As defined  in the NBIC Strategic Plan, biosurveillance integration is combining  biosurveillance information from different sources and domains (e.g.,  human, animal, and plant health; food and environmental safety and  security; and homeland security) to provide partners and stakeholders  with a synthesized view of the information, and what it could mean. Building  upon the National Strategy for Biosurveillance, the Roadmap identifies  biosurveillance capability needs and key research and development  priorities, including those related to integration. The NBIS community predated  the enactment of the 9/11 Commission Act. NBIC analysts may also  make requests for information to NBIS partners for additional information. Special Event Report: a report  requested by government partners, such  as state and local governments, to  provide a public health assessment for a  selected event. For  example, as shown in figure 5, 10 NBIS partners stated that NBIC’s  products and activities enhance their agencies’ ability to carry out their  biosurveillance roles and responsibilities to little or no extent, 4 responded  to a moderate extent, and 5 responded that they did not have a basis to  judge. Data that NBIC could use to identify and characterize a biological event of  national concern using statistical and analytical tools, as called for in the  9/11 Commission Act, are limited. NBIC and NBIS partners noted that there were several kinds of data that  could be useful for this kind of biosurveillance integration, but these data  may not exist or may not be in a usable form. NBIC Has Developed Procedures to Coordinate with Biosurveillance Partners, but Faces Limited Participation and Provision of Partner Personnel

To fulfill its Coordinator role, NBIC has established procedures that occur  daily, weekly, and as emerging or significant biological event occur, but  the center faces challenges related to participation of NBIS partners in the  center’s activities, the provision of partner personnel to NBIC, and  competing structures for convening NBIS partners. Jointly Developed Products: NBIC  brings together its multidisciplinary  partners to develop joint products that  enhance understanding of new or  potential biological events. NBIC Has Efforts Under Way to Develop New Biosurveillance Tools, but Faces Challenges Prioritizing Development Efforts in a Limited Resource Environment

To fulfill its Innovator role, NBIC has funded several pilot projects, sought  new data sources, and made efforts to enhance its IT system, but faces  challenges related to its limited resources and the varying needs of its  partners. The most  recent pilot, initiated in fiscal year 2012,  funds the Department of Defense’s  Naval Surface Warfare Center to  develop analytical techniques to improve  the use of social media data for  biosurveillance. Further, NBIC has also funded  three pilot projects examining the feasibility of using open-source data  from various social media applications in order to identify possible health  trends. From fiscal  year 2012 through 2015, NBIC’s budget ranged from $10 million to $13  million annually. Related to its limited resources, NBIC also faces challenges prioritizing its  innovation efforts because its partners have diverse, and sometimes  conflicting, needs. Officials from another agency  questioned the feasibility of NBIC’s mission because the data and  technology that are currently available do not provide for the accurate  projection of biological events or facilitate the provision of early warning. There Are a Range of Options for Addressing Biosurveillance Integration Challenges, and Each Has Associated Benefits and Limitations

The challenges previously described illustrate that NBIC faces significant  obstacles in implementing its roles as a biosurveillance integrator as  originally described in the 9/11 Commission Act. We identified these options and their  benefits and limitations, on the basis of the roles of a federal-level  biosurveillance integrator we identified in the 9/11 Commission Act,  NBIC’s strategic plan, and the perspectives of the NBIS partners obtained  during our structured interviews. These options are not exhaustive, and  some options could be implemented together or in part. In developing  these options, we did not evaluate the financial implications of  implementing each option, to the extent it is knowable, but we  acknowledge they are likely to result in an increase, decrease, or shifting  of funding based on the changes described. Option 1: Reinforce NBIC’s Analyzer Role

			Benefits

Developing meaningful information not otherwise available: This  option would address some of the challenges NBIC faces in  implementing its Analyzer role, such as access to data from the NBIS  partners, and would better position the center to develop meaningful  information that could not be gleaned in isolation, potentially leading  to earlier warning of emerging events and shared situational  awareness. Further, in recent years, NBIC has been able to  obtain or partially fund liaisons from other agencies. It is unclear whether  additional time or what additional actions will improve partners’  experience with NBIC’s overall value to the national biosurveillance  capability. Limitations

