Why did you take on the challege of the new National Center for Disaster Preparedness?
Whats the countrys current preparedness level for terrorism-related disasters?
Funds are coming but theyre very slow and there are layers of bureaucracy. The first money for hospital preparedness was released about eight months ago. In New York state it amounted to $40,000 per hospital, which was an extraordinarily inadequate amount to do any substantive preparedness. We dont know yet whats going to happen with the second round of funding.
The first thing that has to happen is there must be an in-depth analysis of the critical issues in disaster preparedness. How do we make the most effective use of our resources? Were looking to create the infrastructure to conduct some of this analysis in the new National Center for Disaster Preparedness. However, because these are enormous tasks, we will need to build collaborations with other public health schools and institutions, public and private.
Are preparedness programs diverting attention from other public health issues?
Preparedness programs must not undermine the focus on the traditional public health agenda, like expanding childhood vaccination programs, HIV/AIDS prevention and the like. I strongly believe that the schools of public health have an invaluable role to play as watchdogs ensuring an appropriate balance between preparedness and traditional agenda.
How will the new center contribute to preparedness?
A second division will focus on preparedness needs of special populations and communities. Our program on pediatric preparedness held a conference in February in Washington that brought 65 experts together and issued a report that details how children respond differently to terrorist weapons than adults. The document is useful for public policy and for people working in hospitals. For example, it gives child-specific dosages for specific agents. But theres little literature or definitive research on treating children exposed to many of the possible weapons of mass destruction. Antibiotics, for instance, that might be used to treat adults for exposure to certain biological agents may not be formally approved for kids. The report we produced is a consensus of what experts think are the best approaches, given the current state of knowledge. I fully expect that it will be modified as we move forward with more research.
Similar studies and analysis need to happen for other special populations, including the elderly, people with disabilities and others. This will be an important agenda for the new center.
We will also focus on needs of communities. Preparedness information and resources cannot only be directed to health departments and hospitals. We need to involve neighborhood organizations, community-based providers and families. Families want to know what they must do to be prepared for disasters. They want information about smallpox and other possible scenarios. We believe that you can develop a commitment to preparedness that is reasonable and without panic or fundamental change in our way of life.
All this talk about the lack of preparedness is unnerving, yet somehow I havent done much to prepare myself. How are other people reacting?
This range of individual reactions mirrors the challenge we face as a society. We have to decide how much of our resources we're going to put into preparedness and at what costs to other social programs or balancing the budget. How much do we want to tolerate infringement in personal liberty to get higher levels of security or readiness?
Its difficult to judge others perspectives with a couple of caveats. First, we must have some level of increased security and preparedness. I dont want someone whos complacent about potential terrorism making decisions about preparedness resources. On the other hand, we dont want paranoid zealots in charge either who will spend or do anything to create a locked-down state of siege in America. Most of us would not pay that price or tolerate significant infringement on the civil rights that are so much part of our national societal contract. Were truly struggling to find a balance.
What are your goals as associate dean for public health advocacy?
Im interested in developing programs to help researchers influence policy-makers, elected officials, the media, and the public. This may require getting comfortable with settings and strategies that might not be so familiar or comfortable for many academics like social marketing, working with legislators or dealing with the press. I am pretty certain that well make some progress in all of this, at least enough so some of my colleagues will get turned on by seeing more impact than they might have thought possible from the great work theyre doing. Thats my hope.