New developments in health and medical preparedness related to the threat of terrorism

Abstract

Since 1999, and particularly the tragic events of September 11, 2001, the federal government has sought to prepare against the threat of bioterrorism by developing a comprehensive national "preparedness and response" program that encompasses state and local health agencies. In fiscal year 1999, approximately $150 million was made available through the Department of Health and Human Services (DHHS) to develop bioterrorism preparedness and response infrastructure in public health departments. Emergency medical services (EMS) funding was not specifically considered in this DHHS program, primarily because EMS is usually funded through traditional first-responder programs in other departments of the U.S. government. This approach may be effective in addressing some EMS needs, but it is insufficient for enhancing the emergency medical infrastructure throughout this country or for linking emergency public health and emergency medical prehospital initiatives. The role of EMS is shifting. As EMS in the future will be expected to be more comprehensive and encompass the urgent aspects of public health preparedness and response, more resources must be applied to the medical control units of EMS systems so that they may provide the most benefit to the public health and medical system. Emergency medical systems and their leadership are poised to play a critical role in national preparedness against bioterrorism. Preparedness funding within the health sector will continue to expand markedly in the near future. However, a well-developed strategy will be necessary to sustain the best linkage between EMS, hospital preparedness, and public health preparedness at the local, state, and federal levels.