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Written testimony submitted for the record is also available at www.hhs.gov/asl/testify/t011003.html.

MR. CHAIRMAN, SENATOR SPECTER, DISTINGUISHED MEMBERS OF THIS COMMITTEE.

THANK YOU FOR YOUR ATTENTION TO A SUBJECT THAT HAS LONG BEEN AN INTEREST OF MINE AND THAT HAS BECOME A CONCERN OF ALL AMERICANS SINCE THE TERRORIST ATTACKS.

THE DEPARTMENT OF HEALTH AND HUMAN SERVICES IS RESPONSIBLE FOR THE PUBLIC HEALTH RESPONSE TO ANY BIOLOGICAL OR CHEMICAL ATTACK, AS WELL AS FOR DISEASE SURVEILLANCE AND MEDICAL PREPAREDNESS.

IN THE WAKE OF SEPT. 11, THERE ARE QUESTIONS ABOUT HOW PREPARED OUR NATION IS TO RESPOND TO A BIOLOGICAL ATTACK, AND RIGHTFULLY SO.

LET ME CHARACTERIZE OUR STATUS THIS WAY: WE ARE PREPARED TO RESPOND. BUT THERE IS MORE WE CAN DO - AND MUST DO - TO STRENGTHEN OUR RESPONSE.

WE HAVE NEEDS IN THE SHORT-TERM AND THE LONG-TERM. AT HHS, WE ARE AGGRESSIVELY PURSUING THOSE NEEDS SO WE CAN BUILD THE STRONGEST, MOST COORDINATED RESPONSE POSSIBLE TO A BIOLOGICAL ATTACK.

LET ME OUTLINE FOR YOU THIS MORNING WHAT STEPS WE'VE TAKEN, WHAT WE ARE DOING NOW, AND WHAT OUR MOST PRESSING NEEDS ARE.

WE'VE MADE GREAT STRIDES IN OUR PREPAREDNESS THE PAST EIGHT MONTHS BECAUSE THE PRESIDENT AND HIS ADMINISTRATION HAVE MADE IT A PRIORITY.

LAST SPRING, THE PRESIDENT ASKED VICE PRESIDENT CHENEY TO DEVELOP A COORDINATED DOMESTIC PREPAREDNESS EFFORT THROUGHOUT THE FEDERAL GOVERNMENT. AND NEARLY TWO WEEKS AGO, THE PRESIDENT CREATED THE OFFICE OF HOMELAND SECURITY TO MAKE SURE WE ARE COORDINATED AND PREPARED IN OUR DEFENSE OF AMERICA. THIS OFFICE WILL HELP KEEP BIOTERRORISM PREPAREDNESS AND A STRONG PUBLIC HEALTH RESPONSE A PRIORITY.

FOR ME, BIOTERRORISM HAS BEEN A CONCERN FOR YEARS. IN FACT, AFTER BEING NOMINATED FOR THIS POSITION LAST DECEMBER, THE FIRST BRIEFING I ASKED FOR AND RECEIVED WHILE STILL BACK IN WISCONSIN WAS ON BIOTERRORISM.

ONCE HERE, WE MOVED RAPIDLY TO MAKE SURE HHS WAS IMPROVING ITS ABILITY TO RESPOND. WE BEGAN BY MAKING SURE WE WERE BETTER COORDINATED, NOT ONLY WITHIN OUR DEPARTMENT AND THE ADMINISTRATION BUT WITH THE STATE AND LOCAL PARTNERS WE DEPEND ON SO MUCH FOR A STRONG AND EFFICIENT RESPONSE.

I MOVED BIOTERRORISM INTO MY IMMEDIATE OFFICE, APPOINTING SCOTT LILLIBRIDGE OF THE CDC AS MY SPECIAL ASSISTANT FOR BIOTERRORISM. SCOTT IS ONE OF THE COUNTRY'S MOST RESPECTED BIOTERRORISM EXPERTS, AND I CHARGED HIM WITH MAKING SURE HHS WAS WORKING IN A COORDINATED AND AGGRESSIVE MANNER TO STRENGTHEN ITS CAPABILITIES. WE SENT A STRONG MESSAGE TO OUR DEPARTMENT THAT THIS ISSUE IS A PRIORITY AND THAT WE WILL BE READY.

