Welcome to MedShield: A National Biodefense System in the Age of AI
Hello, I’m Ylli Bajraktari, CEO of the Special Competitive Studies Project. In this edition of our newsletter, SCSP’s PJ Maykish and Abigail Kukura explore MedShield, a comprehensive AI-powered system designed to protect us from biological threats, aiming to create a fully-integrated defense against a wide range of biological dangers.
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Welcome to MedShield: A National Biodefense System in the Age of AI
What is MedShield? Imagine a system that could protect us from dangerous pathogens and bioweapons as effectively as our military would defend against inbound ballistic missiles (NORAD) or nuclear attacks (STRATCOM). That's the idea behind MedShield. This potential national technology program is a bold, fully-integrated, AI-enabled system-of-systems that could neutralize a biological threat, whether from a state, non-state actor, or nature (biological threats go beyond pathogens into five basic types). MedShield would create one holistic “kill chain” against biological threats. The MedShield recommendation first appeared as a recommendation by the National Security Commission on Artificial Intelligence (NSCAI), which saw great promise for AI to fundamentally change the game on protecting our citizens and allies from biological threats. MedShield was refined and recommended again in SCSP’s National Action Plan for U.S. Leadership in Biotechnology, as well as in SCSP’s report, Generative AI: The Future of Innovation Power.
The Problem: Tech Everywhere But No Integrated System
Historically, the U.S. approach to biodefense has been reactive and fragmented. Individual agencies and institutions possess valuable expertise and resources, but their efforts are often siloed, hindering effective coordination and rapid response. Creating MedShield would represent a paradigm shift, moving from fragmented biodefense capabilities to a unified, proactive system-of-systems capable of anticipating, preventing, and mitigating biological threats like a “shield.”
The COVID-19 pandemic exposed critical vulnerabilities in the nation's ability to rapidly respond to biological threats via one integrated defensive system. Operation Warp Speed (OWS) was a noble organizational innovation that demonstrated the potential for rapid mobilization of scientific and technological resources. Yet the fact that OWS was needed in the first place underscores the fractured nature of technological solutions across five technical areas that would make up MedShield: biosurveillance, improved vaccination speed and quality, rapid therapeutics tailored to new pathogens, advanced AI modeling and simulation applied to those three areas, and R&D for rapid manufacturing of the full suite of pandemic solutions from therapeutics down to personal protective equipment. MedShield would provide integrated tech solutions that support a 24/7, 365-day-a-year, operation center housed at the Department of Health and Human Services (HHS), not unlike the vigilance required by NORAD and STRATCOM operations centers.
Why Is An Integrated Defensive System the Answer?
An integrated systems approach is essential for biodefense for several reasons. First, a fully integrated system like MedShield would allow for the efficient leveraging of existing resources and expertise. HHS, the National Institutes of Health (NIH), the Centers for Disease Control and Prevention (CDC), the Biomedical Advanced Research and Development Authority (BARDA), and the Defense Advanced Research Projects Agency (DARPA) all drove health innovation during Covid-19 and continuously to this day. However, great capabilities do not make an integrated system by chance. Currently, valuable technologies and data for them are scattered across various government agencies, research institutions, and, increasingly, private sector entities. MedShield would function as a tech system that creates a central architecture, coordinating these disparate elements into a cohesive and adaptive whole in the form of a national shield. This integration would streamline information sharing, facilitate collaboration, and prevent duplication of effort, ultimately maximizing the impact of national investments in biodefense with one clear and audacious Apollo-like national program ambition.
Second, the full power of private sector innovations will remain ungathered and underutilized without a national program to integrate these capabilities into a system greater than the sum of its parts. Companies could support MedShield with powerful data integration and analysis platforms, cutting-edge tools for threat detection, rapid response, and countermeasure development, and novel biosurveillance capabilities such as wastewater surveillance. However, these capabilities lack the unifying national force of an initiative that integrates these capabilities into government systems and deploys them effectively. A focused Apollo-like program, as suggested by the MedShield concept, could galvanize these disparate efforts with one national stretch goal that will impact all future generations once built.
