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NACCT: Recommendations to the Secretary

June 12, 2003

The Honorable Tommy G. Thompson
Secretary of Health and Human Services
U.S. Department of Health and Human Services

Dear Mr. Secretary,

On behalf of the National Advisory Committee on Children and Terrorism (NACCT), I am pleased to present our recommendations to you. In accordance with the objectives specified in the Public Health Security and Bioterrorism Preparedness and Response Act of 2002, the goal of our recommendations is to assist you in identifying and preparing a comprehensive public health strategy to ensure the safety of America’s children and to meet their physical, medical, psychological and social needs in the face of the threat of terrorism. Such a strategy should comprehensively address all phases of preparation, response and recovery from terror events.

There are more than 70 million children under the age of 18 in the United States today, and more than 22 million are ages five and younger. In the event of a terrorist attack, these children would be among the most vulnerable populations in our society. Protecting children and families should be at least as important as protecting bridges and buildings. Yet, while significant resources have been dedicated to the protection of bridges, national monuments and other physical assets, comparatively little has been done to safeguard the health and well-being of children. As recently as 1997, data collected by FEMA showed that no state disaster plans had pediatric components. A recent study showed that only about 20% of hospitals have access to pediatric emergency physicians, and the majority of emergency personnel have little pediatric training or experience.

While the Department of Health and Human Services (DHHS) and other federal agencies have responded to the September 11 attacks with a number of excellent efforts and initiatives, a great deal more must be done to help the United States be fully prepared to protect its children in the event of terrorist attacks. The unique needs and vulnerabilities of children must be incorporated into disaster plans at every stage of preparation, planning and response in order to facilitate family and community resilience before, during and after terror attacks. Federal, state, and local agencies should immediately initiate programs to enhance the safety and security of children during disasters and terror events, and DHHS should develop mechanisms to support international collaborations to increase our nation’s access to lessons learned by other nations with experience with terrorism.

The NACCT has reached remarkable consensus that 1) a comprehensive public health strategy to meet the needs of children in planning and responding to terrorism will require review of all current DHHS programs and guidance to require that a specific focus be placed on meeting the needs of children and families, 2) funding decisions for terrorism-related programs and initiatives should be linked to confirmation that children’s needs have been specifically accounted for, 3) structures within DHHS should be created to ensure continued oversight and adequate response to the needs of children and families in DHHS programs and initiatives, 4) significant new pediatric and psychosocial initiatives are needed to address the needs of the nation’s children and families in light of the continued threat of terror events, and 5) addressing the needs of children and families in the face of terrorism should be recognized to be an essential part of America’s national security response to terrorism.

Your leadership to our Nation during these challenging times has been exemplary. It is our hope that these recommendations will assist you in preparing and initiating new strategies as well as continuing and following up on the excellent work already being done to ensure the public health of America’s children by meeting the physical, medical, psychological and social needs of infants, children, adolescents and families in all phases of preparation and response to conventional, chemical, biological, radiological and nuclear terrorism. We are confident, given your long record of passion and support for children and families that the challenge of addressing the needs of children in the event of terrorist attacks is in good hands. The Committee looks forward to working with you and your staff on an ongoing basis as you move forward in carrying out these recommendations. We will provide whatever assistance and expertise is necessary in order to ensure that these recommendations are pursued and that sufficient resources are devoted to this most important of tasks, safeguarding our nation’s children from terrorism.

Sincerely,
Angela Diaz, MD, MPH FAAP
Chair, National Advisory Committee on Children and Terrorism
Jean C and James W Crystal Professor of Pediatrics and Community Medicine
Mount Sinai School of Medicine
Director, Mount Sinai Adolescent Health Center

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