Research ReportC O R P O R AT I O N

LUKE J. MATTHEWS, MARY LEE, BRANDON DE BRUHL, DANIEL ELINOFF,CHRISTOPHER A. EUSEBI

Plagues, Cyborgs,
and Supersoldiers
The Human Domain of War

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About This Report
Advances in biotechnology within the past half decade have renewed questions about the use of
biotechnologies in a warfighting context. Prior to advances of the past few years and with respect tonation-states, biological weapons were usually deemed too liable to inflict harm on one’s own forces tobe of much strategic value; past military applications of genomics are viewed largely as misguided
eugenicist pseudoscience; and, until recently, such technologies as brain-computer interfaces (BCI)
were too unwieldy for the battlefield. As of this writing in 2023, technological improvements—
including messenger ribonucleic acid (mRNA) vaccines, the use of CRISPR (clustered regularlyinterspaced short palindromic repeats) gene sequences as genetic engineering tools, and advances in
BCI—and their accessibility to both friendly forces and adversaries—could shift these strategic
calculations. This report explores how recently achieved or likely future technologies change strategic
choices for the human body as a warfighting domain.
The analyses and recommendations in this report should be of interest to policymakers in thebiotechnology, defense, and intelligence communities, as well as to a general audience.

RAND National Security Research DivisionThis research was sponsored by the Office of the Secretary of Defense and conducted within the
Acquisition and Technology Policy Program of the RAND National Security Research Division(NSRD), which operates the National Defense Research Institute (NDRI), a federally funded
research and development center sponsored by the Office of the Secretary of Defense, the Joint Staff,
the Unified Combatant Commands, the Navy, the Marine Corps, the defense agencies, and thedefense intelligence enterprise.
For more information on the RAND Acquisition and Technology Policy Program, seewww.rand.org/nsrd/atp or contact the director (contact information is provided on the webpage).

Acknowledgments
We thank Barry Pavel for his guidance and for supporting this work, as well as our RAND
colleagues, Chris Mouton, Yun Kang, Caitlin Lee, Michael Spirtas, and Zachary Pandl of NSRD. We
also thank Edward You of the Office of the Director of National Intelligence for sharing his insights.
We are grateful to our RAND colleague Richard Silberglitt for his help with our Internet of Bodies
patent analysis. We also thank RAND colleagues Tim Bonds, Marjory Blumenthal, Christy Foran,
Alison Hottes, Don Prosnitz, Todd Richmond, Jon Schmid, and Tricia Stapleton, as well as the
RAND Pardee Graduate School Technology and Narrative Laboratory Conclave for fruitful
discussions.

iii

Many thanks to Sydne Newberry for helping to edit and improve the clarity of this report and to
Rachel Widom for formatting it. We are grateful to Marjory Blumenthal and Christy Foran for theirthoughtful reviews of an earlier draft of this report.

iv

Contents
About This Report ........................................................................................................................................................... iii
Figures and Tables ............................................................................................................................................................ vi
CHAPTER 1........................................................................................................................................................................................ 1

Introduction ....................................................................................................................................................................... 1
Motivation for This Research ..................................................................................................................................... 1
Defining the Human Body as a Warfighting Domain............................................................................................. 3
CHAPTER 2........................................................................................................................................................................................ 6

Trends in Human Domain Biotech Development........................................................................................................ 6
Methods and Limitations ............................................................................................................................................ 6
Engineered Pathogens .................................................................................................................................................. 7
Internet of Bodies ....................................................................................................................................................... 12
Genomics ..................................................................................................................................................................... 18
CHAPTER 3...................................................................................................................................................................................... 25

Risks and Opportunities of Human Domain Biotech ................................................................................................ 25
Recommendations ...................................................................................................................................................... 26
Conclusions ................................................................................................................................................................. 29
Abbreviations ................................................................................................................................................................... 30
References ......................................................................................................................................................................... 31v

Figures and Tables
FiguresFigure 2.1. Long-Standing Differences in Cultural Values Affected COVID-19 Mortality ................................ 10
Figure 2.2. Country-Level Cultural Resistance to BSL-3 Pathogens Versus Capabilities for Production .......... 12
Figure 2.3. Trends in Patent Applications of Internet of Bodies Technologies ...................................................... 17
Figure 2.4. Genomic Citation Counts Across Country and Technology Category ................................................ 23

TablesTable 1.1. Features of Putative Warfighting Domains................................................................................................. 4
Table 3.1. National Security Risks and Opportunities of Human Domain Biotechnology .................................. 25

vi

Chapter 1

Introduction
Recent advances in biotechnology have renewed questions about the use of biotechnologies in a
warfighting context. In the past, biological weapons were thought to present too great a risk ofinflicting harm on friendly forces to be of much strategic value (Department of Homeland Security,2023; Mauroni, 2022); past military applications of genomics are viewed largely as misguided
eugenicist pseudoscience (Roll-Hansen, 2010); and, until recently, such technologies as braincomputer interfaces (BCIs) were too unwieldy for the battlefield (Binnendijk, Marler, and Bartels,
2020; Tucker, 2023). Today, technological improvements, including messenger ribonucleic acid(mRNA) vaccines, the use of CRISPR (clustered regularly interspaced short palindromic repeats)
gene sequences as a genetic engineering tool, and advances in BCI, may shift these strategic
calculations. The emergence of ever more countries with advanced biotechnology capabilities raises a
new, more dynamic future for biotechnology at war. While these visions of the future might seemfantastical, we need only consider the great conflicts of the 20th century to see how biotechnology
played pivotal roles as both weapons and cures. Given the rapid advancements brought about by the
21st-century biotechnology revolution, the application of artificial intelligence (AI) algorithms, andadvanced human-machine systems, we see a complex, high-threat landscape emerging where futurewars are fought with humans controlling hyper-sophisticated machines with their thoughts; themilitary-industrial base is disturbed by synthetically generated, genomically targeted plagues; and thefuture warfighter goes beyond the baseline genome to become an enhanced warfighter who is capableof survival in the harshest of combat environments. In this report, we explore how recently achieved or
likely future technologies change strategic choices for the human body as a warfighting domain.

Motivation for This ResearchConsider the scenario described in Vignette 1.

1

Vignette 1: Pandemic Land Grab
In September 2028, a previously unknown coronavirus begins to spread across countries in the South
China Sea. Public health officials find that the virus is different enough from severe acute respiratory
syndrome coronavirus 2 (SARS-CoV-2)—which caused the coronavirus disease 2019 (COVID-19)
pandemic—that the new virus is granted its own designation as SARS-CoV-3. It easily evades immunityfrom prior COVID-19 infections and vaccinations and is exacerbated in spread by the ongoing monsoon
season that keeps people indoors. It then appears, near-simultaneously, on multiple U.S. Navy vessels,
forcing most of the Nimitz carrier strike group to cease operations. Officials at the Centers for Disease
Control and Prevention (CDC), the Department of Defense (DoD), and the Central Intelligence Agency
begin a bureaucratic turf battle over which agency is best suited to investigate whether or not the
shutdown of naval forces is due to an infectious agent of wholly natural origins. Regardless, with the
U.S. naval response compromised and Taiwan having enforced stringent SARS-CoV-3 control
measures, the Chinese military mounts an assault on Taiwan in the first week of October as the rains
clear, and its military captures the island in 46 hours. The new virus is spreading slowly among the
Chinese population and is curiously absent among the Chinese military and military supply-chain
workers. The World Health Organization (WHO) highlights this as evidence for the success of Chinesesocial distancing procedures. What the WHO does not know is that since late 2027, nearly all membersof the Chinese military—and roughly half the Chinese population—has been unwittingly vaccinated for
SARS-CoV-3 under the pretense of a standard COVID-19 booster campaign.

