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Issues in bioterrorism response

Issues in bioterrorism response. Nicole Lurie, M.D., M.S.P.H. RAND. Criminal Acts Intended To Coerce Governments and Populations To Change Policies. New faces of terrorism Lessons from 9/11 and anthrax Importance of dual use Community health security systems Challenges for the future.

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Issues in bioterrorism response

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  1. Issues in bioterrorism response Nicole Lurie, M.D., M.S.P.H. RAND

  2. Criminal Acts Intended To Coerce Governments and Populations To Change Policies • New faces of terrorism • Lessons from 9/11 and anthrax • Importance of dual use • Community health security systems • Challenges for the future

  3. New Faces Of Terrorism • Ideology vs. poverty • Middle class vs. uneducated • Mass casualties vs. messages • Non-state vs. state origin • Domestic vs. foreign

  4. Lessons From 9/11 and Anthrax • Public health infrastructure has decayed • Communications failures were rampant • Lab and investigatory capacity were overwhelmed • Our surveillance and information sharing systems are underdeveloped and inadequate • Involved ‘community response’ must be broad

  5. Uniqueness of Biological Events • Slow to evolve • Progressive nature • Occult presentations • Distinguishing natural from man-made • Focus on surveillance and response • Vaccines and antibiotics • Fear!!!

  6. Systems are being built and rebuilt • Dual use is critical • Cost effectiveness • New and emerging infections • Antibiotic resistance • Must serve interests and needs of health delivery and public health systems • Must involve broader public

  7. Community Health Security Systems • Public Health • Medical • EMS • Public Safety • Defense and intelligence • Media • Community organizations • Disaster organizations

  8. Federal, State and Local Responses • Federal funds • State organizations • Local responses

  9. Challenges • Maintenance of interest and effort • Coordination • Who is in charge • Law enforcement vs. health? • Communications • Between entities • Data sharing and surveillance • Media • Spokespersons

  10. Challenges • Research needs- vaccines, antibiotic resistance • Public health needs • Surveillance techniques e.g. syndromic approaches • Lab capacity and reporting • Preparedness and response • Trade-offs?? • National vaccine strategy • Cost effectiveness (people, beds, and funds) • Ethical and civil liberties • Academic openness vs. security

  11. The Intelligence-Health Interface • National Intelligence Fusion Center • Privacy • HIPAA • Security Clearances • Standards???

  12. Challenges for compliance community • Lack of standards • Inconsistent measures, metrics, reporting formats • Unclear data sharing agreements and procedures • Meeting needs of bioterrorism surveillance, public health, and health care simultaneously

  13. Looking Ahead • Living with risk • Maintaining our values • Serving as effective stewards of societal resources • Strengthening our security • Maintaining our perspective

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