The State of Bioterrorism Surveillance

By Lilly Chapa

The NAS report also revealed that local officials have little faith in the BioWatch program as a whole. “Some [local public health officials] stated to the committee that they would be unlikely to administer prophylaxis on the basis of a BAR alone, waiting instead until clinical cases occur before taking that step,” the report noted.

Overall value. The GAO’s Caldwell says that they do not question the overall value of a biosurveillance program, despite concerns with BioWatch. “It seems completely reasonable to us because we’ve got demonstrations of terrorists using that kind of thing, and we’re certainly not questioning the need for something that would be able to do some kind of monitoring in key places,” he states.

That view isn’t shared by everyone. Given that “we’re never going to have enough money to cover every possible contingency for every possible threat,” says Kellermann, this particular approach, which “addresses such a narrow piece of the threat space,” may not be the best use of limited resources.

Those funds may be better directed elsewhere, say others. For example, Rep. Tim Murphy (R-PA), speaking at the congressional hearing on the program, said “It makes no sense to expand outdoor monitoring for a less likely large-scale attack, while not addressing the declining number of public health responders who are needed in any kind of attack.”
Focusing on the core public health infrastructure and building capacity that would allow the country to respond to a much wider range of threats would be a better strategic choice, Kellermann says.

A 2009 Center for Strategic and International Studies paper reported that the U.S. response to bioterrorism overemphasizes detection and countermeasures at the expense of prevention and strengthening public health.

“Rebuilding the U.S. public health infrastructure would provide both better detection and better capability to treat the impacts of a biological attack, as well as improve surge capacity to deal with other mass casualty incidents,” the report states.



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