Vignette 1 is science fiction, but it is not far-fetched. Although it remains unresolved whether
genetic manipulations, such as gain-of-function research or an unintentional lab leak,1 played a role in
the origins of SARS-CoV-2, advances in biotechnology make it straightforward for any suitablytrained and equipped laboratory to produce coronaviruses—or other pathogens—that will escapeimmunity from prior infections or vaccines.
The COVID-19 pandemic enabled the first test of mRNA vaccine technology, which facilitatesmuch faster vaccine design and production than afforded by prior techniques. The mRNA technology
allowed the vaccine for COVID-19 to be developed within a single year, whereas the previous record
was four years for the development of the mumps vaccine (Ball, 2020). The facts that (1) pathogens
can be engineered to escape immunity and (2) mRNA vaccines can be rapidly developed introduce thepotential for strategic use of bioweapons that previously would have been much less tractable. From apurely technical standpoint, at this time, many countries could engineer pathogens to infect others
while rendering their own populations immune through mRNA vaccines. The use of a coronavirus
bioweapon in the scenario described in Vignette 1 could make rational strategic sense for such U.S.
adversaries as the Chinese government because such a weapon might be able to paralyze U.S. naval
responses without incurring the military cost from a U.S. response to an opening salvo of kinetic
strikes against the U.S. military. This is possible because the origins of an engineered pathogen would
be highly uncertain, scientists would likely presume natural zoonosis (crossing from animals tohumans) as the simplest explanation, and it would take years of research to ascertain the origin
empirically. This ambiguity could serve a nation-state well in a scenario like Vignette 1, especiallyconsidered in contrast to the lack of ambiguity once a country begins kinetic strikes against the U.S.

1

Gain-of-function research refers to intentional laboratory-induced genomic mutations aimed at increasing the infectivity or
lethality of microorganisms, such as viruses or bacteria, to their hosts.

2

Navy. A bioweapon of ambiguous origin could be a strategically valuable way to degrade an adversary’s
capabilities in advance of the onset of kinetic actions. This strategy is similar to the coupling ofcyberattacks with subsequent kinetic attacks. Because the attribution of cyberattacks is difficult,adversaries can take advantage of the confusion by following with a kinetic attack (Libicki, 2020). Thisoccurred in the Russia-Georgia war in 2008, when a kinetic attack was preceded by a distributed
denial-of-service attack against Georgian military communications (Libicki, 2020).
In what follows, we outline additional scenarios—some that are near term and high-probability
and some longer term and more speculative—for advances in engineered bioweapons, the Internet ofBodies (IoB),2 and genomics. But first, we consider the definitional question of the extent to which thehuman body is a distinct domain of warfighting.

Defining the Human Body as a Warfighting Domain
The China-Taiwan scenario described in Vignette 1 postulates that an engineered bioweapon
could be used in close coordination with actions in other domains (e.g., sea and air) to achieve astrategic goal (e.g., conquest of Taiwan). Warfighting domains are conceived as spatial or virtual placesin which conflict can take place. Land, sea, and air are the traditionally recognized warfighting
domains (space having been added in the past decade). Whether other zones of warfare, such as cyber,constitute domains is contested by researchers and strategists (Doherty, 2015; Egloff, 2022; McGuffinand Mitchell, 2014).
But can the human body itself be a warfighting domain? Can the body be an offensive or defensive
weapon or a very specialized kind of target? As one approach to understanding the ways in which thehuman body might or might not be a distinct domain of warfighting, our team identified domainfeatures mentioned in the research literature on warfighting domains and then assigned proposed
domains for each of the features (Table 1.1).

2

The Internet of Bodies (IoB) is the ecosystem of internet-connected devices collecting biometric or person-generated health data
about an individual, together with the data it collects (Lee et al., 2020; see also Matwyshyn, 2019). The IoB includes but is not
limited to technologies that connect the human body to an online network via devices that are connected to the body in someway, either by virtue of having been swallowed, implanted, or worn, so that the body can be monitored or controlled remotely.
The IoB is part of the Internet of Things, and individuals whose capabilities are enhanced through IoB are cyborgs under most
dictionary definitions for this term.

3

Table 1.1. Features of Putative Warfighting Domains

Putative
Domain

Domain-Specific
Human Movement
and Survival
Constraints

Domain Features
Observed IntraDomain
DomainEscalation
Specific
Without CrossAttack
DomainModes
Escalation

Observed
Warfarea
Within
Domain

DomainSpecific
Personnel
and Skills

Land

Yes

Yes

Yes

Yes

Yes

Sea

Yes

Yes

Yes

Yes

Yes

Air

Yes

Yes

Yes

Yes

Yes

Space

Yes

Yes

?

No

Yes

Cyber

N/A

Yes

Yes

No

Yes

Intelligence

N/A

Yes

Yes

No

Yes

Yes

b

Yes

?c

Human body

N/A

No

a

By warfare, we mean the generally accepted understanding of it as “a conflict between political groups involving
hostilities of considerable duration and magnitude” (“War: The Causes of War,” undated). Such a definition does not
require that those hostilities always be lethal, but it does require that they have a duration (i.e., a beginning and an end
that are notably distinct from normal relations between the relevant political groups). In other words, uses of evenlethal violence between political groups might not be warfare if they do not constitute a notably increased level ofhostilities for a definable duration.
b
We are unaware of any clear cases of domain-specific escalation, such as exchanges of attacks via engineered
pathogens between nation-states, in the published literature. Such escalation, however, is conceivable.
cMedical professionals might be considered as human-body-domain–specific personnel, but they also might beregarded as personnel components of the traditional domains.
NOTE: N/A = not applicable.

Table 1.1 highlights one feature of traditional warfighting domains (land, sea, and air) that is
inapplicable to such domains as cyber or the human body; that is, requiring particular modalities forhuman movement and survival. In other words, humans must be able to move, operate, and survive inthese traditional domains, and the methods to do so must be compatible within that domain. If thisfeature is taken as necessary for something to constitute a domain, then by definition of the more
newly proposed domains (space, cyber, intelligence, and the human body), only space can beconsidered a domain. Analysis arguing for space as a warfighting domain generalizes from thetraditional land, sea, and air domains by noting that, although few humans may move through, fightin, or die in space, space still involves movement through a distinct spatial medium (vacuum) just as
traditional domains have their own mediums (solid, liquid, gas) (Dolman, 2022).
Table 1.1 therefore helps qualify aspects of disagreement about whether the human body can be a
warfighting domain. If the domain concept does not require domain-specific movement, then thehuman body can be a warfighting domain in that it exhibits at least half of the remaining domaincharacteristics. The domain characteristics exhibited by the human body include specific modes ofattack (e.g., pathogens, hacking IoB devices) that do not apply to other domains specifically.
Furthermore, there are historical examples of weaponizing the human body in warfighting, such as
medieval tactics that used infected persons to spread disease among besieged castles and cities(Wheelis, 2002).

4

This contrast with space, as a domain dominated by satellites and other unmanned craft, highlights
another intersection of traditional domains with the human body as a domain; specifically, thattraditional warfare on land, at sea, or in the air is focused on the destruction of human bodies. Thisbegs the question of whether the human body is a domain of war distinct from the taking of humanlife during land, sea, or air domain operations. Medieval use of infections during sieges may beconsidered rightly as simply a form of bioweapon deployed strategically within the land domain. Thus,
it is perhaps contingent on the ongoing development of biotechnology and the greater ability toleverage biocapabilities independent of conflict in traditional domains that will cause the human bodyto emerge increasingly as a distinct domain of warfighting.
China has made exploiting advancements in biotechnology and genetic engineering a highpriority—especially for enhancing warfare and national defense—because its military leaders consider
biotechnology the next revolution in military affairs. A significant amount of this research is
conducted in military hospitals, especially the People’s Liberation Army General Hospital. China’s
Academy of Military Medical Sciences, the National University for Defense Technology, and theCentral Military Committee’s Science and Technology Commission have made significant
investments in “biology-enabled warfare” (Kania, 2019), which includes BCIs, brain networking,advanced biometric systems, human performance enhancements, and genetic engineering.
Chinese military leaders have also indicated that they consider biotechnology as among the new“strategic commanding heights” and are considering it a new military domain (Kania, 2019). Chinese
military texts discuss offensive and defensive approaches to the biological domain, including
dominance and deterrence through “ethnic-specific genetic weapons” (Kania and Vorndick, 2019).
Regardless of what U.S. academics and strategists conclude on this definitional matter, that Chinese
military leaders consider the human body to be a warfighting domain underscores the importance ofour research.
Given this analysis, throughout the rest of this report, we adopt a halfway stance as to the degree
to which the human body is a warfighting domain and will refer to our object of inquiry collectively as
human domain biotech.

