Monique K. Mansoura
Biodefense Expert Sees National Preparedness from All Angles
Monique K. Mansoura, Ph.D., MBA, leads MITRE’s work in global health security and biotechnology. An expert in biodefense and drug development and policy, Mansoura credits several man-made and natural disasters with sharpening her resolve to find ways to reimagine how the U.S. prepares for and navigates major events like the COVID-19 pandemic.
My parents came to the U.S. from Germany and Egypt with hope for a better life, and I was raised to understand that education was a path to meaningful options. I had an affinity for science and math and was on autopilot to become an engineer like my dad. I was also an athlete and musician—being versatile was important to me. It helped me pivot to new opportunities, and it’s a survival skill for a career focused on preparing for worst-case scenarios.
After college, I worked in the oil industry as a chemical engineer. But that wasn’t my life’s calling. I decided to study bioengineering at the University of Michigan as a bridge to medical school. As a research assistant in an orthopedic biomechanics lab, I found a passion for scientific discovery. I changed course to earn a Ph.D. in bioengineering.
When I heard Francis Collins speak about [what was then] a new scientific endeavor, the Human Genome Project, I was instantly drawn to the mission. The idea that we could engineer biology was transformational.
I went from wanting to make better knee replacement joints [following a softball injury] to wanting to translate sequencing the human genome to develop life-saving drugs. My dissertation research on cystic fibrosis gave me invaluable insight into translational science for drug development.
Francis Collins became my thesis adviser and mentor as a post-doc at the National Institutes of Health. He taught me that scientists have an obligation to leave the lab and talk to people about the research and its promise to transform medicine. It was essential to discuss the ethical, legal, and social implications of the Human Genome Project. We engaged Black churches, the Navajo Nation, and other key communities to hear what concerns people had.
That experience helped me understand that effective community engagement is critical to addressing COVID-19 vaccine hesitancy.
Securing Biopharmaceutical Supply Chains
(gentle music begins)
- [Narrator] The coronavirus pandemic,
the great power competition, wide area wildfires,
and other major events heighten the vulnerabilities
in our nation's bio-pharmaceutical supply chains.
Securing and diversifying these supply chains
is not just a matter of public health and well-being.
It's vital to our national security.
We need to strengthen the safety and security
of basic life-saving
and specialized medicines and equipment.
Weaknesses at any point in this critical infrastructure
threaten the whole system.
Shortages in any one area puts lives at risk.
- What we're finding is that we have a shortage triggered,
in large part exacerbated by the COVID-19 pandemic,
that 29 out of 40 critical drugs
that are required to preserve and protect and save lives
are now in critical shortage.
Unlike any other threat that we prepare for as a nation,
nuclear threat, cyber attack, others,
this is a near-simultaneous global event.
- [Narrator] Industrial-based policy
and innovative business models are needed
to realign incentives and enable requisite production
to strengthen the bioeconomy
and achieve national security objectives.
- There's a need right now
for the strengths and the capabilities that MITRE brings.
Again, our systems thinking,
our deep expertise in supply chain risk management,
our understanding and the trusted relationships
we've established with the bio-pharmaceutical industry,
to be a neutral, independent arbiter,
understanding that there are differences
between the public health and the industrial communities.
- [Narrator] Developing solutions
to secure bio-pharmaceutical supply chains
is part of MITRE's mission of solving problems
for a safer world.
(gentle music ends)
Preparedness as a National Security-Public Health Relationship
The anthrax attacks after 9/11 showed us that these threats are real, we were vulnerable, and the country and the scientific community were unprepared. I went to HHS [the Department of Health and Human Services] to help develop medical countermeasures. I met brilliant and dedicated public servants there. I joined for a 30-day detail and stayed nine years. It was a remarkable opportunity to build an organization [the Biomedical Advanced Research and Development Authority] that’s central to our nation’s pandemic response.
We’re having similar discussions about countermeasures and preparedness 20 years later. But now I more fully appreciate the complexities of this mission.
We saw shortages of saline and other critical drugs after Hurricane Maria devastated Puerto Rico in 2017. Now the pandemic, unlike any other recent event, has highlighted the vulnerabilities in our biopharmaceutical supply chains and bioindustrial policy.
We must do better to prepare for threats that could disrupt access to medicines and trigger surges in demand for medical countermeasures. Threats like cyber, severe weather, trade disputes, and naturally occurring, accidental, or intentional biological events.
MITRE’s response to this pandemic has been inspirational, and I’m honored to be a leader in the COVID-19 Healthcare Coalition. We’ve engaged over 1,000 partners to build the capabilities needed so that we’ll never again see what has played out this past year. We’ve already learned a great deal.
New Models to Grow the Bioeconomy
After many years leading strategy and policy in federal medical countermeasures, I realized that we didn’t have a science problem; we had a business problem.
Free markets are economically efficient to optimize financial success and require leaders in health and national security to be innovative in establishing the capabilities and capacities required. Driving resilience to drug shortages and enhancing biopreparedness from threats like SARS-CoV-2 will require novel business models and financing strategies—as we’ve seen with CivicaRx and proposed for global health security.
I left the government to earn an MBA [at MIT] to learn the business side of biopharmaceutical development. When I joined a major pharmaceutical company working on pandemic preparedness, I sat on the other side of the public-private partnership.
Changing our models is critical to the safety, security, and availability of basic and life-saving drugs and equipment. Applying sound industrial base policy and assessment for manufacturing of essential medicines, medical countermeasures, and medical supplies is key. Being over-reliant on foreign countries as sources of raw materials or active pharmaceutical ingredients and medical supplies makes us incredibly vulnerable to disruptions. These pipelines are core to our critical infrastructure and national defense.
The Power of Diversity
Studies show that women and people of color are underrepresented in science. That’s not good for science or society. We know from genomics that there’s strength in diversity. I’m happy MITRE fosters diversity and inclusion.
I came here three-and-a-half years ago after being invited to a MITRE-sponsored event about developing a national strategy for biomedical innovation. Light bulbs went off during our discussions. I love the systems approach we take to challenges and the access to talented scientists and technologists in the hard sciences and social sciences. I’m excited about the diverse team we’re building in global health security.
I’ve had many champions and mentors in my life. It’s why I’m committed to paying it forward to young professionals. I encourage different voices to be heard at every opportunity.
—as told to Karina Wright
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