By Greg Seigle
Global Security Newswire

WASHINGTON — The unprecedented $6 billion that U.S. President George W. Bush wants to pump into bioterrorism protection in fiscal 2003 indicates how ill prepared the nation’s health system is to handle any biological attacks, health care officials said today.

The record funding levels are needed not only to boost the capabilities of hospitals and medical staffs around the country, but also to research and develop new vaccines and antidotes, the officials said (see GSN, Feb. 5).

The White House budget request includes $1.6 billion geared to increase the capacity of state and local health care systems to respond to a bioterrorism attack by building overflow facilities, providing equipment and training doctors and nurses.  Another $2.4 billion is slated to boost the research and development of vaccines and antidotes, and the final $2 billion is earmarked to boost current vaccine stockpiles and improve communication abilities.

“There are some facilities [across the country] that have the capabilities to handle a bioterrorism attack now, but many more do not,” Herbert Herscowitz, a professor of microbiology and immunology at the Georgetown University Medical Center, told Global Security Newswire this morning.  “We also need money for training.  It’s sorely needed.”

“Our nation’s hospitals stand in the first line of defense against potential incidents that could involve large-scale casualties, including bioterrorism and chemical terrorism,” Health and Human Services Secretary Tommy Thompson said yesterday in a news conference.  “They must be ready to respond effectively, and they need the nation’s assistance to become prepared.”

The federal government has already begun the process of bolstering the capabilities of hospitals nationwide with more than $2.2 billion allotted for bioterrorism preparedness in this year’s budget, but these resources and the additional funds requested for fiscal 2003 are simply a “down payment” for a long-term plan to dramatically improve the health care system, Thompson said.

“Some of that money is going to waste.  There’s no help for that,” Tara O’Toole, director of the Johns Hopkins Center for Civilian Biodefense Strategies, said in November.  “We have got to get money to the local level very quickly in order to just get some raw capacity in there.”

State and Local Funds

Of the $1.6 billion requested for state and local health care systems, the largest share — $591 million — is earmarked for improving the infrastructure and response capabilities of hospitals, according to a White House budget release.  The funds would be used to build overflow annexes, decontamination facilities and communication systems.  They would also be used to devise training activities and coordination plans “that will help public health and emergency response communities work together better,” the release said.

The state and local health care section of the budget also includes $210 million for states to assess their existing capabilities to respond to biological attacks and to strengthen their abilities to do so, the release said.  An additional $200 million would boost state laboratory systems to speed up the collection and identification of biological or chemical agents, according to the release.

“Our first goal is to ensure that hospitals on the front lines have the capacity to identify the signs of biological attack and to be prepared to respond to biological and chemical incidents,” Thompson said.

“In addition, hospitals must be better prepared to control infection for communicable diseases,” he continued.  “We also want to help hospitals purchase the equipment they need, including personal protective equipment, to enable them to maintain service, control infection and decontaminate as needed.”

Vaccine and Antidote R&D

Of the $2.4 billion earmarked for aggressive research and development of vaccines and antidotes in the budget request, $1.75 billion would go to the National Institutes of Health.

“We know exactly what we’re going to spend our money on,” Anthony Fauci, director of NIH’s National Institute of Allergy and Infectious Diseases, told GSN yesterday (see GSN, Feb. 4).

Basic research and development to study the fundamentals of pathogens such as anthrax or smallpox — and how the human body reacts to them — would take up $441 million, Fauci said.  The agency would spend $592 million on discovery and development of vaccines and drugs that would hopefully stem the effects of biological weapon agents, he said.

Clinical research would take up $195 million, with $520 million used to build special facilities to conduct research with the deadly agents, Fauci said.  “You can’t do this [research] in a regular lab,” Fauci said.

“It’s going to be a nice blend,” he said.  “We’ve been massaging this budget for some time.  I think we have an enormous opportunity, and we’re going to deliver” some promising results.

“Ring Containment”

If there is a biological weapons attack before the hospitals and state and local health care systems are fully prepared to respond, officials believe that doctors, nurses, paramedics and other first responders will rise to the challenge, even though they acknowledge they are currently poorly prepared.

“We do have the means at this point to contain and quarantine,” said Georgetown’s Herscowitz.

Currently the CDC advocates a “ring containment” strategy modeled after the World Health Organization method that successfully eradicated smallpox around the globe by 1980 (see GSN, Nov. 27, 2001).  If one person is exposed to a contagious, potentially lethal biological agent, local authorities quickly need to quarantine them and at least the last 20 people who had been in contact with them.  Sources said the crucial factor in such worrisome scenarios is rapidly identifying the outbreak, so it can be contained.  Hence, doctors, emergency crews and other local officials on the front lines need to have as much funding and training as possible, they said.

“I think it’s pretty apparent to people by now, following the anthrax attacks, that medicine and public health is at the heart of a response to bioweapons threats,” O’Toole said in November.  “In the search for [financial] efficiency we have eliminated all excess capability … the public health system is in even worse shape.”

“It’s important to be able to recognize what’s happening,” Bush said yesterday.  “Secondly, we’ve got to respond in a modern way, a way that will help the American people survive any [biological] attack if it were to come.”

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