5Chapter 2

Trends in Human Domain Biotech
Development
Our team set out to explore the kinds of biotechnology applications that are in practice and thatcan plausibly be considered for the near future in a warfighting context. We then considered the risks
and benefits of such technologies should they be integrated into defense strategies by the UnitedStates, its allies, and its adversaries.

Methods and Limitations
We identified three aspects of biotechnology—engineered pathogens, IoB technologies, andgenomics—that collectively comprise what we refer to as human domain biotech and whose further
development could substantially influence warfighting. These areas overlap significantly with the fieldof synthetic biology (Zegart, 2022). Given the broad scope of synthetic biology, we limited ourinsights to the three aspects of biotechnology discussed here.
Our research team met with other RAND Corporation subject-matter experts about each of thethree aspects of human domain biotech. These discussions provided qualitative input that guided theteam to available quantitative databases that were pertinent to each aspect, described in subsequent
sections.
A necessary limitation of our research approach is that the results are exploratory in nature. They
are not conclusive, and given the goal of quantifying innovation, they should be regarded as informed
projections. In particular, an assumption of our research is that the pace of progress in thesetechnologies will continue at a similar rate as it has in the past two decades. Another limitation is that
this work does not consider other biotechnologies that might affect warfighters indirectly. For
example, the potential consequences of adversary progress in the bioeconomy holistically—including(1) synthetic biology technologies related to agriculture and alternative energy sources and (2)genome-adjacent technologies, such as the microbiome or RNA modification—may affect national
security and grand strategy considerations but are out of the scope of analysis for this report.
Moreover, we limited our research to open-source information. We hope the results motivate further
research and analysis of human domain biotech so that free states can work together to ensure a safeand prosperous world, even as humanity’s technological powers over human bodies increase.

6

Engineered Pathogens
We compiled data from published sources on country-level cultural values known to enable strong
societal resistance to pandemics and compared these data with records of the numbers of biosafetylevel 3 (BSL-3)3 laboratories in these countries. Traditional analysis has long been concerned with thepossibility of a state or nonstate actor using an engineered bioweapon (Department of Homeland
Security, 2023; Mauroni, 2022). Bioweapons can be classified as either person-to-person transmissible
or not transmissible (Department of Homeland Security, 2023; Global Biolabs, undated; Goad, 2021;
Koblentz et al., 2023; Mauroni, 2022; Peters, 2018). In this report, we focus on the potential fortransmissible bioweapon use because this use is most relevant for strategic actors, such as nationstates. This is because, in comparison with nontransmissible pathogens, transmissible ones (1) are
inherently difficult to attribute to an actor or even to natural versus human causes (as we have seen
with COVID-19), (2) have much greater potential for mass casualties and societal disruption, and (3)avoid the need for a mechanism to broadly disperse the pathogen, which is an inherent technicalproblem for nontransmissible bioweapons.
Nontransmissible bioweapons, such as aerosolized anthrax, might be strategically rational for anonstate terrorist actor because they are much more attributable—aerosolized anthrax cannot infest
the New York City subway system as an accident of nature. Terrorists usually want to take credit for
their atrocities because this is how they seek to coerce political or other concessions. In contrast, it
would be difficult for a terrorist group to prove that it, in fact, was responsible for a noveltransmissible bioweapon, even if the group tried to prove it, because transmission via natural origins(such as zoonosis) is commonplace among transmissible pathogens. In fact, the only documented useof a bioweapon by a nonstate actor on U.S. soil was the salmonella poisoning by members of the
Rajneeshee cult in 1984 in Oregon. Their goal was not biological terrorism (i.e., seeking to gain
notoriety through horrific acts) but instead to sicken voters in particular precincts during a local
election so that their own candidate would succeed. Although their electoral ambitions failed, the casehighlights how bioweapons could be used strategically by a nation-state because the Rajneeshees’
salmonella outbreak was mistaken as a natural occurrence, and only after more than a year ofinvestigation was the plot ascertained (Parachini and Gunaratna, 2022). These same authors note thatboth al-Qaeda and the Islamic State examined bioweapons for the purpose of biological terrorism, butthey did not pursue bioweapons because other means of terrorism (bombs, guns, planes) were so much
more available, attributable, and easier to deploy.
Past natural zoonotic diseases have taken decades of research to fully establish their origins
through epidemiology and evolutionary genetic investigations. This is the case with the most deadly
zoonosis of the 20th century, HIV, whose exact origin still is debated; some contend that needle reuse
during mid–20th century vaccination campaigns against African sleeping sickness might have
3

A BSL-3 or a Pathogen (P)3 lab is a research laboratory with biocontainment facilities that conform to worldwide requirements
for handling pathogenic microorganisms that are airborne or whose toxic properties are transmitted by air. Laboratories areclassified into four BSLs based on the pathogenicity of the agents handled in them. For example, BSL-1 laboratories handle lowrisk microbes, such as nonpathogenic strains of E. coli, and BSL-2 laboratories handle such agents as human immunodeficiency
virus (HIV) that are not transmissible through casual contact. In contrast, SARS-CoV-1 and -2 and influenza can be handled
only in BSL-3 or BSL-4 laboratories because they both cause illness and are highly transmissible through the air, while the Ebola
virus is a BSL-4 agent because of its high lethality.

7

exacerbated HIV’s spread through Africa after an initial zoonotic transfer via bushmeat butchering(Carlsen, 2001; Gürtler and Eberle, 2017). The intrinsic ambiguity of disease transmission is a
strategic asset for actors who wish to achieve concrete goals (e.g., rigging an election, depleting force
effectiveness in advance of kinetic strikes) in a clandestine manner. Conceivably, disease transmission
mechanisms could be tailored to target populations or groups that engage in particular behaviors thatfacilitate a particular transmission mode. For example, eating uncooked vegetables or meat makes aperson vulnerable to particular foodborne illnesses that are much less likely without these behaviors,and patterns of sexual partner-switching are intrinsically related to the epidemiology of sexuallytransmitted infections.
That said, we cannot rule out the possibility of a strategic or irrational nonstate actor who simply
wants to spread mayhem and death regardless of whether they can take credit for their actions. But
this would seem a low-probability concern because empirical research and conventional logic establishthat terrorists want to take credit for their actions (Matthews, 2020).
These features of transmissible bioweapons make such weapons strategically rational for certain
nation-state armed conflict scenarios. Nation-states would seek to use bioweapons in coordination
with other modes of warfare—e.g., warfare in the land, sea, or air domains—to accomplish operational
objectives. Lack of attribution is a desirable property in this context because nation-states most likely
will not use these weapons to coerce concessions; they will use them to degrade military and supplychain capabilities to accomplish traditional nation-state objectives, such as seizing territory andcontrolling populations.
The easiest technical means for realizing a transmissible bioweapon would be for a malicious actor
to gain access to a laboratory already equipped to manipulate high-risk pathogens. While a malicious
actor could develop a bioweapon by independently acquiring all the needed materials, potentially via a
do-it-yourself (DIY) biology model (Kolodziejczyk, 2017), a likely easier path to achieving this aim
would be to access an existing BSL-3 laboratory.
Monitoring and policing every individual’s intentions is an impossible task, so a key defense
against the use of a bioweapon by a nonstate actor is to reduce the overall access to BSL-3 or -4
facilities. This can be accomplished through vetting of personnel, but inevitably such vetting must havea nonzero failure rate. Thus, another important proposed safety measure is simply to reduce theongoing proliferation of BSL-3 and -4 facilities. This can be a defense against nonstate malicious
actors and against wholly unintentional accidents in which pathogens “leak” out of a lab by infecting
lab workers who then pass the infection onto others. China experienced two documented leaks of
SARS-CoV-1 from its labs prior to the COVID-19 pandemic (Enserink and Du, 2004; Walgate,2004), and these SARS-CoV-1 leaks were part of the impetus for some academic researchers to callfor regulations that would restrain the still ongoing proliferation of labs that handle dangerous
pathogens capable of pandemic spread (Klotz and Sylvester, 2014; Merler et al., 2013). Assuming
only accidental risk, Klotz and Sylvester (2014) stated, “there is a substantial probability that apandemic with over 100-million fatalities could be seeded from an undetected lab-acquired infection,”and this probability can only increase if we add the potential for malicious actors to access labs to thelist of risks.
The main international regulation for dangerous pathogens is the Bioweapons Convention(BWC). Although 185 countries are signatories to the BWC and thereby have pledged not to develop

