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Jeffrey Levi Headshot

U.S. Biosurveillance Is More Maxwell Smart Than Jack Bauer

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Watching shows like "24" or "NCIS," you'd think emergency responders could pinpoint bioterrorism attacks or identify new catastrophic disease outbreaks within moments. The fictional characters have every new-fangled, state-of-the-art piece of equipment and computer they need to magically detect and respond to emerging threats.

In reality, we seriously do not have a real-time, coordinated biosurveillance system in the United States to rapidly identify and track disease outbreaks or bioterrorism events. Instead, states around the country have a hodge-podge of different systems and reporting methods -- most of which are seriously outdated. Not only do we not have the futuristic gadgets of a Jack Bauer -- we don't even have systems that meet today's basic modern technological standards.

The truth is, the country's ability to monitor potential public health emergencies doesn't even match the systems major retail chains used to track inventory or customer patterns. Our biosurveillance system lags behind the capabilities of Kmart, Target and Sears.

The lack of a real-time coordinated biosurveillance system is one of the most troubling and ongoing gaps in our health emergency response system in this country. Earlier this week, we at the Trust for America's Health put out the eighth annual edition of our "Ready or Not? Protecting the Public's Health from Diseases, Disasters, and Bioterrorism" in partnership with the Robert Wood Johnson Foundation. Over the years since September 11, 2001, we've seen lots of advances in collecting, reporting and timeliness of biosurveillance data -- the truth is, there has not been an investment to overhaul the system to bring it into the 21st century. This hampers the intelligence public health officials have to track and control disease outbreaks or bioterrorism events.

Obviously, looking for resources in today's economic climate to upgrade systems is even more challenging than usual. However, health reform -- the Affordable Care Act (ACA) -- provides us with a potential new opportunity.

The Prevention Fund includes $15 billion for a broad range of public health programs. As of now, in fiscal year 2010, the Obama Administration has already devoted $70 million in one-time funds to improve public health infrastructure. In the future, Congress and the Administration could make a multi-year commitment to use a defined portion of the Prevention Fund to continue to improve infrastructure.

If we are smart about it, the ACA devoted to infrastructure could be coordinated with other preparedness funding, such as the Public Health Emergency Preparedness (PHEP) grants to leverage meaningful modernization of biosurveillance and other fundamental capabilities of state and local health departments.

We could narrow the gap from the fictional capabilities we see on TV and the outdated reality we live with.

If we finally focused on upgrading these core capabilities, in just a few years, we could see:

  • A real-time surveillance system with uniform national standards -- which could be compatible with emerging Health Information Technology and Electronic Health Record standards;
  • Laboratories with state-of-the-art, interoperable technologies and trained experts;
  • The coordinated, efficient ability to distribute vaccines, medications, and equipment to the public; and
  • A dedicated workforce with the expertise to manage information and new technologies.

This isn't a dream of science fiction or action shows -- it's within our reach -- if we "Get Smart."

The full "Ready or Not?" report -- which was released by Trust for America's Health and the Robert Wood Johnson Foundation -- and recommendations are available at http://healthyamericans.org/reports/bioterror10/.