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Summary:
The anthrax attacks in 2001, along with the events of September 11, have heightened concern about the nation's ability to respond to bioterrorist attacks. The role of public health in bioterrorism preparedness and response is to plan and coordinate emergency medical and public health response capabilities, to detect, investigate and identify disease outbreaks using surveillance systems, epidemiology and laboratory services, to maintain healthy conditions by regulating environmental conditions, food and water safety to minimize disease threats, and to communicate rapidly and clearly with response partners, health practitioners, the media and the public. The capacity to fulfill these responsibilities depends on the strength of the infrastructure that supports the provision of public health services. The public health infrastructure is the organizations, people and data systems needed to assure the provision of essential public health services. Public health organizations exist at the federal, state and local level and interact with each other, the health care delivery system, public safety providers, private enterprises and volunteer organizations to provide public health services. Even before September 11 and last fall's anthrax attacks, a consensus had emerged among public health experts that the public health system had deteriorated. Recent studies and reports have cited outmoded technology and information systems, insufficient resources to combat emerging and drug-resistant diseases, a public health workforce with inadequate training to address new threats or to adapt to new ways of doing things, poor communication among responsible parties, and inadequate capacity in hospitals and laboratories to respond to a mass casualty event as several of the major challenges facing public health organizations. Recent congressional action has provided funding and guidance to improve public health capacity at the federal, state and local level. Challenges remain in a variety of areas, including: coordination and communication between public health officials and other participants in public health preparedness and response, upgrading data and information systems capabilities, improving laboratory capacity, increasing emergency medical response capacity, improving the skills and education of the public health workforce, and conducting research to improve bioterrorism prevention, detection and treatment options. Finally, many worry about how to be sure that the increased funding devoted to increasing public health capacity yields results in improved preparedness and response capability. This report will be updated as the public health system evolves and responds to congressional action.