8biological agents for warfare, the BWC makes no restrictions on the number of BSL-3 and -4
laboratories that a country may have, nor does it facilitate or require any formal registry or otherrecord-keeping for these facilities (Biological Weapons Convention, 1976).
We consulted several existing databases compiled by academics, including one that was the mostcomprehensive (Peters, 2018), to assess the number of BSL-3 laboratories. We focused on BSL-3
because most BSL-4 pathogens, such as the Ebola and Marburg viruses, are so lethal that they are
unlikely to cause major disruption to the U.S. military or U.S. society more generally. This assessment
is based on experience, which has shown that the U.S. public health system’s epidemiologicalprotocols—which focus primarily on diagnosis, isolation, treatment, and contact tracing—have beenhighly effective in preventing community spread of Ebola (van Beneden et al., 2016).
This medicalized approach to pandemic control proved less effective to control the spread of
COVID-19. The spread of COVID-19 was a result of its much lower mortality rate post-infection(referred to as case fatality rate [CFR]) and substantial level of asymptomatic spread compared with
Ebola, which enabled infected people to move about and spread the pathogen, all largely unwittingly.
These factors also rendered contact tracing ineffective and inefficient as a countermeasure. Societiesthat did best against COVID-19 were those that were able to spur nearly their entire population to
adopt simple behavioral rules (such as masking or avoiding large groups) that reduced the spread of
the pathogen in aggregate. This aggregate reduction prevented cases and thereby prevented overallmortality, even if it did not reduce CFR (Figure 2.1). Certain cultural values that show long-standing
differences among countries were the most important predictors of a country’s ability to mobilize thepopulation en masse to adopt behavioral COVID-19 mitigation measures: These are cultural tightness
and cosmopolitanism (Gelfand et al., 2021; Ruck, Borycz, and Bentley, 2021; Ruck et al., 2020).
Ultimately, the COVID-19 pandemic ended in a state of global SARS-CoV-2 endemicity: Infectionlevels were brought into a steady state by population immunity, and that was achieved either throughnatural infection or vaccination. As with nonpharmaceutical infection control measures, compliancewith vaccination fundamentally is a choice heavily influenced by cultural factors (Matthews et al.,2022).

9

Figure 2.1. Long-Standing Differences
in Cultural
COVID-19
vs... Values Affected COVID-19 Mortality
Cultural Tightness

Cosmopolitanism

COVID19 Deaths (per Million)

3000

United Kingdom

2000

MexicoMexicoUnited States

BrazilChile

1000

RussiaIsrael0
0.0

Germany

IranJapan
Saudi Arabia
Australia ROK
India
China
0.5

1.0

1.5

Iran
IsraelSaudi Arabia Russia
Egypt
ROK
India
ChinaPakistan Japan
2.0

0

1

Cultural Tightness

Chile

2

United States
FranceBrazilGermany
Australia
34

Cosmopolitanism

AfricaEuropeNo rthern America

Asia

Latin America and the Caribbean

Oceania

SOURCES: Features information on cultural tightness from Gelfand et al., 2021; cosmopolitanism from Ruck et al., 2021;
and COVID-19 deaths from Mathieu et al., 2020.

Cultural tightness is a measure of a society’s emphasis on following rules simply because they arerules, while cosmopolitanism is a measure of a society’s willingness to tolerate those who violate social
norms and expectations. While these measures are correlated, they are distinct conceptually andempirically, and the studies whose findings are shown in the left-hand and right-hand panels of Figure
2.1 were conducted independently and used different survey data sources. All this points to thesepatterns being scientifically robust and likely to repeat in the next pandemic. We note that some ofthese values are things that, for other reasons, Americans do not and should not want to change. In
other research, we have shown that, in particular, cosmopolitanism is among the best predictors ofwhether or not a society is a democracy or autocracy; it even predicts democratization 20 to 30 years
in advance of governmental institutions forming (Ruck et al., 2020). This is because a willingness totolerate immigrants; people of other races; or those with different languages, religions, or lifestyles iswhat is required to be a liberal democracy: A truly open society fosters that type of diversity. If the
majority of participants in a society are not willing to tolerate such diversity, then they do not want to
do what being a democracy requires, and democracy predictably fails under these cultural conditions.
Because the United States cannot change its relatively cosmopolitan culture, it can expect to berelatively disadvantaged in a global release of a BSL-3 bioweapon. While our opening scenario(Vignette 1) focused on the potential for China to use a bioweapon to achieve a near-term andspatially discrete objective, China would also be on the advantaged side of a more global release.
More-speculative scenarios could be imagined for a state actor seeking to create a disruption
similar to what we witnessed during COVID-19, particularly in the democratic West, which tends tohave cultural values that preclude robust BSL-3 disease mitigation by their populations (for an

10example of such a scenario, see Vignette 2). This scenario could be coordinated as part of a
propaganda, military, and economic campaign to produce a tipping point away from the existing worldorder to reshape it into a set of economic and alliance connections that center on a cadre of autocratic
states. Countries that exhibit cultural advantages in this type of scenario, and the capability to engineer
pathogens in BSL-3 facilities, are shown in Figure 2.2.

Vignette 2. Pandemic Geopolitics
It is a seasonably hot and sticky summer in Washington, D.C., in August 2033 when a novel airborne
pathogen begins spreading. Public health officials scramble to improve ventilation and filter compliance for
air-conditioned spaces—features that had long since lapsed into deregulation and disregard since the
COVID-19 pandemic. The new infection exhibits an astonishingly long asymptomatic contagious period of
three weeks, followed by a 2.5-percent mortality rate. Contact tracing fails as an intervention because of theamount of asymptomatic spread, and by four months after the infection was first detected, nearly 1 million
Americans are dead. With a projected 6.5 million still to die, essential workers reasonably insist on reduced
person-to-person contact until a vaccine is produced. U.S. and Western European supply chains reduce to
one-third of their original throughput.
China and Russia, meanwhile, are relatively unaffected by the virus because they had advance access to aneffective vaccine. China readily deployed the vaccine to its now even more ethnically homogenous andcompliant population, while Russia used brutal crackdowns against anti-vaccine populists. As Russia andChina launch simultaneous aggressive moves on their borders, the United States and its European allies areunable to muster public will to mount a unified resistance. Regardless, their military supply chains areinterlinked with civilian ones, severely compromising any military response had they raised one. Several
former Soviet countries are annexed wholesale into Russia. Other nearby countries, e.g., India, sign stringent
treaties with the aggressors to retain sovereignty. The Pax Americana, fraying since the invasion of Ukraine in
2022 and annexation of Taiwan by China in 2028, is officially ended.

11

Figure 2.2. Country-Level Cultural Resistance to BSL-3 Pathogens Versus Capabilities for
Production

SOURCES: Y-axis from study team calculations. Cultural resistance to BSL-3 pathogen calculated as the product oftightness and cosmopolitanism after each standardized to a 0–5 Likert-type scale. BSL-3 counts are derived fromPeters, 2018.

While China and Russia feature in the scenario of Vignette 2, undeniably, global geopoliticaltensions could be very different ten years from this writing. However, such researchers as Gelfand etal. (2021) and Ruck, Borycz, and Bentley (2021) have shown that the cultural values that are among
the most predictive for pathogen mitigation are multigenerational patterns that are highly resistant tochange. Figure 2.2 identifies the countries that we can predictably anticipate will be on the relatively
advantaged side of an airborne pathogen pandemic, and these patterns will persist ten and even 20
years from this writing.

