AFTER-ACTION REPORT FOR DEMETER'S RESILIENCE, THE

UNCLAS STATE 091332 SENSITIVE SIPDIS E.O. 12958: N/A TAGS: CA EUN FR GM IT JA PTER RS TBIO UK SUBJECT: AFTER-ACTION REPORT FOR DEMETER'S RESILIENCE, THE G8 FOOD DEFENSE EXERCISE REF: A. STATE 14591 ¶B. STATE 39260 ¶1. (U) Summary: Following the recommendations of the G8 Bioterrorism Experts (BTEX) Group in 2005, a series of G8 workshops dealing with decontamination, food defense and public health/law enforcement cooperation was organized. "Demeter,s Resilience" was the second G8 food defense event and was held May 27-29, 2008 at the U.S. National Center for Food Protection and Defense (NCFPD) in Minneapolis, Minnesota (reftels). The exercise was designed to stimulate national and international cooperation and communication in identifying, responding to and recovering from a terrorist attack on the food supply. The NCPFD, a DHS Center of Excellence, designed the exercise scenario and facilitated the exercise. Exercise participation was lively and robust, although not all G8 nations attended. The After-action Report (para 4) contains further details on the exercise format, scenario, emerging themes and key recommendations. End Summary. ¶2. (U) U.S. Delegation: The U.S. delegation consisted of Lindsey Hillesheim (State),John Guzewich (FDA),Perfecto Santiago (USDA),Robert Hooks (DHS),and Bill Zinnikas (FBI). The U.S. also sent several additional observers from FDA, USDA, DHS, FBI, and OSTP. ¶3. (SBU) Other Delegations: - The Government of Germany,s (GOG) delegation came well-prepared for the exercise with answers in hand for many of the discussion questions. Their delegation was composed of representatives from the Federal Foreign Office, the Federal Institute for Risk Assessment, and the Federal Ministry for Food, Agriculture and Consumer Protection. Since Germany is organized as a federal system like the U.S., much of the detection and response tasks fall to the Landers (similar to states). Thus GOG emphasized the importance of robust local public health and food safety systems and the need to coordinate these systems across a federal organization. - In addition to several observers, the Government of Canada,s (GOC) official delegation was robust and balanced including representatives from the Department of Foreign Affairs and International Trade Canada, Royal Canadian Mounted Police (RCMP),Canadian Food Inspection Agency, Health Canada, and the Department of Public Safety. The GOC food defense response system is similar to the U.S. system, thus providing significant opportunities to share best practices. - Her Majesty,s Government,s (HMG) delegation, while missing a foreign affairs representative, was very active during the exercise and included officials from the Health Protection Agency, Food Standards Agency, and the Centre for the National Protection of Infrastructure. Participants from the G8 other delegations found many of the lessons identified by HMG as a result of the Sudan Red recall in 2005 to be particularly useful, including the use of "scoping meetings" that include experts from industry to map out how an ingredient was distributed. - The Government of Japan (GOJ) sent only one person from the Cabinet Office,s Consumer Safety Division. This small delegation was surprising given that GOJ holds the G8 presidency and gave approval for the exercise to be held and hosted by the USG. - The Government of France (GOF) sent technical experts from the Ministries of Health, and of Agriculture and Fishery. Due to the lack of foreign affairs and law enforcement officials, a complete picture of GOF,s response to a terrorist attack on the food supply is not possible. - The Governments of the Russian Federation and Italy did not send delegations. - The European Commission and the World Health Organization both sent observers to the exercise. ¶4. (U) The following "After-action Report for Demeter,s Resilience" includes input and comments from the countries present at the exercise. A formatted version of the After-action Report has already been shared with participants and G8 BTEX points of contact. Begin text of After-action Report. EXECUTIVE SUMMARY Demeter,s Resilience was a three-day exercise on food supply protection for the G8 nations with fifty participants from Japan, Canada, France, Germany, United Kingdom, and United States. The exercise aimed to strengthen coordination, cooperation, and communication between G8 nations in the event of an intentional attack on the food supply. In addition, the World Health Organization and the European Commission along with a private industry representative participated in the exercise. The exercise was hosted by The National Center for Food Protection and Defense (NCFPD) at the University of Minnesota. The exercise provided nations an opportunity to discuss roles and responsibilities of various stakeholders in event of a terrorist attack, and enhance strategies for working together to prevent and respond to a terrorist attack on the food supply. In addition, Country representatives shared insights on preparedness planning and lessons learned from previous experiences. Key recommendations resulting from this exercise include: ¶1. Establish and maintain key functional contacts in areas relevant to food defense. ¶2. Establish a mechanism or leverage an existing one to develop complementary risk communication messages during a widespread outbreak. ¶3. Foster collaboration between countries to address gaps in knowledge and capabilities in food-related surveillance, diagnostics, decontamination procedures, and risk assessments of threat agents. ¶4. Foster and develop relationships among stakeholders within and between countries as these informal networks can enhance the communications between nations and between sectors relevant to food defense, as well as strengthen the collective capacity of G8 nations to anticipate, prevent, respond to, and recover from intentional contamination of the food supply. EXERCISE DESIGN AND FORMAT In 2004 and 2005, G8 leaders committed to defending against bioterrorism by; strengthening national and international biosurveillance capabilities, increasing protection of the global food supply, and improving bioterrorism investigation, response and mitigation capabilities. In 2005 the G8 Bioterrorism Experts Group (BTEX) agreed on a work plan that included the development of a food defense tabletop exercise. Demeter,s Resilience served to initiate a dialogue between G8 member nations on communication mechanisms during an intentional