Black ICE (Bioterrorism International Coordination Exercise)

Black ICE After Action Report

Imagine you awoke to the news this morning that a country with fragile infrastructure and few resources had been the victim of a smallpox attack. Our international political and social landscapes would be altered in an instant. I'm sure that each of you are immediately and keenly aware of the implications a bioterrorism attack, especially one employing a high-consequence agent like smallpox, would have for nations and societies around the world.

Context for Black ICE

As we have learned from Switzerland's Ambassador Ziswiler a few minutes ago, Black ICE, a U.S.-Swiss co-hosted bioterrorism tabletop exercise for senior leaders from international organizations, emphasized the role of international organizations in a bioterrorism response and how they would interact with national governments.

The U.S. and Switzerland were motivated to sponsor an international organization exercise like Black ICE because we see them as vital to an international response to a bioterrorism attack. A chain of real-life events including the anthrax attacks in the U.S. in 2001, preparations for pandemic influenza, naturally-occurring disease outbreaks such as SARS, and various bioterrorism hoaxes have shown us all how vulnerable the world is to disease outbreaks, whether naturally-occurring or as the result of bioterrorism. Exercises focusing on fictional bioterrorism scenarios sponsored by national, international, and non-governmental bodies have also pointed out national and global vulnerabilities.

Through these actual and fictional events, it has also been very clear that some nations around the world intend to rely heavily on support of international organizations to respond to bioterrorism. If called upon to respond to bioterrorism, international organizations would quickly be involved in an intense and prolonged multisectoral effort with a broad range of international organization partners. Some of these organizations have not traditionally had close ties to one another.

In preparation for this possible scenario, Black ICE organizers focused on promoting greater inter-organizational understanding of mandates and available capabilities, while looking for opportunities to leverage resources and support collaborative efforts among organizations as well as between organizations and national governments.

The organizations that participated in Black ICE represent diverse sectors involved in bioterrorism response efforts: health, law enforcement, transportation, humanitarian assistance, and military. Participating organizations came from a broad cross-section of the international community: International Civil Aviation Organization (ICAO), International Maritime Organization (IMO), and the World Customs Organization (WCO) on transportation and technical issues; NATO, the Organization for Security and Co-operation in Europe (OSCE), UN Department for Disarmament Affairs (UNDDA), and Interpol on security issues; and International Federation of Red Cross and Red Crescent Societies (IFRC), the International Committee of the Red Cross (ICRC), the International Organization for Migration (IOM), the World Food Program (WFP), and the World Health Organization (WHO) on humanitarian and health issues.

What Black ICE Means

Let me take a moment to explain to you the name of the exercise, a name that very accurately describes a bioterrorism scenario. While Black ICE is an acronym for the "Bioterrorism International Coordination Exercise," it is also a common term in American English referring to a very smooth layer of ice on a road surface that, because it is so smooth, appears to be simply water. Black ice is particularly dangerous because it appears to be harmless, so drivers are not as cautious and vigilant as they might be if they recognized the danger of the situation.

In a similar way, a bioterrorism attack can appear to be simply a manageable, naturally-occurring disease outbreak with predictable transmission patterns and without the potential for "re-load" (subsequent attacks). If not appropriately prepared and vigilant, law enforcement, public health, and all of the other sectors involved in a bioterrorism response may not recognize a bioterrorism attack or may not respond appropriately.

Exercise Scenario

The Black ICE tabletop exercise scenario simulated a smallpox attack with self-infected terrorists traveling via airplane from South Asia to Central Asia, and then moving about a major city during a large, outdoor event to infect as many others as possible. Eventually, over the course of the Black ICE scenario, the disease spreads throughout Europe, South Asia, Central Asia, and North America, resulting in cases in 17 nations, with 357 individuals infected, and 108 dead.

The disease is first discovered when an extremely ill, apparently homeless young man is brought to a hospital and diagnosed with smallpox. He turns out to be one of the terrorists who had traveled from South Asia. The scenario's fictional terrorist group was called The Council of Eight, a radical student group at a medical college in South Asia. The Council of Eight has a history of threatening propaganda with unclear intent and vague motivations.

The various facets of the Black ICE scenario raised a range of complex, global issues surrounding movement and border restrictions; vaccination policies; investigation strategies; trade implications; relationships between international organizations and national governments, relationships between various sectors such as public health, law enforcement, and military; and many other challenging multisectoral issues.

Black ICE incorporated fictional news broadcasts for each move in the scenario. These videos are examples of some kinds of media reporting. They are not inflammatory nor do they provide misinformation. As we can all imagine, there are a range of ways, however, in which the media can and will report on suspected or actual bioterrorism.

It is difficult to overestimate the impact of the media on a response to any emergency, but in a bioterrorism attack with its inherently international implications, the media's role may be even more profound given their ability to help disseminate critical, life-saving information about how to limit risk factors and any restrictions, or their ability to make a bad situation worse by spreading inaccurate information, increasing panic, and causing the public to take unwise actions.

An Opportunity to Prepare

Based on the experiences in Black ICE, the U.S. and Switzerland make the following recommendations:

• Because of finite resources among international organizations, nations should increase their own capacity to prevent and respond to bioterrorism;
• Nations should establish mechanisms for sharing medical countermeasures internationally and support international organizations' efforts to develop and sustain an effective system for the apportionment of medical countermeasures;
• International organizations should work, with the support of national governments and other organizations, to clarify the coordinating authority of a response by international organizations to bioterrorism;
• International organizations and individual nations should acknowledge and emphasize the multi-sectoral nature of preparation for and response to bioterrorism; and
• International organizations should evaluate their bioterrorism response capabilities and systems to pinpoint potential areas for creative collaboration with other organizations.