Internet of Bodies
The IoB includes such devices as fitness trackers, wearables, and other smart consumer devices, aswell as such internet-connected medical devices as pacemakers, exoskeletons, and prosthetic limbs.
Advanced IoB devices, such as smart contact lenses, are also under development (Jin et al., 2023).
Matwyshyn (2019) characterizes the IoB as a progression of the Internet of Things and defines the
IoB in three generations: body external, body internal, and body melded. Such technologies have thepotential to transform warfighting.
IoB and related technologies present a variety of potential opportunities to warfighters. For
example, the U.S. Army is running studies to determine whether wearables can help with soldier well-

12being and fitness (Fish, 2023). Australian researchers have shown that military robot quadrupeds canbe steered by brain signals collected and translated by a graphene sensor worn behind the ear of anearby soldier (Tucker, 2023). In May 2023, the U.S. Space Force (USSF) announced plans for alarge study in which guardians can choose between using wearable devices and participation in the
traditional annual physical fitness tests to assess physical fitness (Hadley, 2023).4 This plan can help
USSF track fitness continuously and focus on year-round health rather than driving its personnel toengage in dangerous habits, such as eating disorders, in the months leading up to annual body weightchecks and fitness tests (Schmid, 2022).
Combining IoB data with advanced machine learning (ML) and AI algorithms can potentiallyenable tremendous advancements in health care, particularly precision medicine. AI has opened thedoor for more-efficient and automated analysis of complex data from across diverse sources. Thesealgorithms speed up the data pipelines that are often necessary to support the complex interaction ofhuman-machine interface. The collection and analysis of data collected on human physiology, activity,and genetics require efficient algorithms to manifest practical results (Hinkel, 2022). AI/ML
algorithms can be trained on the vast amount of data collected by the network of IoB devices andpredict acute or chronic changes in health status. For example, DoD is investing in wearable
technologies using AI algorithms that could predict infection up to 48 hours before symptoms appear(Vergun, 2023).
Although IoB technologies offer significant potential and have already realized benefits, some havealso been shown to incur risks to the warfighter and to national security. One type of IoB risk derives
from information security issues with IoB-collected data. In early 2018, it was discovered that the
publication of a heatmap of users’ running routes by the fitness app Strava revealed sensitive locationand layout information of U.S. military bases around the world (Hsu, 2018). A security vulnerability
in the Strava app reportedly allowed unknown users to identify and track the movements of Israeli
service members inside military bases, even if users limited who could view their Strava profiles(Brown, 2022; Hern, 2022). In 2023, it was reported that the Strava app might have been used to
track a Russian submarine commander who was killed while jogging (Knight et al., 2023). In responseto the first Strava incident, in August 2018, DoD banned personnel from using apps with geolocators
while in overseas operational areas (Browne, 2018). However, these devices are in wide use outside
military operational contexts. We present a scenario in Vignette 3 in which an insider threat uses an
IoB device to capture sensitive government data.

4

Guardian is the term used to signify a space professional working in the USSF (Secretary of Air Force Public Affairs, 2020),
analogous to an Army soldier or Navy sailor.

13

Vignette 3. An Insider Threat Uses the Internet of Bodies to Steal Sensitive Government
Information
In 2027, a mid-level U.S. government employee undergoes cataract surgery in one eye, during which thenatural lens inside the eye is replaced with an artificial lens to restore vision. The surgery, which takes about
15 minutes, is extremely safe and is performed on millions of people a year.
One big difference, though, is that this new lens contains a tiny camera, which is connected to a micro
storage device placed subcutaneously at the man’s temple and hidden under the hairline. This allows him tocapture and store images of everything he sees.
The employee has access to highly restricted government facilities and sensitive documents. As soon as hehas healed from the surgery, he begins a months-long effort to collect as much information as he can about
U.S. military plans and intelligence activities. He sends this information back to his home country, which pays
him a handsome sum. The U.S. government is unaware of the leaked information and is unable to understandwhy its military operations are unsuccessful.

One IoB technology—BCIs—may have a particular impact on warfighting. BCIs collect electricalsignals from the brain and translate them into external outputs, such as commands (Shih, Krusienski,
and Wolpaw, 2012). BCIs can be body external (e.g., a noninvasive electroencephalogram [EEG]
wearable cap) or body internal (e.g., implanted into the brain). Some BCI technologies have shownpromise for people who have lost the function of certain limbs or neuromuscular capabilities byreading brain signals (Ouellette, 2022). A fighter pilot who has lost function of their limbs could thus
potentially use this technology to connect to and operate an aircraft. Future BCIs might even have theability to write to the brain (Binnendijk, Marler, and Bartels, 2020). A military commander could use
this technology to communicate with their forces about a change in commander intent or a pivot inbattlefield tactics. But if this technology were hacked, a malicious adversary could potentially inject
fear, confusion, or anger into the commander’s brain and cause them to make decisions that result inserious harm. In fact, several organizations based in China were found to “use biotechnology processes
to support Chinese military end uses and end users, to include purported brain-control weaponry”(Department of Commerce, 2021), and, because of this, these entities were added to the Departmentof Commerce’s Entity List to restrict trade with those organizations. In Vignette 4, we present a
hypothetical scenario in which BCIs gravely challenge national security.

14Vignette 4. Brain-Computer Interface That Influences Mood
In 2050, a few octogenarian congressional leaders face tough re-election campaigns because of rumors of ill
health and poor cognitive fitness for their roles. Three of these members of Congress quietly have state-ofthe-art BCIs implanted into their brains, a practice that has become somewhat commonplace among wealthysenior citizens. The members had previously shown signs of slowing down, but this BCI enables them tomove and speak normally, particularly with the help of political allies who conceal their true condition.
The BCI developers suspect that their implants have the ability not just to read brain signals but to affect theusers’ temperament in subtle and inconspicuous ways. However, the developers keep this quiet because
they have not been able to identify a fix. This susceptibility in the BCI ends up causing much confusion for the
congressional leaders in this scenario. They have episodes of erratic behavior, forgetfulness, and irrationality,
and they take a belligerent approach with their fellow members of Congress, allies, and partners. The U.S.
populace is demoralized. Once-friendly countries begin to distance themselves from the United States.

To characterize emerging IoB technologies relevant to the warfighter, we investigated thecumulative number of patent applications filed in a variety of IoB technology areas.5 We looked forwhat we refer to as technology emergence, the rapid growth over time of the cumulative number ofpatent applications that were assigned by patent examiners to a specific technology subclassification.
This is an indication that many individuals or organizations were submitting applications in the same
specific technology area in a particular period. Technology emergences are time-dependent andtypically follow a logistic or S-curve, representing diffusion of the emerging technology through atechnological network, and can be inferred from co-assignments by patent examiners of the same
technology to different subclassifications in the technical hierarchy of the patent-granting organization(Eusebi and Silberglitt, 2014).
For this effort, we used patent data from the IFI claims direct platform. This dataset includes fulltext patent data from 38 countries, as well as metadata, such as filing date, patent classes, assignees,and drawings. The data include more than 100 sources and 125 million records. Patent text is
machine-translated to English, and its format is standardized to facilitate analysis (IFI Claims Patient
Services, undated).
The analysis of patent applications presented here was limited to technologies related to BCIs,
monitoring technologies, and wearable electrodes. The data show that the United States has a lead of
about three to five years in many of the patent application categories that we evaluated, such as input
arrangements of EEGs, invasive EEG circuits, and nerve conduction (see Figure 2.3). However, in thecase of wearable electrodes and analysis of EEGs, China’s patent applications surpassed those of theUnited States in 2021 and 2022, and, in the case of BCIs, China is quickly catching up. If the trends
continue as expected, China likely will catch up to the United States in IoB human domain biotech
areas within the next few years.
We acknowledge limitations to this analysis. Patent applications do not necessarily indicate
dominance in a particular technology area, they may not result in patents granted or in the adoption ofsuch technologies, and military operational benefits of such devices may not materialize. This analysis
5

These technology areas are defined by classifications and subclassifications in a technical hierarchy established by national andinternational patent-granting organizations. For this work, we used the Cooperative Patent Classification scheme from the U.S.
Patent and Trademark Office, undated.

15

provides only a limited overview of trends in a narrow range of IoB technologies. Nevertheless, thesepatterns are an indicator of the extent to which China is investing in these technologies; moreover,previous work discusses China’s activity in a cluster of related areas of biotechnology (Blumenthal etal., 2021). These trends suggest that the United States might be losing its advantage in this space.

