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Biopreparedness 10 Years After the Anthrax Attacks

Jonathan Moreno’s new book, The Body Politic is stirring up discussion of a range of science policy issues from the ethics of cloning, synthetic biology, and stem cell research to how our national investments in science are among the key  drivers of longterm economic growth. In this Politico repost, Tom Daschle, former majority leader of the U.S. Senate, and Jonathan Moreno, Science Progress editor-in-chief, discuss how far we’ve come in our ability to respond to biological threats like the anthrax attacks that rocked the country ten years ago.

Ten years ago, a series of anthrax attacks throughout the country followed hard on the heels of 9/11. The deadly powder made its way through the postal system – including several sent to Senate offices — ultimately claiming five victims. The nation was alerted as never before to yet another threat to national security. Suddenly words like biopreparedness and Cipro were on everyone’s lips.

How much have we learned about biodefense in the last decade? Is America more prepared for a biological weapons attack, or even a pandemic, than it was during that frightening October 2001? In the last few weeks, Hollywood has chimed in with a film, “Contagion,” that plays out the worst possible scenario.

The good news is that there are reasons to be reassured about our preparedness. The bad news is that we are in danger of backsliding.

Whether the source of a pandemic disease is natural or political, the first line of defense has to be medical. Our system for developing, storing and disseminating needed medications is inadequate. Not only do we lack a rich supply of antibiotics and vaccines for recognized threats, scientists worry that new biotechnologies designed to save lives could be diverted to the creation of organisms resistant to our current defenses.

In 2004, Congress passed a law called BioShield, intended to encourage private companies to begin developing new medicines that are both safer and more effective to address biological threats. The usual market incentives don’t necessarily apply when government is the only customer. Industry worries about the legal liabilities of large-scale distribution of medications that may have risky side-effects, like the smallpox vaccine.

BioShield was a good concept — but the results have been mixed at best. Some ideas that researchers thought could be promising have been failures. Worried about BioShield’s ability to take promising scientific findings into development, in 2006 Congress created the Biodefense Advanced Research and Development Authority, known as BARDA, and placed it under the control the Department of Health and Human Services. But Congress has been chipping away at the BioShield funds.

For all the importance of new medications, we have over-emphasized the “high tech” side of biopreparedness. Again, because the first response to an event would require public health assets, regardless of whether the sources were natural or man-made terrorism, we need to focus on the capacity of public health departments.

But these state- and county-level agencies are often understaffed and under-resourced. Coordination between agencies is frequently inadequate. Microbes don’t respect state boundaries — so any failure of cooperation and communication could be deadly.

The Trust for America’s Health provides a biennial report card for state biopreparedness. Their 2010 report concludes that, over the past 10 years, most states have improved their readiness to prevent, identify and contain public health threats. However, “Ready or Not” also notes that 33 states and the District of Columbia have cut health funding since 2008, and local health departments have lost 23,000 jobs since then. Among these are the first responders, whom we will rely on during a crisis.

As we’ve been reminded by Hurricane Irene and the earthquake in the Northeast, these are standing resources we always need — however much we hope we never need to call on them. With the growing pressures on state and local budgets we should be worried about a continuing decline.

There’s no mystery about what needs to be done. There are gaps in funding and infrastructure, disease surveillance, workforce, vaccine and drug research and development and manufacturing, surge capacity and community resilience. The only serious question — and one for which there is no algorithm — is whether the public and our leaders are committed to biopreparedness.

Let us hope that another bioterror incident is not required to focus the mind.

Tom Daschle served as Senate majority leader, when his office was targeted by one anthrax letter. He is now a distinguished senior fellow at the Center for American Progress and senior policy adviser at DLA Piper. Jonathan Moreno, a bioethics professor at the University of Pennsylvania and senior fellow at CAP, is the author of, “The Body Politic: The Battle Over Science in America.”

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