The Covid-19 pandemic has thrown open multiple issues that question the preparedness of not just India, but the world as such to fight challenges like the one we are faced with, today. The author informs that till now biosecurity has been treated as a health issue in India, instead of being viewed as a part of the national security paradigm. The author’s analysis merits examination in order to better protect our societies against disruptions that such pandemics can cause, as we do find ourselves immersed in, today.
“We must come together to prevent, detect, and fight every kind of biological danger whether it is a pandemic, a terrorist threat, or a treatable disease.”
S. President Barack Obama, United Nations General Assembly, September 22, 2011
India is a vast country with porous borders, a great variety of flora and fauna and an over bulging population. Climatic conditions vary from perennially humid and sultry to snow-capped. In such a cauldron of a natural ripe potion, a drop of a toxic pathogen can cause havoc. The question is, are we going to turn off the stove when the drop goes in or make provisions to ensure the drop does not go in at all.
I must salute the concerted actions in response to the Covid-19 pandemic by Indian authorities. There have been commendable actions by many state administrations, most stakeholders and great support by the public. However, the current and earlier epidemics show that India is switching off the stove, meaning, we are mostly responsive or reactive to such bio-threats.
Biosecurity has been dealt with as a health issue leading to many areas of concern. The Coronavirus pandemic has raised national awareness levels and brought out many lessons. It is endeavoured to discuss some of the lessons thrown up in the recent crisis with the aim to strengthen our National Biosecurity.
Biosecurity means putting in place procedures or measures designed to protect the population against harmful biological or biochemical substances. Biosecurity is designed to reduce the risk of transmission of infectious diseases in crops and livestock, quarantined pests, invasive alien species, and living modified organisms. These preventive measures include a combination of systems and practices put in place at bioscience laboratories, by border control, customs agents, agricultural and natural resource managers to prevent the spread of dangerous pathogens and toxins. Biosecurity is a National security subject and should be a subset of CBRN (Chemical, Biological, Radiological and Nuclear) Security.
India has a robust legislative system to combat biosafety issues, refined and strengthened over the last four decades. National biosafety and bio-waste activities are governed by legislation through state health ministries and environment ministries (Pollution Control Boards). Under the Integrated Disease Surveillance Programme, a network of public laboratories with biosafety practices and infrastructure is being set up. Biosecurity has sadly remained a stepbrother of Biosafety.
Key ministries involved with biosecurity and biosafety are Ministry of Science and Technology (MoST), Ministry of Health and Family Welfare (MoHFW)and Ministry of Environment, Forests and Climate Change (MoEFCC). Many laws and regulations covering Biosecurity from WMD, laboratory biosafety and Biosecurity, vaccine development, disease research and DNA testing are managed by these ministries through the Indian Council of Medical Research (ICMR), Council of Scientific and Industrial Research (CISR) and Defence Research and Development Organisation (DRDO).
The proposed Agricultural Biosecurity Bill 2013 and the National Biotechnology Regulatory Authority (NBRA) aim to establish an integrated national biosecurity system covering plant, animal and marine issues. The Bill (which is still pending approval) does not include epizootics/zoonoses like Coronavirus and Avian Flu. Laboratory Biosafety and Biosecurity is managed by ICMR. In India, about 30 Bio-Safety Level (BSL) laboratories of the level of BSL3 or BSL2+ are currently under operation. The two BSL4 facilities in India are The National Institute of Virology (NIV) at Pune and The National Institute of High-Security Animal Diseases (NIHSAD) at Bhopal. Bio Laboratories are graded based on types of pathogen researched or analysed, levels of containment and security/protection ranging from the lowest biosafety level 1 (BSL-1) to the highest at level 4 (BSL-4).
International Obligations and Support
India has signed and ratified the Biological and Toxins Weapons Convention (BTWC) of 1972. It has also declared its support to all international efforts for strengthening norms against bioweapons and bioterrorism while maintaining a credible deterrent against the use or the threat of use of WMDs against India.
India has expressed its support for UNSCR 1540. India is especially concerned about export controls on bioweapons. It has therefore been exercising control over the export of Special Chemicals, Organisms, Materials, Equipment and Technologies (SCOMET), which includes micro-organisms/toxins, including bacteria, fungi, parasites, viruses, rickettsial, plant pathogens, and genetically modified organisms.
The Gaps and Thoughts on Restructuring
Many essential factors imperative to strengthen our national biosecurity paradigm need to be considered. While well ahead of the global pack and proactive in a larger perspective, India’s stance to the ongoing Corona Biosecurity crisis has been largely responsive, and not proactive from a biosecurity perspective.
National Security Issue
Until now, biosecurity has been a health matter (state subject) and the Ministry of Health has been issuing only guidelines. This has caused varied implementation and imbalanced response by states causing vulnerabilities in the National Biosecurity framework. Biosecurity is a national security matter and needs to be viewed with appropriate seriousness and importance. It needs to be a Central, not a State subject.
Highlighting its importance, in many countries like the US, UK and Japan, Biosecurity is under the Prime Minister’s Office (PMO), Homeland Security or Ministry of Defence. Biosecurity should come under National Chemical, Biological, Radiological and Nuclear (CBRN) Security paradigm. Apropos, the Central Government should be issuing Directives and not Guidelines to all states for compliance. Directives legally compel action, guidelines do not. This will iron out the inequalities and help build a robust system across the Nation.