16

Figure 2.3. Trends in Patent Applications of Internet of Bodies Technologies

Brain-computerinterfaces
4,000

400

3,000

300

2,000

200

1,000

100

0
2002

600

2012

0
2002

2022

Year
Analysisof EEGs

Wearableelectrodes

2012

2022

Year
Input arrangementsof EEGs
4,000
3,000

400

2,000
200
0
2002

200

1,000
2012

0
2002

2022

Year
Invasive EEG
circuits

300

150

2012

2022

Year
Nerve
conduction

200

100
100

50
0
2002

400

2012

0
2002

2022

Year
ECG
circuits

4,000

300

3,000

200

2,000

100

1,000

0
2002

2012

0
2002

2022

Year

2012

2022

Year
Circuits formonitoring

2012

2022

Year

SOURCE: Features information from IFI Claims Patient Services, undated.
NOTE: ECG = electrocardiogram. In this figure, patent application counts were limited to technologies related to BCIs
and wearable devices.

17

Genomics
Similar to other emergent scientific fields, human genomics—the study of humanity’s genetic
makeup—holds substantial transformative promise, potentially altering humanity’s relationship withnature in ways that can be both beneficial and costly. Human genomics has profound implications forthe present and future of human warfighting. Genomic knowledge may revolutionize how militaries
prepare and equip their soldiers, enhancing their resilience and optimizing their performance andrecovery. From personalized (precision) nutrition and training regimens to advanced medical
treatments and even genetic enhancements, genomics could provide the key to supporting a newgeneration of warriors who are better equipped to overcome the vicissitudes of modern warfare.
For the most-speculative area of genomics, we conducted a systematic quantification of
publications in genomic technologies by authors’ countries as a way to identify growth and innovation.
We found two typologies—surveillance and enhancement—within the context of genomic science
applications to warfighting:••

Genomic surveillance combines genomic data with sorting, identifying, and surveillancetechnologies.
Genomic enhancement is the process of isolating and using accessible genomic information ortreatments to alter a trait in the human body or the environment to enhance resiliency at a
micro (individual) or macro (societal) scale.

These typologies represent a conceptual framework for evaluating possible use cases when genomic
technologies interact with a warfighting environment. This is not an exhaustive or comprehensive listof typologies; rather, these represent what we believe to be the most-relevant applications within theconcept of the human body as a warfighting domain.

Genomic Surveillance
Genomic surveillance is a near-term capability already in use in the private sector and deployed byother countries to identify genomic patterns. These technologies are used to analyze ancestry, track
viral mutations within human cells, and survey microbial evolution within the environment (CDC,2023). The biggest challenge to applying genomic surveillance to warfighting forces is to find robust
correlations of genotypes with characteristics (phenotypes) that effectively align with military roles.
The most prominent technique for finding such genotype-phenotype associations has been the use of
genome-wide association studies (GWAS), but GWAS may have plateaued in their ability to findmeaningful associations due to the complexity of the human genome (Singh and Gupta, 2020). For
over a decade, researchers have proposed that advances in AI will produce a robust understanding ofgenome-phenome links, but this has yet to materialize (Computational Pan-Genomics Consortium,2018). Writing in American Scientist, de los Campos and Gianola (2023) contended that new AI
algorithms are unlikely to surpass insights from GWAS anytime soon because vast genomic
complexity and relatively small sample sizes that can realistically be achieved for humans mean that AI
will be unable to solve the task at hand. Essentially, because genomic complexity is so vast, it may take18

training samples in the tens of millions for AI to actually solve gene-gene and gene-environment
interactions in a way that GWAS cannot.
This seems counterintuitive because large language models (LLMs) have shown such great successat replicating human language, but language has an important contrast with genomes in that theformer is intrinsically a system of meaning created by intelligent agents (humans). LLMs are AI that is
replicating natural intelligence. Meaningless utterances are rare. Thus, the training data for humanlanguage are many orders of magnitude more richly informative (low noise-to-signal ratio) than are
genomic data. Genomes also are information systems, but they are created by a wholly unintelligent
algorithm—Darwinian evolution—that, although it produces beautifully adapted creatures, it does sothrough an immensely inefficient and even wasteful process. Evolutionary biologist and science
communicator Richard Dawkins famously riffed off the theologian William Paley and called evolution
a “blind watchmaker” (Dawkins, 1986), but in contrast with LLMs and language, the evolved genome
can aptly be called a “tale told by an idiot” (Macbeth).
Should the challenges of genome-phenome associations be solved in the near future, then genomic
data may be useful to identify traits in warfighting forces that could be used in a predictive sorting
model. For example, if a nation-state needed to employ a military draft and the relevant genomic andphenotypic data were adequately collected and stored, then a learning algorithm might sort candidates
into the proper class of job for the term of service or perhaps develop a hierarchy of associated jobs
using demand. These data, properly collected, can be crosswalked with other data sources to identify
key traits for recruitment. In Vignette 5, a short narrative highlights how a combination of genomic
data could support the selection of military recruits. Genomic surveillance will only be a value-add,
however, if it predicts potential or future phenotypic traits that are not easily observable throughphenotype itself. For example, a genetic test that predicted height or strength would seem relatively
useless because these features are more easily and inexpensively observed in the phenotype directly. In
contrast, a genetic test that predicted the potential for an individual to master a specialized BCI after
weeks or months of training might be highly valuable if this future potential were not readily
observable phenotypically.

19Vignette 5. Genomic Recruitment Screening
In a recruiting office, a taciturn USSF captain supervises the 343 incoming recruits assigned to participate in a
new orbital drop trooper program. The captain quickly reviews the selection data on their tablet. Eachcandidate has several composites of ability scores with detailed genomic histories. The genomic data
gathered during Selective Service registration allows the rapid identification of candidates for several special
programs using genetic potential. An evaluation by a think tank had shown that the U.S. Air Force (USAF) had
improved the efficiency of pilot selection by 15 percent through the application of genomic tools. The USSF’s
orbital drop trooper program was different and far more demanding than the USAF pilot selection program;each candidate would be expected to endure the tribulations of high-altitude jumps, such as Felix
Baumgartner’s historic 127,852-foot jump. The captain knew this program was experimental and risky; thus,
only those who met the stringent standards could be recruited.

Genomic Enhancements
The most future-focused of our typologies is genomic enhancement—the ability to temporarily or
permanently enhance an individual’s genomic traits. Genomic enhancement has been the stuff ofscience fiction and comic books for many decades. The desire to create supersoldiers has deep
historical roots in early experimentations, starting as far back as the late 19th century (Lin et al.,2014). Much of eugenics—the attempt to use reproduction to increase the proportion of individuals
with desirable traits—derives from a fundamental misunderstanding of human genomics and a desire
to enhance genetic traits in fighting forces (Roll-Hansen, 2010). These pseudoscience theories
contributed to the justification of ethnic cleansing and the rise of genocide later in the 20th century(Bashford and Levine, 2010).
The development of genomic enhancement and its role as a technology application have beenmuch discussed in literature. Potential near-future genomic enhancements of key warfighting traits
could be the ability to function with less sleep, more physical stamina, and improved breathing
capacity (Almeida and Diogo, 2019; Blendon, Gorski, and Benson, 2016; National Academies of
Sciences, Engineering, and Medicine, 2017). Genomic enhancement as an actionable tool is early in its
scientific understanding and development. Deploying genomic enhancement has several limitations,many of which are associated with scalability, sequencing time, and cost. Although sequencing timeand cost have decreased by over six orders of magnitude since 2000 (National Human Genome
Research Institute, 2021), it remains to be seen, as noted previously, how well genetic sequences canbe interpreted meaningfully with respect to a person’s traits, and how well synthetic biology
enhancement tools will scale in the future. It is unlikely that genomic enhancement of the warfighter
will be realistic within the next five years, when scientists can only just now—20 years after the
Human Genome Project (HGP), whose goal was to sequence the whole human genome—cure singlelocus diseases, such as sickle cell anemia.
Given the aforementioned constraints for the warfighter, genomic enhancement might be applied
soonest to highly specialized missions in which a marginal positive change in some physical or
psychological activity would tip the balance toward benefit. In Vignette 6, we present a vignette that
explores a far-future application of genomic enhancement.

