What should we do?

#12 Prepare and plan
a biosecure future

John Clarkson and Carol Brayne

The pandemic is forcing us to change direction, to rethink what we do
and how we do it.

We ask our experts:
where should we go from here?

Prepare and plan a biosecure future

by Dr Luke Kemp

COVID-19 has exposed a lack of preparedness for biological hazards – both in the UK and globally. Here, Luke Kemp from the Centre for the Study of Existential Risk discusses findings from a series of ‘horizon scans’ he led shortly before the pandemic to help identify future biosecurity risks. Some of it proved prescient, some promising, and some petrifying.   

In the year before the SARS-CoV2 pandemic reached the UK, the country was ranked second in the world for global health security by the Global Health Security Index. Underpinning this confidence in the UK capabilities was its 2018 UK Biological Security Strategy.

Fast-forward to 2021 and the ongoing fall-out from how the pandemic has played out across the nation has led many to question the implementation of this strategy. The 2021 report on “Biosecurity and National Security” from the Joint Committee on the National Security Strategy identified shortcomings in the planning, preparation and leadership of the strategy.

Clearly, improvements are needed – not just to prepare for a future COVID-19-like event, but also for a range of developments in biological engineering and related fields. According to recent research conducted at the Centre for the Study of Existential Risk, we could encounter not just microbes, but anything from brain-altering bioweapons, to mass surveillance through DNA databases to low-carbon clothes produced by microorganisms. While many of these may seem to lie in the realm of science fiction, such advanced capabilities could prove to be even more impactful, for better or for worse than the current pandemic.

"The potential for using genetic databases for mass surveillance will only grow in coming years, accompanied by the rise of new tracking and monitoring methods, powers and apps during the COVID-19 response."

Dr Luke Kemp

CSER along with the BioRISC project at St Catharine’s College and the collaboration of a range of experts, has been at the forefront of preparing for this future, leading an exercise to identify the most impactful research questions for UK biosecurity. The results were published earlier this year. We used foresight methods that are exercises in ‘wisdom of the crowds’ among experts. This follows our 2020 ‘horizon scan’ in bioengineering published in eLife. The findings give glimpses into challenges and opportunities that could emerge both in the post-COVID world, but also in the midst of the pandemic. 

Identifying priority research questions for UK biosecurity

The aim of the exercise was to develop a targeted, evidence-based research agenda for the UK’s 2018 Biological Security Strategy that accounted for emerging issues.

To do so, 41 experts across academia, industry and government (collaborating with a further 168 experts) put forward 450 questions that they considered to have the highest potential impact on UK biosecurity. These were then voted on, ranked, discussed and debated, and refined to a final list of 80 questions during July 2019.

The most salient set of questions was for disease threats. Many of these are pressing given the current COVID-19 pandemic. These include understanding how new technologies may be used in syndromic surveillance – data gathering and analysis that aims to detect the earliest signs of an emerging epidemic – and how social media can be integrated into these systems. Delay in addressing the pandemic has proven costly for several countries, including the UK and the US.

Experts also highlighted the importance of understanding, monitoring and preparing for a future influenza pandemic. The threat of an influenza pandemic has regularly topped the UK National Risk Registry for most impactful hazards. Questions included understanding the evolutionary pathways by which avian influenza could jump to humans, and the phenotypic changes needed for a non-human flu to become a human pandemic. Experts also pointed to the need to better comprehend the consequences of failing to address the rise of antimicrobial resistant infections.

"Imagine a world in which law enforcement uses drugs to placate and control crowds, greatly diminishing the promise of non-violent protest movements on climate and social justice."

Dr Luke Kemp

One of the most pressing questions for bioengineering and UK biosecurity was “What are the major pathways by which a biologically engineered threat could enter the UK?”

For policy, the questions (developed before the emergence of COVID-19) were prescient, including asking what cross-government coordination was necessary for the Strategy and how parliament could best build capacity. Answering such questions will need to form the backbone of improving the UK’s Biological Security Strategy and preparedness in the coming years.

