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U.S. Response: Public Health System Has Improved, Experts Say By Mike Nartker Styling its report as a school report card, the association gave grades of B or higher to U.S. efforts to improve public health capabilities in several areas. The association praised U.S. efforts to strengthen public health infrastructure by increasing funding for public health programs and developing new laboratories in which analysts can test for chemical and biological agents (see GSN, Oct. 16). The association also concluded, however, that the United States still lacks a baseline set of performance goals with which to measure public health preparedness, and it lacks cooperation at regional levels, with readiness being lower in rural areas than in major urban centers. The United States has increased potential access to medicines and vaccines following a terrorist attack and educated health professionals and the public about possible consequences of terrorism, according to the association (see GSN, June 7). While medical schools have begun teaching more bioterrorism-related information, experts still disagree over how to integrate such information into curricula, the report says. The association reported progress in addressing mental health needs of those affected by terrorism and in creating a capability to collect data on mental health-related consequences of terrorism. U.S. officials have also better ensured protection of the environment and food and water supplies, the report says. Thousands of facilities, however, use and store chemical agents that might pose risks to the general population in the event of a release, the association said (see GSN, Aug. 1). The association gave a grade of C — the lowest in areas related to the U.S. public health system — to the progress made in delineating roles and responsibilities among public health agencies, law enforcement entities and first responders. The U.S. General Accounting Office has determined that officials have so far failed to achieve any highly integrated approach to securing the country against possible threats, the association report says. Potential response roles in the event of an attack have also been poorly defined among state and local law enforcement and emergency personnel, according to the association (see GSN, Oct. 25). International and Sociological Factors The association harshly criticized the apparent lack of progress in addressing sociological and international concerns. It gave one of the lowest grades, a D, to U.S. efforts to control and eliminate weapons of mass destruction (see GSN, Oct. 8). The association criticized decisions in 2001 and 2002 to reject a protocol to strengthen the Biological Weapons Convention and to withdraw from the 1972 Anti-Ballistic Missile Treaty. It also criticized delays in destroying the U.S. chemical weapons arsenal as mandated by the Chemical Weapons Convention. The association praised the the swift accomplishments of the war in Afghanistan, which overthrew the Taliban regime. The United States has made less progress, however, in providing humanitarian assistance to international populations affected by terrorism and in promoting human rights, the report says. The association gave another D grade to U.S. efforts to address poverty and social injustices that could lead to terrorism, and it gave an F grade to progress in preventing hate crimes and protecting civil liberties. The latter grade is based, in part, on the Operation TIPS program, proposed by the U.S. Justice Department, which would recruit civilian informants for surveillance purposes, the report says. The association also criticized the establishment of military tribunals for suspected terrorists, the classification of two U.S. citizens as “enemy combatants” and their subsequent detention on terrorism suspicions and the detention and deportations of U.S. aliens following the Sept. 11 attacks (see GSN, June 12).
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