Pandemic disease and bioterrorist attack pose an increased threat to society. The nature of these biothreats requires governments, drug and vaccine developers to consider contingency plans that challenge the conventional wisdom of ethical R&D processes. Complete preparation is not possible, so planners must make optimal use of available resources to radically, yet ethically, accelerate the R&D process. This means balancing the high risks of inaction, once the threat becomes apparent, against the risks of drug side-effects to early test subjects.