Dr. Harvey Rubin, director for the Institute for Strategic Threat Analysis and Response at the University of Pennsylvania, used current disease outbreaks, including the millions of people infected with tuberculosis and HIV/AIDS worldwide, to demonstrate the impact of global illnesses.

Rubin told a conference at the Marshall Institute May 30 that the pandemic threat needed to be treated as an international problem. To prevent and reduce the effects of a pandemic, he suggested the creation of an international treaty -- the Framework for the Detection and Containment of Infectious Diseases.

"This is a much more global issue," Rubin said. "The problem clearly calls for solutions that integrate new ideas in science, technology and social and political realities. It has to be a very creative constellation of solutions."

The treaty would use scientific and political leaders to help reduce the threat to international health and includes several framework points to fight possible pandemic threats.

One of the most crucial and potentially controversial facets of the treaty would be the creation of a vaccine treatment center devoted to research and the creation of vaccines for current and possible future infections.

"Let's build an international facility whose sole purpose is to make enough vaccines for the world -- hundreds and hundreds of millions of doses," Rubin said.

Rubin said the research center should be awarded to the country with the most convincing offer, not to the lowest bidder. He also said the scientists would have to agree to some sort of moral code.

The center would "establish codes of conduct for the appropriate use of modern molecular biology -- sort of a Hippocratic oath among biological scientists saying, 'I'm not going to use this for nefarious purposes,'" Rubin said.

Stephen Morrison, executive director of the HIV/AIDS task force at the Center for Strategic and International Studies, agreed that greater global cooperation was needed to combat pandemics. However, he doubted, the feasibility of relying upon one primary international research center. "I don't think you're going to have one single unitary global center," Morrison said. "Instead you are going to have coordinated centers."

Researchers and scientists are rushing to get such a center built and operating.

"The campaign has just begun but is certainly underway," said Steph Rosenfeld, a risk communications consultant who works with Rubin. "It is largely a matter of public information, of laying out (Rubin's) approach. This is not a trial balloon; there is no time for trial balloons because the clock is ticking and time is of the essence."

Rosenfeld said that meetings with elected officials at the federal level, as well as diplomatic officials and groups such as the World Health Organization, Physicians without Borders and the Red Cross, are part of the campaign for the treaty.

Rubin wants to establish routine procedures among countries for quickly reporting outbreaks and establishing the best laboratory methods.

Rosenfeld said geopolitical, not scientific, concerns were the biggest roadblock to the establishment of the treaty. "I think you have to build the sort of intellectual infrastructure that allows you to erect strong bridges and effectively navigate long-standing turf conflicts."

But that is easier said than done.

Because humans are human, political pressures will make Dr Rubin's idea a slippery ring to grasp," said Dr. David Franz, chief biological scientist at the Midwest Research Institute.

"There will be those nations which, for pride or fear of loss of tourism income, won't want to share their data on disease incidence. There will be those who will argue that it will cost them too much and those who fear they will not benefit enough. There will be those who won't trust because it was 'made in the USA'."

"However, I believe this is a case for which 'process' will be as important as 'product,'" Franz said. "Science and medicine share a common language internationally. When scientists work together on hard problems, walls of misunderstanding crumble; pandemics are hard problems."

Rubin said an international treaty would help to combat bioterrorism as well as natural pandemics. "We know what we have to prepare for with some of the national pandemics, and what we're all a little worried about are the engineered agents," he told United Press International.

Rubin said the establishment of an international research center would help scientists stay one step ahead of potential engineered agents.

"We're still a little bit far away from that," he said. "But it's the bad things that people can engineer to make worse that are of great concern."

"It's much like any security," said Don Donahue, executive director for the National Security of Health Policy Center, who is working with Rubin. "The bad guys will always figure out ways to get around what you are doing."

But Donahue, who has been working on emergency preparedness since 1997, said the project is still evolving from an idea to a reality.

"Certainly a project has many challenges," Donahue said. "But clearly any huge project starts with a vision, but it's certainly a vision worth pursuing."

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