Expert: Bioterrorism Defense Funded in 'Knee-Jerk Fashion'

Pentagon Adviser Says Lawmakers Haven't Developed Realistic Plan
To Combat Threat of Biological Agents

BETHESDA, Md.–As President Bush readies his pen to sign a multibillion-dollar bioterrorism funding bill, a top Defense Department adviser says Congress has failed to set a timetable for improving the United States' bioterrorism readiness and is simply "throwing money against a problem."

In an interview published on the Health Affairs Web site (www.healthaffairs.org), George Poste, who chairs a Pentagon bioterrorism task force, tells health care futurist Jeff Goldsmith that lawmakers haven't "set up a realistic set of priorities as to what is doable within one year, three years, five years or what will require ten years." "

These monies have been allocated in a rather knee-jerk fashion without careful assessment," Poste says. "Too many people in Washington feel that by dispensing billions in the wake of September's horrors, they've done their bit and all is now well. They believe this in no small measure because the people who are the beneficiaries of the funding have told them that it will indeed be so."

A former research and development executive with SmithKline Beecham, Poste is a member of the Defense Department's Defense Science Board and chairs its bioterrorism task force. A pathologist, Poste also is chief executive of consulting group Health Technology Networks, which specializes in genomics technologies and computing in health care.

In the interview, Poste says that since the United States doesn't yet have the capability of detecting where terrorists or hostile countries are developing biological weapons, the best defense is improving diagnosis of and communications of infectious disease outbreaks that could signal a bioterrorist attack.

Today, many diseases that could be used as a biological weapons, such as anthrax, have the same symptoms as the flu, so clinics and hospitals need to be equipped with better testing capabilities to detect potential bioterrorist attacks and then communicate with public health officials when tests identify a suspected bioterrorism victim.

"Over the next twelve months, we need to completely rebuild the vital first line of public health defense," Poste says. "We've started to do this. More money for the [Centers for Disease Control and Prevention] and for state and local public health departments will help to accomplish this."

That may not be enough. As understanding of how the human body functions and how to engineer organisms grows, Poste warns that bioterrorists could develop as yet unseen ways to kill or cripple humans.

Poste also critiques the government's reaction to the anthrax episodes of last year, as well as how it has limited the health care system's ability to react to disasters. The anthrax episode showed that the government needs to effectively communicate the risk of infection for people exposed and those not directly exposed to biological agents, he says. Meanwhile, Poste also says that the federal government has limited hospitals' preparedness for all types of disasters, not just bioterrorism, by limiting reimbursement and forcing hospitals to reduce the number of beds they staff in the name of efficiency. But he adds that local health care networks haven't always done a good job of preparing for disasters, ranging from finding potential places to house patients to how to keep fearful employees on the job.

To speak with Dr. Poste, contact his executive assistant, Laura Stutzman, at 610-705-0828 or lstutzman@healthtechnetwork.com.

Health Affairs, published by Project HOPE, is a bimonthly multidisciplinary journal devoted to publishing the leading edge in health policy thought and research.

©2002 Project HOPE–The People-to-People Health Foundation, Inc.