(image by CDC Global)
By Mitchell Croom
The recent public health crisis in West Africa has captured the attention of the world, and has brought to the forefront important questions about this country’s ability to respond to an epidemiological threat like Ebola. In 2001, just after the anthrax attacks, we faced a similar problem and acted swiftly to create federal programs for state-level healthcare providers, who serve as the United States’ first line of defense against infectious diseases. Overall, the federal programs were a resounding success, and today’s health infrastructure is more able than ever to respond to an outbreak.
The anthrax attacks of 2001 shifted national focus from the terrorist attacks of September 11th to the possibility of a bioterror attack, which could potentially harm many more people than another “conventional” act of terrorism. People, and Congresspeople, demanded that the country ready itself for the possibility of a biological attack. But the country’s health infrastructure was simply not up to the challenge. A 2002 study of the Institute of Medicine found that public health infrastructure in the United States suffered systemically from
- Outdated technologies
- An insufficiently-trained and understaffed workforce
- Antiquated labs
- Lack of live monitoring for epidemics
- Ineffective communication between health centers
- Incomplete emergency response plans
As a result, Congress passed the Public Health Security and Bioterrorism Preparedness and Response Act of 2002. It created billions of dollars in federal funding for the modernization of public health infrastructure and the creation of rapid-response capabilities to a domestic outbreak. Today, the Public Health Emergency Preparedness (PHEP) and Hospital Preparedness Program (HPP) cooperative agreements provide federal funding to all 50 states plus the District of Columbia, New York City, Los Angeles, and Chicago (independently of their states), as well as eight overseas territories.
Fiscal Year 2013 saw PHEP and HPP award a combined $916 million to hospitals and health centers around the United States. Through the benefices of this program, public health in the United States no longer suffers from the same problems it did it 2002. Every problem listed in the Institute of Medicine’s study has been significantly reduced since the implementation of the Public Health Security Act. However, public health is certainly not an issue to be treated lightly, and much work is left to be done.
The Department of Health & Human Services and the CDC have outlined 15 “public health preparedness capabilities” they believe are vital to maintaining an acceptable level of readiness to address challenges to public health going forward. Top priorities for continued improvement still include Command-and-control capabilities, so that emergency-response officials can coordinate nationwide efforts to stop epidemics if necessary. Information-sharing networks between and among hospitals also still have room for improvement, as does the actual distribution of medical materials. But the picture overall is a brighter one. Hospitals are much better-equipped to respond to public health crises now than fifteen years ago. Emergency responders are better-trained, hospitals are required to have regularly-updated emergency plans to address outbreaks and the like, and federal funding allows for lifesaving medicines and medical expertise to be transferred across the nation to areas of need almost instantaneously.
The hard-learned lessons of late 2001 and the quick action taken to address them have paid off in the long run. Important strides remain to be made, but public health has come a long way in the past decade and is set to go further still.
Any opinions expressed in this article are those held by the author, and are not representative of the Policy Review.