The committee recommends that federal agencies and CDC, specifically, be held accountable for their unique federal responsibilities in an emergency response and assessed on their progress in facilitating national public health emergency preparedness.

The committee recommends that CDC consider utilizing the 10 Essential Public Health Services as a framework for the readiness indicators.

The committee recommends that CDC collaborate with Health Resources and Services Administration (HRSA) to integrate the preparedness indicators into one document, in order to help the health care and public health communities work hand-in-hand to plan, implement plans, and evaluate their readiness to respond to threats (including, but not limited to, a smallpox attack) and to avoid requiring duplicate reporting from states.


The committee recommends that all federal entities concerned with bioterrorism preparedness (e.g., CDC, HRSA, and ODP) should more actively coordinate guidance and funding activities. Federal agencies should also work together to develop mechanisms that facilitate coordination and collaboration among their grantees at the state and local levels. Federal efforts should include the clarification of primary responsibility and authority in bioterrorism events, to ensure that CDC can fulfill its unique role as the nation’s public health agency.

The committee recommends that CDC should collaborate with all of its partners to strengthen preparedness by applying research findings and experience in public health emergency response, bioterrorism preparedness, and disaster management. In order to strengthen the evidence base for public health preparedness, CDC should:

  • Strengthen the link between public health research and practice;

  • participate in and promote interdisciplinary research about preparedness;

  • support a system to assure the ongoing collection, synthesis, and sharing of lessons learned and best practices from public health preparedness exercises and public health response to proxy events; and

  • in coordination with the appropriate federal-level partners, such as AHRQ, evaluate the effectiveness, design, and opportunity costs of preparedness strategies, such as exercises.

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