Cablegate: After-Action Report for Demeter's Resilience, The

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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

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