WE'VE ALSO REACHED OUT TO WORK MORE CLOSELY WITH STATE AND LOCAL GOVERNMENTS, AS WELL AS THOSE EXPERTS IN THE BIOTERRORISM PREPAREDNESS COMMUNITY WHO COULD HELP US RAPIDLY IMPROVE OUR CAPABILITIES.

WE HAVE TAKEN STEPS TO IMPROVE OUR PHARMACEUTICAL STOCKPILES AND MADE INVESTMENTS IN RESEARCH AND OUR PUBLIC HEALTH INFRASTRUCTURE. IN FACT, THIS WEEK, WE SENT OUT ANOTHER $10 MILLION TO 25 CITIES THROUGH THE METROPOLITAN MEDICAL RESPONSE SYSTEM TO HELP THEM IMPROVE THEIR MEDICAL RESPONSE CAPABILITIES. THROUGH THIS PROGRAM, WE'VE HELPED 97 CITIES BETTER PREPARE FOR AN EMERGENCY.

AND JUST THIS PAST WEEK, WE ACCELERATED PRODUCTION OF A NEW SMALLPOX VACCINE. WE BROUGHT TOGETHER THE CDC, NIH, FDA, THE MANUFACTURER AND SOME OUTSIDE CONSULTANTS AND DEVELOPED AN ACCELERATED PLAN THAT WOULD PRODUCE THIS NEW VACCINE BY MID-TO-LATE NEXT YEAR. THE NEW VACCINE AND 40 MILLION DOSES WERE TO BE DELIVERED BY 2004 OR 2005.

THIS SHOWS HOW AGGRESSIVELY WE ARE STRIVING TO STRENGTHEN OUR READINESS AND RESPONSE.

BUT MY CONFIDENCE IN OUR ABILITY TO RESPOND ALSO COMES FROM HOW OUR DEPARTMENT PERFORMED ON SEPT. 11.

WE HAD TWO MAJOR CITIES HIT SIMULTANEOUSLY WITH TERRORIST ATTACKS. WHEN WE BEGAN TO RESPOND THAT MORNING, WE DIDN'T KNOW IF THERE WAS BIOTERRORISM INVOLVED, AND WE DIDN'T KNOW HOW MANY INJURIES OR CASUALTIES THERE WOULD BE.

YET, WE IMMEDIATELY IMPLEMENTED OUR HEALTH ALERT SYSTEM AT THE CENTERS FOR DISEASE CONTROL AND PREVENTION. THIS IMMEDIATELY PUT STATE AND LOCAL HEALTH DEPARTMENTS ON ALERT FOR ANYTHING UNUSUAL OR MYSTERIOUS IN TERMS OF ILLNESSES. WE PUT 81 HEALTH LABORATORIES ACROSS AMERICA ON ALERT, TOO.

WE THEN ACTIVATED OUR NATIONAL DISASTER MEDICAL SYSTEM, PUTTING AT THE READY 7,000 MEDICAL PROFESSIONALS. WE ENDED UP SENDING FIVE TEAMS OF DOCTORS, NURSES AND EMTS TO NEW YORK AND FOUR TO THE PENTAGON WITHIN HOURS ON THAT FIRST DAY.

THESE MEDICAL TEAMS WERE ON THE GROUND SUPPLEMENTING THE LOCAL HEALTH CARE SYSTEM. IN ADDITION, WE SENT MORTUARY TEAMS TO NEW YORK, VIRGINIA AND PENNSYLVANIA TO ASSIST WITH THE FATALITIES.

