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Flexible Defenses Roundtable Meeting: Promoting the Strategic Innovation of Medical Countermeasures

Gigi Kwik Gronvall, Jason Matheny, Bradley T. Smith, Michael Mair, Allison T. Chamberlain, Shana Deitch, Luciana Borio, Thomas V. Inglesby, Tara O’Toole
Date posted:
September 15, 2007
Publication type:
Meeting report

Biosecur Bioterror 2007;5(3):271-277

Mary Ann Liebert, Inc.
Available on publisher's website
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Full article as PDF


On May 10, 2007, the Center for Biosecurity of the University of Pittsburgh Medical Center convened an invitational meeting to discuss a national strategy for developing “flexible defenses” against chemical, biological, radiological, and nuclear (CBRN) threats. This was the second of two meetings held by the Center to discuss issues related to those aspects of the Pandemic and All-Hazards Preparedness Act (P.L. 109-417, passed in December 2006) that are intended to improve the development of medical countermeasures for national security threats.

The Act requires that the Department of Health and Human Services (HHS) deliver to Congress on June 19, 2007, a strategic plan for developing medical countermeasures against CBRN threats. The first Center for Biosecurity meeting, held on March 22, 2007, discussed administrative and implementation issues of Title IV of the Act, including the role of the Biomedical Advanced Research and Development Authority (BARDA), how medical countermeasure procurement processes might be improved, and the essential elements for successful leadership of BARDA. In the May meeting, participants focused on the January 2007 Homeland Security Presidential Directive 18 (HSPD-18), which requires HHS to develop a flexible defense strategy—defined as “a rapidly deployable and flexible capability to address both existing and evolving [CBRN] threats”—using the Title IV authorities in the Pandemic and All-Hazards Preparedness Act.

The concept of a flexible defense is still a term of art. There is limited consensus on what it could or should mean. Meeting attendees and interviewees (“participants”) expressed a range of views on the possible goals of a flexible defense strategy for medical countermeasures and how those goals might be implemented. These diverse views, summarized in this report, will need to be evaluated for their technical feasibility and prioritized, as the nature and proportion of countermeasure investments in a national flexible defense strategy are refined.



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