Almost all of these recommendations have their foundation in the crucial role national governments play in improving our collective ability to prevent and respond to bioterrorism. In addition to directly supporting the work of international organizations, all of our nations can strengthen internal, national, and regional abilities to counter bioterrorism by increasing our individual and collective capabilities, and enhancing collaboration and partnership with neighboring nations to provide for mutual support to complement or supplement possible support from international organizations.

U.S. Vision for International Collaboration

The U.S. believes that the four essential pillars of effective and cooperative global and multi-sectoral efforts to combat bioterrorism are:

• Threat Awareness -- including bioterror-specific intelligence, timely assessments, and strategies for anticipating future threats.
• Prevention and Protection -- including proactive prevention activities and counterproliferation efforts, along with critical infrastructure protection.
• Surveillance and Detection -- including early detection and attack warning; disease diagnosis, identification, and the ability to discern unusual patterns of disease; epidemiological investigation to determine the extent and cause of the outbreak; laboratory testing to confirm the disease agent; provision of information regarding the outbreak to key stakeholders; attribution, and interdiction.
• Response and Recovery -- including response planning, provision of treatment and the ability to contain the outbreak through focused public health intervention, mass casualty care, risk communication, medical countermeasure development (drugs and vaccines) and distribution, decontamination, and recovery from the immediate and long-term effects of the outbreak.

Each of these elements requires input, skill, and guidance from a range of sectors including military, law enforcement, intelligence, public health, agriculture, environment, and science. And, to be effective, all of these elements require intense and sustained international collaboration.

Black ICE is one component of an ongoing international policy dialogue about the broad range of national and international strategies to combat bioterrorism and strengthen biodefense.

Where do we go from here?

Bioterrorism is a unique threat because, unlike terrorism with conventional weapons or even chemical, nuclear, or radiological materials, the response to a bioterrorism attack will require careful coordination among sectors that are not traditionally involved in counterterrorism and security activities and may not often work together. These varied sectors including health, law enforcement, humanitarian assistance, security, defense, and transportation are the critical disciplines represented in Black ICE.

A bioterrorism attack almost anywhere in the world -- regardless of the level of national preparedness and response capacity -- will require immediate and significant engagement by international organizations. The organizations that participated in Black ICE represent both the first response and the last resort for many nations.

The challenges in coordination, however, are not simply technical or logistical, but political as well. Some organizations are, for example, used to working on counterterrorism and security issues, but find it daunting to engage with humanitarian relief, public health, or agricultural efforts. For others, there are concerns about linking their health care or development work to security or counterterrorism initiatives, for fear of compromising much-needed humanitarian assistance. And for all international organizations, there are the competing needs and demands of multiple member states and limited overall resources.

We view Black ICE as a valuable step toward enhanced international and intersectoral coordination in bioterrorism response. A collaborative response is fundamental to effectively preventing and responding to bioterrorism. Thus, building and enhancing relationships among relevant organizations is an important, concrete step towards a collaborative response.
Our Swiss partners share our opinion regarding the vital role that international organizations play and have agreed to continue to work with us to find new ways to address these important issues. I am also pleased to share the news that one of the international organizations that participated in Black ICE already plans to build upon the themes and work of Black ICE. While in Switzerland, Interpol announced its intention to convene two more bioterrorism exercises for international organizations -- a valuable contribution to continuing to develop international and multi-sectoral collaboration.

Conclusion

Let me take a moment at the conclusion of my remarks to gratefully acknowledge the tremendous contributions of our partners in this effort.

We were fortunate to have financial support from two prestigious institutions, the Alfred P. Sloan Foundation and the Nuclear Threat Initiative's (NTI) Global Health and Security Initiative. Their support was vital in making Black ICE a success.

Further, on behalf of the U.S. Government, I would like to offer sincere thanks to the Government of Switzerland for its tremendous role in this partnership. It is difficult to adequately thank our Swiss partners for their collaboration and contributions. Our nations' joint sponsorship of Black ICE is an outgrowth of a long history as friends and allies in our work to make the world a better and safer place for people around the globe. We look forward to continuing this productive partnership in future joint work to defend against bioterrorism and strengthen biodefense and are very grateful to Ambassador Ziswiler's government for its tremendous support and unstinting hospitality.

Finally, I want to acknowledge the efforts and investments of time, energy, and resources from the Black ICE participating organizations themselves. Their willingness to participate actively at very senior levels for the two-day exercise is ultimately what makes Black ICE a success. None of this could have happened without their continued engagement, support, and good will -- and we are honored to have been able to work together with them.

Because combating bioterrorism is too complex- and inherently international-a problem for any one nation or sector to solve alone, it is vital that we identify those areas where our expertise and interests intersect, both within our own governments and among other nations. A collaborative response is fundamental to effectively preventing and responding to bioterrorism. Building relationships among relevant agencies within our governments, among international organizations, and between governments is an important, concrete step towards a collaborative response. Investing time and effort in building these relationships now, while we are not facing an emergency, will increase the effectiveness of a national or international response to bioterrorism and assure the safety of the global community.