WITHIN THE FIRST 24 HOURS, THE CDC SENT A GROUP OF 35 EPIDEMIOLOGISTS TO NEW YORK TO ALSO HELP SUPPLEMENT LOCAL MEDICAL NEEDS. THESE HIGHLY TRAINED EXPERTS WERE IN NEW YORK HOSPITALS LOOKING FOR ANY SIGNS OF BIOTERRORISM OR THE POTENTIAL FOR AN OUTBREAK OF DISEASE AS A RESULT OF THE DAMAGE.

FOR THE FIRST TIME, WE SENT A PUSH PACK CONTAINING 50 TONS OF MEDICAL SUPPLIES TO NEW YORK CITY. WE HAVE EIGHT OF THESE PACKS STRATEGICALLY LOCATED THROUGHOUT THE COUNTRY, AND THEY'RE SUPPOSED TO ARRIVE AT ANY LOCATION WITHIN 12 HOURS. WE GOT THIS PUSH PACK TO NEW YORK IN 7 HOURS.

THIS IS THE FIRST TIME OUR EMERGENCY RESPONSE SYSTEM HAD BEEN TESTED AT THIS EXTREME LEVEL, AND IT RESPONDED WITHOUT A HITCH.

GRANTED, WE DID NOT FIND ANY SIGNS OF BIOTERRORISM. BUT WE WERE THERE QUICKLY. WE HAD EXPERTS LOOKING FOR ANY PROBLEMS. AND WE WERE PREPARED TO MOVE RAPIDLY TO CONTAIN AND TREAT ANY PROBLEMATIC DISEASE.

OUR RESPONSE ENCOURAGED ME. IT SHOULD ENCOURAGE THIS COMMITTEE AND THE CONGRESS. AND IT SHOULD ENCOURAGE THE AMERICAN PUBLIC THAT WE DO HAVE THE ABILITY TO RESPOND.

NOW, I DO NOT BY ANY MEANS CONTEND THAT OUR SYSTEM IS PERFECT OR WITHOUT WEAKNESSES. WE HAVE GAPS. WE CAN, INDEED, MAKE OUR RESPONSE STRONGER. AND IT'S IMPERATIVE THAT WE DO SO.

WE MUST CONTINUE TO ACCELERATE OUR PREPAREDNESS EFFORTS, AND THAT WILL REQUIRE A STRONG PARTNERSHIP WITH THIS COMMITTEE AND CONGRESS.

FRANKLY, BIOTERRORISM PREPAREDNESS HASN'T BEEN THE HIGHEST FISCAL PRIORITY IN THE PAST AS IT COMPETED WITH OTHER PUBLIC NEEDS. MY HOPE IS THAT WILL CHANGE AS A RESULT OF GREATER AWARENESS OF OUR NEEDS.

HERE ARE THE AREAS IN WHICH WE NEED TO MOVE AGGRESSIVELY:

1.) OUR PUBLIC HEALTH INFRASTRUCTURE:

WITHOUT QUESTION, THIS IS OUR GREATEST NEED. WE MUST CONTINUE WORKING WITH STATE AND LOCAL PUBLIC HEALTH SYSTEMS TO MAKE SURE THEY ARE STRONG AND PREPARED. THIS WILL INCLUDE DEVELOPING RESPONSE AND CONTINGENCY PLANS, MAKING SURE THEY HAVE THE TOOLS TO RESPOND, AND EDUCATING THEIR MEDICAL COMMUNITY.

A STRONG AND COORDINATED RESPONSE BETWEEN FEDERAL, STATE AND LOCAL GOVERNMENTS IS FUNDAMENTAL TO OUR ABILITY TO RESPOND EFFECTIVELY IN AN EMERGENCY. WE MUST CONTINUE STRENGTHENING THIS PARTNERSHIP.

WE NEED TO MAKE SURE DOCTORS AND MEDICAL PROFESSIONALS GET THE CONTINUING EDUCATION AND TRAINING THEY NEED TO BE ASTUTE IN THE AREA OF IDENTIFYING DISEASES FROM A BIOLOGICAL ATTACK.

