State governments are starting to get an infusion of federal funds to help them improve their defenses against possible future biological attacks. The federal government recently moved to make the first installments of more than $200 million available to the states so they can help bolster public health infrastructure preparedness.
The funds are coming from a $2.9 billion supplemental bioterrorism appropriations measure signed into law by President Bush in January. The remaining 80 percent of the $1 billion in state funds will be awarded once the Department of Health and Human Services receives the state plans called for in the initial funding round.
State plans are due to HHS no later than May 15. In its plan, each state is to outline how it will respond to a bioterrorism attack and other outbreaks of infectious disease. Each will be reviewed and endorsed by the states governor before being submitted to HHS.
Lawmakers moved quickly to boost funding for the public health infrastructure after the recent anthrax attacks revealed holes in the system.
How the money will be targeted
The initial round of funds will be used to upgrade infectious disease surveillance, expand public health laboratory and communications capacities, and improve connectivity between hospitals, and city, local, and state health departments to enhance reporting ability.
The Lab Network is one of the first areas to be targeted. The network consists of laboratories across the country that conduct tests for purposes of identifying outbreaks of disease, including disease from a bioterrorism attack. The funds in this category will be used to expand the network further and enhance lab capabilities.
Another area to be targeted is the Health Alert Network (HAN), a communications network used by the Centers for Disease Control and Prevention (CDC). HAN communicates with state and local health departments regarding possible disease outbreaks and provides warning if a disease outbreak is known to exist somewhere in the country. The aim is to eventually have at least 90 percent of the U.S. population covered by the HAN network.
Some of the funds will also be used to increase the national supply of push packs preassembled packages of life-saving medical supplies. These stockpiles include doses of smallpox vaccine and antibiotics that can be rushed to public health agencies within 12 hours in the event of an attack or infectious outbreak. Currently, eight 50-ton packages are available in various locations around the country. The new funds will make it possible to increase the number to 12. In addition, states will develop emergency plans to deal with receiving and distributing the stockpile, as well as vaccines or antibiotics.
Funding amounts for the Washington, D.C. area have already been announced. Maryland, for example, will ultimately receive $19 million; Virginia, $23 million; and the District of Columbia, $12 million. Public health officials in the area will use some of the funds to develop a regional medical surveillance system that will track symptoms reported at emergency rooms and then share the data with state and local health officials.
While public health officials are pleased with the increased funding, they worry that the funds will not be available over a sufficiently long period of time. Its important to avoid yo-yo funding, which ultimately results in fluctuations in health, Dr. Georges Benjamin, M.D. said at a recent media briefing. Dr. Benjamin is secretary of Health and Mental Hygiene for the state of Maryland and president of the Association of State and Territorial Health Officials.
Sustained funding is needed if the capacity of the public health infrastructure is to be transformed from the capacity to deal with a single event to being able to deal with a broad range of events, he added.
Public laboratories are now expected to handle more urgent responsibilities, noted Mary J. R. Gilchrist, Ph.D., director of the University of Iowa Hygienic Laboratory and president of the Association of Public Health Laboratories. For example, these laboratories need to be able to rapidly identify the whole breath of potential infectious agents with devices that are just becoming available, she said.
Looking to the future, Dr. Gilchrist said public health laboratories need individuals to conduct tests, communicate to our clientele, educate and provide information technology. We need instruments to conduct tests, ensure safety of personnel, and provide rapid communication, and documents to archive our results.
Increased and sustained federal funding, public officials say, will make these objectives possible. President Bush is already moving in that direction. It was recently announced by his administration that the President will ask Congress to approve $11 billion in funding over the next two years to improve our public health system and protect the country against biological terrorism.
Joan Szabo is a Washington, DC, freelance writer specializing in healthcare issues. She has been writing the Washington Report column for MLO for the past five years.
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