The American Public Health Association,
Recognizing the essential public health role of assessment, prevention, response, and training to mitigate the potential disastrous consequences of emerging and re-emerging infectious diseases, including bioterrorism; and
Recognizing that our public health system would be called upon to detect and respond to a bioterrorism event, just as we are asked to respond to other disasters, conventional infections and disease outbreaks; and
Recognizing that APHA previously called for increased training of the public health work force to prepare for and respond to disasters1 and that this need has only increased since that time; and
Recognizing that preparedness for emerging and re-emerging infectious diseases, including bioterrorism, requires collaboration between public health authorities and civilian emergency managers that can also enhance public health participation in common natural and technological disasters; and
Noting that CDC has chosen not to recommend the mass vaccination of the civilian population; and
Noting that the US Department of Health and Human Services designated the Centers for Disease Control and Prevention (CDC) to lead the effort to upgrade national public health capability to counter potential acts of bioterrorism and that in September 1999, CDC provided $40 million to fund 127 bioterrorism-related projects at state and local health departments to build public health infrastructure for both routine and emergency use;2 and
Understanding that the CDC, in cooperation with the working group on domestic and international surveillance for possible bioterrorism, is providing public health leadership3-5 to strengthen public health readiness to address bioterrorism through (1) surveillance to detect unusual events; (2) investigation and containment of outbreaks; (3) laboratory diagnosis; (4) coordination and communicating with the Department of Justice, Office of Emergency Preparedness, Food and Drug Administration, National Institutes of Health, Department of Defense, Federal Emergency Management Agency, and others; and (5) preparedness and planning; therefore,
- Supports federal government efforts to provide financial resources to build state and local capacity of health departments and urges the federal government to allocate new dedicated funding to assure minimum nationwide capacity in all state and local health departments; and
- Supports the activities of CDC in providing national public health leadership in surveillance, investigation and containment of outbreaks, laboratory diagnosis, coordination and communication, and preparedness and planning; and
- Supports the activities of state and local health departments in providing local public health leadership in surveillance, investigation, and containment of outbreaks; laboratory diagnosis; coordination and communication; and preparedness and planning; and
- Supports training of public health professionals in their preparation for and response to emerging and re-emerging infectious diseases, including bioterrorism and similar events; and
- Urges that the planning for public health emergencies, such as emerging and re-emerging infectious disease, including bioterrorism, include public health professionals as a full partner with sufficient autonomy to protect the public’s health; and
- Calls on DHHS to develop a participatory process to fully evaluate whether the current funding for building capacity of the public health infrastructure and training the public health work force has been sufficient to protect the public from all outbreaks of infectious disease, including bioterrorism; and
- Urges that this process include an objective characterization of the bioterrorist threat; an evaluation of alternatives for threat reduction; an assessment of measures necessary to guarantee that "defensive" programs do not promote offensive capabilities; an examination of other ways to primarily protect U.S. and global populations from deliberately-induced, naturally occurring, or re-emerging infectious diseases, including strengthening public health infrastructure; an analysis of potential effects on civil liberties; and, if CDC should reconsider mass vaccination of civilians populations, a scientifically rigorous assessment of the effectiveness of mass vaccinations for organisms that could be genetically modified prior to use as weapons; and
- Reaffirms APHA’s support of federal resources for security being directed to building the global capacity of the public health infrastructure to strengthen laboratories, surveillance, and technology; and
- Urges the federal government to allocate new funding for protection of the public from emerging and re-emerging infectious diseases, including bioterrorism, that does not divert resources allocated for other human needs, underscoring APHA's long-standing commitment to the provision of adequate nutrition, housing and health care as a central tenet of public health protection.
References
- APHA Policy Statement 9116: Health Professionals and Disaster Preparedness. APHA Policy Statements 1948–present, cumulative. Washington DC: American Public Health Association; current volume.
- Operating Plan for Anti-Bioterrorism Initiative FY 99. Washington, DC: US Department of Health and Human Services, 1999.
- Statement of James M. Hughes, MD, Director, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Department of Health and Human Services, Before the Subcommittee on Labor, Health and Human Services, and Education Committee on Appropriations, US Senate, June 2, 1998.
- Statement of James M. Hughes, MD, Director, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Department of Health and Human Services, Before the Subcommittee on Technology, Terrorism and Government Information, Subcommittee on Youth Violence, Committee of the Judiciary, US Senate, April 20, 1999.
- Statement of Scott R. Lillibridge, MD, Director, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Department of Health and Human Services, Before the Subcommittee on National Security, Veteran Affairs and International Relations, Committee on Government Reform, US. House of Representatives, September 22, 1999.
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