Attachment

9 In the scenario, according to mprovement In addition to advising countries on their exercise plans, the GERM team would measure readiness in other ways, for example by looking at how well a given country's health system is detecting and responding to non-pandemic diseases. If it's a place where malaria is a problem, how early does the system there detect big outbreaks? Or with tuberculosis, how well are they tracing the recent contacts of people who test positive? On their own, these proxies wouldn't tell researchers everything they need to know, but they would offer clues about weaknesses in the system that need more attention. The countries that do a good job of watching for, reporting, and managing endemic diseases are in a good position to respond to pandemic threat. The GERM team's most important role will be to distill the findings from exercises and other measures of preparedness, and record the recommendations that come out of them--ways to strengthen supply chains, better methods for coordinating across governments, agreements to improve the distribution of medicines and other supplies--and then try to keep the pressure on world leaders to translate these findings into action. We've already seen how little things changed after Dark Winter, Crimson Contagion, and the other outbreak simulations. Unfortunately, there's no innovation that can make sure that after-action reports don't simply get stored on some website and then forgotten. Political leaders and policymakers will need to change this. To get a sense of the different scales at which full-scale exercises can be run, let's look at two examples from disaster preparedness, starting with a relatively small one. In the summer of 2013, Orlando International Airport in Florida simulated a horrific aviation-related disaster, an exercise designed to meet the federal government's requirement that all U.S. airports run a full-scale exercise once every three years. 9 In the scenario, according to an article in Airport Improvement magazine, a hypothetical jetliner carrying ninety-eight