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Bioterrorism Experts Discuss Future Of United States Public Health System

By Vicki Kemper

The latest in a series of events elevating the public health system from the distant backwater of U.S. medicine to a central role in the nation’s defense against terrorism is unfolding here this week in a cavernous hotel ballroom.

But none of the officials attending the first meeting of a new advisory council on public health preparedness is gloating about the new respect -- not to mention $3 billion in federal funding -- they’ve gained since last year’s anthrax attacks.

If anything, the potentially overwhelming challenge of helping to prepare the nation for a smallpox, botulism, plague, or other bioterror attack energized the council’s 21 members and a corps of public health officials to use their new status and resources also to address their more traditional concerns: controlling infectious disease epidemics, immunizing children, and most recently, guiding state and local responses to the West Nile virus.

“Bioterrorism creates enormous challenges and risks to the system,” Dr. Julie Gerberding, director of the Centers for Disease Control and Prevention, said Monday. “If there is a silver lining [from the anthrax attacks], it is that we do have renewed attention. But we have to make people realize that it’s part of providing care all the time.”

Indeed, the formation of the committee -- 21 epidemiologists, health school deans and other public health experts who report to Tommy G. Thompson, secretary of health and human services -- is merely the Bush administration’s latest affirmation of the public health system’s role in bioterrorism preparedness.

Jerome M. Hauer, director of the Office of Public Health Preparedness, itself less than a year old, said he knew of “no other time in federal government history when so much money has gone out so quickly.”

It was in January that President Bush signed legislation passed by Congress providing $3 billion for public health preparedness. By the end of that month, $1.1 billion had been awarded to states and major cities, and 20 percent of that was made available immediately. By early June, after state plans for the money had been approved by federal officials, virtually all the state and city funds had been distributed.

Explaining that federal officials had a “low threshold for bureaucratic nonsense,” Hauer said they “wanted to ensure the money was used to build a system, not to buy toys.”

The funds are being used to renovate laboratories and increase their capacity, to improve the detection of bioterror and other infectious disease outbreaks, for health worker training, bioterror response facilities and equipment and the development of so-called “surge capacity,” making sure that at least 500 hospital beds are available to handle a sudden influx of bioterror victims.