HHS readiness to respond to a biological or other emergency

Nicole Lurie, MD

By Nicole Lurie, MD

[Editor’s note: Nicole Lurie, M.D., M.S.P.H., Assistant Secretary for Preparedness and Response, U.S. Public Health Service, U.S. Department of Health and Human Services (HHS), delivered on Oct. 18, 2011 the following testimony to the Senate Committee on Homeland Security and Governmental Affairs, entitled, “Safeguarding our Nation: HHS Readiness to Respond to a Biological or Other Emergency.”]

Good morning Chairman Lieberman, Ranking Member Collins, and Members of the Committee.  I am Dr. Nicole Lurie, the Assistant Secretary for Preparedness and Response (ASPR) at the U.S. Department of Health and Human Services (HHS).  Thank you for inviting me here today, on behalf of HHS, to testify on our nation’s public health preparedness for a biological event. 

Ten years ago, letters containing anthrax spores were mailed to several offices in Congress and the news media.  While we were ill prepared at the time to face those attacks, we have made steady and significant progress over the past decade in our capabilities to prepare for and respond to such events.  We have learned many lessons from subsequent events and continue to identify, improve and refine our capabilities.  Thanks to investments made by Congress and the guidance that we continue to receive, we have made significant improvements in preparedness, response, and recovery at the federal, state, and local levels and have invested in a number of medical countermeasures to respond to a chemical, biological, radiological, or nuclear threat.  State and local partners are more prepared than ever before, due to enhanced response capabilities, improved coordination, and enhanced awareness among the public health and medical communities. We have new legal and policy tools including statutes that created the Office of the ASPR to oversee a national program, and programs elsewhere that bolstered our nation’s defenses against a chemical, biological, radiological, or nuclear (CBRN) event. 

One of the biggest challenges we have encountered in the last decade is the lack of common national approaches and effective coordination among governments, health and response systems, and communities.  The September 11, 2001 attacks in New York, Pennsylvania, and Washington D.C., and Hurricane Katrina offer particularly poignant examples of challenges and the imperative to improve.  While there is still a lot of work ahead of us, we have made great strides in developing a unified national direction in strategy, policy, planning, and operations.  Today, we have the National Response Framework and the National Recovery Framework to guide collective efforts to respond to and recover from disasters and emergencies, from the smallest incident to the largest catastrophe.  In 2009, HHS released the National Health Security Strategy (NHSS), which refocuses the patchwork of disparate public health and medical preparedness, response, and recovery strategies to ensure that the nation is prepared for, protected from, and resilient in the face of health threats.  The NHSS is the first strategy focused specifically on protecting people’s health during an emergency, and has a vision built on resilient communities and strong, sustainable health and emergency response systems.   

Our resilience depends on shared responsibility for preparedness across governments – from local communities to global partners, and includes all members of the public as full and equal partners in health security.  Looking back, I’m encouraged by how far we have come and by how we are working together now in planning for the future.  Challenges do however remain.  The threats to national security and public health are real and are constantly evolving.  As science and technology create new opportunities for useful advances, they may also lead to new threats.  As I testify today on our readiness, I will address both specific progress we’ve made over the past decade and the strategies we have in place to ensure that we continue to improve in advancing toward our goals.  

In 2001, the use of anthrax spores in a biological attack killed five people, infected 17 others, threatened thousands more, and resulted in billions of dollars in costs—forcing us to re-think our approaches to preparedness for the CBRN threats that we face.  Collectively, we recognized that we lacked basic capabilities and that a long-term concerted effort would be required to close the preparedness gap.  Since that time we have also learned that investment alone is not enough—and in response we have established a common set of investment priorities and have fundamentally changed the way we manage our medical countermeasure enterprise.  As Secretary Sebelius noted in 2010, “our nation must have the nimble, flexible capability to produce medical countermeasures rapidly in the face of any attack or threat, whether known or unknown, novel or reemerging, natural or intentional.”