National Biosecurity Strategy
India needs an effective strategy to mitigate biosecurity risks of criminal, accidental or natural origin that requires a very high level of co-operation and co-ordination both between different national agencies as well as among international and regional organizations. Lack of harmonization of national preparedness and fragmentation of responsibilities (even between states as seen during the Corona crisis) can reduce the effectiveness of prevention strategies and cause a delay in response. A National Biosecurity Experts group should ideally be created under the PMO. Other Experts, scientists and agencies can provide advice on specialist issues. Nodal Ministries, like MoHFW or MoST, may be nominated to deal with various aspects, tasks and activities and to develop plans and SOPs.
There is a need to develop a sound bio-threat intelligence system integrated into existing intelligence networks. This would include bio-surveillance at ports, airports, cyber intelligence and monitoring local health and suspicious activities in areas of interest. Special training of intelligence analysts in biosecurity aspects is essential.
Forewarning and Anticipatory Actions
Bio-threats need time to manifest and can give warning signals. Supported by intelligence and expert advice, contingency planning must be done in advance. Actions and activities, both silent covert ones, as well as open ones, need to be planned out sequentially. Agencies and stakeholders should be earmarked and tasked to undertake these on specific timelines or triggers.
To elaborate the above point, on the initial indication of the Coronavirus spreading in China, some trigger at some agencies should have gone off seeking a silent check on availability, serviceability and adequacy of saying testing kits or thermal detectors at airports and railway stations. Such a trigger either did not exist or did not go off as we find ourselves grossly short of these items three months after the initial alarm on the virus spread. Similar is the case for facilities at hospitals, laboratories, availability of masks and many more.
Public Private Partnership
The realisation that private hospitals and laboratories can contribute seems to be a lesson still being learnt. In a biosecurity scenario, all assets need to be brought into action. It is like a war situation. When required, such assets should automatically come under a central regulation to take on specific testing or analysis as well as containment actions. Such mandates must be factored into the Strategy. In the current scenario, it was only in March 2020 that private assets were called upon to contribute.
Capacity building is needed in terms of equipment, infrastructure and trained manpower. Visionary planning and stock maintenance for critical situations are called for.
- Testing Equipment: Most health centres and clinics are working with outdated ineffective equipment. Test kits and temperature detectors are in short supply. There are no field-level bio detectors available in the country. It was only after we were hit by the virus that we started searching for adequate testing kits. The huge “Make in India” impetus and “start-up” revolution has not drawn any takers for developing Bio detection and field analysis devices. And that need should have emerged from the National Biosecurity Strategy, which is sadly missing.
- Protective Measures: Personal Protective Equipment (PPE) today carry a premium. Masks are a prized commodity. There are many Indian manufacturers but outputs are low and were never planned to be ramped up. The Government should support such industries.
- Decontamination: Decontamination has yet remained restricted to hand sanitizers and soap and water. What about larger decontamination requirements? Buildings, aircraft, airports, hospitals, laboratories and many more may need decontamination. Mass personnel decontamination may need to be undertaken. We are yet to talk of the equipping and training of biosecurity response teams at municipal levels. A requirement in case India goes into late Stage 3 of the current crisis.
- Medical Management: Medical infrastructure in India shall always fall short of requirements. Nevertheless, there is a need to ramp up basic life-saving measures. Capacity needs to be built in terms of laboratory facilities for rapid bio-sample analysis and identification of agents. Medical management capacity for isolation measures, trained field teams of medics and paramedics for triage and containment, mass casualty management in terms of bed space and adequate hospital care also needs attention. e.g., create a dormant capability, to quickly construct a few 1,000 bedded hospitals, with ten firms simultaneously executing Tenders.
- Security Systems: Security and oversight at sensitive laboratories and research establishments are of concern. In many cases, these are but rudimentary. We need to build robust security systems, not just physical but also electronic, around such establishments. Optimal use of technology should be made. While India has very good laws and regulations, our implementation and oversight are of concern. Swift interdiction of suspicious activity and strict punitive action is called for.
- Private Industry Support: All private industries that are engaged in making medical equipment or medical support equipment need to be taken stock of. Under the Biosecurity Strategy, such industries should be mandated to maintain the capability for a set level of production while maintaining optimal quality. The Government must give incentives and support for regular R&D to upgrade its systems to maintain global standards and quality control. Standards for specific equipment must be developed and shared with Industry for developing state of the art life-saving equipment.
- Developing Biosecurity Culture: There is a serious need of developing a Biosecurity Culture amongst government agencies, corporate industry and various stakeholder organisations. Coronavirus crisis has helped raise awareness to a good extent. Much needs to be done to dispel myths and instil faith in the right procedures and systems. “Chaltahai” (disdain for rules) attitude needs to be ruthlessly curbed. Such security culture should seep through to society and be included in high school and college curricula with the disaster management studies. Medical colleges must train doctors and paramedics/nurses for not just biosecurity but all aspects of CBRN casualty
Globalisation has resulted in booming tourism, business travel, and trade of agricultural products, cattle, poultry, seafood and plant products. Unwanted disease-causing organisms piggyback with people and with trade goods transporting diseases and their causative organisms hitherto unheard of in India. The current Coronavirus crisis has highlighted many lessons which need serious thought and concerted action. To implement stringent biosecurity guidelines and to mitigate biological threats, a holistic approach is required on part of the government, medical and research agencies and other stakeholders.
By Col Ram Athavale, PhD