bioterrorist attack upon the G8 food supply. The exercise provided an opportunity for G8 nations to strengthen lines of communication, which may enhance prevention, mitigation and recovery efforts on food system events. The simulated attack was based around a hypothetical food product that is widely exported to and/or imported from all G8 nations. Demeter,s Resilience was intended to accomplish the following primary objectives: -- Examine food defense communication and coordination procedures within and among G8 countries in response to a terrorist attack on the food supply. -- Discuss the roles and responsibilities of the various ministries, organizations, and sectors in responding to a terrorist threat or attack on the food supply (e.g. law enforcement, foreign affairs, food/agriculture/public health agencies, and the private sector). -- Through facilitated discussion and simulation, examine G8 countries, responses to a bioterrorism incident targeted at the food supply system. Demeter,s Resilience took place on May 27-29, 2008, and was hosted by the National Center for Food Protection and Defense (NCFPD) at the University of Minnesota, Minneapolis, Minnesota. Established in 2003 and led by the University of Minnesota, the NCFPD is a Department of Homeland Security Center of Excellence. The Center is a consortium of academic, public sector, and private sector partners tasked with developing technologies and strategies to prevent, respond, and recover from intentional contamination of the food system in order to mitigate the public health and economic impact of the event. In addition to the time participants spent engaged in the exercise itself, an informal evening reception and lunches allowed participants to interact outside of the structured exercise. These informal events strengthened the personal relationships and communication networks of exercise participants. Besides the interactions among participants physically present at the exercise, World Health Organization (WHO) representatives participated via a web link from the WHO,s global Strategic Health Operations Center (SHOC) in Geneva, Switzerland. To familiarize participants with other countries, response plans and capabilities, each country provided an overview of how response to food safety and/or food defense events was organized in their respective country. Demeter,s Resilience employed a fictitious scenario and scenario elements or information--including descriptions, timelines, and instructions--were provided by the exercise facilitators to stimulate participant activity. The scenario ensured necessary events occurred so that all objectives were met. The exercise was divided into four distinct phases representing significant periods in a food defense event: notification, identification, investigation, and recovery - followed by an interactive discussion session to capture key features, lessons learned, and identify opportunities for further work. Each phase began with an overview of key events and communications occurring within the phase. Following the phase overview and facilitator instructions, participants reviewed the situation and engaged in group discussions within and between G8 countries regarding an appropriate response. The exercise was intended to be a safe, open, and stress-free environment to allow all participants to openly share their perspectives. Varying viewpoints were encouraged, as there are no international standards for handling a terrorist attack on the food supply. Participants were encouraged to focus on the communication process, and identify opportunities to strengthen communication within and between governments. Participants were encouraged to move among groups and interact with the experts to ensure thorough, thought-provoking discussion and problem resolution. Exercise participants representing various government agencies from six of the eight G8 countries were present. Government agencies represented included those in the fields of law enforcement, food safety, public health, agriculture and foreign affairs. The World Health Organization and the European Commission also had representatives present at the exercise. A representative from industry was also present to answer questions about their experiences in responding to incidents of contamination occurring in the food supply. SCENARIO OVERVIEW An unspecified poultry processing facility in the United States is the source of a breaded chicken product designed primarily for restaurant distribution both in the United States and for export. The contaminated poultry product is shipped from the United States to all G8 member countries through various modes of transport. The product is contaminated during production via adulteration of the breading mix, resulting in 24 breading batches contaminated in a single day. The contaminant is relative heat stable, with little or no organoleptic impact on the finished product (i.e. not altering the taste, texture or smell). Clinical presentation of acute gastroenteritis, often accompanied by vomiting and diarrhea, occurs after a one day latency period. Severely affected patients developmultiple organ failure five days after apparent initial recovery. Phase one consisted of public health identification and notification of the initial illness. Because shipment times and product consumption varied over different countries, various numbers of illnesses were reported to the relevant agencies at different times. This phase focused on illness reporting within country, and how this information would be both handled within the country and relayed internationally. The phase ended with a fictional video news clip shown to the entire group from "Global News Network" announcing unusual and widespread illnesses occurring around the globe. Phase two consisted of the initial epidemiological investigation suggesting a single common source for many of those affected during the outbreak. Some individuals, who had previously gone to hospitals with vomiting and diarrhea, returned later with multiple organ failure. This led to a large number of hospitalizations, with several patients dying. Phase three began with a video news clip from "World News" in which a terrorist organization claimed responsibility for the outbreak. During this phase the specific product responsible and the lot and shipment information were also confirmed. Phase four focused on recovery. Contaminated product lots were retrieved, and decontamination protocols were issued. The rate of new illnesses rapidly declined, while