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Managing Past, Present and Future Epidemics

Published 27 Aug 2023

On Tuesday 8 August Raina MacIntyre, Professor of Global Biosecurity in the Kirby Institute at the University of New South Wales, addressed the Institute on the lessons Australia and the international community need to learn about global health and biotechnology from the Covid pandemic. Professor MacIntyre drew on the research on the prevention and control of infectious diseases explored in her book Dark Winter: An Insider’s Guide to Pandemics and Biosecurity (NewSouth Press, November 2022).

Professor MacIntyre opened with an alarming anecdote: an illegal lab owned by Prestige Biotech was discovered in Fresno, California, in March 2023 containing genetically-engineered mice. These mice were humanised – modified to replicate human responses to pathogens – and could spread COVID-19 or SARS-CoV-2, the herpes virus, HIV and other diseases dangerous to humans. The lab was located 35 kilometres away from a naval base and had links to China, but nobody appeared to be alive to the implications of this discovery: there are huge gaps in the awareness of biosecurity issues among law enforcement, intelligence and military agencies.

A US congressional hearing had received testimony that the COVID-19 pandemic had been the result of a lab leak in Wuhan, a lab that had received funding from the United States. In response to a question from the audience as to what might motivate two notorious rivals like China and the United States to participate in joint research efforts in this way, Professor MacIntyre suggested that one possible reason could be that certain forms of research could only take place in certain settings, and in certain countries.  She was open to the idea that COVID-19 could have originated from an accidental, or even deliberate, leak from the Wuhan Institute of Virology. She stated that this is not a right-wing conspiracy, but a plausible hypothesis.

Open-source methods are now available to manufacture synthetic biological weapons cheaply. Dual-use technology – technology that can be applied for good or bad – increases the risk of man-made pandemics. These “unnatural” diseases carry much greater risks than naturally-occurring pandemics. In Professor MacIntyre’s view, biological warfare is the ‘next arms race’, as nation-states seek to create new weapons to combat potential threats to their national security. She drew the audience’s attention to the retention of the smallpox virus by the former Cold War superpowers, Russia and the US. In theory, the virus is retained for research purposes, but the possession of the smallpox virus seems likely to be for possible biological warfare. She had scrutinised the availability of formulas for deadly pathogens on the internet: the omnipresence of these formulas meant that anyone with the requisite training and equipment could create a pathogen for a biological weapon. For example, she claimed that a Canadian scientific team had easily recreated the horsepox virus – a cousin of smallpox – in 2017 by using publicly available research.

Next, Professor MacIntyre turned to the potential for engineering human embryos. While the World Health Organisation (WHO) has made attempts to regulate genetic engineering experiments involving humans, she believed certain governments and organisations have continued to undertake research in engineering ‘superhumans’.  She called for governments to agree on principles to strictly regulate the development of such technology, in order to prevent adverse global impacts. The United Kingdom and the United States are among countries that have been conducting research on the creation of “super soldiers” which Professor MacIntyre warns has the potential to become a future arms race. The objective is to create soldiers who are stronger, fitter and with greater stamina and resistance to pain by conferring changes to the human genome. She warned that hostile states may in future find a way to alter the genome of vulnerable target peoples.

Professor MacIntyre drew parallels between the future of pandemics and climate change: although governments have had a vested interest against combatting global heating, it is public awareness of the phenomenon and its effects that will truly make a difference. Current regulation of biotechnology is heavily driven by the need to protect the interests of research scientists, and community awareness and engagement have been very low. But the solutions to the existential crisis posed by man-made pandemics will have to come from the community, empowered with the requisite knowledge and given a voice. The public need to seek information and press governments to respond to threats. The final chapter of Professor MacIntyre’s book is entitled ‘A biological winter’, alluding to an existential threat to humanity comparable to threat of a nuclear winter.

Professor MacIntyre commented on the declining compliance with established research ethics principles, such as the need for individual consent and the ‘do no harm’ rule, largely borne out of the Helsinki Declaration and the Nuremberg trials. She argued that research committees have failed to consider the effect of research on people in other countries. For this reason she strongly advocates the registration of all clinical trials.

