1. 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

2. MORU’s strategic position…. Half of the world’s population within 2000 miles….

3. Major field site / laboratory Laos project field site Bangkok Unit Collaborator’s site Mozambique AQUAMAT collaborative sites Sri Lanka MORU – 2011

4. Diseases driving the needs?

5. BSL3 labs in SEA - The MORU experience

6. “BSL3/4 labs” in South East Asia 5 1 13 7 5 2 8 1 1 2

7. Biocontainment facilities in SEA

8. 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

9. National legislation

10. International Standards

11. 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

12. Personnel

13. 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

14. Training – MORU experience

15. 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

16. Facilities maintenance and testing

17. 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

18. 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

19. Thank you