Swine flu has now caused more than 100 deaths in Mexico and more than 20 confirmed cases in five U.S. states, making the issue of public health—global, national, and local—a paramount national concern once again. As a result, the Centers for Disease Control is in contact with and closely monitoring actions taken at the local level, which leads us to the most important question going forward. Since public health is first and foremost a local responsibility, how well will local authorities perform, particularly if the disease spreads further?
The public health system in the United States—the network of federal, state, local, and private-sector entities responsible for the health of the nation’s population—has been under stress for decades, even before the current economic crisis. While medical surveillance systems have improved, particularly in rural areas, they are largely dependent on an informal network of public health, veterinary, and natural resource professionals and are not yet incorporated into a national system of public health. And despite our state-of-the-art medical technology and dedicated health professionals, we do not have sufficient medical infrastructure in many parts of the country to accommodate everyone who might need medical care in a crisis.
Public health became a national security concern in the aftermath of the 2001 anthrax attacks. But this emerging swine flu epidemic poses a more significant and more likely threat to the United States and the region. It will be important to act aggressively and sensibly, deepen national and international relationships and trust, learn valuable lessons, and continue to make prudent investments to improve public health capabilities across the country and around the world.
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