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What does CORDS stand for?

CORDS stands for ‘Connecting Organizations for Regional Disease Surveillance’.

The organization was established as an ‘Association’ in Lyon, east-central France in 2012. It has a small headquarters and will have four members of staff.

Professor Nigel Lightfoot was appointed as Executive Director designate of CORDS in April 2012 and took up his appointment on 1 September 2012. Here he answers some questions about the work he is doing.

What does CORDS do?

“CORDS is a unique international not-for-profit partnership. It was first set up in 2009 to provide a framework for networks between countries around the world to improve their capacity to detect, identify and respond to the threat of diseases within countries and across borders, to establish exchange of information between networks and to stimulate a culture of early communication about potential events.”

“The international community has recognized the crucial need to be able to identify and respond rapidly to disease outbreaks –

– In this, the age of global air travel, viruses like SARS and the influenza A (H1N1) 2009 pandemic virus can be given a free ride anywhere in the world and have the potential to have a rapid and devastating impact on people, industries and economies.”

What is the aim of CORDS?

“The aim of CORDS is to promote the exchange of information among different disease surveillance networks around the world and to share best practices, surveillance tools, strategies, training courses, innovations, successful operating procedures, case studies and other technical data.”

Who is in CORDS?

“As at January 2013 CORDS has six founding members – with plans to expand. The founding members are:

 

CORDS is also welcomed by the World Health Organization (WHO), the World Organization for Animal Health (OIE) and the Food and Animal Organization (FAO) of the United Nations.”

 

CORDS in the developing world

 

“In developing countries a lot of the surveillance infrastructure required for the early detection and identification of diseases is simply missing. Even in the developed world public health surveillance systems are quite compartmentalized.

 

CORDS believes the key to limiting – or perhaps even preventing – the next pandemic is the early suspicion about – or recognition of – any new emerging disease, whether it be flu or something else, with the potential to become a pandemic.”

 

CORDS and communication

 

“There’s a willingness to develop capacity in the developing countries and, with the in-country training that CORDS will provide under the global One Health initiative, health practitioners and veterinarians will be able to work and communicate their thoughts and findings on potential emerging public health threats internationally via the CORDS website.”

 

CORDS online

 

“The development of the CORDS website aims to facilitate and promote a culture of collaboration and communication. The website will have three key elements:

 

1. A public facing element to provide information via the Internet

2. A knowledge management element to provide a virtual library of best practices and information for CORDS networks and other networks

3. A web portal or ‘chat room’ for health practitioners and veterinarians in countries around the world to promote the early discussion of unusual cases

 

Working in this way CORDS will be ‘on the ground’ and close to the emerging action, complementing the work done by the WHO, OIE and FAO.

 

And finally, CORDS will provide daily news alerts on potential public health threats to all its members.”

 

CORDS and collaboration – a recent example

 

“The work that CORDS will do will be about collaboration on all levels and between countries across the globe. One recent example of this is the discovery of a novel coronavirus (which, of course, has the potential to become a pandemic but which does not appear to transmit readily between humans at the present time).

 

Since June 2012 we have seen nine cases of novel coronavirus infection, including a possible cluster, which was associated with the emergency department of a hospital in Jordan.

 

The recognition that something was ‘not right’ when the cases of illness in Jordan first appeared in the news streams that we scan over at NL Intelligence was immediate. Something didn’t ring true. I spoke to the Jordanians and advised them to get the patient samples tested outside the country after the tests conducted in Jordan had found nothing unusual.

 

The samples were taken to Egypt and tested again and, again, nothing was found. But when the novel coronavirus appeared again later in the year and was identified, the Jordanian samples were tested again and three cases of infection were found.

 

And it’s this suspicion, this recognition that something is out of the ordinary and doesn’t quite ‘fit’, combined with the knowledge of what to do about it when it happens that is the key.

 

It’s the early suspicion and early discussion amongst peers that something is not quite right that is so vital in successful early detection.”

 

CORDS and surveillance

 

“CORDS will be implementing innovative surveillance solutions such as using mobile phone technology to report field test results to a central surveillance database within the network.

It will promote the joining up of networks to enable the sharing of cutting-edge technology such as molecular identification and fingerprinting of pathogens.”

 

A new phase begins…

 

“Although CORDS has been developing under the stewardship of the Nuclear Threat Initiative and The Rockefeller Foundation since 2009, a new phase for the organization begins now.

 

CORDS was created as a legal entity in France in 2012 and will officially be launched at the Prince Mahidol Awards Conference in Bangkok, Thailand at the end of January 2013.

