December 2003

Grant Results

SUMMARY

From 2000 to 2002, the Johns Hopkins University School of Medicine's Center for Civilian Biodefense Strategies, Baltimore, worked to educate and promote communications among medical and public health professionals and policy-makers about bioterrorism, emerging infections and emergency preparedness.

The dual threats of new or emerging infections and bioterrorism present urgent and complex challenges to the nation's public health system. Yet these threats have arisen as the capabilities of the public health infrastructure to monitor and respond to infectious disease outbreaks are eroding. In 1998, the Institute of Medicine (IOM) reported that the public health system in the United States is "in disarray."

Key Results
During the grant period, the center:

  • Held a series of eight dinner lectures for medical and public health professionals.
  • Gave expert testimony to various congressional committees and subcommittees.
  • Briefed members of Congress.
  • Maintained and enhanced its Web site, which provided practical information about bioterrorist threats and emergency preparedness. The Web site is now inactive; see After the Grant for information on the new Web site.
  • Disseminated its free newsletter, the Biodefense Quarterly.

Funding
From September 2000 to August 2002, the Robert Wood Johnson Foundation (RWJF) provided $299,863 to the center.

 See Grant Detail & Contact Information
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THE PROBLEM

The dual threats of new or emerging infections and bioterrorism present urgent and complex challenges to the nation's public health system. Public health agencies at the municipal, county, state and federal levels will be central to efforts to recognize and respond appropriately to these threats. Yet these threats have arisen as the capabilities of the public health infrastructure to monitor and respond to infectious disease outbreaks are eroding.

In 1998, the Institute of Medicine (IOM) reported that the public health system in the United States is "in disarray." In a report the following year, the IOM and the National Research Council emphasized the importance of improving the capacity of health departments to address infectious disease outbreaks promptly.

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RWJF STRATEGY

RWJF has previously funded a number of programs to address infectious diseases, including Turning Point: Collaborating for a New Century in Public Health, which is aimed at improving the public health infrastructure by strengthening state health departments; Old Disease, New Challenge: Tuberculosis in the 1990s; and All Kids Count: Establishing Immunization Monitoring and Follow-Up Systems.

A common goal of these and related RWJF grants is to improve population health by strengthening the capability of public health agencies to prevent, monitor and respond to disease outbreaks. With this grant, RWJF sought to link its commitment to a strong public health infrastructure and effective infectious disease surveillance with the need to shape appropriate responses to the threat of bioterrorism.

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THE PROJECT

From September 2000 to August 2002, RWJF provided $299,863 to the Center for Civilian Biodefense Strategies to educate medical and public health professionals and policy-makers about bioterrorism and emerging infections, to promote dialogue among them, and to brief members of Congress and their staffs on these issues.

RWJF originally anticipated that the project would yield recommendations for strengthening the state and local public health infrastructure and disease surveillance so that it can respond effectively to epidemics. However, following the events of September 11, 2001, and the subsequent anthrax attacks, the center redirected its energies towards providing current information and expertise to medical and public health professionals, policy-makers and the public about anthrax and bioterrorism.

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RESULTS

During the grant period, the Center for Civilian Biodefense Strategies:

  • Held nine dinner lectures, extending invitations to a multidisciplinary group of professionals with expertise on, or responsibility for, managing epidemics. Between 31 and 54 medical and public health professionals attended each of these events, which dealt with biological weapons, biotechnology, smallpox and the safety of the food supply, among other topics. The small group format facilitated discussions about how to improve the public health response.
  • Gave expert testimony to various congressional committees and subcommittees, including the House Budget Committee, the House Intelligence Committee and the Senate Foreign Relations Committee. The testimony related to bioterrorism budget priorities, emerging threats, biotechnology advances, the role of the Federal Emergency Management Agency (FEMA) in managing bioterrorist attacks and other topics.
  • Briefed members of Congress, their staff and federal officials on bioterrorism, emergency preparedness, biological weapons and strategies for homeland defense. Those briefed include staff of the Senate Armed Services Committee, Vice-President Dick Cheney, and the Deputy Secretary of the Department of Health and Human Services.
  • Maintained and enhanced its Web site, which provided practical information about bioterrorism preparedness and response. After averaging between roughly 5,000 and 10,000 unique visitors monthly from September 2000 through August 2001, the site received 165,423 unique visitors in October 2001, following the anthrax attacks; by the end of the grant period, the number of Web visitors was averaging 29,000 per month. The site has been called an exceptional resource in Wired, Science and the New Republic magazines and by the National Academies of Science. (See After the Grant for current information on the Web site.)
  • Disseminated its free newsletter, Biodefense Quarterly. Among the 2,500 subscribers are public health, military and other federal, state and local officials, academics, medical professionals, corporations, media outlets and private citizens.
  • With partial salary support from the RWJF grant, sponsored a three-day course on preventing and responding to epidemics through the Johns Hopkins School of Public Health's Summer Institute in Epidemiology.

Communications

See the Bibliography for lists of the dinner lectures under Sponsored Workshops and the center's presentations and testimony.

