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Written testimony submitted for the record is also available at www.hhs.gov/asl/testify/t011023.html

Chairman Shays, Congressman Kucinich, members of the subcommittee, thank you for inviting me to join you today. And thank you for coming down from the Hill to the HHS auditorium. I'll try to make you feel at home � but if you feel like giving me a rough time, remember to be nice to your host.

The President and the entire Administration are committed to preventing bioterrorism. Our rapid and effective efforts on September 11 and the days immediately following demonstrated that commitment.

Even before then, I had been working vigorously with Dr. Scott Lillibridge -- one of the nation's leading experts on bioterrorism and, since June, my Special Assistant for National Security and Bioterrorism -- on domestic preparedness. That's characteristic of the seriousness with which the President and the Administration have, since taking office, taken the need for preparedness.

That ability to respond has been tested -- on September 11, and more recently with the current anthrax investigations. Let me emphasize that we have worked together with our partners across all levels of government -- from the Federal Bureau of Investigation to the U.S. Postal Service, from local hospitals to county governments -- to address these more recent terrorist events.

Soon after the first case of anthrax exposure in Florida, the Department of Health and Human Services, through the CDC, alerted all public health departments in the country to be on the lookout for anthrax-like symptoms, including those associated with inhalation and cutaneous.

As you know, anthrax is not contagious. Contracting inhalation anthrax, for example, is fundamentally different from exposure to the agent. You would have to inhale 8,000 spores of anthrax into your lungs before actually coming down with the disease. So simply having anthrax spores in one's nose doesn't mean you have anthrax.

The drug ciproflaxicin, commonly known by its brand name Cipro, is effective in the treatment of inhalation anthrax even after an infection. We have taken and continue to take every precaution, and have made Cipro available to the widest number of people suspected of being exposed to inhalation anthrax. But other drugs such as doxycycline and penicillin have been approved by the FDA as treatments for anthrax.

The FDA's approval will include instructions on what dose to use and how long to treat the inhalation form of anthrax.

The CDC has asked that local hospitals in and around the Nation's Capitol pay particular attention to any suspicious respiratory or skin infections. We at the Department have been monitoring hospitals in this area and are closely monitoring the cases of two postal workers who are infected with inhalation anthrax in the District of Columbia. And we are all deeply saddened by the deaths of two local postal employees, whose deaths have been linked to anthrax. Our thoughts and prayers are with their families.

Throughout the past month, the CDC and local public health departments have been working hard to trace back the source of the anthrax-tainted letters that have been received in this country.

They've used the best science to follow the trail of these letters. And they've used the best science to assess the risk of anthrax exposure to employees, both at the workplaces where the letters were received and at the postal facilities where the letters passed through.

Public health officials are relying heavily on science as they track these letters, identify those who may have been exposed, and determine a course of treatment. These efforts were evident in the Florida and New York cases where the letters were identified and those who may have been exposed were tested and treated.

The CDC has done a good job of finding the letters in question and getting treatment to those at risk. The work of the CDC has likely saved many from serious illness and death.

We have good science. But it is also an evolving science. Remember, we have never had cases of anthrax attacks in this manner before. It is a new challenge that we are all facing as a country.

We also need to get ahead of the science. We will be even more aggressive in securing the safety of our postal workers who may have been exposed to a tainted letter.

Therefore, I am making it clear today that the Centers for Disease Control, when a case of anthrax does emerge, will immediately move in at any and all postal facilities that might have handled that piece of mail.

In other words, we'll not only immediately begin testing and treatment at the site where the letter was received, but simultaneously begin testing and treatment at all postal facilities through which the letter may have passed.

We'll make medicine immediately available to those employees who may have been at risk of exposure. We have plenty of antibiotics to treat anthrax, and we'll err on the side of caution in making sure people are protected.

I ask for the cooperation and partnership of local public health departments in this endeavor.

We're also going to lend the U.S. Postal Service our scientific expertise in developing ways to protect postal workers as they sort and deliver the mail, as well as what technology might help in making mailrooms more safe. We've been assisting the postal service from the onset and will continue to make our resources and expertise available to them.

Postal workers have a tough job. And it's a job that's become even tougher in some parts of the country. But we're going to ease their burden by going to the greatest lengths to make sure their health is protected.

If we suspect that an anthrax-tainted letter may have passed through a facility, we're going to get there, test the facility and make the appropriate treatment available to those who may have been exposed.

We're going to act quickly and, if need be, let the science catch up to our actions. If it turns out postal workers did not come in contact with anthrax spores, we can always take them off the antibiotics.

Never has our nation's public health surveillance been more important, and the dedicated public servants in the Department of Health and Human Services -- and public health officials in all of our local communities -- are committed to being even more thoroughly prepared to respond tomorrow than we are today.

I know some critics are charging that our public health system is not prepared to respond to a major bioterrorist attack.

I know that some state and local labs are feeling overwhelmed right now as they respond to people's natural fears about what might be waiting in their mail. And I understand that our local first responders are feeling overburdened.

