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U.S. Biodefense Criteria Not Yet Prepared
The U.S. Centers for Disease Control and Prevention has yet to fully develop mandated criteria for judging the success of federally funded biodefense efforts around the nation, the Associated Press reported yesterday (see GSN, Feb. 8). “We’re not able to demonstrate accountability,” said Craig Thomas, who leads the agency office that tracks and evaluates public health agencies. “It’s not just accountability to the CDC. It’s accountability to your community. It’s accountability to your local stakeholders and the people who fund you as well.” Biodefense funding for states rose from $40.7 million in 1999 to $950 million in 2002, part of a huge increase in antiterrorism spending in the wake of the Sept. 11 attacks and the anthrax mailings that followed. Total bioterrorism and pandemic preparedness funding has reached $5 billion. Funding has been used for disease surveillance, hiring medical personnel, and purchases of drugs and equipment. This helped health agencies to significantly improve their ability to face major threats, according to health officials. Congress wanted statistical proof that the money is being well spent, but the Centers for Disease Control has relied on anecdotal evidence, AP reported. “The difficulty comes down to, how do you measure (improvement), how do you quantify that, so you have something you can track over time, something you can use to identify gaps that have to be filled,” said Richard Besser, head of the CDC terrorism preparedness office. The agency last year used only 23 of the 100 benchmarks developed in 2003. Questions for states include the length of time needed to: have a “knowledgeable public health professional” answer an urgent call, deliver a specimen to a laboratory, or initiate an epidemiological investigation of an incident. There are two major hurdles to developing the measurements, CDC officials say: the absence of data showing what actions would achieve the greatest results in a specific incident and trouble reaching agreement among health departments on what needs to be measured. There is a lack of clarity regarding many of the measurements, according to health officials who attended a recent conference in “I don’t think they’re asking things that are measurable. The right questions are not being asked,” said Kimberly Allan of the Virginia Health Department, calling the measurements overly broad and difficult to answer. Besser acknowledged that improvements are needed. “But it’s absolutely essential that we move forward and start measuring, and then as we get more experience, we’ll continue to refine and improve them,” he said (Kevin Freking, Associated Press/Yahoo!News, March 11).
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