stuart d. blacksell mph, phd, rbp mahidol-oxford tropical medicine research unit (moru), bangkok,...

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Stuart D. Blacksell MPH, PhD, RBP Mahidol-Oxford Tropical Medicine Research Unit (MORU), Bangkok, Thailand. Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Vientiane, Lao PDR. Centre for Tropical Medicine, University of Oxford, United Kingdom. International Cooperation in Strengthening & Mitigating Biothreats

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Page 1: Stuart D. Blacksell MPH, PhD, RBP Mahidol-Oxford Tropical Medicine Research Unit (MORU), Bangkok, Thailand. Wellcome Trust-Mahosot Hospital-Oxford Tropical

Stuart D. Blacksell MPH, PhD, RBP

Mahidol-Oxford Tropical Medicine Research Unit (MORU), Bangkok, Thailand.

Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Vientiane, Lao PDR.

Centre for Tropical Medicine, University of Oxford, United Kingdom.

Stuart D. Blacksell MPH, PhD, RBP

Mahidol-Oxford Tropical Medicine Research Unit (MORU), Bangkok, Thailand.

Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Vientiane, Lao PDR.

Centre for Tropical Medicine, University of Oxford, United Kingdom.

International Cooperation in

Strengthening & Mitigating Biothreats

Page 2: Stuart D. Blacksell MPH, PhD, RBP Mahidol-Oxford Tropical Medicine Research Unit (MORU), Bangkok, Thailand. Wellcome Trust-Mahosot Hospital-Oxford Tropical

MORU’s strategic position….

Half of the world’s population within 2000 miles….

Page 3: Stuart D. Blacksell MPH, PhD, RBP Mahidol-Oxford Tropical Medicine Research Unit (MORU), Bangkok, Thailand. Wellcome Trust-Mahosot Hospital-Oxford Tropical

Major field site / laboratory

Laos project field site

Bangkok Unit

Collaborator’s site

MozambiqueAQUAMAT collaborative sitesSri Lanka

MORU – 2011

Page 4: Stuart D. Blacksell MPH, PhD, RBP Mahidol-Oxford Tropical Medicine Research Unit (MORU), Bangkok, Thailand. Wellcome Trust-Mahosot Hospital-Oxford Tropical

Diseases driving the needs?

Page 5: Stuart D. Blacksell MPH, PhD, RBP Mahidol-Oxford Tropical Medicine Research Unit (MORU), Bangkok, Thailand. Wellcome Trust-Mahosot Hospital-Oxford Tropical

BSL3 labs in SEA - The MORU experience

Page 6: Stuart D. Blacksell MPH, PhD, RBP Mahidol-Oxford Tropical Medicine Research Unit (MORU), Bangkok, Thailand. Wellcome Trust-Mahosot Hospital-Oxford Tropical

“BSL3/4 labs” in South East Asia

5

1

13

7

52

8

1

1

2

Page 7: Stuart D. Blacksell MPH, PhD, RBP Mahidol-Oxford Tropical Medicine Research Unit (MORU), Bangkok, Thailand. Wellcome Trust-Mahosot Hospital-Oxford Tropical

Biocontainment facilities in SEA

Page 8: Stuart D. Blacksell MPH, PhD, RBP Mahidol-Oxford Tropical Medicine Research Unit (MORU), Bangkok, Thailand. Wellcome Trust-Mahosot Hospital-Oxford Tropical

Biosafety challenges in SE Asia

• Running a Biocontainment facility RESPONSIBLY is a huge investment of time, people, facilities and money.

