Only seven states and three cities have the capability to deliver and administer vital medicines in the event of a large-scale emergency. Over 50% of Americans today live in states that still lack plans for dealing with large-scale casualties in the event of a catastrophic biological terrorist attack, and 20% of Americans would have no access to hospitals with sufficient medical equipment to handle such a mammoth emergency.

This sorry state of affairs — documented by the Trust for America’s Health — exists despite over $30 billion deployed by the federal government since 9/11 to prepare for the worst, with more than half that going towards stockpiling vaccines and other vital medicines. Today’s hearings before the Senate Appropriations Committee’s Homeland Security subcommittee on the nation’s biodefense preparations offer the subcommittee members the opportunity to reconsider the premise of the federal government’s National Response Plan (NRP) to a terrorist-induced epidemic=

The NRP relies on state and local authorities to take on the primary responsibility for any biological attack while the federal government devotes the bulk of its efforts to gathering vaccines. The problem: Until state and local authorities acquire the capabilities to implement their own effective biosecurity strategies, the NRP needs to assume that they would be quickly overwhelmed by a large-scale emergency.

With adequate resources available to so few Americans, a comprehensive national public health strategy is key to widespread success across the United States in the event of disaster. In addition to strengthening the public health system, the NRP must also realize that their effectiveness in preventing biological threats within American borders hinges on the accessibility of public health. Uninsured Americans and those marginalized in the health care system are among the most vulnerable.

Not only is it unfair for some Americans to receive preferential treatment, such as vaccines, over others, but leaving part of the population at risk undermines the national security of the country as a whole by potentially creating pockets of infection. Furthermore, the United States must work to strengthen the World Health Organization and other international partners’ efforts to detect and contain contagious diseases.

Current U.S. strategy focuses primarily on domestic protection but fails to sufficiently work towards detecting and containing epidemics before they reach American shores. Increased global cooperation is also needed in order to ensure more fail-safe global guidelines for keeping dangerous pathogens secure and out of the hands of terrorists and extremist regimes.

The Center for American Progress late last year warned Congress and the Bush administration that gaps in our nation’s biodefenses were serious, if also reversible (click to see our report below). Next month the Center will publish a detailed biosecurity action plan authored by Andrew Grotto, Senior National Security Analyst at the Center, and Jonathan Tucker, a Senior Fellow at the Center for Nonproliferation Studies of the Monterey Institute of International Studies. Stay tuned.

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