new threats to the food supply were received. EMERGING THEMES Food safety authorities and responsibilities are distributed in different ways across countries and investigations into a food borne illness outbreak vary by agency, country and event. When an event is recognized as a food safety problem, the roles of various agencies involved are fairly well defined; however in intentional contamination (e.g. a food defense problem),the triggers which initiate a concurrent criminal investigation are more difficult to determine. Recognition of a food borne disease outbreak is driven by the characteristics of the illness, rather than actual numbers of ill individuals. Some patterns considered were geography, population demographics, as well as exposure information. The event characteristics often determine which agencies are involved in the investigation, and how soon other agencies would be contacted. While international reporting may vary due to legal constraints and uncertainty during an outbreak, the effectiveness of international communication channels are greatest when utilized as soon as possible after identification of an outbreak. During the course of a food borne disease outbreak there are often multiple levels of communication underway. These often include government communications to their affected or at-risk populations, within country communications between agencies or ministries, bilateral ministerial communications between countries, ad hoc communications between scientists, and perhaps communication with the media. Due to the multiple levels of communication which occur, it is often difficult to achieve consistent risk communication messages. In addition, multiple communication messages may be needed to reach different cultures or audiences. On a global scale, it is challenging to develop a common case definition. Several factors contribute to this challenge including country differences in data collection and one country,s ability, or inability, to utilize another country,s investigative data. There is also variability in the degree to which countries would involve the private sector and civil organizations at different stages in a response. During an intentional contamination event, the health and safety of the public remain the priority of all agencies involved. A claim or suspicion of terrorism shifts leadership of the overall investigation to law enforcement, but not at the expense of the public health investigation. Multiple agencies continue to provide active support for the investigation. Uncertainty as to the route of contamination, the contaminating agent, and the scale of the event all contribute to the challenge of managing the response to a widespread food contamination event. Law enforcement, food safety, and public health working together on a major food defense issue is a relatively new paradigm, and, as such, there is a recognized need for increasing the knowledge of public health, food safety, and law enforcement response protocols within each country and between countries. KEY RECOMMENDATIONS Establish and maintain key functional contacts in areas relevant to food defense. A system for up to date information for key contacts and for promoting a network among key individuals/agencies is needed both within countries and across the G8 to ensure a timely and coordinated response to a food contamination event. Existing global forums should be utilized and expanded to discuss and share lessons identified after an international bioterrorism attack on the food supply. Establish a mechanism, or leverage an existing one, to develop complementary risk communication messages during a widespread outbreak. Current global communication channels (e.g. WHO INFOSAN and IHR notification) can be strengthened to facilitate multi-national communication in the event of a terrorist attack on the food supply. The sharing of information needs to be fostered, and processes created to forewarn countries of upcoming public announcements, as well as exchange public messages and risk communication materials. Foster collaboration between countries to address gaps in knowledge and capabilities in food-related surveillance, diagnostics, decontamination procedures, and risk assessments of threat agents. A process to facilitate collaboration among relevant researchers in multiple countries to address these gaps should be developed. Foster and develop relationships among stakeholders within and between countries as these informal networks can enhance the communications between nations and between sectors relevant to food defense, as well as strengthen the collective capacity of G8 nations to anticipate, prevent, respond to, and recover from intentional contamination of the food supply. Particular attention should be given to developing relationships among public health, food safety, and law enforcement agencies within countries and to understanding the roles, responsibilities, and statutory authorities of the various agencies required in responding to an intentional contamination of the food supply. Tabletop exercises could continue to be integrated to build capacity and expand the personal networks of individuals responding to during a bioterrorism event. Developing memoranda of understanding and agreements between agencies ahead of time will avoid confusion during an actual event. In addition to public health, food safety, and law enforcement agencies, non-traditional partners, such as private industry representatives, consumer organizations, environmental agencies and other stakeholders, should also be considered for inclusion in training exercises. CONCLUSION Demeter,s Resilience increased participants, awareness of G8 member nation,s food safety authorities and protocols in G8 member nations for responding to incidents of intentional contamination of the food supply. Exercise discussions recognized the need for increased communication and information sharing on an international level during a bioterrorism attack on the food supply. The discussions also reinforced the need for international communication channels to be utilized early during an emerging event. End text of After-action Report. ¶5. (U) Additional Information: Please contact OES/IHB,s Lindsey Hillesheim (HillesheimLN@state.gov, 202-647-6922) for additional information on this event, including the participant list and a formatted version of the report. Other inquiries related to G8 BTEX activities should be directed to ISN/CTR,s Kendra Chittenden (ChittendenKA@state.gov, 202-647-6294). RICE