To meet the charge presented by CDC, the committee has endeavored to: (1) examine conceptual issues and challenges related to integrating public health into disaster preparedness and response; (2) review some of the evidence base from disaster research and practice that is germane to public health preparedness; (3) learn from the public health response to proxy events; (4) discuss the usefulness of modeling; and (5) discuss the usefulness of exercises, including a description of some of the exercise activities occurring in the federal government.

Summary of Recommendations

The report’s recommendations revolve around the issues of interagency and intersectoral coordination, learning from experience and research, and continuously improving performance.

Recommendation 1:

The committee recommends that all federal entities concerned with bioterrorism preparedness (e.g., CDC, the Health Resources and Services Administration [HRSA], the Office of Domestic Preparedness [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. Such mechanisms may include, but are not limited to, regular meetings to familiarize CDC and ODP program staff with each other’s program priorities and activities, a database for informing ODP and other partners of exercises planned by CDC grantees, etc. Federal coordination efforts should also 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.

Recommendation 2:

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



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