goal of public health nor the evidentiary standard required by law enforcement (Butler et al., 2002; Richards, 2002).

In the wake of the anthrax attacks of 2001, the position of CDC liaison to the FBI was created (Butler et al., 2002; GAO, 2003c). This seems to be a step in the right direction, but it would be useful only as long as the liaison unit is considered a priority by both agencies and it is given an adequate scope of work and level of authority. The Forensic Epidemiology training program, a joint effort between CDC and Department of Justice to facilitate mutual understanding between law enforcement and public health, is an example of successful and productive collaboration between public health and law enforcement in the area of bioterrorism preparedness and response (CDC, 2003b).

Collaboration between seemingly disparate government agencies and disciplines is not a new need, and there is some history on which to draw to help clarify and streamline these relationships. In the early 1980s, the CDC and the Federal Bureau of Investigation (FBI) created an interagency bioterrorism unit, located at CDC with secure communication capacity in the wake of a botulinum hoax. Plans were developed for the defense of the civilian population in the event of a bioterrorism incident. This unit was later disbanded (personal communication, W. Foege, Bill and Melinda Gates Foundation, March 30, 2004). This is an example of the type of collaboration that must be initiated and sustained to help address deliberate threats with health consequences.

Common Definitions and Terminology Are Needed

The emergency and disaster management field and federal agencies associated with it have developed a great deal of experience planning for disaster response and designing and conducting exercises to promote relationship building and training (GAO, 2001; Kuhr and Hauer, 2001; Landesman, 2001; FEMA, 2003). As disaster response becomes increasingly interdisciplinary, a common language is needed for good communication and interagency coordination in preparing for and responding to a chemical, biologic, radiological, nuclear, or explosive incident.

The committee found that similar terms do not always have the same meaning in documents created by different federal agencies (e.g., CDC, HRSA, FEMA, and ODP) or in the way they are used by the many disciplines conducting disaster research (CBACI, 2002; Hilhorst, 2003). The terms “exercise,” “drill,” and “simulation” in particular can mean different things to different agencies and disciplines.

Language differences go beyond practical terms used to describe specific activities. Definitions for fundamental concepts such as preparedness and response also are not unambiguous and certainly not universally shared



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