U.S. Biosecurity and the Center for Biosecurity's Work:
A Series of Interviews from Homeland Security: Inside and Out

Tara O’Toole: “There are very few things that could actually rock the country, destabilize the country, and a big bioterrorist attack, or a moderate sized bioterrorist attack, or a campaign of such attacks, or an epidemic such as a pandemic flu episode would be on that list of horrible things that could happen.”

Thomas Inglesby: “Ultimately what I think we need to do for biosecurity and biodefense has a lot to do with building preparedness for other kinds of public health emergencies and for responding to infectious diseases more broadly…what the fruits of research and development effort[s] will yield will be a better approach to diagnosing and treating infectious diseases systematically, better approaches to vaccine development, to getting medicines to people….many people rightly welcome this infusion of research and development effort because they see it as a way of getting at some of the more intractable infectious diseases problems that we’ve been facing for so long….”

Gigi Kwik Gronvall: “…the fact is that pathogens are found everywhere…in hospitals, in research labs all over the world, in the soil. So you can’t really say you’re going to lock up this lab and get the security you’re looking for. You really need to examine the threat as a whole and make sure you’re prepared to deal with those pathogens no matter where they come from.”

Eric Toner: “An individual hospital maybe could handle 5 or 6 casualties with serious injuries from an event. Anything much larger than that will require the distribution of patients to multiple facilities and the collaboration between those facilities.”

Jennifer Nuzzo: “Biosurveillance isn’t the central mission of any particular agency. … It’s actually quite difficult to get a handle on, but our best guess is that there are probably dozens, if not hundreds [of biosurveillance programs] across the federal government, and then there are some that exist at the state and local level as well.… The fact that no one agency is responsible…makes it very difficult to evaluate whether there’s any kinds of overlap…conflicting missions between the programs, whether or not we have any gaps, if we’re investing too much in one area and not enough in another.”

Monica Schoch-Spana: “…we need to think more broadly about the citizen role in public health preparedness. Now, typically, we’re asking citizens to set aside an emergency stockpile of essential goods and asking them to tune to either the television or the radio for instruction from officials. Both of those things are very important, but if we just image the citizen role to be private stockpiling and private action, we’re missing out on a great deal. Think of public health preparedness and the citizen role in a continuum from private action to group action, such as volunteers, to communitywide decision making. So what we need to do is to continue to invest in infrastructures that allow people to volunteer and also provide them opportunities to offer their input into health emergency planning.”

Dr. D.A. Henderson: “The book [Smallpox: The Death of a Disease] will be coming out in June, and will recount…a kind of inside story of how this [smallpox eradication] was done, with all of the problems one has with working with many different countries—in civil war, and famine, bureaucracy—it’s an illustration of what can be done, but with great difficulty.” “One of the things…I learned was that a lot of our success [in eradicating smallpox] had to do with getting young people involved and giving them the opportunity to take off. They didn’t know what they couldn’t do, and they made a very big difference.”

Brooke Courtney: “All medications have a manufacturer-assigned shelf life, which is generally 12 to 16 months from the time of manufacture. But the actual shelf life of certain medicines, if they’re stored properly, can be significantly longer…. The [Shelf Life Extension Program, or SLEP] is designed to defer and reduce the replacement costs of the medicines [in the Strategic National Stockpile] by extending the useful shelf life through periodic FDA testing and strict environmental controls.” … “The [SLEP] program has resulted in significant savings for the federal government and should be [made] available for local and state stockpiles, particularly for their first responder stockpiles.”