Since the 2001 terror attacks, $5 billion federal dollars have been to public health departments to prepare for a bioterrorist attack or a flu pandemic. However Congress approved the money with a catch, they set criteria to evaluate how the health departments spent their funds. This unenviable task fell to the Centers for Disease Control and Prevention, but the CDC has struggled to meet this task. “We’re not able to demonstrate accountability,” said Craig Thomas, who is the head of the office that evaluates and monitors public health departments. “It’s not just accountability to the CDC. It’s accountability to your community. It’s accountability to your local stakeholders and the people who fund you as well.”

Thomas’ comments don’t mean that the money was wasted, but that we can’t be sure that the nation is any better prepared for this type of attack than we were before 9/11 and the anthrax letters. “The difficulty comes down to, how do you measure (improvement), how do you quantify that, so you have something you can track over time, something you can use to identify gaps that have to be filled,” said the CDC’s Dr. Richard Besser, who oversees the Office for Terrorism Preparedness and Emergency Response.

The problem is that no one is able to agree on what or how the government should measure improvement. “Every health department is different, so where one may have strengths and they feel very confident in measuring something, another may have that as a weakness and feel less confident,” said Donna Knutson, a senior adviser at the CDC. The CDC asks states some very subjective questions. For example, health departments are asked how long does it take to get a “knowledgeable public health professional” to respond to an urgent call. The problem is that definition of a knowledgeable health   professional can be very subjective.


The problem is that without having a good idea where we stand, we have know idea how prepared we really are. The CDC and health departments have to come together to agree upon common terminology, then the federal government should establish benchmark levels of preparedness. The CDC is a scientific organization that depends on data to make its recommendations. Without data, or even common agreement, we really have no idea how prepared the United States is for a bioterrorist attack.

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