July 9, 2002 (CIDRAP News) - Several national public health organizations are urging Congress and the Bush administration not to shift federal bioterrorism preparedness programs from the Department of Health and Human Services (HHS) to the proposed Department of Homeland Security.
The American Public Health Association (APHA), the National Association of County and City Health Officials (NACCHO), and the Council of State and Territorial Epidemiologists (CSTE) contend that transferring bioterrrorism preparedness planning and research to the new department would hinder efforts to strengthen the public health system. They assert that the same types of activities and resources are needed to deal with bioterrorism and with natural disease threats.
"Public health infrastructure and bioterrorism preparedness are so closely related that we believe the nation cannot have one without the other," stated CSTE President Gianfranco Pezzino, MD, MPH, in a Jul 2 letter to Bush. If bioterrorism-related programs are moved to a new department, he said, "This may create a disconnect between bioterrorism preparedness and other essential components of infectious disease response and control, compromising the ability of public health officials at the state and local level to work effectively. Such a move could jeopardize the dual-purpose nature of bioterrorism preparedness activities that is so essential for a successful response strategy."
As currently described on the White House Web site, the administration's proposal would put the Homeland Security Department in charge of research and development of measures to protect the nation against chemical, biological, radiological, and nuclear (CBRN) terrorism. The department also would set guidelines for state and local efforts to counter such threats.
The proposed legislation says the department would administer its bioterrorism-related research and development "through the Department of Health and Human Services (including the Public Health Service)." However, the homeland security secretary "shall have the authority to establish the research and development program, including the setting of priorities."
When the administration unveiled the Homeland Security Department proposal Jun 6, the plan included transferring 150 jobs and $1.99 billion in civilian biodefense research from HHS to the new department.Officials also said the National Pharmaceutical Stockpile, now administered by the Centers for Disease Control and Prevention, would move to the new department.
APHA voiced its concerns about the plan in a Jun 27 news release. "APHA opposes transferring public health priority setting, funding, research, and program management to a new department," the group stated. "APHA urges Congress and the administration to preserve the integrity of the current public health system and leave public health preparedness with those individuals and agencies with the expertise and credibility to get the job done."
APHA also complained that the administration proposal does not "adequately delineate" the public health responsibilities of the new department and HHS. "Further, the proposal separates the priority setting and the funding streams for public health programs from the operations and implementation of such activities," the group said. "The result is a lack of accountability for public health objectives and the potential for disruption of public health assistance programs that have basic public health responsibilities as well as homeland security functions."
NACCHO expressed similar concerns in a position statement dated Jun 26. The group said it has "grave concerns about any federal action that would remove policymaking and/or administrative authority for public health preparedness for bioterrorism from the Department of Health and Human Services. We believe that such an action would compromise the speed, efficiency, and scientific integrity of the nation's activities in preparing the public health system to detect and respond to an act of bioterrorism."
NACCHO asserted that separating bioterrorism preparedness from other public health functions would reverse progress made as a result of the Public Health Threats and Emergencies Act of 2000 and the Public Health Security and Bioterrorism Response Act of 2002. Further, the group argued that such a separation would lead to duplicated efforts and fragmented leadership.
"HHS has administered emergency supplemental funds for state and local public health capacity building with unprecedented efficiency," NACCHO said. "A change in leadership and management would inevitably create disruption and inefficiency in a process that is serving the nation well."
A Jul 8 "action alert" on the NACCHO Web site said House and Senate committees would mark up the Homeland Security Department legislation this week. The alert urged members to fax letters to Bush and to Congress urging that the HHS grant program for state and local bioterrorism preparedness not be transferred to the new department.
The White House's Homeland Security Office today did not return a phone call seeking comment on the public health groups' concerns.
APHA has about 50,000 members in various healthcare disciplines, while NACCHO represents about 3,000 local health departments. Both groups are based in Washington, DC. CSTE, headquartered in Atlanta, has about 400 members.
See also:
CSTE home page with links to letters to President Bush and Congress
[No longer available]
Text of Title III of the proposed Homeland Security Department bill, addressing chemical, biological, radiological, and nuclear threats
[No longer available]