Where should we go from here?

In addition to defining the key questions for strategic biosecurity, we have also conducted ‘horizon scans’ on the future of bioengineering using a method known as the ‘IDEA Protocol’: experts put forward issues, anonymously score them, discuss and then revote. The end result of the most recent scan was a list of 20 priority issues published last year in eLife. They cross timelines of less than 5 years, 5-10 years and 10+ years.

Our previous bioengineering ‘scan’ proved fruitful, identifying ‘platform technologies to address emerging disease pandemics’. Now, many vaccine candidates for COVID-19 currently undergoing clinical evaluation have been developed from platforms for non-Coronavirus candidates such as influenza, SARs and Ebola. This includes the Oxford-AstraZeneca vaccine, which used a platform based on the common cold.

Issues in the 2020 horizon-scan ran from the promising to the petrifying.

The horizon scan pointed toward the pressing concern (<5 year) of surveillance through DNA databases. China has already used blood samples to target the Muslim Uighur population. Commercial DNA databases have become popular and may become the next frontier of ‘Surveillance Capitalism’ or state surveillance.  The potential for using genetic databases for mass surveillance will only grow in coming years, accompanied by the rise of new tracking and monitoring methods, powers and apps during the COVID-19 response.

One of the highest-ranked issues was the malicious uses of neurochemistry, a development that likely lies over a decade in the future. Advances in neuroscience and bioengineering could lead to new beneficial drugs and “nootropic” cognitive enhancers, but also new weapons.

Imagine a world in which law enforcement uses drugs to placate and control crowds, greatly diminishing the promise of non-violent protest movements on climate and social justice. Regulation is critical at both the international and national level. We need to ensure that new insights into the human brain are not weaponised for either the army or police-force.

Bioengineering could provide new ways of addressing climate change. Bio-based production of materials could lead to low-carbon constructions materials, plastics and clothes made from renewable microorganisms. Metabolic engineering could allow for the creation of plants and bacteria that efficiently draw-down masses of greenhouse gases. Such industrial outcomes are distant, but plausible, especially if actions such as carbon pricing are scaled up.

The cartoon summary below provides a brief excursion into what the future could look like as these issues in bioengineering develop.

What’s next?

COVID-19 has emerged on the heels of decades of experts urging action on preparing for the next pandemic.

Foresight in the world of the life sciences is indispensable. Failure to prepare for foreseeable, plausible high-impact events can be catastrophic.

Informed, deliberating expert groups are surprisingly effective at sketching out possible futures. Governments should create and empower dedicated, cross-cutting teams that work with academia to conduct foresight activities, particularly for low-probability, high-impact threats. This should include a similar foresight body focusing on catastrophic risks within the UN. Rather than feed these into parliamentary debates, deliberative democratic juries and assemblies should be used to develop forward-looking policy, technology assessments and preventative measures. 

The world, not just the UK, needs a thoughtful, transparent and evidence-based way of identifying emerging issues in biosecurity and bioengineering. Whether it be a new flu pandemic, new bioweapons, or new ways to sequester carbon, forewarned is forearmed.

Luke is a Research Associate at the Centre for the Study of Existential Risk (CSER) at the University of Cambridge. He focuses on how we can foresee and govern global risks and emerging technologies. He has advised the Australian Parliament on ratifying the 2015 Paris Agreement on climate change and has a decade of experience in international negotiations. His research has been covered by media outlets such as the New York Times, the BBC and the New Yorker. He holds a Doctorate in International Relations from the Australian National University where he is an honourary lecturer.

Further reading

Kemp, L, Sutherland, W, et al (2021) 80 questions for UK biological security, PLOS ONE

Kemp, L, Sutherland, W, et al (2020) Point of View: Bioengineering horizon scan 2020, eLife

Editor: Fred Lewsey
Artwork: Balvir Friers
Series Editor: Louise Walsh

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