 

CORDS is in receipt of funding from the Rockefeller Foundation, the Bill and Melinda Gates Foundation and Skoll Global Threats Fund.”

 

Moving forwards

 

Professor Lightfoot already has plans to carry out a mapping of all networks and stakeholders globally to provide a future context for the development of CORDS and, importantly, has planned a network workshop at Les Pensières – the Fondation Mérieux conference centre in Annecy, France – in April 2013.

 

At this workshop he will galvanize ‘the excellent work already achieved’ by the founding networks of CORDS into a mission to ‘create the eyes and ears of the WHO, OIE and FAO’..

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You may have heard of the influenza viruses found in pigs, commonly known as ‘swine flu’. You will very likely have heard of the influenza viruses found in birds known as ‘bird flu’. But how about ‘seal flu’? Or ‘bat flu’?

At NL Associates we keep a close eye on the influenza viruses found in animals and birds in the natural world and an even closer eye on what is called the ‘animal/human interface.’  This is where influenza viruses are transmitted from animals to humans.

A Bit of Background Information – the 2009 H1N1 Influenza Pandemic

Pandemic: ‘an epidemic of infectious disease that has spread through human populations across a large region; for instance multiple continents, or even worldwide.’

In 2009 a new strain of influenza H1N1 virus was detected in humans.  This strain emerged after a series of co-infections and mutations at the animal/human interface and it began with an infected pig.

Pigs are susceptible to avian, human and swine influenza viruses. If a pig is infected with influenza viruses from different species at the same time, the creation of a new virus is possible. This process, in which genes from different viruses mix to create a new virus, is called an ‘antigenic shift’.

How it happened:

Studies of the genetic make up of the pandemic H1N1 virus have shown that it is a completely new virus, quite unlike the previous H1N1 viruses that affected humans in the 1918 pandemic and the 1977 pandemic. These genes have been found before in North American H1N2 swine influenza viruses, Eurasian H1N1 swine influenza viruses and human H3N2 seasonal influenza virus. It has appeared after a so- called “triple re-assortment in pigs”.

It seems that the virus first appeared some years ago and has been circulating in pigs in North America.

It then infected humans in Mexico in about February 2009 and was mistakenly considered to be seasonal flu.

The new virus was confirmed in US citizens on 24 April 2009 and subsequently confirmed as the cause of the influenza in Mexico.

Influenza viruses are continually evolving and mixing and the exact chain of events leading to the new pandemic strain appearing cannot be determined. Conspiracy theories abound on the internet but it is highly likely that this is a “Mother Nature” determined event. There is no evidence to suggest that this new virus was created in a laboratory; it does not like growing in eggs.

Since April 2009 the pandemic caused a reported 18,500 laboratory confirmed deaths worldwide and may, according to The Lancet, have killed many thousands more.

Flu vaccines now protect against the H1N1 virus.

Avian Influenza H5N1

Close attention is paid to the influenza H5N1 virus throughout the world. To date the virus has infected 607 people worldwide and killed 358. (Source: WHO)

Earlier this year new research was published into a strain of the H5N1 virus that had been mutated under laboratory conditions into an airborne strain. Scientists were worried that the results of the research were ‘too dangerous’ to publish for fear it might get into the wrong hands and because a bioterrorist threat. In an article about the research, published by The Guardian, John Oxford, professor of virology at Barts and the London School of Medicine and Dentistry said:

“Forget all the nonsense about bioterrorism. These papers tell us that nature is where we should focus our concern … The mutant strains that (the researchers) described are probably already out there. They must be out there. Fortunately for us, it is probably in some duck in Siberia, but were it to move close to hand by the vagaries and chances of nature, we’d be for it.

This post’s title is ‘Three Reasons Why H5N1 is Not the Only Influenza Virus to Watch’ because in recent months we have seen reports, not only of avian influenza H5N1 in the world, but of a number other types of influenza. And they are doing very interesting things:

Reason 1: Pigs

In the US this month there has been activity at the animal/human interface with a large outbreak of variant influenza H3N2v virus. This virus usually infects pigs but it can be directly transmitted to humans, as the health officials who have reported over 144 cases of human infection with the virus in the states of Indiana, Ohio and Hawaii in the last few weeks will attest.

So far there have been no cases of human-to-human transmission of this variant virus but health officials in the US are continuing to investigate the possibility that this might happen.