• Most facilities are not properly prepared – Legislation and Standards

– Financial

– Administrative

– Personnel

– Logistics

– Facilities and Equipment

– Enforcement

Page 9: Stuart D. Blacksell MPH, PhD, RBP Mahidol-Oxford Tropical Medicine Research Unit (MORU), Bangkok, Thailand. Wellcome Trust-Mahosot Hospital-Oxford Tropical

National legislation

Page 10: Stuart D. Blacksell MPH, PhD, RBP Mahidol-Oxford Tropical Medicine Research Unit (MORU), Bangkok, Thailand. Wellcome Trust-Mahosot Hospital-Oxford Tropical

International Standards

Page 11: Stuart D. Blacksell MPH, PhD, RBP Mahidol-Oxford Tropical Medicine Research Unit (MORU), Bangkok, Thailand. Wellcome Trust-Mahosot Hospital-Oxford Tropical

Financial and Administrative Issues • Financial

– Limited budgets

• Maintenance

• Training

– Corruption!

• Administrative

– Institutional Biosafety Committee

– Incomplete documentation

• Biosafety manual

• Emergency Response Plan

• Interaction with First Responders (Police/Fire)

• Standard Operating Procedures

Page 12: Stuart D. Blacksell MPH, PhD, RBP Mahidol-Oxford Tropical Medicine Research Unit (MORU), Bangkok, Thailand. Wellcome Trust-Mahosot Hospital-Oxford Tropical
Page 13: Stuart D. Blacksell MPH, PhD, RBP Mahidol-Oxford Tropical Medicine Research Unit (MORU), Bangkok, Thailand. Wellcome Trust-Mahosot Hospital-Oxford Tropical

Security/Restricting Access

• Site specific security plan• Staff with access

– USA • FBI clearance - Restricted person criteria (Criminal,

Drugs, Terrorism)• US Dept of Justice registered “entity” personnel

– Thailand • Local Police check using national and international

databases

– Laos • No capability

Page 14: Stuart D. Blacksell MPH, PhD, RBP Mahidol-Oxford Tropical Medicine Research Unit (MORU), Bangkok, Thailand. Wellcome Trust-Mahosot Hospital-Oxford Tropical
Page 15: Stuart D. Blacksell MPH, PhD, RBP Mahidol-Oxford Tropical Medicine Research Unit (MORU), Bangkok, Thailand. Wellcome Trust-Mahosot Hospital-Oxford Tropical

Logistics – Infectious inventories

• Baseline Inventory established– Agent, source, quantity, use– Audit trail– Checked periodically by RO’s

• Quarterly check of inventory, people, security

• MORU experience– Freezerworks software

– Very labor intensive• 2 people – 24 months – 20,000 samples

Page 16: Stuart D. Blacksell MPH, PhD, RBP Mahidol-Oxford Tropical Medicine Research Unit (MORU), Bangkok, Thailand. Wellcome Trust-Mahosot Hospital-Oxford Tropical

Facilities maintenance and testing

Page 17: Stuart D. Blacksell MPH, PhD, RBP Mahidol-Oxford Tropical Medicine Research Unit (MORU), Bangkok, Thailand. Wellcome Trust-Mahosot Hospital-Oxford Tropical

Other considerations

• BSL3 Energy costs– Tropical climate – BSL3 single pass air = very expensive and wasteful– Why not recirculation 85% of the air with additional HEPA filtration

• Regional training faculties – Biocontainment engineering/Biosafety Officers/Maintenance– Not for profit– Use facilities and experience that is already available locally

• Assess the risks – Do we really need a BSL3 lab? – Can we use BSL2 lab with BSL3 practices

Page 18: Stuart D. Blacksell MPH, PhD, RBP Mahidol-Oxford Tropical Medicine Research Unit (MORU), Bangkok, Thailand. Wellcome Trust-Mahosot Hospital-Oxford Tropical

Conclusions

• Focus areas for biosafety and biocontainment– Regulations and legislation– Biosafety Administration – Assess the risks – do we really need a Rolls Royce?– Training

• Biosafety administration

• Biosafety practices/PPE

• Emergency response

– Facilities maintenance and testing/certification– Forward planning for budgets– Appropriate physical security

Page 19: Stuart D. Blacksell MPH, PhD, RBP Mahidol-Oxford Tropical Medicine Research Unit (MORU), Bangkok, Thailand. Wellcome Trust-Mahosot Hospital-Oxford Tropical

Thank you