADEMY OF SCIENCES
In Cooperation with the Indian National Science Academy
THE NATIONAL ACADEMIES PRESS
Washington, D.C.
www.nap.edu
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This activity was supported by Contract/Grant No. S-ISNCT-12-CA-1003 between the National Academy of Sciences and the U.S. State Department and by the Kumar and Shela Patel Endowment. Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project.
International Standard Book Number-13: 978-0-309-37866-6
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Suggested citation: National Academy of Sciences. 2016. Indo-U.S. Workshop on Challenges of Emerging Infections and Global Health Safety: Summary of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/21810.
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U.S. COMMITTEE ON INDIA-UNITED STATES
COOPERATION ON
CHALLENGES OF EMERGING INFECTIONS AND
GLOBAL HEALTH SAFETY
James W. LeDuc, Co-Chair, The University of Texas Medical Branch at Galveston
Indira Nath, Co-Chair, Indian National Science Academy
David R. Franz, Independent Consultant
Diane E. Griffin (NAS/NAM), Johns Hopkins Bloomberg School of Public Health
Joseph Kanabrocki, The University of Chicago
National Academies Staff
Benjamin J. Rusek, Senior Program Officer
Rita S. Guenther, Senior Program Officer
Micah D. Lowenthal, Director
John Ahearn, Senior Program Associate
PREFACE AND ACKNOWLEDGMENTS
The United States and India, the world’s two largest democracies, have pledged to deepen the linkages between their people, their businesses, and their governments “for the mutual benefit of both countries and for the promotion of global peace, stability, economic growth and prosperity.”1 As open societies and leaders in different world communities, India and the United States must both be resilient to domestic and international public health threats. Both nations are now inclined to improve relations and cooperation, but the nations need specific actions that will yield progress and, just as important, build confidence and momentum for further cooperation. Emerging infectious disease is a natural area for partnership.
The Indo-U.S. Workshop on Challenges of Emerging Infections and Global Health Safety, held November 18-20, 2014, on the campus of the Indian National Science Academy (INSA), encouraged scientists from both countries to examine global issues to share experience and approaches, and to identify opportunities for cooperation to improve practice and research in these areas. The workshop was the culmination of a multi-year joint effort by INSA and the U.S. National Academy of Sciences (NAS) to enhance partnership among the scientific and technical communities of the two countries on urgent topics in global health and biological safety.
The primary goal of the workshop was for experts from both countries to share challenges and lessons learned regarding biological safety, laboratory management, and the efficient and sustainable conduct of public and animal health research, and clinical laboratories. A second goal was to encourage collaborative partnerships among Indian and American scientists in areas identified by both groups during the workshop keeping in mind the existing bilateral agreements between the two countries.
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1 U.S.-India Strategic Dialogue Joint Statement released at the conclusion of the United States-India Strategic Dialogue, held in Washington, D.C. on June 1-4, 2010. Available at: http://www.state.gov/r/pa/prs/ps/2010/06/142645.htm; accessed April 10, 2016.
Workshop speakers outlined the burden of infectious diseases and the importance of antimicrobial resistance, pathogen identification, infectious disease control (including the global challenges of influenza and Ebola), and provided an overview of laboratory diagnostics for virulent and drug resistant pathogens. They also emphasized that discussion of biotechnology and synthetic biology is essential because the rate of scientific advancement is only increasing, promising both enormous benefits and potential risks to global health safety.
Participants cited the unique roles and capabilities of the science academies of India and the United States to provide guidance to their governments. Participants also noted that the cooperation between INSA and NAS exemplified in this workshop underscored the opportunities for relevant, realistic, long-term, and sustainable partnership between the life-science communities of the two nations.
In preparation for the workshop, NAS and INSA formed a planning committee comprising prominent Indian and U.S. scientists, laboratory managers, biosafety experts, and government officials. The planning committee members worked collaboratively with scientific and technical experts in both countries to develop the agenda for the workshop.
The following summary intentionally includes a large portion of the material discussed during the workshop to provide readers with extensive insights into the views of the Indian and U.S. participants. The challenges they described are faced by both the United States and India, and both nations have much to learn from the exchange of information and experiences to enhance critical biological research, ensure the efficiency of laboratory operations, and improve the safety of employees, location populations, and the environment. As a result, the technical approaches detailed here will be of interest to many readers. For those readers interested in a high-level overview of the workshop discussions, key messages and promising topics for collaboration arising from the presentations and discussions have been highlighted in the Synopsis.