Reason 2: Seals

Elsewhere in the US, an influenza virus similar to one seen in waterfowl since 2002 has been detected in the bodies of 162 dead New England Harbor Seals. The seals died between September and December 2011 in an outbreak of pneumonia and the postmortem research found that the avian influenza or bird flu H3N8 virus had mutated to adapt to a mammalian host.

Calling the virus ‘bird flu’ is slightly misleading because it is not the highly pathogenic H5N1 virus prevalent in Asia that people normally think of when they read bird flu. Instead, this variant of influenza virus, H3N8v, travels in between species.

Reason 3: Bats

In February 2012 we saw a story about the discovery of influenza A virus in fruit bats in Guatemala. This is the first time that a flu virus has been identified in bats and means that the species may act as a source of flu viruses. The CDC reported on the story that the virus ‘should be studied as a potential source for human influenza.’ This virus is not believed to pose a threat to human health.

In Conclusion

So, pig flu, bird flu, seal flu and bat flu are out there. The recent human infections with variant influenza virus, seen in Indiana, Ohio and Hawaii, are a reminder that influenza viruses from pigs could potentially produce the next pandemic strain. The significance, in the case of the dead seals, is that the virus mutated while in the waterfowl and created a new variant virus capable of transmission from birds to mammals and in Guatemala, influenza has been identified in a new species this year.

The ever-changing nature of influenza viruses mean that it is vital to keep a close eye on stories like these as they emerge across the world. Avian influenza H5N1 is not the only virus that is out there and that has the potential to change and mutate.

And Finally: H2N2

In 1957 “Asian” flu appeared, caused a pandemic, went on to be seasonal flu and then disappeared in 1968 when the current H3N2 strain caused a new pandemic. The virus therefore disappeared from the wild but is kept in some laboratories; it was mistakenly sent out as a quality control strain to influenza laboratories in 2005. Anyone under 44 years old is susceptible to this previous pandemic strain.

When it comes to influenza:

It is important to be prepared.

It is vital to identify changes early.

It is important to respond appropriately.

NL Associates can provide expertise to help you in all three of these key components of emergency preparedness and response in the context of infectious disease generally and influenza specifically..

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Risk Assessment – Enterovirus 71

We have been closely monitoring outbreaks of Hand, Foot and Mouth Disease across Asia for a number of months and have recently observed an increase in the number of reported cases.

Last week an unknown illness was reported in Cambodia which had killed more than 50 children since April 2012. Within days the WHO issued a statement citing the probable cause as Enterovirus 71 which can cause Hand Food and Mouth Disease.

We have therefore created a Risk Assessment and will be monitoring the situation in South East Asia closely:

Level 2 Risk Assessment EV71.

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Public Health News in Brief

PLAGUE IN US

Another case of plague has been reported in the United States (June 14th Oregon, St Charles Medical Centre) and the international media have made their concern clear. The facts are, however, entirely reassuring. Although the plague Bacillus which caused medieval pandemics continues to exist in low levels in rodents in the south west of America, the conditions for it to go on to cause a pandemic through rats and fleas simply do not exist in the modern world.

The local American public are well aware that cases of plague will be contracted from wild animals from time to time – and they attend their doctor accordingly to receive antibiotic treatment. Due to an incorrect understanding of the mechanisms of disease, there has been an overreaction in the media – which is understandable, but unfounded – and may be causing undue worry to some people.

 

FOOD SAFETY IN CHINA

Yet another food contamination incident in China has occurred, with mercury being detected in infant milk powder from a major dairy firm in the Inner Mongolian city of Hohhot. This is likely to have happened during preparation and serves to illustrate just how widespread a food hazard can become in todays mass-market food distribution networks.

The 2008 scandal, when contamination by melamine killed six babies and made 300,000 ill, caused a heavy blow to China’s milk industry and unfortunately this current incident takes place during China’s “Food Safety Week” and a day after the cabinet introduced fresh measures to tighten food safety control.

 

LEGIONNAIRES’ IN SCOTLAND

The ongoing outbreak of Legionnaires’ disease in Scotland, which has so far caused two deaths, is of clear concern. The authorities have been unable to identify the source or perhaps unwilling to reveal their findings, which does nothing to reassure the public. It’s important to note that the Heath and Safety Executive are involved in the investigation.

Professor Lightfoot comments, ‘I’m surprised by the handling of the outbreak on two counts. Firstly, that reverse epidemiology methods as developed by the HPA modeling team at Porton Down (using case postcodes and movements) have not been called in to help identify geographic location. Great success was achieved using this method in the Hereford Legionnaires’ outbreak a few years ago. And secondly, if we clearly learnt these lessons years ago, why is this happening again? It is of vital importance that lessons are identified and learned, and if necessary, steps taken towards enforcement.’

