Antibiotics have represented the primary line of defense for treating bacterial infections since 1935 when the first sulfur-containing compounds were introduced. Many antibiotic compounds are produced naturally by microorganisms while some more recently developed antibiotics are chemically designed based on a knowledge of susceptible biochemical pathways or physiological processes in pathogenic bacteria. Ciprofloxacin (“cipro”), a synthetic broad-spectrum antibiotic, functions by interfering with DNA replication.

Increased use and mis-use of antibiotics has led to increased numbers of pathogenic bacteria that are resistant to one or more antibiotics. Some resistant microbes possess mechanisms that allow continued growth in the presence of multiple antibiotics. These multiply drug-resistant pathogenic bacteria may also possess pathogenic properties that result in significantly more severe disease than their drug-sensitive cousins. Medical misuse of antibiotics – prescribing antibiotics for viral infections, failure of patients to complete treatment with the full regiment of antibiotics, or application of antibiotics based on inaccurate or incomplete tests can lead to selection of antibiotic resistant bacteria that can then cause infections that cannot be treated with the antibiotic(s) to which they are resistant. Multiple drug resistance can quickly reduce or eliminate all antibiotic-based treatment options. Infections caused by antibiotic resistant bacteria are very difficult to treat and can sometimes lead to death of the patient.

Antibiotic resistance can also result from selection based on exposure to antibiotics present in the environment. More than 70% of the antibiotics sold in the U.S. are used as supplements to animal feed. The intestinal bacteria in the animals provided with such feed often show resistance to the antibiotics in the feed and, in some documented cases, have transferred this resistance to pathogenic microbes with which they share the environment.

A brief of history of antibiotic use and the medical and public policy factors that are, in part, responsible for increased antibiotic resistance in pathogenic microbes and for a decrease in the development of new antibiotics will be presented. An introduction to new directions that are being taken to develop a next generation of antibiotic compounds will also be provided.

Speaker Biography:

Paul Jackson received his Bachelor's of Science degree from the University of Washington in Cellular Biology and his Ph.D. from the University of Utah in Molecular Biology. He became a CISAC Visiting Scholar in September 2011. He was previously a CISAC affiliate.

For the past 18 years he has been studying bacterial pathogens, first working to develop DNA-based methods of detecting these microbes and their remnants in environmental and laboratory samples, then developing methods to differentiate among different strains of the same pathogenic species. Research interests include the study of different methods of interrogating biological samples for detection and characterization of content, and development of bioforensic tools that provide detailed information about biothreat isolates including full interrogation of samples for strain content and other genetic traits.

Methods he developed have been applied to forensic analysis of samples and aid in identifying the source of disease outbreaks. He contributed to analysis of the Bacillus anthracis present in the 2001 Amerithrax letters and conducted detailed analyses of human tissue samples preserved from the 1979 Sverdlovsk anthrax outbreak, providing evidence that was inconsistent with Soviet government claims of a natural anthrax outbreak.

His current work continues to focus on development of assays that rapidly detect specific signatures including antibiotic resistance in threat agents and other pathogens. More recent activities include identification and characterization of new antimicrobial compounds that are based on the pathogens' own genes and the products they encode. These include development of such materials as therapeutic antimicrobials, their application to remediate high value contaminated sites and materials, and their use to destroy large cultures and preparations of different bacterial threat agents. Efforts to address issues of antibiotic resistance and treatment of resistant organisms have recently been expanded to look at non-threat agent pathogens that cause problematic nosocomial or community-acquired infections of particular interest to the military.

Paul spent 24 years as a Technical Staff Member at Los Alamos National Laboratory where he was heavily involved in development of the biological threat reduction efforts there. He was appointed a Laboratory Fellow at Los Alamos in recognition of his efforts. He moved to Lawrence Livermore National Laboratory in 2005 where he is presently Senior Scientist in the Global Security and Physical and Life Sciences Directorates. In addition to his work at the National Laboratories, he has served on the FBI's Scientific Working Group for Microbial Forensics, on NIH study sections and review panels, and continues to serve on steering and oversight committees for other federal agencies.

Much study has been put into the concept of a multinational or international “nuclear fuel bank,” and in 2010 two such banks became a reality according to the Nuclear Threat Initiative. However, all of the conceptual studies along with the two IAEA-approved banks are not really “fuel” banks; rather they are low-enriched uranium (LEU) reserves. While uranium is a commodity, fuel for a nuclear reactor is a highly-engineered product of which uranium is a component.

It has been argued that because there are more fuel fabricators than enrichers, the enrichment step is the crux of a supply assurance mechanism. This is a gross oversimplification. If one cannot get from LEU to a fabricated fuel assembly, then the fuel supply assurance is not available. There are issues of fuel design, core physics, regulation, intellectual property, and liabilities that could preclude fuel fabrication and delivery in a timely manner. These issues and obstacles will be discussed along with some suggestions about how they might be overcome to provide real fuel assurances.

Speaker Biography:

Dr. Alan Hanson was appointed as Executive Vice President, Technologies and Used Fuel Management of AREVA NC Inc. in 2005. In this position he was responsible for all of AREVA’s activities in the backend of the nuclear fuel cycle in the U.S. Prior to that he served as President and CEO of Transnuclear, Inc., also an AREVA company, which he joined in 1985. Transnuclear designs, licenses and supplies dry storage casks; more than half of the casks in the U.S. have been supplied by Transnuclear.

