States Ill-Prepared for Bio-Terror Attack, Report Says


States are not much better prepared now to deal with public health emergencies than they were before the Sept. 11 terrorist attacks, a new report says.

The report, Ready or not? Protecting the public's health in the age of bioterrorism, was released today (12/11) by the Trust for America's Health, a nonpartisan, nonprofit organization funded in part by The Pew Charitable Trusts, which also funds

The report examined each state's bioterror preparedness in three areas: funding (including state budgets for public health programs); public health infrastructures (such as laboratories and communications capabilities); and indicators that show how new bioterror funding has impacted public health systems.

California, Florida, Maryland and Tennessee achieved the highest rankings by meeting seven of 10 preparedness indicators. Arkansas, Kentucky, Mississippi, New Mexico and Wisconsin scored the worst, meeting just two of the indicators. Seventy percent of states met between three and five indicators, the report said.

"With bioterrorism, chemical terrorism, SARS (Severe Acute Respiratory Syndrome) and West Nile virus representing only a handful of today's health threats, state and local health agencies are being pushed and pulled beyond their limits," Lowell Weicker, the Trust's board president and a former Connecticut governor and U.S. senator, said in a prepared statement. "We need to ensure public health preparedness remains a top national priority and doesn't get caught up in red tape."

All 50 states have initial bioterrorism plans approved by the federal Centers for Disease Control, but coordination and implementation of these plans is not as far along as it first appeared to be, the report said.

States came up short in a number of areas.

The report said, for example, that 26 states failed to spend 90 percent of their allotted federal bioterror funds in fiscal 2002, based on a fall 2003 survey by the National Association of State and Territorial Health Officials (ASTHO). Congress provided the U.S. Centers for Disease Control and Prevention $940 million in fiscal 2002 and $870 million in fiscal 2003 to support state and local public health readiness. Since it was a new source of money, the report said, many states had first to develop spending plans for the funds, which are now in place for future allocations.

"Individual states are certainly going to have some questions and concerns about how they have been evaluated on some of these indicators," George Hardy, executive director of ASTHO told "We are totally supportive of the bottom line findings that progress has been made, considerably more needs to be made and that the sustained commitment (by the federal government) is required."

Another shortcoming cited in the report is that 39 states did not make state-specific information about the SARS outbreak available to the general public and health professionals.

It also said 48 states do not have enough staff to receive and distribute medication and supplies from the Strategic National Stockpile.

And 37 states said they do not have a completed plan for dealing with the emergence of a new, lethal strain of influenza.

The report attributed low readiness scores in part to state budget cuts in public health that occurred in 32 states.

"Clearly states have cut spending in public health ... and we hate to see that, but I think that what you'll hear from governors' offices and legislators is that there were cuts in every agency in state government," Hardy told In most cases, he said, public health wasn't singled out.


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