The U.S. Department of State funded the participation of scientists from the United States and contributed to the participation of scientists in India in this workshop, with supplemental funding from the Kumar and Sheila Patel Endowment to the NAS. INSA provided the facilities and administrative and technical support for the workshop. The generous support of all sponsors is greatly appreciated.
This report is a factual summary of the presentations and discussions at the workshop, and does not provide consensus findings or recommendations. The planning committee’s role was limited to planning and convening the workshop. The key issues and selected thoughts on goals and opportunities for collaboration noted in the Synopsis at the beginning of the report are some of those raised by individual workshop participants. Those statements, and any other views presented in the report, are those of individual workshop participants and do not necessarily represent the views of all workshop participants, the planning committee, INSA, or the U.S. National Academy of Sciences.
This report has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Academies of Sciences, Engineering, and Medicine’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published report as sound as possible and to ensure that the report meets institutional standards for quality and objectivity. The review comments and draft manuscript remain confidential to protect the integrity of the process.
We wish to thank the following individuals for their review of this report: Pradip Kumar Chakraborti, Institute of Microbial Technology, India; Bhudev Chandra Das, University of Delhi; Aysen Gargili, Marmara University; James LeDuc, The University of Texas Medical Branch at Galveston; Alemka Markotic, University Hospital for Infectious Diseases, Croatia; Indira Nath, The National Academy of Sciences, India; and David Swayne, United States Department of Agriculture.
Although the reviewers listed above have provided many constructive comments and suggestions, they were not asked to endorse the content of the report, nor did they see the final draft before its release. The review of this report was overseen by John Ahearne, Sigma Xi, The Scientific Research Society (Retired). Appointed by the Academies, he was responsible for making certain that an independent examination of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this report rests entirely with the rapporteurs and the institution.
As was demonstrated during the workshop, experts in both India and the United States seek opportunities to work together on issues related to biosafety, high-containment laboratory safety and security, and the benefits to the global population from continued biological and related research. While the task of addressing such a broad range of issues is vast, so too is the experience and expertise available in our two countries to meet this challenge. Joint efforts such as this workshop provide the basis for India and the United States to continue to learn from each other, to exchange ideas for collaborative efforts, and to increase the confidence and support necessary to take their cooperation further as they work to enhance global health safety in their respective countries and around the world.
Rita S. Guenther and Micah D. Lowenthal
Rapporteurs
CONTENTS
Goals and Objectives for Joint Workshop
Building on the Success of the Workshop
Selected Thoughts on Goals and Opportunities for Cooperation
Determining and Developing the Right Elements for Safe and Secure Research
Influenza as a Global Challenge for Human Health Research
Perspectives on the West African Ebola Outbreak
The Ebola Control Strategy in India
3 HUMAN AND ANIMAL HEALTH: THE WAY AHEAD
Biocontainment Solutions for Poultry Research with Veterinary and Zoonotic Pathogens
High Security Animal Disease Laboratory, Bhopal: Containment of Zoonotic Infections
4 THE BIOTECHNOLOGY REVOLUTION: EXPLORING NEW TERRITORY TOGETHER
Emerging Capabilities in the Life Sciences and Challenges for Global Health
From Genomics to Public Health
Innovation in Molecular Diagnostics for Resource Poor Situations
Challenges of Synthetic Biology
Regulatory Oversight of BSL-3 Laboratories
Regulatory Oversight of BSL-4 Laboratories
Ethical Codes Relevant to Medical and Human Health Research Laboratories
6 APPLYING AND USING NEW TOOLS AND KNOWLEDGE SAFELY
Building an Affordable and Effective BSL-3 Laboratory
Management of Natural Disasters
Biosafety Needs and Partnerships
7 COLLABORATION AND GOING FORWARD IN PARTNERSHIP
A INDO-U.S. WORKSHOP ON CHALLENGES OF EMERGING INFECTIONS AND GLOBAL HEALTH SAFETY
B INDO-U.S. WORKSHOP ON CHALLENGES OF EMERGING INFECTIONS AND GLOBAL HEALTH SAFETY