 

ANTHRAX IN GERMANY

A new case of Anthrax has been reported in a heroin user in Germany. Similar cases occurred in the UK last year, mainly in Glasgow. Although Anthrax has not been detected in the heroin itself in Germany, Professor Lightfoot explains how the infection is likely to have begun, ‘I still believe that the contamination occurs during the collection of the Opium poppies in animal skins, which we know are often contaminated with Anthrax spores in Afghanistan. This is not surprising, because although inhalation anthrax has an infectious dose of 10,000 organisms, when injected into the skin, one single Anthrax spore is enough to cause infection.’

 

UNKNOWN INFECTIONS

There are three serious events of illness due to unknown causes still occurring worldwide; the skin disease in Vietnam, which may be due to arsenic poisoning; the nodding disease in Uganda, which still evades identification although infection with a parasitic worm called Onchocercus has been postulated; and there is an ongoing outbreak of suspected but as yet unproven Japanese Encephalitis in India, resulting in over 100 deaths so far. These deserve more attention – we must learn lessons for the benefit of future public health and we need to collaborate internationally to identify the loopholes which continue to prevent early diagnosis in developing countries.

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NLA News Update

CORDS in CANADA

Professor Lightfoot has recently taken on the role of Executive Director Designate of a new NGO called CORDS – Connecting Organisations for Regional Disease Surveillance. This is an exciting opportunity and he spent last week in Canada, alongside TDV Global (Ottawa), preparing an implementation strategy for funding submissions to the Bill & Melinda Gates Foundation, the Rockefeller Foundation and the SKOLL Global Threats Fund.

CORDS has been created with a unique vision – to create a world-class coordination and support network, linking regional disease surveillance and improving and empowering global capacity to respond to infectious disease. This is a challenging mission for all involved and Nigel Lightfoot Associates will be producing a more detailed insight into CORDS shortly.

The weather in Canada was predictably warm and sunny, and Professor Lightfoot particularly enjoyed his visit to Lake Chandos. He also attended the Global Health Security action group meeting while in Ottawa for the Department of Health (UK), where he is the expert advisor.

Next week he will be travelling to Palma to the European Food Safety Agency, where he will take part in a meeting on Emerging Food Threats and present on the Early Alerting and Reporting Project.

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Nigel Lightfoot Associates maintains a constant global watch for emerging public health threats.

Our weekly news updates, in combination with up to the minute analysis from Professor Lightfoot, are designed to keep clients and readers informed and empowered with the knowledge they need to protect their companies and staff.

The earlier we know that a problem is beginning to occur, the better the outcome.

Don’t forget to keep your preparedness plans up to date – please get in touch if you’d like to find out more.

 

SYRIA

The political situation in Syria continues to cause concern. We are aware of stockpiled chemical weapons, such as mustard gas and sarin, and it is of the utmost importance that they do not get into the hands of home grown terrorists.

Stores of biological weapons remain unconfirmed, but these would likewise be of concern and pose a major global threat to public health.

TUNA

Although blue fin tuna caught off the US Pacific Coast has been found to contain Caesium, which clearly demonstrates the potential for global spread, the radiation levels are far below safe-to-eat limits set by the U.S. and Japanese governments.

Likewise, the Japanese government’s coastal testing programme, carried out over many months, revealed low levels of Caesium in fish, but nowhere near high enough to cause health problems. We should not be alarmed by these findings – they were always to be expected.

ANTHRAX

There has been another animal outbreak of Anthrax, this time in Colombia, and two subsequent human infections. We will soon be issuing a summary report on global Anthrax cases so far this year.

Professor Lightfoot first started working with Anthrax 35 years ago, when he was tasked with managing biological warfare defence for the armed forces and developing policies for post exposure prophylaxis with antibiotics. He went on to carry out ground breaking Anthrax research, in terms of antibiotic efficacy and typing methods.

Anthrax is always out there and presents an easy source for terrorists. Even though the organism is under lock and key in highly secure laboratories in Western nations, in the bigger picture it remains freely available.

In Professor Lightfoot’s own words, ‘Anthrax has always impressed me. It basically never dies, it exists in the environment as spores, and it is able to survive for many years. The cases I often saw in clinical practice were from imported Mohair wool from Afghanistan and hides from Africa. In terms of preparing for a bioterrorism threat, the persistence of anthrax spores presents a unique and difficult problem especially in terms of recovery from attack’.

