So far, the government's efforts to combat bioterrorism seem to have largely escaped the problems of overlapping jurisdictions that have plagued other counter-terrorism functions. Perhaps that's because bioterrorism is essentially the responsibility of one agency: the Department of Health and Human Services. After some initial missteps in dealing with anthrax, HHS Secretary Tommy G. Thompson has gotten good marks for marshaling department resources.
President Bush's proposed reorganization would end HHS's dominant role by transferring 300 employees and $4 billion from HHS to a new Department of Homeland Security--a move that Thompson says would allow bioterrorism experts to benefit from other intelligence data. Some members of Congress, however, worry that the transfer could create a duplication of effort and uproot some public health specialists from their traditional home at HHS.
"I don't know a lot of the details [about the HHS transfers], but I'm very uneasy about it," said Sen. James M. Jeffords, I-Vt., who sits on the Health, Education, Labor and Pensions Committee, which has jurisdiction over public health. "It's strange to think it's going to be a wonderful thing."
Sen. Bill Frist, R-Tenn., said that important questions need answering. "I'll be concerned if they start to separate scientific research and begin fragmenting it to the point where it's losing the synergies of having one place," he said, adding he's starting to talk to "friends" at HHS to see whether the move "makes sense or not."
Currently, Thompson has a one-stop shop at HHS. He has authority over the Public Health Service, which includes the Centers for Disease Control and Prevention (the experts on infectious disease); the Food and Drug Administration (the regulator of vaccines, drugs, and food safety); and the National Institutes of Health (the premier medical research entity). Moreover, HHS is home to the Office of Emergency Preparedness, which seeks to ensure that hospitals and other bioterrorism responders are ready to meet the challenge of an attack. In addition, Thompson has created the Office of Public Health Preparedness to coordinate the department's many efforts on bioterrorism.
Kevin Keane, assistant secretary for public affairs at HHS, said he expects the national pharmaceutical stockpile, the Office of Emergency Preparedness, and the new Office of Public Health Preparedness to move. Keane also believes the proposed department would take control of most of the bioterrorism grants that Thompson recently approved for states and cities to build up their public health systems.
But any division of labor could run into problems. Many NIH scientists working on bioterrorism have other responsibilities as well. "If you're an infectious-disease specialist, you know smallpox, but you also know West Nile virus and influenza," said Keane. One possibility being considered, Keane said, is to leave CDC and NIH personnel where they are, but to have the new department contract with them for bioterrorism-related work.
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