Officials report that a federal integrator is important: Although  federal partners generally thought that NBIC’s products and activities  did not provide meaningful new information, they largely thought that  the concept of having a federal entity to integrate biosurveillance  information across the federal government was important.
Why GAO Did This Study

A biological event, such as a naturally occurring pandemic or a terrorist attack with a weapon of mass destruction, could have catastrophic consequences for the nation. This potential threat underscores the importance of a national biosurveillance capability—that is, the ability to detect biological events of national significance to provide early warning and information to guide public health and emergency response. The 9/11 Commission Act of 2007 addresses this capability, in part, by creating NBIC within the Department of Homeland Security (DHS); it was tasked with integrating information from human health, animal, plant, food, and environmental monitoring systems across the federal government, to improve the likelihood of identifying a biological event at an earlier stage. In recent years, NBIC's budget has ranged from $10 million to $13 million annually.
GAO was asked to evaluate NBIC. This report discusses the (1) extent to which NBIC is implementing its roles as a biosurveillance integrator, and (2) options for improving such integration. To conduct this work, GAO reviewed NBIC products and activities; conducted interviews and surveyed 19 federal partners, 11 of which have key roles in biosurveillance; interviewed NBIC officials; and analyzed the 9/11 Commission Act, NBIC Strategic Plan , and National Strategy for Biosurveillance .

What GAO Found

The National Biosurveillance Integration Center (NBIC) has activities that support its integration mission, but faces challenges that limit its ability to enhance the national biosurveillance capability. In the Implementing Recommendations of the 9/11 Commission Act of 2007 (9/11 Commission Act) and NBIC Strategic Plan , GAO identified three roles that NBIC must fulfill to meet its biosurveillance integration mission. The following describes actions and challenges in each role:
Analyzer: NBIC is to use technology and subject matter expertise, including using analytical tools, to meaningfully connect disparate datasets and information for earlier warning and better situational awareness of biological events. GAO found that NBIC produces reports on biological events using open-source data, but faces challenges obtaining data and creating meaningful new information. For example, most of the federal partners with key roles in biosurveillance (8 of 11) stated that NBIC's products help their agencies identify biological events to little or no extent, generally because they already obtain such information directly from other federal partners more quickly. In addition, data that could help to identify and characterize a biological event may not exist or are not in a usable form. Further, few federal partners (5 of 19) reported that they share the data they do have with NBIC, citing legal and regulatory restrictions, among other reasons..
Coordinator: NBIC is to bring together partners across the federal biosurveillance community to enhance understanding of biological events. NBIC has developed procedures and activities to coordinate with partners, such as daily and biweekly calls, but faces challenges related to the limited partner participation in the center's activities, lack of partner personnel detailed to NBIC, and competing structures for convening federal partners. For example, although NBIC would like to obtain liaisons from each of its federal partners, only 3 of 19 partners provided NBIC with dedicated liaisons.
Innovator: NBIC is to facilitate the development of new tools to address gaps in biosurveillance integration. GAO found that NBIC has efforts underway to develop some tools, such as pilot projects examining the use of social media data to identify health trends, but faces challenges prioritizing developmental efforts. For example, partners noted limitations in NBIC's ability to address gaps, like limited resources and the difficulty in prioritizing the center's innovation efforts because its partners have diverse needs.
GAO identified various options that could address these challenges, ranging from strengthening the center's ability to implement its current roles to repealing NBIC's statute. GAO also identified potential benefits and limitations with each option. For example, one option would be to provide NBIC with additional authorities to obtain data to better develop meaningful information; however this may also require additional investments. Another option is to not pursue national biosurveillance integration through NBIC and to consider designating one of the other federal partners with key roles in biosurveillance as the federal integrator. The options identified are not exhaustive, and some could be implemented together or in part. GAO did not evaluate the financial implications of each option, but acknowledges some options may require additional investment or shifting of resources or priorities to result in significant long lasting change.

What GAO Recommends

GAO is not making recommendations. GAO provided this draft to DHS and its federal partners who provided technical comments which were incorporated, as applicable.