In the years since terrorists ripped through the World Trade Center and the Pentagon and Hurricane Katrina cut a devastating swath of destruction through the Gulf Coast, steady progress has been made toward shoring up the nation’s public health emergency preparedness.
But a report released in December by Trust for America’s Health warns that budget cuts and the continuing economic crisis could result in a rollback of the progress made toward better protecting and preparing the nation for emergencies.
The report came just days after an independent commission on weapons of mass destruction released a congressionally mandated report warning of the likelihood of a biological or nuclear attack at home or abroad by the end of 2013.
Members of an FBI radiological assistance team decontaminate a “victim” during a demonstration in Miami in 2007 that simulated the response to a weapon of mass destruction.
Photo by Roberto Schmidt, courtesy AFP/Getty Images
A growing economic recession and ballooning federal and state budget deficits are likely to contribute to a continued decline in federal funding for preparedness, already down 25 percent since its high in 2005, Jeff Levi, PhD, executive director of Trust for America’s Health, said at a December news conference releasing the sixth annual report, “Ready or Not? Protecting the Public’s Health from Diseases, Disasters and Bioterrorism.”
Over the past six years, the report, produced in partnership with the Robert Wood Johnson Foundation, has documented steady progress toward improved public health preparedness. This year, however, the report noted that cuts in federal funding for state and local preparedness since 2005, combined with cuts states have had to make to their budgets as a result of the economic downturn, threaten to erode that progress.
According to the report, 11 states and the District of Columbia cut their public health budgets in the past year. Looking ahead, 33 states will face shortfalls in their 2009 budgets and 16 states are projecting shortfalls to their 2010 budgets.
“From pandemic influenza planning to antiviral stockpiling to radiological laboratory capacity to setting altered standards of care in an emergency, states will be hard-pressed to take on these new, expanded roles and responsibilities while maintaining current progress in public health emergency preparedness unless there is a dramatic increase in resources,” said Levi, an APHA member.
Pandemic flu, emerging infectious diseases, terrorism and natural disasters remain serious threats to national security. Instead of slashing federal funding for essential state and local preparedness programs, the report called on then President-elect Barack Obama and the new Congress to prioritize the issue and dedicate “sustained and increased funds” to ensure the nation’s safety.
Cuts in federal support to protect Americans from diseases, disasters and bioterrorism are already hurting state response capabilities, Levi said, noting that gaps remain in many critical areas of preparedness, including surge capacity, rapid disease detection and food safety.
The 2001 anthrax attacks revealed serious gaps in the nation’s preparedness for bioterrorism — deficiencies that have been only partly addressed in the past seven years, according to a report released in December by the Commission on the Prevention of Weapons of Mass Destruction Proliferation and Terrorism. The report, “World at Risk,” called on Obama and Congress to take immediate steps to address the weapons of mass destruction that pose the greatest threat: nuclear and biological weapons.
“We are losing ground, and we are more vulnerable today than we were five or 10 years ago,” former Sen. Bob Graham, the commission chair, told The Nation’s Health. “A weapon of mass destruction being used somewhere on the Earth is more likely in the next five years, and it is more likely that the weapon will be biological than nuclear.”
That report, chartered by Congress to help the new administration assess threats, said prevention alone is not sufficient to counter the threat of biological weapons proliferation and terrorism. A robust system for public health preparedness and response is also vital to the nation’s security, the report said. To date, however, the federal government has invested most of its nonproliferation efforts in preventing nuclear terrorism, the report said, even though bioterrorism, is a higher priority.
Anthrax is the most likely near-term biological threat to the United States, said Graham, pointing to the commission’s recommendation that the federal government ramp up its efforts to implement a response plan that can counter an anthrax attack. According to the report, establishing an effective system to respond to an anthrax attack would also improve the nation’s ability to manage other disasters.
“The United States still does not have, and must quickly develop, a fully comprehensive and tested system for the rapid delivery of lifesaving medical countermeasures against anthrax and other bioterrorist threats,” the report said.
The commission called on Congress to take “urgent action” to allocate funds for developing medical countermeasures, such as antibiotics, and innovative ways of distributing them.
“Cuts in preparedness funding for public health are steps in the wrong direction,” said former Sen. Jim Talent, the commission’s vice chair. “We are going to need a coordinated and well-prepared public health system if an attack occurs, whether it is a biological or nuclear attack.”
Cutting funding both weakens the response and makes the nation a “richer-looking target,” Talent told The Nation’s Health. “If (terrorists) think they can cause enormous chaos, it is more likely they will attack.”
Talent also highlighted the commission’s concerns about medication delivery after an attack, noting that “we are not confident that the government has an effective system for distributing Cipro in the event of an anthrax attack.”
Whatever the threat, Graham said he believes the nation’s public health workers will play a key role in preparing their communities to respond to an attack, be it nuclear or biological. And such preparedness requires funding.
“Budget cuts threaten the nation’s safety,” Graham said. “This is particularly true today at the state and local level, where communities are under a lot of economic pressure. When the event does occur, if you are not prepared, instead of having a manageable tragedy, you will have an out-of-control catastrophe.”
For more, visit www.preventwmd.gov and www.healthyamericans.org.
- Copyright The Nation’s Health, American Public Health Association
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