On January 10, 2002, President George W.Bush signed appropriations legislation providing $2.9 billion for DHHS, a tenfold increase in the department’s funding for bioterrorism preparedness. The funds have been used to develop comprehensive bioterrorism preparedness plans; upgrade infectious-disease surveillance and investigation through HAN; enhance the readiness of hospital systems to deal with large numbers of casualties; expand public health laboratory and communications capacity; and improve connectivity between hospitals and city, regional, and state health departments to enhance disease reporting. As the lead federal agency in preparing for the threat of bioterrorism, DHHS works closely with states, local government, and the private sector in building the needed, new public health infrastructure and accelerating research into likely bioterrorism-related diseases.
Reflecting the need for broad-based public health involvement in terrorism preparedness and planning, staff from different agencies in DHHS participated in developing a strategic WMD plan. These agencies include CDC, the Health Resources and Services Administration (HRSA), and the Office of Emergency Preparedness. CDC will target state and local programs supporting statewide preparedness activities for bioterrorism, infectious diseases, and public health emergency. HRSA will provide funding, which will be used by states to create regional hospital plans to respond in the event of a bioterrorism attack.
Future goals of federal public health preparedness efforts include the following:
§ Having at least one epidemiologist in each metropolitan area with a population greater than 500,000
§ Developing an education and training plan that will reach health professionals, emergency department physicians and nurses, local public health officials, and the public with information relating to bioterrorism, new and emerging diseases, and other infectious agents
§ Targeting bioterrorism research to new vaccines, antiviral drugs, and new diagnostic tools to better protect against biologics
Implementation of the objectives outlined in DHHS’s strategic plan will be coordinated through the DHHS Office of the Assistant Secretary for Emergency Preparedness and Response. DHHS program personnel are charged with helping build local and state preparedness, developing U.S. medical expertise regarding potential threat agents, and coordinating medical response activities during actual bioterrorist events. Program staff have established priorities for fiscal year 2004 regarding these focus areas
Successful implementation of these priorities will require state and local public health agencies to collaborate and partner with a number of other persons and groups, including the following:
§ Medical research centers
§ Healthcare providers and their networks
§ Professional societies
§ Medical examiners
§ Emergency response units and responder organizations
§ Safety- and medical-equipment manufacturers
§ Federal agencies
§ International organizations
Recent threats and use of biological and chemical agents against civilians have exposed the United States’s vulnerability and highlighted the need to enhance our capacity to detect and control terrorist acts. The United States must be protected from an extensive range of critical biological and chemical agents, including some that have been developed and stockpiled for military use. Even without threat of war, investment in national defense ensures preparedness and serves as a deterrent against hostile acts. Similarly, investment in the public health and healthcare systems provides the best civil defense against bioterrorism.
Tools developed in response to terrorist threats serve a dual purpose. They help detect rare or unusual disease outbreaks and respond to medical emergencies, including naturally occurring outbreaks or industrial injuries that might resemble terrorist events in their unpredictability and ability to cause mass casualties (e.g., a pandemic influenza outbreak or a large-scale chemical spill). Federal WMD terrorism-preparedness activities, including the development of a public health communication infrastructure, a multilevel network of diagnostic laboratories, an integrated disease surveillance system, and an MMRS will improve our ability to investigate rapidly and control public health threats that emerge in the twenty-first century (U.S. DHS 2003a, 2003b).
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