20Vignette 6. Genomic Enhancement for Degraded Environments
By 2050, the National Aeronautics and Space Administration’s Artemis program has been a great success forover two decades, enabling astronauts to conduct a variety of missions to explore the lunar surface.
However, with the establishment of a few permanent Moon bases, a new Cold War has broken out among the
major spacefaring countries because of competition over ownership of those bases. The USSF sends aplucky young captain on her first support mission to the Moon. As the spacecraft hurtles toward one suchcontested base, she gazes out the window at the moonrise.
Moments before landing, a breach in the carbon fiber shell of the captain’s spacecraft—a breach likely causedby this trip being the ship’s fifth reuse—has caused the craft to veer off course. The captain lands miles from
the Moon base without the air and water levels needed to make it by rover. The captain calls back to herhome station and requests support. The operations center commander informs the captain that she has beenauthorized for the emergency use of genomics enhancement for degraded environments, which should slow
the captain’s breathing and water consumption and extend her life support by 96 hours. The captain stops
voice communications to preserve her oxygen and water supply. Those 96 hours allow just enough time foranother spacecraft to be launched with resupply materials, and, after a flurry of transmissions, the captainconfirms that she survived.

Genomic Technologies in the Age of International Competition
Genomic research is a key strategic asset for national security, but its complexity creates deep
uncertainty in when or whether genomic advancements will be truly useful to the warfighter.
Nevertheless, China has been conducting applied gene research for potential military use. One
example is a prenatal genetic test developed by BGI Group, formerly known as the Beijing Genomics
Institute (Needham and Baldwin, 2021). In 2021, it was reported that BGI worked with the Chinese
military to help increase “population quality” using the data gathered from this prenatal test
(Needham and Baldwin, 2021).
Understanding the landscape of genomics research is critical to understanding global competitionin this area. We examined recent (within the past ten years) genomic publications, using data from the
Web of Science, to track the progress of genomic-focused research, and found that the United States
and China are leading the way and are neck-and-neck in overall publications.
To understand these trends better, we segmented the publication dataset into five categories ofgenomics research. These categories represent five key technology areas that enable the warfighting
genomic typologies of surveillance and enhancement that we described previously:
1. Genomic editing: Also called gene editing, this is an area of research seeking to modify genes ofliving organisms to improve our understanding of gene function and develop ways to treat
genetic or acquired diseases (Committee on Human Gene Editing, 2017).
2. Epigenomics: This is a field of study, also sometimes called epigenetics, that is focused onchanges in DNA (deoxyribonucleic acid) structure that do not involve alterations to theunderlying gene sequence (National Human Genome Research Institute, 2023b).
3. Transcriptomics: The DNA sequence of genes carries the instructions, or code, for building
proteins. As the first step, a gene is transcribed into a related molecule, mRNA. The
transcriptome is a collection of all the mRNA molecules (gene readouts) present in a cell, at
any given time (National Human Genome Research Institute, 2020).
21

4. Proteomics: The mRNA molecules serve as intermediate templates that are then translated
into proteins; proteomics characterizes the total and individual pattern of proteins in a tissueor organ (National Human Genome Research Institute, 2018).
5. Sequencing: To sequence a person’s DNA, researchers follow three major steps: (1) purify andcopy the DNA, (2) read the sequence, and (3) compare it with other sequences (National
Human Genome Research Institute, 2023a).
The clear pattern across all keyword groups in this analysis is that the United States has dominated in
all areas of genomic research publications, but an emergent China shows an upward trend in
publications that threatens to overtake those of the United States (Figure 2.4).

22

Figure 2.4. Genomic Citation Counts Across Country and Technology Category
1,500

Overall80

Editing

60
1,000
40
500
20
0
2012

0
2012

2022

Year
100

Epigenomics

500

80

400

60

300

40

200

20

100

0
2012

Transcriptomics

0
2012

2022

Year
600

2022

Year

2022

Year

Proteomics

300

Sequencing

500
200
400
300

100

200
2012

0
2012

2022

Year
U.S.

2022

Year
China

EuropeJapan

South Korea

Australia

SOURCE: Features information from Clarivate Analytics, undated.

This analysis has some limitations. The associated publication counts represent an incomplete
heuristic of national knowledge; the genomic technology postures in other countries have many
unknowns. One such unknown is that raw counts do not consider the quality of research.
Additionally, the private market plays a large role in developing new technology, and the nature ofcounting reported research articles is tricky. Because of the deeply collaborative nature of genomic
research, many other countries send their scholars to conduct research in—or simply collaborate
with—U.S. universities and other research institutions. Furthermore, U.S. institutions have a culture23

of “publish or perish” that may result in more-aggressive publication reporting. Finally, U.S. research
institutions have diverse sources of funding that can support a wide and diverse genomic research field.
Reported values simply represent overall trends and are not wholly complete. Nevertheless, theseresults demonstrate that China has been aggressive in expanding genomic research funding andopportunities for collaboration.

24

Chapter 3

Risks and Opportunities of Human
Domain Biotech
Engineered pathogens, the IoB, and genomics are biotechnologies for the human domain that willcontinue to innovate in the next five to ten years and longer. Innovation in these areas may evenaccelerate compared with the time of this writing, although whether this happens and in what
application areas is uncertain. Using the research summarized previously and discussions with subjectmatter experts on these topics, we identified several notable risks and opportunities, presented acrossthese biotechnology domains in Table 3.1.
Table 3.1. National Security Risks and Opportunities of Human Domain Biotechnology
Biotechnology Domain
Risks

Opportunities

Engineered Pathogens
1. Achieve near-term
land grab by nationstate
2. Achieve long-term
geopolitical reset bynation-state
3. Achieve societal
chaos for nonstate
actor

Limited for the UnitedStates because it is likely tocomply with the BWC and ison the disadvantaged sideof cultural resistance toBSL-3 pathogens

Internet of Bodies
1. Siphon data to gather
details about secret
military installations
2. Obtain compromising
personal information
about important U.S.
personnel
3. Hack IoBtechnologies like
implanted BCIs
1. Detect pathogens
2. Replace lost
capabilities (e.g.,limbs, hearing)
3. Reduce physicaltraining time
4. Augment existing
capabilities

Genomics
1. Identify minority
groups forpersecution
2. Enhance adversary
soldiers
3. Design a pathogen
to target U.S.
populations
4. Raise geneticallyengineered
supersoldiers fromembryo1. More quickly andefficiently screen
soldiers into combat
roles, especially inthe context of massmobilization
2. Genetic
engineering toaugment
capabilities (e.g.,
altitude tolerance)

NOTE: Bold items are likely realizable within five years of this writing. Italicized items are likely at least five or more
years in the future.

As Table 3.1 shows, engineered pathogens present risks but almost no opportunities for theUnited States. This is because the United States very likely will continue to abide by its commitment25

to the BWC, which prohibits the development of pathogens for biological warfare. But U.S.
adversaries are unlikely to adhere to the BWC—the Department of State (2022) has publishedconcerns about noncompliance with the BWC by China, Iran, North Korea, and Russia. In particular,
use of a bioweapon to achieve an immediate land-grab goal could be a strategically rational option forseveral U.S. competitors and adversaries. Using bioweapons as part of a plan for broader geopolitical
restructuring or as a plot by a nonstate actor to sow anarchy seem like less clearly rational calculations
and are probably less likely.
Several IoB technologies are realizable today or likely in the very near future. The 2018 Strava
incident is a small example of how use of IoB technologies could reveal critical information to U.S.
adversaries. Risk of information compromises will only increase as more IoB technologies are deployed
to a greater proportion of the U.S. population. Detecting pathogens and replacing lost or
compromised capabilities through IoB have shown rapid advances in recent years (Ouellette, 2022;
Vergun, 2023) and present opportunities for improved tactical performance and readiness for military
units. Longer-term IoB developments are uncertain at this point. For example, it remains unclear
whether BCIs will be truly tractable to enhance military operations under realistic field conditions. It
is similarly unclear at the time of this writing whether IoB can truly enhance human physicalperformance or substantially reduce training times for physical or mental conditioning. Each of these
possibilities presents risks and opportunities for the warfighter.
Because of the highly complex nature of genomic systems, genomic technologies bear mostly
speculative risks and opportunities that are at least five years in the future: Genetic advancements havetended to happen in a two-steps-forward and one-step-backward fashion. The translation of the HGP
into patient benefits remains a work in progress. On the cusp of the project’s 20-year anniversary,
Joyner and Paneth (2019) wrote,[N]early two decades after the first predictions of dramatic success, we find no impactof the Human Genome Project on the population’s life expectancy or any other publichealth measure, notwithstanding the vast resources that have been directed atgenomics.”

