Biosecurity and Bioterrorism: An interview with Dr. Rebecca Katz

 Draft cover.

Draft cover.

I am currently writing a textbook on homeland security (due out from Elsevier next spring 2015).  Unique to this text are interviews with renowned experts in the fields of homeland security and national security.  Dr. Rebecca Katz is one such expert.  Her work focuses on public health preparedness, particularly the intersection of public health preparedness and national security.  She is the author of the Essentials of Public Health Preparedness (a great book that I have used in my consulting work) and several other volumes.  A short excerpt of her interview - where she talks about her career, thoughts on her field and the gender disparity in her profession - appears below. Read the rest when it publishes spring '15

Dr. Rebecca Katz is an Associate Professor at The George Washington University School of Public Health and Health Services in the Department of Health Policy. Currently her primary research concerns the domestic and global implementation of the International Health Regulations. Generally, Dr. Katz’s research focuses on public health preparedness, the intersection of infectious diseases and national security, and health diplomacy. Dr. Katz continues to be a consultant to the State Department on issues related to the Biological Weapons Convention, Avian and Pandemic Influenza, and disease surveillance. Previously, she worked on Biological Warfare counterproliferation at the Defense Intelligence Agency, was an Intelligence Research Fellow at the Center for Strategic Intelligence Research in the Joint Military Intelligence College, and spent several years as a public health consultant for The Lewin Group. She also authored a textbook on Public Health Preparedness. Dr. Katz obtained her undergraduate degree in Political Science and Economics, an MPH in International Health, and a PhD in Public Affairs.

Tell us a little about yourself and how you came to your current position.
RK: I’m an associate professor of Health Policy and Emergency Medicine. My background is in social science--demography, public policy, and epidemiology, all focused on public health policy. I think, there are many different avenues for working public health preparedness. Some have hard science backgrounds, but it is not a requirement.

Is a background in national security law or policy helpful for the work you do?
RK: Absolutely, some background in these subjects helps.

What would you advise a student, in terms of their academic career, if they chose to do the work you do on a regular basis?
RK: One thing that is consistent amongst all of us on our team, even those not formally trained in public health, is that we all take a public health perspective.

Is it a detriment to your success in the field if you don’t have that perspective?
RK: No. But then you won’t be the public health person in the room.

What do you believe is the most valuable experience you’ve had in shaping your career?
RK: My answer for when I was in my twenties is different for my answer for my thirties, which will be different for my answer for when I’m in my forties. I come from a public health background, many members of my family are public health professionals. I always knew I’d end up in that field. After I graduated from college I was volunteering in maternal and child health clinics in southern India and got very sick. The bug that I was sick with, Brucella melitensis, turned out to be a Class B biological weapons agent. It’s the first agent the United States ever weaponized, as part of the US offensive biological weapons program in the early 1950s.

So, I’m assuming you got better once they figured out what you had?
RK: It took four years. And I still have it. It’s endemic in some parts of the world. If you get it through lab exposure you know right away. Otherwise it becomes intracellular and really hard to treat. I spent much of my masters programs hooked up to I.V. medication. I would go in the morning to the medical center to get my I.V. drip then go to class. What was really interesting was, you come back to the States and you have this disease nobody knows about and you have to become, as any patient does, your own expert in your disease. And the best literature on my disease in the US was related to bioweapons. So the interest in my own condition helped me to develop an interest in public health and bioterrorism issues. I thought, "Hey I have this social science, political science, international relations, and economics background, and I’m studying epidemiology in international health – and here is this thing, bioterrorism, that brings all of these interests together. So I became really interested in bioterrorism issues and biodefense, and I started going to meetings on these issues after graduate work.

Talk a little bit more about the gender disparity in your profession.
RK: Since I’ve been interested in these issues, the world has changed a lot. Up until 9/11 the people who looked at biological weapons were part of a very small community. Mostly, they were members of the military or intelligence communities. It wasn’t a question about gender disparity- there just weren’t many people interested- male or female. I had completed my masters and I was working in the public health field and I decided I really wanted to become an expert in this area of disease and security, so I applied for my doctoral degree in 1999. I wanted to do my PH.D. in epidemiology and the schools of public health almost uniformly told me that they liked me as a candidate but we’re not sure about this "thing" (biological weapons, bioterrorism) you’re interested in. I had a hard time finding faculty who were willing to work with me. I ended up in a policy school for my doctoral work, which was more amenable to multidisciplinary approaches, and I found a mentor who was willing to take me on.

Still the case?
RK: I wrote a paper on biological weapons as a public health problem and handed it in on Sept. 10, 2001 to my faculty advisor. One day later, 9/11 happened, and there was suddenly a lot of interest in the things I had been studying. The 90s were a time that people were admitting emerging infectious diseases were a problem again. In the 1970s there had been a shift of focus from infectious diseases and onto non-communicable diseases. Cancer was the new thing in public health in the 1970's, and it wasn’t until the emergence of HIV, Ebola, and other emerging infectious diseases in the late 80s and early 90s that people in the public health community started talking about infectious diseases again as a problem and starting to focus on the connection between disease and security. For instance, the term “emerging infectious diseases" wasn’t even coined until the early 1990s. Really the shift in thinking to infectious diseases as weapons or weaponized agents - didn’t start until late in the Clinton Administration.

Where do you see the field headed?
RK: The Global Health Security Agenda was launched in February 2013. So hopefully that is the future: what actions the global community should take to protect population's health and make populations more secure against bio-threats. So the 2000s, was about making the intellectual jump that public health and security are connected and now we’re looking at what the public health community is going to do about it.

What challenges do you see coming up in the next 5-10 years in the field?
RK: One of the things that we are thinking about a lot is metrics: asking how do you measure success? Is your population safe? Yes or No? Do you have disease surveillance? Yes or no? Have you been able to detect outbreaks? It’s not as easy as some of the other questions in terrorism-related disciplines. To me, metrics is the next major intellectual challenge. Measuring success is what holds people accountable.

If you could ask Congress for one thing what would it be?
RK: Money spent wisely. I think investing in building good disease surveillance systems, which means systems and policies which can help detect outbreaks of infectious diseases quickly, is a valuable use of resources. Good disease surveillance means you can also respond quickly to disease outbreaks and save more lives. We don’t have these kinds of detection systems in many parts of the world. You can’t separate the domestic from the global, so spending the money across the world is in many ways just as useful as spending it at home.

Let’s say somebody graduates from college and is about to embark on a career like yours. They don’t really know what you do day to day, but they are passionate about the subject. So what career advice, in terms of courses that are important, internships to take etc., would you give to such a student?
RK: First, if you want to work overseas, you actually have to get some global experience. The easiest time to do that is right after you graduate college. Life gets much more complicated as you get older. If you have even some idea that you want to do global work, you should try to go abroad. If you want to work in emergency preparedness go spend some time in a local health department. All public health is local, so figure out what that "local" is, whether that is here or abroad, and then go work there.

So practical, on the ground experience is important?
RK: If you have practical experience it makes you somebody worth listening to. It’s important to have policy skills. Some of these skills can be taught. Some can’t be taught and they have to be learned from experience.