TO SUPPLEMENT THIS EFFORT, WE PLAN TO HOLD A BIOTERRORISM CONFERENCE EVERY YEAR FOR EMERGENCY MEDICAL PROFESSIONALS. THE NATION'S BEST EXPERTS AND SCIENTISTS WILL KEEP THEM UP-TO-SPEED WITH THE LATEST ON PREPARING FOR, IDENTIFYING AND TREATING DISEASES FROM BIOLOGICAL WARFARE.

WE WOULD ALSO BENEFIT FROM EXPANDING THE NUMBER OF SLOTS IN THE CDC EPIDEMIC INTELLIGENCE SERVICE - SO WE HAVE MORE HIGHLY TRAINED EXPERTS IN THE FIELD OF IDENTIFYING DISEASE.

IN FACT, I WOULD RECOMMEND THAT THE FEDERAL GOVERNMENT PAY FOR PLACING MORE EIS GRADUATES IN STATE HEALTH DEPARTMENTS. CURRENTLY, THERE ARE 42 EIS EXPERTS IN THE STATES, BUT WE MUST MAKE SURE EVERY STATE HAS AT LEAST ONE. AND WE SHOULD ADD MORE TO STATES THAT COULD USE THE EXTRA RESOURCES.

THIS PROGRAM WOULD PUT UNIQUELY TRAINED INDIVIDUALS ON THE GROUND IN EACH STATE, WHO CAN BE A VALUABLE RESOURCE FOR PUBLIC HEALTH DEPARTMENTS IN EDUCATING AND TRAINING THEIR MEDICAL COMMUNITY, AS WELL AS HELPING TO IDENTIFY ANYTHING UNUSUAL.

ALSO, IN REGARD TO PUBLIC INFRASTRUCTURE, I AM CREATING AN ADVISORY COMMITTEE OF PUBLIC HEALTH EXPERTS, INCLUDING STATE AND LOCAL OFFICIALS. THEY WILL HELP US DEVISE THE MOST EFFECTIVE AND RAPID WAYS TO STRENGTHEN OUR LOCAL PREPAREDNESS.

AND I HAVE ASKED THAT THE NATION'S GOVERNORS, PUBLIC HEALTH AGENCIES, PUBLIC HEALTH INDUSTRIES AND MEDICAL ASSOCIATIONS TO CONVENE A SUMMIT EACH YEAR IN CONJUNCTION WITH OUR DEPARTMENT.

I HAVE SPENT THE PAST FEW WEEKS MEETING WITH LEADERS IN THE BIOTECH, MEDICAL DEVICE, PHARMACEUTICAL AND INSURANCE INDUSTRIES, AS WELL AS THE MAJOR MEDICAL SOCIETIES. THEY AGREE WE NEED TO WORK MORE CLOSELY TOGETHER IN THE PUBLIC AND PRIVATE SECTORS TO MAKE SURE THERE ARE NO WEAKNESSES IN OUR BIODEFENSE.

WE MUST CONTINUE INVESTING IN OUR LOCAL HEALTH CARE SYSTEMS SO WE ARE READY TO RESPOND IN AN EFFECTIVE AND COORDINATED MANNER IN THE EVENT OF A CATASTROPHE.

2.) PHARMACEUTICALS

WE MUST CONTINUE TO ACCELERATE PRODUCTION OF VACCINES AND ANTIBIOTICS, INVEST IN RESEARCH, BOLSTER OUR STOCKPILES, ADD MORE PUSH PACKS

I WOULD LIKE TO ADD TWO MORE PUSH PACKS TO OUR ARSENAL, MAKING MORE EMERGENCY MEDICAL SUPPLIES AVAILABLE THROUGHOUT THE COUNTRY.

AFTER OUR NEW YORK EXPERIENCE IN DEPLOYING A PUSH PACK FOR THE FIRST TIME, WE ARE DOING A REVIEW OF THE PACKAGES AND THEIR CONTENTS. THE PACKAGE PERFORMED WELL. YET, WE EXPECT TO FURTHER STRENGTHEN THE PUSH PACKAGES BY BETTER ORGANIZING THEM IN TERMS OF CONTENTS. FOR EXAMPLE, WE MAY DESIGN A PUSH PACKAGE SPECIFICALLY FOR A CHEMICAL ATTACK, OR ONE SPECIFICALLY FOR A BIOLOGICAL ATTACK.

