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HSPD-21: National Strategy for Public Health and Medical Preparedness

Michael Mair, Crystal Franco
Date posted:
October 23, 2007
Publication type:

Center for Biosecurity of UPMC, October 23, 2007

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Commentary as PDF


On October 18, 2007, the White House released Homeland Security Presidential Directive 21 (HSPD-21) establishing a “National Strategy for Public Health and Medical Preparedness.” This directive is an important and commendable development in national biodefense policy.  It offers clear strategic direction and is in keeping with the best professional judgments of many medical, public health, disaster response and community engagement experts in and out of government. 

HSPD-21 specifically addresses preparedness for catastrophic health events, which are defined as “any natural or manmade incident, including terrorism, that result in a number of ill or injured persons sufficient to overwhelm the capabilities of immediate local and regional emergency response and health care systems.”1 HSPD-21 stresses the importance of:

  • Establishing a biosurveillance capability that can provide “early warning” of a biological attack or naturally occurring disease outbreak and can provide ongoing “near real-time” information about an event as it unfolds;

  • Fostering medical countermeasure stockpiling and distribution so that communities are able to “distribute and dispense countermeasures to their populations within 48 hours after a decision to do so”;

  • Transforming the “national approach to health care in the context of a catastrophic health event” and developing a “disaster medical capability that can immediately re-orient and coordinate existing resources within all sectors to satisfy the needs of the population during a catastrophic health event”;

  • Formulating a “comprehensive plan for promoting community public health and medical preparedness to assist State and local authorities in building resilient communities.”

Commentary as PDF



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