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Editor's note: The following are comments made by Bill Roper, dean of Carolina's School of Public Health, as part of "Rx for Public Health in Responding to Bioterrorism," the topic discussed in the Oct. 16 installment of Public Radio International's To the Point, which is broadcast from KCRW in Santa Monica, Calif. The show was hosted by Warren Olney. The School of Public Health here operates a federally funded Center for Public Health Preparedness, one of only seven in the country. The center helps to train those who respond to current and emerging public health threats. Roper is a former director of the Centers for Disease Control.
OLNEY So far, we seem to be handling this matter [anthrax contamination] well enough. But, how long is that going to be the case if, in fact, there are more such outbreaks, and particularly if the distribution of the spores becomes more efficient?
ROPER Sure. I think we are only at the beginning stages of this. What we learned on September 11th is that terrorism is a real threat to America. And, we've learned, in the last couple of weeks, that bio-terrorism is a real threat to the nation's health. Public health is about protecting against threats to our health. And, we surely have seen that we need to strengthen our nation's public health infrastructure, that many people are now talking about that.
Thankfully, a lot of work has been done in the last few years. Much more yet needs to be done to be sure. But, I think it would be helpful to begin with an understanding of, sort of, who's who and what's what in this kind of process. Our country has, at the local level, around the country, a series of local health departments, like the one, in this case, in Palm Beach County. They, in turn, interact with the state health department in Florida, of course based in Tallahassee.
The staffs in those agencies of government are an important part of this process. They do the on-site investigation, and reporting up to the line, so to speak. Another key element are trained folks working in laboratories, who can diagnose this, and confirm, diagnose and confirm that causative agent, in this case, anthrax. The information system that nets all this together is very important.
One of the things that a number of us have been focused on in recent years has been getting all of this to be done on-line so that it's an instantaneous transmission of information, again, in this case, from Palm Beach, to Tallahassee, to Atlanta, where the federal agency, the Centers for Disease Control and Prevention is located. For all of that to work smoothly, and it appears to have worked smoothly in this case, we need to have lots of things in place, at the ready.
For much of the time that's probably not very exciting. It could be even boring. But, as we've all learned in the last few days, the nation must have this infrastructure at the ready all the time. And, frankly, we need to put some real dollars, and other resources, into strengthening that infrastructure.
OLNEY The federal government, the Health and Human Services Department, is asking for 1.5 billion dollars in all ... for any number of things, buying drugs, developing vaccines, and manufacturing them, training people, and so on. Is that enough?
ROPER It's surely a healthy start. Probably, we will need to have additional investments down the line. That's a dramatic increase, to be sure, from what was the case just a few weeks ago. Sen. Bill Frist and Sen. Ted Kennedy passed legislation a year or two ago, focused on this very issue, strengthening infrastructure to be ready for emergencies, including terrorism, bioterrorism. And, we've had only small amounts of money put into that prior to Sept. 11, of course.
Now, we see one and a half billion devoted to it. Much of that money, and that sounds like a lot of money, is going to be focused on vaccines, and drugs, and so on. But, as I was saying a moment ago, we really need to upgrade the training and equipping of local and state health departments, and the information systems that net all of that together, the laboratories that support the effort, etc.
You mentioned, in your setup, that we run one of the seven Centers for Public Health Preparedness in the country. There need to be more of those. And, we need to have more resources. That sounds self-serving, and I guess it is, but what we do through those centers is train local health department workers, police, and fire workers, the first responders, as they are called, we all have seen on the television news the last couple of days.
The people that ride up with the lights flashing, and then come in and put on these space suits, and do the things that need to be done to get control of the situation ... and see if there really is a problem here. We need to make sure that every community in America has people that are trained to do that. And, we surely don't have that at the moment. Florida, we were lucky, because they have one of these centers at the University of South Florida, Tampa. New York, we were lucky, because Columbia University has one of these centers as well. But, we need much more of this kind of effort around the country.
OLNEY You talked about the federally funded Center for Preparedness. You talked, also, about the need for infrastructure. And, again, let's go back to the 1.5 billion dollars, which the secretary has now proposed. How much of that is, in fact, going to be spent on infrastructure? You said most of it would probably go to drugs and vaccines.
ROPER I haven't seen the full breakout of the number. ... We need, not just to focus on one-time kinds of things particular to this episode, but the broader issue of getting ready for the next thing. A general point I'd make is similar to one that's been made a lot lately in the aftermath of September 11th. That is, the next terrorist event is probably not going to be done with an airplane.
And, so, all the efforts to get our airplanes, and airports, and whatever, to be hyper safe is not wasted, but it's probably not as useful as more general kinds of activity. Similarly, maybe I'm mistaken, but I doubt anthrax is going to be the key agent for bioterrorism going forward. And, so, we need to focus on the broader issue of public health, and the need for surveillance systems, and information systems, and full training of the frontline workers, and so on.
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