WE WANT TO CONINTUE PLANNING FOR TOMORROW BY MAKING SURE THE STOCKPILE AND THE PUSH PACKS ARE AS UP-TO-DATE AS POSSIBLE.

3.) FOOD SAFETY

WE NEED MORE INSPECTORS TO ENSURE THE SAFETY OF OUR FOOD SUPPLY. THE FDA CAN USE MORE HELP IN MONITORING OUR FOOD, FOR THIS IS ONE AREA IN WHICH WE MUST BE MOST VIGILANT.

WE ARE AGGRESSIVELY WORKING WITH THE FOOD INDUSTRY AS WELL TO MAKE SURE THEIR AWARENESS IS APPROPRIATELY HEIGHTENED, AND THEY ARE TAKING THE NECESSARY STEPS TO SECURE THEIR PRODUCTION AND DELIVERY OF FOOD.

4.) SECURITY

FINALLY, WE NEED CONTINUED HELP WITH IMPROVING SECURITY FOR OUR FACILITIES AND THE RESOURCES THOSE FACILITIES HOLD.

PUBLIC HEALTH IS A NATIONAL SECURITY ISSUE. IT MUST BE TREATED AS SUCH, ESPECIALLY IN THESE TIMES. THEREFORE, WE MUST NOT ONLY MAKE SURE WE CAN RESPOND TO A CRISIS, BUT THAT WE ARE SECURE IN DEFENDING OUR STOCKPILES, OUR INSTITUTIONS AND OUR PRODUCTS.

THROUGHOUT THE PAST THREE WEEKS, I HAVE SPENT A GREAT DEAL OF TIME MEETING WITH MEMBERS OF THIS COMMITTEE, THE SENATE AND THE HOUSE. WE'VE DISCUSSED OUR PREPAREDNESS, OUR RESPONSE AND OUR NEEDS. I APPRECIATE YOUR ATTENTION TO THIS ISSUE.

WHILE I AM CONFIDENT IN OUR ABILITY TO RESPOND BECAUSE OF THE STRIDES WE HAVE MADE IN THE PAST FEW MONTHS AND YEARS, I APPRECIATE THIS COMMITTEE REACHING OUT TO DETERMINE WHAT WE CAN DO BETTER AND WHAT RESOURCES WE NEED TO BECOME STRONGER. THIS ENDEAVOR MUST BE PURSUED IN PARTNERSHIP -- NOT JUST IN THIS TOWN, BUT WITH TOWNS ACROSS AMERICA.

AS A NATION, WE MUST DEAL WITH THIS SENSITIVE ISSUE IN A RATIONAL MANNER. PEOPLE SHOULD NOT BE SCARED INTO BELIEVING THEY NEED TO BUY GAS MASKS. AND PEOPLE SHOULD NOT BE FRIGHTENED INTO HORDING MEDICINE AND FOOD. THERE IS NOTHING WE KNOW OF TO WARRANT SUCH ACTIONS.

PEOPLE SHOULD BE AWARE AND ALERT. A BIOLOGICAL ATTACK IS CERTAINLY POSSIBLE. BUT AS PRESIDENT BUSH HAS SAID, WE MUST NOT BE INTIMIDATED. WE MUST GET BACK TO LIVING OUR LIVES.

YES, WE NEED TO DO MORE ON BIOTERRORISM, BUT WE ARE PREPARED TO RESPOND. THE MISSION NOW IS TO ACCELERATE EFFORTS TO STRENGTHEN OUR RESPONSE AND MAKE SURE WE ARE DOING TODAY WHAT THIS COUNTRY ONCE THOUGHT IT COULD PUT OFF UNTIL TOMORROW.

AS ALWAYS, I AM CONFIDENT THAT AMERICANS WILL RISE TO THE CHALLENGE.

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