This was essentially the same assessment of the clinical impacts of the HGP at ten years (Hall, 2020).
Advancement in genomic technologies will rely on continuing progress in other biotechnology
innovations, as well as in data science. Efforts, such as the All of Us Research Program by the National
Institutes of Health, can help pave the way for radical improvements in genomics research (National
Institutes of Health, undated).
In contrast with most genomic innovations in Table 3.1, genomic screening to ascertain an
individual’s identity or ancestry is an already well-characterized technology. This technology has beenused successfully by law enforcement in the United States and globally, but in the future, it may carryrisks to the safety of minority groups living under oppressive regimes (Wee and Mozur, 2021).

Recommendations
Our research suggests that U.S. policymakers should consider the following priority areas foraction. We have divided them into near-term (within five years) and longer-term (five-plus years)
recommendations. We note also that longer-term recommendations are much less certain because it is26

much less known what will be technologically achievable more than five years from now. Some
anticipated capabilities might not come to fruition, and other unanticipated capabilities may emerge.

Near-Term Recommendations
Recommendations for the near term are as follows:
•

•

•

•

•

Revise the BWC to include strong protections, such as independent monitoring of BSLrated laboratories in a manner akin to chemical and nuclear weapon treaties. How to
implement this recommendation is discussed in some detail in Gerstein (2021), although
Gerstein (2022) notes that this effort is unlikely to succeed because biotechnology has too
important a dual-use (i.e., civilian and military) purpose that no countries have shown any
appetite to institute stronger international treaties.
Given that improving the BWC is likely intractable politically, the United States should
also pursue bilateral bioweapon treaties or otherwise divest from supporting biolabs instates likely to use bioweapons in the future. In short, the United States should divest fromlabs like the Wuhan Institute of Virology if the United States and China will not enter abilateral bioweapon control treaty (which is unlikely). Figure 2.2 in this report highlights othercountries that are on the advantaged side of bioweapon strategic use, and the United Statesshould pursue bilateral treaties with these countries or else divest from their biotechnology
sectors.
Continue scrutinizing adversary biotechnology advancements to identify and publicize
BWC violations. The United States should continue to emphasize and monitor compliancewith the BWC with an eye toward transparency and accountability for all signatories’ actions.
Members of Congress should resist anti-vaccine populism that is at the expense of military
readiness. Congress used the fiscal year 2023 National Defense Authorization Act to orderthat DoD rescind its COVID-19 vaccine mandate for all service members. The proposed
language in the fiscal year 2024 National Defense Authorization Act seeks to enshrine theservice members’ ability to refuse vaccines for religious or moral purposes. DoD and theservices must ensure that troops have access to accurate information and a transparent
discussion regarding the benefits and risks of vaccines, but services should retain theirtraditional ability to mandate medical interventions in a manner unlike that in the civilian
population.
The U.S. government should continue to be vigilant about entities that misusebiotechnologies and should continue working to enhance the information security of IoB
devices. The United States could, for example, continue coordinating through the
Department of Commerce and other agencies to put foreign organizations on its Entity List.
Information security of IoB devices is of utmost priority, particularly when used bywarfighters. This will be even more true if BCI fulfills its promise for warfighter enhancement,
potentially with write as well as read capabilities, which will necessitate novel types of
information security. Such security potentially will involve systems for full override,
decoupling, or override and decoupling of IoB systems, as well as the creation of associatedredundancies to conduct warfighting without IoB technologies if needed. The United States
27

•

•

should work with standards-setting organizations and engage the National Institute ofStandards and Technology on this task; see, for example, National Institute of Standards andTechnology, 2022.
Focus the allocation of funding on projects to identify and manage risks and opportunities
arising from genomic surveillance. Genomic surveillance is the most near-term opportunity
for genomics technology innovation, and such surveillance of familial and population ancestry
is already used for both good and nefarious purposes. Furthermore, surveillance that links
genotype to phenotype (traits) is the as-yet unfulfilled promise of the HGP and is a technicaltask that must be completed before enhancements can be applied to a broad swath of traits.
DoD should develop clear guidance on integrating biological warfighting capabilities thatis analogous to guidance developed for cyber and information warfare capabilities. This should
be done not only across the military services but also in collaboration with trusted allies.
Providing battlefield commanders and strategic planners with a clear picture of the biological
warfighting capabilities being developed and how warfighters can benefit from or be hurt bythem will help planners both use those capabilities in future conflicts and prepare to defend
against them.

Long-Term Recommendations
Recommendations for the long term are as follows:•••

Develop warfighting conventions on the use of IoB devices, particularly BCIs. The BWC
concerns only bacteriological and toxin weapons, but we expect that warfighting will
increasingly use IoB devices. Because many of these devices are likely to become more andmore intimately integrated with the human body, the need to develop rules of engagement forthese devices will become critical.
Develop ways to employ genomic surveillance for improvements in military personnel
selection or assignments. If genomic surveillance is realized and able to provide robust
measures of otherwise poorly measured aspects of human potential, then such surveillance
could, for example, be a consideration to help sort candidates into job specialties. It also could
potentially reduce the risk of individuals who are onboarded into the service from washing out
shortly after basic training. U.S. Army washout rates are at about 6 percent at the time ofwriting (Baldor, 2023), and it costs the Army approximately $50,000 for each person who fails
to complete basic training (Kimmons, 2018). Therefore, even a small improvement in thewashout rate could result in substantial gains for cost and time efficiency for staffing the force.
Encourage research on mitigation strategies for novel pathogen potentialities to anticipate
and counter adversary biotechnology threats. The ultimate capabilities for bioweapons will
depend on the details of how humans can and cannot be infected, and how pathogens can andcannot be manipulated. While anything is conceivable (a pathogen that makes sleep
impossible, a zombie virus), bioweapons ultimately are constrained by the possible. DoD willneed to take actions to stay current on the latest scientific developments in viral engineeringand immunology because these developments potentially will be convertible into bioweapons.

28

Conclusions
Our analysis shows that several countries have advantages—when compared with the UnitedStates—in their abilities to deal with the effects of a globally released, highly air- and person-toperson–transmissible bioweapon. While democratized biotechnology may allow a malicious nonstate
actor to develop a bioweapon, a country with an existing lab that handles such pathogens creates aneasier path for a malicious actor. Because it is difficult to identify the origins of person-to-persontransmissible bioweapons, their use by state actors is more likely. In contrast, non–person-to-persontransmissible bioweapons (e.g., anthrax) are more likely to be used for terrorist and DIY goals, where
attribution is paramount.
IoB technology will continue to advance, and the United States must be especially cognizant thatany deployed technology can also be hacked. While this is recognized for military cyber operations,this point will be even more important when soldiers and politicians have cybernetic connections
directly to their activity patterns through wearables and even connections to thought processes via
BCI.
Genomic surveillance is the most likely near-term technology to affect warfighting, but genomic
enhancement could have profound consequences should it become more feasible technically. The
United States should continue to monitor genomic developments.
The United States has long been the dominant player in human domain biotech, but our analyses
suggest that there will be more countries with emergent biotech capabilities in the near future. Because
those and other countries are investing significant resources into biotechnology for the warfighter, therecommendations offered in this report should enable the United States to stay ahead in this rapidlychanging landscape.

29Abbreviations

AI
BCI
BSL
BWC
CDC
CFR
COVID-19
CRISPR
DIY
DNA
DoD
EEG
GWAS
HGP
HIV
IoB
mRNA
SARS-CoVUSSF

artificial intelligence
brain-computer interface
biosafety level
Bioweapons Convention
Centers for Disease Control and Prevention
case fatality ratecoronavirus disease 2019clustered regularly interspaced short palindromic repeats
do-it-yourself
deoxyribonucleic acid
Department of Defense
electroencephalogram
genome-wide association studies
Human Genome Projecthuman immunodeficiency virus
Internet of Bodies
messenger ribonucleic acidsevere acute respiratory syndrome coronavirus
U.S. Space Force30

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