Preparing for Biological and Chemical Attacks - The Federal Role

The U.S. General Accounting Office (GAO) defines biological and chemical terrorism as the threatened or intentional release of viruses, bacteria, poisonous gases, liquids, or other toxic substances for the purpose of influencing the conduct of government, intimidating or coercing a population, or simply intending to cause widespread harm. Any such act that has the potential for, or the intention of, infecting, injuring, or killing hundreds, thousands, or even millions of people is considered terrorism.

In 2001 the GAO identified more than forty federal departments and agencies with some role in combating terrorism, with twenty-nine of those having some role in preparing for, or responding to, the public health and medical consequences of a biological or chemical attack. The cabinet-level departments involved include the U.S. Departments of Agriculture (USDA), Commerce, Defense (DOD), Energy (DOE), Health and Human Services, Justice, Transportation, Treasury, and Veterans'Affairs, along with two independent agencies, the Environmental Protection Agency (EPA) and the Federal Emergency Management Agency (FEMA). Within these larger divisions, departmental agencies take on various roles. The Department of Homeland Security, established in 2002, also plays an important role.

These departments and agencies may work alone or with other agencies in emergency planning for averting or responding to attacks. These units participate in activities that include, but are not limited to: (1) detecting biological agents; (2) developing a national stockpile of drugs with which to treat victims of disasters; and (3) developing vaccines, such as the anthrax vaccine, for the widespread inoculation of U.S. citizens and residents.

Funding for Research

In fiscal year 2001 federal departments and agencies reported total funding for research on biological and chemical terrorism in the amount of $156.8 million. Some of the activities funded include the development of technologies to detect bioterrorist attacks. Funding for bioterrorism research increased dramatically in response to the terrorist attacks of September 11, 2001. In September 2003 Health and Human Services Secretary Tommy G. Thompson announced $350 million in grants over five years to establish eight Regional Centers of Excellence for Biodefense and Emerging Infectious Diseases Research. The eight institutions receiving grants include the Harvard Medical School, Duke University, the University of Chicago, and the University of Texas Medical Branch. According to a statement by the National Institute of Allergy and Infectious Diseases, the research conducted by the Regional Centers will include:

• Developing new approaches to blocking the action of anthrax, botulinum, and cholera toxins
• Developing new vaccines against anthrax, plague, tularemia, smallpox, and Ebola
• Developing new antibiotics and other therapeutic strategies
• Studying bacterial and viral disease processes
• Designing new advanced diagnostic approaches for biodefense and for emerging diseases
• Conducting immunological studies of diseases caused by potential agents of bioterrorism
• Developing computational and genomic approaches to combating disease agents
• Creating new immunization strategies and delivery systems

On July 21, 2004, President George W. Bush signed into law the Project BioShield Act. Project BioShield authorizes $5.6 billion over ten years for the government to purchase and stockpile vaccines and drugs to fight anthrax, smallpox, and other diseases that may be used in a bioterror attack. The Department of Health and Human Services will purchase seventy-five million doses of an improved anthrax vaccine for the Strategic National Stockpile. In addition, grants for bioterror research will be expedited under Project BioShield, as will the delivery of newly developed drugs to victims who may require assistance.

Funding for Preparedness

In 1999 a National Pharmaceutical Stockpile—a reserve of antibiotics, chemical antidotes, antitoxins, life-support medications, IV administration, airway maintenance supplies, and medical/surgical items for use in an emergency—was first authorized by Congress. In March 2003 it was renamed the Strategic National Stockpile. Initially run by the Department of Health and Human Services and the Centers for Disease Control and Prevention, it is now managed by the Department of Homeland Security. Funding for the stockpile has increased fivefold since its inception. Among its accomplishments is the purchase and storage of enough smallpox vaccine to protect every American citizen.

Federal departments and agencies spent almost $650 million on bioterrorism- and terrorism-preparedness activities for fiscal years 2000 and 2001: $296 million in 2000 and $347 million in 2001. In January 2002 the U.S. Department of Health and Human Services announced $1 billion in bioterrorism preparedness grants to be given to states and cities to increase their ability to respond to bioterror emergencies. The CDC announced in June 2004 that grants of some $840 million were available to assist public health facilities to prepare for and respond to bioterrorism.

The Centers for Disease Control and Prevention (CDC)

Most investments in national defense increase national security, especially by acting as a deterrent against hostile acts. Similarly, investments in the public health system, most experts believe, will provide the best civil defense against biological and chemical terrorism. In the lead among federal agencies preparing for future homeland biological and chemical terrorism incidents is the CDC, headquartered in Atlanta, Georgia. The CDC's programs to fight terrorism—particularly bioterrorism—inte-grate planning and training to develop public health preparedness and include surveillance (monitoring trends), epidemiology (studying the incidence, distribution, and control of disease), rapid laboratory diagnosis, emergency response, and information systems (computers and telecommunications).

The CDC assists state and local public health departments by:

• Identifying the biological agents likely to be involved in a terrorist attack
• Developing case definitions to assist in detecting and managing infection with these agents
• Establishing a Rapid Response and Advanced Technology laboratory, which can provide fast identification of biological and chemical agents rarely seen in the United States
• Developing a nationwide integrated information, communications, and training network with the Health Alert Network, the National Electronic Data Surveillance System, and Epidemic Information Exchange. The Health Alert Network (HAN) is, according to the CDC Web site (http://www.cdc.gov), meant to "ensure that each community has rapid and timely access to emergent health information; a cadre of highly-trained professional personnel; and evidence-based practices and procedures for effective public health preparedness, response, and service on a 24/7 basis." Considered an improvement on the existing system of tracking diseases, the National Electronic Data Surveillance System (NEDSS) will create a nationwide standard for the collection and analysis of all health related data. According to the CDC, the Epidemic Information Exchange (Epi-X) is "the nation's secure, Internet-based communications network for public health investigation and response. Epi-X provides public health officials throughout the United States with up-to-the-minute information, reports, alerts, and discussions regarding terrorist events, toxic exposures, disease outbreaks, and other public health events."

In other programs, the CDC seeks to enhance the public health system and to expand response capacity, provides training in preparedness and response for public health employees, and continues to support and grow its networked information systems.