In January of 2011, Dr. Hanson started a year-long assignment as a Visiting Scholar at the Center for International Security and Cooperation (CISAC) at Stanford University on loan from AREVA. At CISAC he conducts research on the worldwide nuclear supply chain and international fuel assurance mechanisms. 

Dr. Hanson began his career in 1975 with the Nuclear Services Division of Yankee Atomic Electric Company. In 1979, he joined the International Atomic Energy Agency (IAEA) in Vienna, Austria. At the IAEA, he served first as Coordinator of the International Spent Fuel Management Program and later as Policy Analyst with responsibilities in the areas of safeguards and non-proliferation policies.

Alan Hanson received a B.S. degree in mechanical engineering from Stanford University in 1969 and earned his Ph.D. in nuclear engineering from Massachusetts Institute of Technology (MIT) in 1977. He also is a recipient of a Master of Arts in Liberal Studies (MALS) degree from Georgetown University in 2009.  He is a member of the American Nuclear Society and the American Society of Mechanical Engineers.

Nuclear energy is politically sensitive. For its proponents, nuclear energy is clean and highly efficient and indeed is the only alternative to fossil fuels in providing a base supply of electricity. For its opponents, nuclear energy is nothing but trouble, a symbol of war and weaponry par excellence, and one that creates environmental problems for mankind today and in the future. What is remarkable in this highly emotional debate is the general division between developed and developing countries. Asian and Gulf states are more active than many in other continents in expanding or developing their nuclear energy capacities. China is leading this expansion with 27 reactors under construction now.

Nuclear development in China highlights a series of objectives many developing countries try to balance – energy and economy, energy and development, energy and environment, energy and security, and the need for both clean energy and adequate and reliable energy supplies. It tells a counterintuitive story about Chinese politics – a single-party authoritarian political system with an extremely fragmented institutional structure in nuclear energy policy making, implementation and regulation and with highly competitive market forces in play. It provides a cautionary tale about the Chinese as well as global nuclear future. This paper discusses the challenges of nuclear energy development, using China as an example. It asks who drives it, what technology is selected and adopted, how human capital is developed, what the rules of the games are, and more importantly, which institutions are responsible for issuing licenses, regulating standards, and overseeing the compliance, and what forms of regulation do they use. At the core of these questions is if and how countries can ensure safe, secure and sustainable nuclear development.

Speaker Biography:

Dr. Xu Yi-chong is a research professor of politics and public policy at Griffith University. Before joining Griffith University in January 2007, Xu was professor of political science at St Francis Xavier University in Nova Scotia, Canada. She is author of The Politics of Nuclear Energy in China (2010); Electricity Reform in China, India and Russia: The World Bank Template and the Politics of Power (2004); Powering China: Reforming the electric power industry in China (2002); co-author of Inside the World Bank: Exploding the Myth of the Monolithic Bank (with Patrick Weller 2009) and The Governance of World Trade: International Civil Servants and the GATT/WTO, (with Patrick Weller 2004); and editor of Nuclear Energy Development in Asia (2011) and The Political Economy of Sovereign Wealth Funds (2010). All these projects were supported by the research grants from either Social Sciences and Humanities Research Council of Canada (SSHRC) or Australian Research Council.

The production and distribution of counterfeit medications has become a significant global public health issue. Though not as rampant in the United States, the Food and Drug Administration (FDA) has seen a 10 fold increase in the number of cases investigated, particularly a rise in illegally imported and diverted medications entering our legitimate drug supply. In order to curb these illegal activities, California and the federal government have introduced various pieces of legislation to address this. In addition, international entities, State Boards of Pharmacy and the FDA have begun promoting utilization of radio frequency identification technology and other technology to effectively track the medication supply. In a recent California survey, pharmacists felt strongly that the presence of counterfeit medications poses a problem in their pharmacy practice, but they still face several challenges in identifying counterfeit medications, counseling their patients, and forging their role in implementing legislative requirements.

This presentation will aim to provide an introduction to the international and domestic counterfeit drugs situation, discuss possible factors facilitating patient exposure to counterfeit medications, examine potential sources for counterfeit medications in the United States, identifiy federal legislation issues, discuss various forms of technology being used to combat counterfeit medications, and recognize the role of pharmacists and the challenges they face in dealing with counterfeit medications.

Speaker Biography:

Dr. Elaine Law is currently a Clinical Pharmacist specializing in Adult General Surgery at UCSF Medical Center and an Assistant Clinical Professor in the UCSF School of Pharmacy. She received a B.S. in Molecular, Cell and Developmental Biology from UCLA, earned a Doctor in Pharmacy from UCSF School of Pharmacy and completed a General Practice Pharmacy Residency at UCSF Medical Center. She holds a Board Certification in Pharmacotherapy and her research interests include roles pharmacists can play in public health issues including counterfeit medications and pharmacist-based immunization programs. She is an advocate of patient care in underserved areas and reaches out regularly to the Tenderloin communities and elderly populations of San Francisco through pharmacy health outreach programs.

As part of the National Consortium for the Study of Terrorism and Responses to Terrorism, counterterrorism and mental health experts discussed combating terrorism through deterrence and building strong, interconnected communities in a panel titled "State and Local Terrorism Deterrence Efforts". They also talked about strategies to improve public resilience, information gathering, and public perceptions of terrorism in the decade since September 11, 2001 and responded to questions from the audience. To view or purchase the event video, please visit: http://www.c-spanvideo.org/program/LocalTerr.