FIGURE G-1 Contrasting roles of public health and traditional responders in bioterrorism and other disasters.

In order to integrate the preparedness and response efforts of public health most appropriately with those of the traditional emergency management and response field, some key differences need to be identified. For example, disaster preparedness and response is the central mission of local, state, and national civilian and military response organizations and they train and exercise regularly to test and maintain their response capabilities. They have the dual role of responding to disasters and to routine emergencies in their communities. For public health agencies, responding to major crises has been the exception from their usual work; therefore, conducting regular drills and training to prepare for disaster response has generally not been a common practice. Also, even when public health agencies have gained experience dealing with disease outbreaks, these events do not typically reach the scale of a disaster, and response is largely limited to the public health and health care communities.

Given the statutory responsibilities and special capabilities of public health, and CDC’s leadership role in the provision of essential public health services under all circumstances, it is clear that CDC and the public health community must be ready to fulfill their primary role in responding to bioterrorism and their support roles in other types of disasters, including terrorism with chemical, nuclear, and other types of weapons (see Figure G-1).

Public health is not entering a monolithic or homogeneous field of emergency and disaster management. Disasters involve people, physical