Medical countermeasures (MCMs) are the first line of defense against novel weapons of mass destruction (WMD) threats, and discussions surrounding the development of improved chemical agent MCM capabilities took center stage at the “Reactivators and Multi-Drug Autoinjector Industry Day” event held on 1-2 November in McLean, Virginia. U.S. government and industry leaders gathered at the Joint Program Executive Office for Chemical, Biological, Radiological and Nuclear Defense (JPEO-CBRND)/Defense Threat Reduction Agency Joint Science and Technology Office (DTRA-JSTO) co-hosted event to discuss reactivators and autoinjector capabilities. The event specifically focused on DTRA-JSTO investments in reactivator discovery and development tools and technologies in support of the guidance for, and alignment to, two new JPEO-CBRND program efforts – the Reactivating Nerve Agent Treatment System (RNATS) and the Consolidated Nerve Agent Treatment System (CNATS) – both of which treat exposure to current and emerging threats.
During opening remarks on day 1, Deputy Assistant Secretary of Defense for Chemical and Biological Defense (DASD/CBD) Ian Watson set the stage for the day.
“One of the Chemical and Biological Defense Program’s (CBDP) main priorities is planning for the future fight, and we have a whole new MCM approach to address the future threat,” said Watson. “There are too many potential threats to develop a single MCM for each one, which is why broad-spectrum MCMs are essential to our new approach. Autoinjectors are tremendous delivery systems for this posture.”
The 2020 CBDP enterprise strategy establishes four strategic goals to improve warfighter readiness and lethality, and number one on the list is planning for the future fight; followed by delivering at speed, driving innovation, and optimizing the enterprise. The reality today is that the nature of war is changing, and the threat environment is continually evolving. We need to be prepared for this future fight, and traditional approaches to developing MCMs specific to single chemical threats will not work in the fight that lies ahead. Broad-spectrum and centrally acting approaches that work across threat classes is the future and the end goal.
“Let’s make autoinjectors the next success story,” closed Watson, a tone which resonated with the group.
Over the next two days, the theme was partnership and trust; developing connections to establish a shared, common understanding of the CBRN battlespace.
“You are our partners in this,” said Chief of Advanced and Emerging Threats at DTRA-JSTO Bradley Norwood. “We are developing the countermeasures that keep the warfighter in the fight in a changing environment with changing threats, and we won’t know about some of these things until they start showing up.”
Building partnerships, sharing information, and establishing common understanding is the way to build more seamless teams through the acquisition process, enhance transitions in advanced development, and reach the goal of fielding and delivering safe and effective MCMs to the warfighter.
“When it comes down to this area, seconds matter, and that’s not hyperbole,” said COL Matthew Clark, Joint Project Manager for CBRN Medical. “When you’re actually on the battlefield, when you’re in the area exposed to these types of threats – even if it’s in a subway in a major metropolitan area – seconds absolutely matter.”
Delivery and trust are the key elements that get us to the seconds that matter, with applicability not just to our warfighters in military environments, but to the civilian population as well.
Highly toxic organophosphorus compounds, called nerve agents, are considered to be the most dangerous chemical warfare agents. Acetylcholinesterase (AChE) reactivators are employed for the prevention and treatment of intoxication with organophosphorus AChE inhibitors, including nerve agents and pesticides. Put simply – nerve agents are used as poisons. They are generally colorless and tasteless, capable of causing mass casualties by inducing seizures and incapacitating organ systems in the body.
The goal of the RNATS is to increase survivability against chemical threats through the development and delivery of an FDA-approved MCM. Additionally, the goal of the CNATS is to increase survivability by delivering a MCM that integrates multiple therapeutics in a modernized multi-drug autoinjector, which provides greater efficacy against chemical warfare nerve agent threats while unencumbering the warfighter.
DASD Watson reiterated in his opening remarks, “We can’t ask the warfighter to carry more.” This is why compound autoinjectors like CNATS are so important. Our warfighters are encumbered; it is our job to do what we can to unencumber them. The CNATS will deliver an FDA-approved autoinjector that consolidates nerve agent treatment into a single platform for use at point-of-injury, reducing the warfighter basic carry load and logistical burden.
Currently, there are seven different autoinjectors approved for the warfighter, in different configurations, by different companies. The CNATS integrates multiple therapeutics (targeting atropine, scopolamine, and an improved reactivator) into a single, modernized, multi-chambered autoinjector, intended to unencumber our warfighters and address the Services’ need to carry fewer autoinjectors.
The JPEO-CBRND is aligned with the CBDP in focusing on three modernization areas; learning from the past to respond more proactively, rapidly, and efficiently in the future. The JPEO-CBRND’s mission of providing the best CBRN defense technology and equipment – at the right place, at the right time, and at the right cost – is only possible with the participation and help of our industry partners.
“Integration is a critical piece of our mission,” said Nicole Kilgore, Deputy Joint Program Executive Officer for JPEO-CBRND. “Integration of both capabilities and with other organizations. This meeting is a great opportunity to share technologies with the team, the ‘One Team’.”
Overall attendance at the event totaled over 160 participants, with representation from 22 companies, four countries, the Services, Department of Defense (DOD) agencies including the Defense Logistics Agency and the Defense Health Agency, and additional non-DOD representation from the FDA, the Biomedical Advanced Research and Development Authority, the Administration for Strategic Preparedness and Response, the National Institutes of Health (NIH)/ Countermeasures Against Chemical Threats, and the United Kingdom and Canadian governments.
“As the world’s greatest defense industry, we are collectively called upon to close capability gaps, increase total force resilience, and work collectively to anticipate and prepare for future security environments and combats,” said Robert Kristovich, Director of the DTRA-JSTO. “Science and technology, I believe, are going to be who defines the world’s superpower in the years ahead. It’s an intense competition, and it’s upon us all to work together to make sure that we win.”