In response to a question from the audience on what the World Health Organisation (WHO) is doing to address the threat posed by man-made pandemics, Professor MacIntyre acknowledged that the WHO has assembled an advisory body, the Scientific Advisory Group for Origins of Novel Pathogens (SAGO), to investigate the origins of new epidemics, natural or otherwise, and also participates in pathogen projects. But arguably it is not doing enough to educate and inform the public – especially given its vested interest in managing the expectations of donor states. Asked whether the WHO is the right organisation to address the risk of future pandemics, she responded that solutions to the problems she outlined earlier would likely stem from interdisciplinary approaches, models and training which would prevent inter-organisational conflicts and increase the ability to work collaboratively. She also touched on the work of Biosafety Now, a US-based non-governmental organisation aiming through regulation to increase the accountability of those who wish to conduct these controversial forms of research.

Responding to a query about the risk of the long-eradicated smallpox virus re-emerging as a epidemic in the future, given that stocks of the virus are held in the US and elsewhere, Professor MacIntyre acknowledged that melting Siberian permafrost has been said to increase the risk of a natural epidemic re-occurring, but considered it likely that future smallpox epidemics will be driven by man-made variants.

Asked about the status of future pandemic planning and vaccine development efforts, Professor MacIntyre discussed the work done by the Coalition for Epidemic Preparedness Innovations (CEPI) to create vaccine equity around the world and Australia’s efforts to expand its Intensive Care Unit (ICU) capacity by 120%. She also discussed EPIWATCH, an AI-based system which taps into open-source data to detect the early warning signals of an epidemic well before any health department in the world and aims to stop the spread before it crosses international borders.

Another audience member commented that they could not understand the scale of rejection against the notion that the COVID-19 virus had been made in a lab when this was a well-known practice of governments in the past, citing the example of the development of the anthrax virus by the UK government decades earlier. Professor MacIntyre responded that the difference can be explained by the post-cold war era we live in now. The development of anthrax during the cold war appeared to face less resistance when it was part of an overt arms race. Although it is arguable that the same practices persist today, they are far more covert.

Asked why the Ebola virus, with seemingly more insidious effects, had been easier to quell than COVID-19 and appeared to have mysteriously disappeared, Professor MacIntyre said that the answer came down to the reproduction variable for each virus and the method of transmission. The COVID-19 virus had a reproduction variable of 8-10 in contrast to a variable of just 2 for Ebola, and COVID-19 was also far more easily spread as a respiratory virus in comparison to Ebola which was spread through blood and bodily fluids.

Asked to explain how gain-of-function research works in practice, Professor MacIntyre used the example of adapting the avian flu virus to infect the human respiratory tract through modification of laboratory animals to transmit human pandemics. But the benefits of gain-of-function research were debatable. Although there have been hopes this research would be useful in developing vaccines and in pandemic planning, there have been no proven beneficial uses. The US National Science Advisory Board for Biosecurity (NSABB) had previously placed a moratorium on gain-of-function research. But Professor MacIntyre argues that intense lobbying by scientists who have invested much of their careers into this form of research has led to the lapse of the moratorium and subsequently the publication of open-source methods of engineering viruses which anyone could replicate.

In response to a question regarding the hateful internet and media rhetoric she has experienced, Professor MacIntyre stated she has been exposed to much vitriol since coming to prominence during the pandemic, and especially after her promotion of the COVID-19 lab leak theory.

In response to the final question of the evening on the degree to which artificial intelligence (AI) is being used to fuel research, Professor MacIntyre stated emphatically that AI was essential in many ways. It has allowed much of the experimental research which needed to be performed repeatedly in animals 20 years ago to now be performed much more quickly through computational means.

Summary by AIIA NSW intern Renuga Inpakumar with input from fellow interns Rachel A and Matthew Vasic


Renuga Inpakumar (left) with Professor Raina MacIntyre (right)