Sep 1 2011
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Idea Gallery: A Decade After 9/11 and Anthrax Attacks, Public Health Preparedness Remains Critical

Idea Gallery is a recurring editorial series on NewPublicHealth in which guest authors provide their perspective on issues affecting public health. Today, Jeffrey Levi, Executive Director of Trust for America’s Health (TFAH), writes about public health preparedness and a report issued by TFAH and the Robert Wood Johnson Foundation, Remembering 9/11 and Anthrax: Public Health’s Vital Role in National Defense.

Ten years ago, the September 11th and anthrax tragedies clearly demonstrated that the public health system was not prepared for the range of modern health threats we face. Since then, significant investments have resulted in the country being much better prepared to respond to public health emergencies ranging from threats of bioterrorism to major infectious disease outbreaks like a pandemic flu or natural disasters like hurricanes, tornadoes, and floods.

However, the United States often takes a band-aid approach to public health preparedness. As new emergencies and concerns emerge and attention shifts, it often means resources are diverted from one pressing priority to another, leaving other ongoing areas unaddressed. The unprecedented federal investment in public health preparedness after the September 11th and anthrax attacks was not at a sufficient level to backfill long-standing gaps in infrastructure or update technologies to meet state-of-the-art standards. Currently, there is an additional new threat to preparedness – the current economic climate and budget cuts at the federal, state and local level mean that progress made over the past decade could be lost.

Until public health emergency preparedness receives sufficient and sustained funding, Americans will continue to be needlessly at risk for a range of public health threats. Major gaps include funding at every level and a major shortage of trained public health workforce and funded positions. In fact, the United States has 50,000 fewer public health workers than it did 20 years ago and one-third of public health workers will be eligible to retire within five years. There is also a gap in surge capacity, the ability of the medical system to care for a massive influx of patients in the event of an emergency. Moreover, the United States still lacks an integrated, national approach to biosurveillance, which would dramatically improve response capabilities ranging from a bioterrorism attack to contamination of the food supply.

We have come a long way in public health preparedness since 9/11 and the anthrax attacks ten years ago, but we still have a long way to go. Here’s what we need to be fully prepared, and to keep our families and communities safe in the event of any emergency:

  • Leadership, planning, and coordination: An established chain-of-command and well defined roles and responsibilities for seamless operation across different medical and logistical functions and among federal, state and local authorities during crisis situations, including police, public safety officials and other first responders.
  • Well-funded core public health infrastructure: Basic public health systems and equipment, including laboratory testing and communications, that keep pace with advances in science and technology.
  • An expert and fully-staffed workforce: Highly trained and adequate numbers of public health professionals, including epidemiologists, lab scientists, public health nurses and doctors and other experts, in addition to back-up workers for surge capacity needs.
  • Rapid development and ability to manufacture vaccines and medications: A streamlined, safe, effective system to ensure rapid research and production of medical countermeasures to protect people from emerging threats.
  • Immediate, streamlined communications capabilities: Coordinated, integrated communications among all parts of the public health system, all frontline responders and with the public, including back-up systems in the event of power loss or overloaded wireless channels.

Since 2001, major investments in preparedness have led to improvements in preparedness planning and coordination, most notably the readiness of public health laboratories, public health workforce availability and training and surge capacity. Continued strategic investment is needed to ensure that the country remains prepared to respond to public health emergencies like bioterrorism or natural disasters – and to the new emergencies and concerns that will undoubtedly emerge.

>> Read more about progress and ongoing vulnerabilities in the nation’s ability to respond to health crises from the Remembering 9/11 and Anthrax report. The report features more than 30 firsthand accounts of public health professionals who were directly involved in the response to the September 11, 2001 and anthrax tragedies.

>>NewPublicHealth will continue to run excerpts from the Remembering 9/11 and Anthrax: Public Health's Vital Role in National Defense report throughout the months of September and October, to mark the anniversary of vital events in our history of public health preparedness. Check back for continued coverage here.

Tags: Emergency Preparedness and Response, Idea Gallery, Preparedness, Public and Community Health