The State of Biopreparedness:
Lessons for Leaders, Proposals for Progress

Overview

I would just ask you to think for a minute about the day after a biological attack occurring
in Seoul or San Francisco. What is it that we're not doing that we will wish we had been doing
that could have prevented that? And what is it that we weren't doing enough of or fast enough
or in enough places that could have better prepared us to deal with such an attack?

- Andrew Weber, September 23, 2010

The state of biopreparedness in the U.S. is improving, but many important challenges remain.

Since 2001, federal, state, and local governments and their private sector and NGO partners have collaborated across disciplines to cultivate working relationships and build systems for preparedness, response, and recovery from biological attacks and other public health threats. Experiences with SARS, West Nile virus, hurricanes Katrina and Rita, H5N1 influenza, the 2009 earthquake in Haiti, and the H1N1 pandemic tested U.S. response plans and systems and provided important lessons that have helped strengthen systems and capabilities.

With regard to biodefense specifically, the U.S. has grown stronger in the past 10 years, but there is work that remains to be done in many realms crucial to biopreparedness-including threat assessment, detection and surveillance, countermeasure development and distribution, public health and medical response, and national recovery-all steps in the chain of resilience described by Senator Bob Graham at the conference, The State of Biopreparedness: Lessons from Leaders, Proposals for Progress (Washington, DC; September 23, 2010).

With the support of the Alfred P. Sloan Foundation (conference sponsor), the Center convened this national meeting to provide a forum for thought leaders from the public and private sectors to discuss ongoing challenges and priorities in biopreparedness and identify opportunities for improvement. Read the conference summary report for highlights.

Suggested Background Reading:

• Smallpox-The Death of a Disease: The Inside Story of Eradicating a Worldwide Killer, by D.A. Henderson. Amherst, NY: Prometheus Books; 2009.
• Hospitals Rising to the Challenge: The First Five Years of the U.S. Hospital Preparedness Program and Priorities Going Forward (Evaluation Report, March 2009). Baltimore, MD: Center for Biosecurity of UPMC. Prepared for the U.S. Department of Health and Human Services under Contract #HHSO100200700038C.
• The Next Challenge in Healthcare Preparedness: Catastrophic Health Events (Preparedness Report, January 2010). Baltimore, MD: Center for Biosecurity of UPMC. Prepared for the U.S. Department of Health and Human Services under Contract #HHSO100200700038C.
• Dispensing Medical Countermeasures for Public Health Emergencies: Workshop Summary. Institute of Medicine. Washington, DC: National Academies Press; 2008.
• Executive Order -- Medical Countermeasures Following a Biological Attack [news release]. Washington, DC: Office of the Press Secretary, The White House; December 30, 2009.
• Maximizing State and Local Medical Countermeasure Stockpile Investments Through the Shelf-Life Extension Program. Courtney B, Easton J, Inglesby TV, SooHoo C. Biosecurity and Bioterrorism. 2009;7(1)
• Getting Medicine to Millions: New Strategies for Mass Distribution. Lien O, Maldin B, Franco C, Gronvall GK. Biosecurity and Bioterrorism. 2006;4(2).
• Assessing the Legal Standard of Care in Public Health Emergencies. Hodge Jr. JG, Courtney B. JAMA. 2010;303(4):361-362.
• National Preparedness for a Catastrophic Emergency: Crisis Standards of Care. Gostin LO, Hanfling D.JAMA. 2009;302(21):2365-2366.
• Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations: A Letter Report (Summary). Committee on Guidance for Establishing Standards of Care for Use in Disaster Situations, Institute of Medicine. September 24, 2009.
• Draft Planning Guidance for Recovery Following Biological Incidents. U.S. Department of Homeland Security, U.S. Environmental Protection Agency. May 2009.
• Environmental Decontamination Following a Large-Scale Bioterrorism Attack: Federal Progress and Remaining Gaps. Franco C, Bouri N. Biosecurity and Bioterrorism. 2010;8(2).