Avian Influenza

On the 5th of June, Hong Kong declared a major public health alert due to a case of avian influenza in a boy who had travelled from his home in Guangzhou. This appears to be an over-reaction by the Chinese authorities, as there is no evidence of further transmission from this case – the boy had visited a market with live birds shortly before he became ill and as yet the H5N1 virus is not able to transmit between humans.

It is possible that recent international concern over the genetic manipulation of H5N1 and the publication of papers describing methods for doing so, has elevated risk perception.

Professor Lightfoot explains, ‘We are aware that a ten year old girl has recently died from H5N1 in Cambodia, after very close contact with infected poultry in her village, but it is the detection of changes in the virus at the animal-human interface that would necessitate global concern and indicate an increased potential for spread. We keep watching for you.’

Next week: Comment on Nodding disease in Uganda, ongoing undiagnosed illness in Vietnam and special report on Anthrax from Professor Lightfoot.

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Hand, Foot and Mouth Disease

In Asia, and particularly in Vietnam, there is increasing concern about hand, foot and mouth disease, which has lead to 27 deaths in children this year. Caused by Enterovirus EV71, this is a different type of virus to the much milder hand, foot and mouth disease caused by a Coxsackie virus seen in the UK and the United States. Both are spread by the faecal-oral route, and the key intervention is hand washing.

So far the issue of virulent hand, foot and mouth disease in Asia has generated little interest in the western world. Both the HPA and CDC websites are quiet on the subject, but any spread to the UK would be of concern. Nigel Lightfoot Associates is keeping a close watch on the situation.

 

Global Food Production

Salmonella

Recent Salmonella outbreaks in the US, most notably the Salmonella bareilly and nchanga infections associated with raw scraped tuna, illustrate the potential for rapid global spread of hazardous food poisoning organisms. Contamination occurred in a single food production facility in India and resulted in widespread dissemination throughout the US. That such an outbreak occurred in the context of Japanese cuisine, usually celebrated in the West for its health benefits, reminds us of the weaknesses in developing countries’ food production systems and the pressures of mass production and global distribution.

Listeria

In North America there have been increasing reports of foods withdrawn from distribution and sale due to contamination with Listeria. This is in part a reflection of increased testing following the Listeria contamination of cantaloupe melons earlier this year, which led to 13 deaths.

Listeria is a common environmental organism and grows at low temperatures (such as the domestic fridge) unlike other food poisoning bacteria. It is common in the environment and from time to time it is found on foods such as salads. Government advice has been directed at those who are more susceptible to Listeria – the immuno-compromised and pregnant women – and recommends that they should avoid unpasteurised cheese and pay attention to sell by dates of fresh foods.

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Joined Up Thinking – Part 2

With a view to the renewal of the NATO Defence Against Terrorism Programme, Professor Lightfoot was invited to speak at the NATO Anthrax Workshop, as part of the Counter Terror Expo in London this April.

He presented an Anthrax Attack Scenario to set the scene for the workshop and co-chaired the meeting with Jamie Shea, Deputy Assistant Secretary General for Emerging Security Challenges at NATO HQ in Belgium.

The main issue under discussion was civil military collaboration in the context of bioterrorist attack, with a view to NATO refining their 2013 programme and identifying gaps in their current response systems.

Professor Lightfoot opened his presentation with two simulated news clips – as if an Anthrax attack were real breaking news. He had commissioned the production company EIOKAY to film these news broadcasts in preparation for the workshop and was impressed with the immediate effect on his audience – their attention was undivided and they were thinking themselves directly into the situation.

The main challenge in such an attack is response time. By the time that the attack has been detected, a large number of people will have moved and the sooner the civilian authorities are able to distribute antibiotics the less the potential for loss of life.

NATO is a big organisation with huge capability, but specifically in preparation for military response. The speed of progression of a bioterrorist attack would test their system and as such they are developing a new phase of their remit – that of civil military cooperation.

NATO’s total capabilities usually take about a week to be properly deployed, but their nascent Rapid Reaction Force will be able to respond much more rapidly. The RRF hails from the Operations Division of the Civil Military Planning Section and the Euro-Atlantic Disaster Response Coordination Centre and is able to field a team at 24 hours notice. The RFF is yet to be used in bio-terrorism scenarios, but they will begin rehearsals in the near future.