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LESSONS LEARNED

  1. Convening small groups of people, such as those who came together at the dinner lectures, may be more useful than convening a much larger conference. In a final report to RWJF, grantee staff noted that engaging small groups in dialogue helps to establish a common language and provides opportunities to learn not only from speakers, but from conversation with one another. Small meetings may allow multidisciplinary networks of professionals to develop who are prepared to respond to crises. (Project Director)

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AFTER THE GRANT

Effective November 1, 2003, the faculty and staff formerly of the Johns Hopkins Center for Civilian Biodefense Strategies are now affiliated with the Center for Biosecurity of the University of Pittsburgh Medical Center (UPMC).

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GRANT DETAILS & CONTACT INFORMATION

Project

Identifying and Communicating Public Health Implications of New and Emerging Infections

Grantee

Johns Hopkins University School of Medicine (Baltimore,  MD)

  • Amount: $ 299,863
    Dates: September 2000 to August 2002
    ID#:  039554

Contact

Donald A. Henderson, M.D., M.P.H.
Tara O'Toole, M.D., M.P.H.
(410) 223 1667
totoole@upmc.edu

Web Site

http://www.upmc-biosecurity.org

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BIBLIOGRAPHY

(Current as of date of this report; as provided by grantee organization; not verified by RWJF; items not available from RWJF.)

Reports

Biodefense Quarterly. A free quarterly newsletter.

World Wide Web Sites

www.hopkins-biodefense.org. "Center for Civilian Biodefense Strategies," a site which disseminated information about bioterrorism and emergency preparedness. Baltimore: Johns Hopkins University Schools of Public Health and Medicine, March 2003. No longer active. See instead www.upmc-biosecurity.org.

Sponsored Workshops

"The Global Security Implications of Biological Agents," April 2001, Baltimore. Dinner lecture attended by 31 epidemic management professionals.

"Advances in Biotechnology: Promise and Peril," May 2001, Baltimore. Dinner lecture attended by 39 epidemic management professionals.

"Smallpox Vaccine for a New National Stockpile: Technical, Regulatory, and Strategic Challenges," July 2001, Baltimore. Dinner lecture attended by 41 epidemic management professionals.

"The Challenge of Biological Weapons Inspections," October 2001, Baltimore. Dinner lecture attended by 51 epidemic management professionals.

"Comparing Biological Weapons Response Efforts: Force Protection vs. Civilian Public Health Protection," November 2001, Baltimore. Dinner lecture attended by 48 epidemic management professionals.

"Prions and the Food Supply: Implications for Bioterrorism and Food Safety," January 2002, Baltimore. Dinner lecture attended by 46 epidemic management professionals.

"USAMRIID," April 2002, Baltimore. Dinner lecture attended by 54 epidemic management professionals.

"Maryland Response to Anthrax," May 2002, Baltimore. Dinner lecture attended by 34 epidemic management professionals.

"Aerial Dissemination of Biological Agents: Potential Impact on Humans," June 2002, Baltimore. Dinner lecture attended by 34 epidemic management professionals.

Presentations and Testimony

Tara O'Toole, "Biological Weapons and Homeland Defense: Proposed Strategies," to the staff of the Senate Armed Services Committee, May 14, 2001, Washington.

Tara O'Toole, "Hearing on FEMA's Role in Managing Bioterrorist Attacks and the Impact of Public Health Concerns on Bioterrorism Preparedness," to the Senate Government Affairs Subcommittee on International Security, Proliferation and Federal Services, July 23, 2001, Washington.

Thomas V. Inglesby, "Briefing on Dark Winter Exercise," to Rep. Gene Taylor, chair of House Armed Services Committee, August 2001, Washington.

Thomas V. Inglesby, Tara O'Toole and John Hamre, "Briefing on Dark Winter Exercise," to Vice President Cheney, September 2001, Washington.

Donald A. Henderson, "Hearing on the Threat of Bioterrorism and the Spread of Infectious Diseases," to the Senate Foreign Relations Committee, September 5, 2001, Washington.

Tara O'Toole, "Leveraging Advances in Biotechnology and Medical Informatics to Improve Homeland Defense Capabilities — Report of the Defense Science Board Task Force," to the House Intelligence Committee, October 3, 2001.

Tara O'Toole, "Briefing on Bioterrorism and Emergency Preparedness," to Health and Human Services Deputy Secretary Claude Allen, October 18, 2001.

Tara O'Toole, "Terrorism Through the Mail: Protecting Postal Workers and the Public (Part II)," to the Senate Government Affairs Subcommittee on International Security, Proliferation and Federal Services, October 31, 2001, Washington.

Tara O'Toole, "Emerging Threats — Dark Winter," to the House Intelligence Committee, November 2001, Washington.

Tara O'Toole, "Department of Health and Human Services Budget Priorities for Fiscal Year 2003," to the House Budget Committee, February 28, 2002, Washington.

Tara O'Toole, "Briefing on Bioterrorism," to Peter Rooney, staff to Sen. Jay Rockefeller, March 14, 2002, Washington.

Thomas V. Inglesby, "The State of Public Health Preparedness for Terrorism Involving Weapons of Mass Destruction: A Six Month Report Card," to the Senate Government Affairs Committee, April 18, 2002, Washington.

Tara O'Toole, "Creating the Department of Homeland Security: Consideration of the Administration's Proposal," to the House Committee on Energy and Commerce Subcommittee on Oversight and Investigations, June 25, 2002, Washington.

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Report prepared by: Christina M. Valente
Reviewed by: Karyn Feiden
Reviewed by: Molly McKaughan
Program Officer: James R. Knickman

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