But the response from state and local authorities -- to each and every threat -- is continuing and will continue. And we should be proud of how well we have all responded to events that have broken our hearts even as they have steeled our resolve.

We must continue our efforts to be prepared for future events, however.

So, in an effort to ensure the department is fully prepared and better coordinated, I recently announced the creation of a bioterrorism advisory committee in my office.

Dr. D.A. Henderson, who is renowned for his role in eradicating smallpox, heads this committee. Dr. Henderson and his staff will provide seasoned advice to the department on all bioterrorism activities, including efforts to improve state and local preparedness.

Last week, President Bush requested an additional $1.5 billion to strengthen our ability to prevent and respond to a bioterrorism attack. Of the total funds requested, two-thirds --$1.2 billion -- are being designated for the production of vaccines and antibiotics.

We must accelerate the production of vaccines and antibiotics, and invest in essential programs to ensure the speedy and orderly distribution of antibiotics and other supplies in the event of a bioterrorism event.

The President's request includes $643 million to expand the National Pharmaceutical Stockpile and $509 million to speed the purchase of 300 million doses of smallpox. With these resources, HHS will expand its program capabilities to respond to an all-hazards event.

As you may know, there are currently 8 Push Packs available as part of the stockpile. Each one includes no less than 84 separate types of supplies; things like antibiotics, needles and IVs, a tablet counting machine and oxygen masks.

Each Push Pack provides a full course of antibiotics and other medical supplies and is shipped to an area within 12 hours to help state and local response efforts.

These Push Packs have enough drugs to treat 2 million persons for inhalation anthrax following exposure. I have directed that the stockpile development should be increased for inhalation anthrax, so that 12 million persons can be treated. CDC will reach that level of response within the next 12 months.

With the additional resources, we will also add four more Push Packs to the current eight already located across the country, making more emergency supplies available and augmenting our existing supplies of 400 tons by another 200 tons.

The President and my Department are also committed to the development and approval of new vaccines and therapies. The CDC, the Food and Drug Administration and the National Institutes of Health -- all agencies within HHS -- are collaborating with the Defense Department and other agencies to support and encourage research to address scientific issues related to bioterrorism.

The capability to detect and counter bioterrorism depends to a significant degree on the state of relevant medical science. Our continuing research agenda in collaboration with CDC, FDA, NIH, and DOD is critical to overall preparedness.

Let me outline several other areas that our budget requests:

The president is calling for $88 million to expand HHS' capacity to respond to bioterrorist incidents, including $20 million for the CDC's rapid response and advance technology and specialty labs, which provide quick identification of suspected agents and technical assistance to state labs.

Also included in this amount is $20 million to support additional expert epidemiology teams that can be sent to states and cities to help them respond quickly to infectious disease outbreaks and other public health risks.

And let me reiterate my conviction that every state should have at least one federally funded epidemiologist who has graduated from the Epidemic Intelligence Service Training Program.

The President is also asking for $50 million to strengthen the Metropolitan Medical Response System to increase the number of large cities that are able to fully develop their MMRS units. It is imperative that we work closely with cities to ensure that their MMRS units have the proper equipment and training.

We're also providing $50 million to assist hospitals and emergency departments in preparing for, and responding to, incidents requiring mass immunization and treatment. And we're providing $10 million to augment state and local preparedness by providing training to state health departments on bioterrorism and emergency response.

The president is also requesting $40 million to support early detection surveillance to identify potential bioterrorism agents, which includes web-based disease notification to the health community nationwide.

This amount will provide for the expansion of the Health Alert Network, which helps early detection of disease, to 75 percent of the nation's 3,000 counties. I intend to have all counties connected in the coming year.

We're providing $15 million to support increased capacity in no less than 78 laboratories in 45 states. This funding will enhance our ability to identify and detect all critical biological agents. And we're implementing a new hospital preparedness effort to ensure that our health facilities have the equipment and training they need to respond to mass casualty incidents.

Finally, as to food safety, the President is also requesting $61 million to enhance the frequency and quality of imported food inspections and modernize the import data system to enable us to detect tainted food. This funding will also provide for 410 new FDA inspectors to help ensure that our food is better protected.

The Administration has sent to Congress legislation to strengthen our ability to protect the nation's food supply. This measure will require prior notice of imported food shipments, enhancing our ability to inspect food, allowing for detention of foods suspected of being tainted and providing flexibility for the FDA to approve drugs and other treatments for dealing with illnesses resulting from biological attacks.

Mr. Chairman, let me conclude by noting that despite the events of recent days, every American must and should continue to live their lives -- working, spending time with family, having a meal out or shopping at the local mall -- with confidence. America's citizens can be sure that their government agencies -- local, state and federal -- are ready to respond to biological warfare and bioterrorism quickly and effectively throughout the country.

None of us enjoys contemplating bioterrorism. But as responsible public servants, doing so is a matter of fulfilling the public's trust in us.

Under the leadership of President Bush, we are taking all the steps necessary to keep America safe in an era when biological and chemical attacks are as possible as they are unthinkable.

Thank you, Mr. Chairman, for letting me speak about this matter of critical importance. I'm glad to answer questions.

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