The workshop proved incredibly useful and the team were able to make clear recommendations to NATO for swift progress as follows:

  1. Develop a Standardised Range of Scenarios to help determine their contribution to civilian military response in the context of bio-terrorist attack
  2. Run a Large-Scale Anthrax Exercise to assess the capabilities, identify gaps and define the tools required for coordinated international response
  3. Rehearse Rapid Response Deployment on a regular basis
  4. Review the Virtual Stockpile of antibiotics and other medical counter measures
  5. Create an Inventory of National Capabilities
  6. Establish a Virtual Institute of Risk Communication
  7. Promote the concept of Sharing Between Governments
  8. Commission Academic Research

In the words of Professor Lightfoot, ‘the workshop was very effective in bringing out the issues that need further work. The next step is for NATO to

consider a large scale exercise and I look forward to seeing the Defence Against Terrorism Programme for 2013, in particular more use of dramatic simulated news items – which gets people sitting on the edge of their seats.’

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Joined Up Thinking – Part 1

Biosafety refers to principles, technologies, practices and measures to prevent unintended exposure to biological agents and toxins. Biosecurity refers to the protection, control and accountability measures implemented to prevent the loss, theft, misuse or intentional release of biological agents and toxins.

In approaching these vast issues, it is crucial that open discussion and a focus on positive, achievable outcomes are maintained. The challenge remains clear: how to engage governments in a forward thinking dialogue.

Professor Lightfoot devised, planned and chaired an international conference at Chatham House in May, to assess the state of biomaterial security in the developing world and examine options for the future:

Safe and Secure Biomaterials; Matching Resources to Reality’ http://www.chathamhouse.org/events/view/182665

Chatham House defines itself as a forum for ‘Independent Thinking on International Affairs’ and such was the tone of the gathering – a chance to generate fresh thinking on a topic of huge contemporary importance.

Hosted by The Centre for Global Health Security and The International Security Research Unit, the conference brought together an international group of individuals and organizations in the field of biomaterial security, with wide expertise in government, academia, the private sector, civil society and funding agencies.

The meeting took the form of a round-table discussion, divided into four sessions, with individual speakers from a variety of backgrounds.

Three key themes emerged:

  1. The Need for Enhanced Collaboration – multisectorial participation and a global approach
  2. The Challenge to Think Differently – letting go of the attitude that developing countries are lagging behind and a smarter use of resources
  3. The Conundrum of Biosecurity – High tech facilities in the West versus resource poor environments

Everybody was in agreement: there is a need to help developing nations improve biosafety and biosecurity – not through high-tech, costly solutions (as in the West where strict bio-security measures have become the norm post 9/11 and the 2011 Anthrax letters) but through basic standards of containment, with a view to sustainability.

With this approach the potential for dual standards emerges – one process for rich countries and one for poor. As such, a change in attitude is required. It is not a question of reducing standards – but to focus on what really matters (effective containment) and import this mentality.

Presentations from across the globe proved to be illuminating and demonstrated that engineers and architects have devised ways of implementing solid security standards in a simple way. The conference concluded that the West needs to take notice and embrace a different way of thinking. It is clear that we can improve a hundred laboratories in several countries for the cost of one high-tech, unsustainable laboratory in one.

It also became apparent that there is a piece of the puzzle missing – support and funding from governments in developing nations for the good work that is already underway.

The Safe and Secure Biomaterials conference succeeded in bringing together a wide variety of international perspectives and resulted in a stimulating, purposeful examination of the issues. The output, soon to be published in a Chatham House Briefing Paper, is as follows:

  1. To Generate the potential for low resource biosafety and biosecurity initiatives
  2. To Influence international debate and policy formation
  3. To Incorporate the views of leading experts in the field

Professor Lightfoot concludes:

‘In the last two years, Biosafety professionals have been requesting improved solutions for laboratories in developing countries. In response, we have pulled together experts from all sectors and from across the globe and have been pleasantly surprised by the complete and shared agreement to move forwards. What is missing is an action plan, which will require input from the international biosafety societies and others to ensure committed and successful implementation – ultimately strong leadership will be required to pull everything together. As a first step, the Chatham House Briefing Paper will be sent out around the world. Watch this space.’

Chatham House have produced a podcast to accompany the event, featuring an interview with Professor Lightfoot and Patricia Lewis, available online:

http://itunes.apple.com/gb/podcast/biosecurity-is-cross-sectoral/id456893350?i=115560851

The international journal of science, Nature, has published a story covering the conference:

http://www.nature.com/news/biosafety-concerns-for-labs-in-the-developing-world-1.10687.

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