Third, the nature of biological threats is rapidly evolving. From 2019-2021, the NSCAI imagined how AI could be used to intentionally create biological dangers across a spectrum. AI could lower the barriers to developing novel pathogens, increasing the risk of accidental or deliberate release. Simultaneously, globalization and potentially climate change are accelerating the emergence and spread of infectious diseases, as witnessed with COVID-19. These trends demand a comprehensive and fully integrated tech system capable of adapting to new and unforeseen challenges. MedShield, with its focus on integrating cutting-edge technologies like AI, would provide the necessary framework for this national ambition. As AI could be used to accelerate biological dangers it can equally be used to dominate and defend against them.
Fourth, the MedShield concept emphasizes the AI moment. AI is demonstrating the fascinating ability to fuse information, automate certain functions like global tracking of pathogens, and optimize biological solutions in therapeutics, vaccines, and manufacturing. AI models are showing the ability to out-perform humans as a general trend. Two recent examples include Claude 3.5’s coding capabilities, and OpenAI’s “o1” model which can now outperform humans in science benchmarks using a “reasoning” function (called “chain of thought” processing). This latter change illustrates that AI algorithms can probably analyze vast datasets from diverse sources, including genomic information, epidemiological trends, and environmental factors, to identify emerging threats and predict outbreaks with unprecedented speed and accuracy. AI can also accelerate the development of vaccines and therapeutics by optimizing drug discovery processes and predicting the efficacy of different treatment strategies. By harnessing the power of AI, MedShield would significantly enhance the nation's ability to anticipate, prevent, and respond to biological threats.
Furthermore, MedShield's operational model, inspired by successful systems like NORAD, would ensure constant tech-enabled vigilance and preparedness. The 24/7 operational center at HHS, staffed by experts from various agencies and disciplines, does continuously monitor potential threats, analyze data, and coordinate response efforts but they lack an integrated system that includes the best available AI and biotech. MedShield would augment this effort by building a fully integrated system for defense rather than a patchwork of capabilities. This full-spectrum “kill-chain” system, would enable rapid and decisive action in the event of a biological crisis, minimizing the impact on public health and national security.
How Should the United States Organize this Moonshot?
The Secretary of Health and Human Services has the right operations center and mandate to own and operate MedShield. But HHS would need the support of a diverse team of external partners for MedShield to truly be successful. Partners in the private sector, at national labs, and others could support HHS in tackling each technical area. For example, JHU’s Applied Physics Laboratory developed the pathogen surveillance innovation behind the Covid-19 tracker and could serve as the office of collateral responsibility (OCR) for Tech Area 1 Surveillance. Lawrence National Livermore Laboratory conducts computational vaccine and therapeutic development along with modeling that would make that lab fit to lead Tech Area 2 (AI-enabled vaccines), Area 3 (AI-enabled therapeutics) and Area 4 (AI-enabled modeling and simulation). The Technical Area 5 OCR on rapid manufacturing of solutions could be supported by Manufacturing USA by bringing their tradecraft to this Apollo-like team of teams.
The investment in MedShield is an affordable and strategic imperative for national security. The economic and social disruption caused by the COVID-19 pandemic underscored the devastating consequences of inadequate biodefense. By investing in MedShield, the nation could mitigate these risks and safeguard its citizens, economy, and critical infrastructure from the potentially catastrophic effects of future biological threats. After considering the government’s costs related to the COVID-19 pandemic, a government investment of $2 billion over three years for MedShield is reasonable to potentially thwart significant additional costs of another pandemic or bioterrorism event.
Finally, MedShield would pay dividends for the broader U.S.-China tech competition. First, certain AI and biotech breakthroughs needed for MedShield would also spin-out of the program and thus foster broader AI positional advantages for the United States. Second, MedShield would raise the security baseline against not just pathogens but also bioweapons. It is reported that the CCP maintains a biological weapons program for time of war and MedShield could provide a defensive deterrent against such programs. In these ways, MedShield could represent the critical step towards a more secure and resilient future as AI and biotechnology mutually rise as general purpose technologies. By integrating cutting-edge technologies, fostering collaboration, and adopting a proactive operational model, MedShield could provide the nation with a robust safety net in the age of biotechnology experimentation and a truly adaptable biodefense capability.