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Exercise Illuminates TransAtlantic Leaders' Reactions to Bioterror Attack

Atlantic Storm spotlights need for preparedness at international level

BALTIMORE, MD -- January 17, 2005 -- What would world leaders do if they were faced with a bioterrorist attack on cities around the world? How would they react to a fast-moving and deliberately caused epidemic?

These questions were raised Friday at Atlantic Storm, a table-top exercise that simulated a smallpox attack on the nations of the transatlantic community. The ministerial bioterrorism exercise was presented by the Center for Biosecurity of the University of Pittsburgh Medical Center, the Center for Transatlantic Relations of Johns Hopkins University, and the Transatlantic Biosecurity Network.

During the exercise, which was held in Washington, DC, former prime ministers and other senior government officials from nations on both sides of the Atlantic played the roles of the heads of government of their respective nations in a mock summit.

The scenario presented to the participants was the simultaneous outbreak of smallpox in several cities: Istanbul, Frankfurt, and Rotterdam, with attacks in the U.S. surfacing later in the day. It was made clear early on that the disease had been spread deliberately, and a terrorist group claimed responsibility for the action.

The assembled world leaders debated the availability of vaccine in their countries and were surprised to learn that although some countries - including the U.S., the UK, France, Germany, and the Netherlands - had enough to vaccinate their entire populations, many countries do not. Italy and Sweden, for example, have enough vaccine for only 10% of their populations.

The issue of whether to use "ring" vaccination-that is, vaccinating those who have been in contact with patients, and health-care workers - or to opt for mass vaccination of the whole population led to discussions of which countries would be willing or politically able to share vaccine, pitting the "haves" against the "have - nots."

Acting as the U.S. President, Madeleine Albright expressed doubts as to whether the American people would be willing to give away a portion of the U.S. stockpile to European countries whose governments had been less than supportive of U.S. policies in the recent past.

"It was clear that this group of leaders all wanted to do the right thing, and they largely agreed on what that was," noted Tara O'Toole, CEO of the Center for Biosecurity. "But they were worried that their people were not prepared to accept the necessary decisions (sharing), and they at times felt compelled to take actions that might have bad implications for world."

As the day went on, the number of reported smallpox cases grew rapidly, and the number of countries whose populations were affected also increased. Cases were reported in the U.S., in Canada, and in Mexico, as well as in countries throughout Europe.

When the participants were told that dock workers in Rotterdam were infected and that the port had been closed, and that Polish citizens were streaming into Germany to try to obtain vaccine that was not available in their country, the assembled leaders were forced to confront the economic and political consequences of the crisis. A debate ensued about the advisability of closing borders, quarantining cities, and limiting the movement of people and goods.

In a discussion after the exercise had concluded, many of the players expressed surprise that their countries had not stockpiled enough vaccine. Several agreed that there was not sufficient awareness at the highest levels of governments on both sides of the Atlantic of the possibility and consequences of such a bioterrorist act.

It was also clear to the participants that no organization or structure, including NATO, the EU, and the UN, is now agile enough to respond to the challenges posed by a bioterrorist attack of this scope and complexity. The participants wanted the WHO to manage the distribution of vaccine, but former WHO Director-General Gro Harlem Brundtland admitted that its resources were limited and were already stretched by the tsunami relief response. She reminded the others that the annual WHO budget is "about as big as that of a middle-sized English hospital."

"A bioterrorist attack will immediately be an international crisis," said O'Toole, "and countries must be able to communicate and coordinate response in near-real time. Atlantic Storm has shown how critical it is for leaders to be prepared to respond to bioterrorist attacks of international dimensions requiring stark and extraordinary decisions."

The participants in the mock summit included:

  • Madeleine Albright, former U.S. Secretary of State, playing the part of the President of the United States;
  • Sir Nigel Broomfield, former Ambassador of the UK to Germany, playing the Prime Minister of the United Kingdom;
  • Gro Harlem Brundtland, former Prime Minister of Norway and former Director-General of the World Health Organization, playing the Director-General of WHO;
  • Jerzy Buzek, former Primer Minister of Poland, playing the Prime Minister of Poland;
  • Klaas de Vries, former Minister of the Interior of the Netherlands, playing the Prime Minister of the Netherlands;
  • Jan Eliasson, Ambassador of Sweden to the U.S., playing the Prime Minister of Sweden;
  • Werner Hoyer, member of the German Bundestag and former German Deputy Minister of Foreign Affairs, playing the Chancellor of the Federal Republic of Germany;
  • Bernard Kouchner, former Minister of Health of France, playing the President of France;
  • Erika Mann, member of the European Parliament, playing the President of the European Commission;
  • Barabra McDougall, former Foreign Minister of Canada, playing the Prime Minister of Canada;
  • Stefano Silvestri, former Italian Deputy Minister for Defense, playing the Prime Minister of Italy; and
  • Eric Chevallier, Associate Professor, Institut d'Etudes Politiques de Paris and the French Ecole Nationale d'Administration, playing the Executive Secretary of the Summit.

Still photos are available to the press at


The Center for Biosecurity of the University of Pittsburgh Medical Center (UPMC) works to prevent the development and use of biological weapons, to catalyze advances in science and governance that diminish the power of biological weapons as agents of mass destruction, and to lessen the human suffering that would result if prevention fails.

The SAIS Center for Transatlantic Relations engages international scholars and students directly with government officials, journalists, business executives, and other opinion leaders from both sides of the Atlantic on issues facing Europe and North America. The goal of the Center is to strengthen and reorient transatlantic relations to the dynamics of the globalizing world. The Center is part of the Paul H. Nitze School of Advanced International Studies.



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