From: Armchair Generalist (weblog)
October 24, 2005
Biological Defense and Public Policy
Here's a good working example of public policy in action, using the ever-popular topic of bioterrorism versus natural public health threats - which to fund? The Republican senators of the Health, Education, Labor and Pensions Committee, led by Senator Richard Burr (R-NC), have approved the Biodefense and Pandemic Vaccine and Drug Development Act of 2005, which will go to the Senate floor for full vote. Burr is the chair of the Bioterrorism and Public Health Preparedness Subcommittee. What is this wonderous act, you ask?
The bill creates a Biomedical Advanced Research and Development Agency (BARDA) within Health and Human Services (DHHS). This agency would lead in the development of new medical countermeasures against bioterrorism and natural disease outbreaks, but in particular, oversee the research to support industry's investment into developing more drugs and vaccines for bioterrorism. The Repubs do not believe the current BioShield acts do enough, since the big pharma firms aren't diving into the business of making more bioterrorism countermeasures. Ergo, create a new federal agency. That will, in the words of Senator Mike Enzi (R-WO), ensure "that we as a nation are prepared for a variety of threats..." Of course it will, senator. Just like having FEMA ensured we were ready for Katrina...
But wait! The bill does more. It allows DHHS to sign exclusive contracts with particular firms and forbids government purchases of generics. It provides the companies with complete liability protection from being sued unless the DHHS secretary believes that they are liable. It offers grants and rebates to said firms and limited antitrust exemptions, while exempting BARDA from FOIA and FACA requirements, essentially shielding the agency from any public or federal cost oversight. In short, this bill is to Big Pharma what the recently passed energy bill was to Big Oil - good times.
And a comment posted to that by saheli
Over on my blog we were having a somewhat esoteric and abstract discussion on the ability of humanity to coalesce and attack a problem without needing some other group to dehumanize and fight as other, and my friend Scott, who works in disaster preparation and disaster relief on a grassroots level every day, left this comment:
I won't claim to have figured it out, but I submit that a good test case for sustaining momentum against a nonhuman "them" will be how much we as a country continue to prepare for natural disasters. Especially if you compare it to our response in the last few years to deliberate-human-caused disasters, which fits PN's mold of a convenient "them" much better.
Sadly, I think he's right--as your post seems to prove. We've got so much natural disease to fight, day in and day out, for which we so often shrug and say no. When I went to hearings on the second anniversary of 9/11 near ground zero, the overwhelming theme was "Please, at least invest more in public health."
Posted by: Saheli | October 26, 2005 at 01:56 AM
Some ask whether the net impact -- reducing existing public health programs -- was actually seen as a benefit of this bill in some quarters. The same pattern, of cutting overall funding while raising the mandated amount that had to be spent on bioterrorism preparedness, with a net result of permanent damage to existing programs, was hotly debated a few years ago when there was a push to immunize the whole US population against smallpox.
Below are some links to that previous discussion.
BMJ 2005;331:E378-E379 (17 September 2005), doi:10.1136/bmj.331.7517.E378
BMJ USA: Education and debate
Funding the public health response to terrorism
Erica Frank, professor, vice chair, and division director
Department of Family and Preventive Medicine Emory University School of Medicine Atlanta, GA, efrank@emory.edu
Thoughts on the fourth anniversary of 9/11
On September 11, 2001, 3400 people died because of four horrific, intentional plane crashes. These individuals' only unifying characteristic was that they were in the wrong place in America at the wrong time. Their deaths, and those of Londoners killed on July 7, 2005, were a tragic alarm about our vulnerability, and they understandably launched an avalanche of responses.
Among the consequences of these deaths, several subsequent deaths from anthrax, and other current and potential terrorist threats, were a major redefinition and redirection of the United States government's role in and funding for public health. Since governments must protect their citizens, addressing these possible future threats is appropriate and could prove essential to Americans' health. However, there is an immediate, real threat that these government actions will allow enormous numbers of Americans to die unnecessarily. This threat is the redirection of funds away from basic, currently necessary public health services to the prevention of potential future bioterrorism (BT) threats.
In 2002, New York State designated $1.3 million to reduce heart disease, the leading killer of New Yorkers; contrast this with the $34 million awarded by HHS for bioterrorism preparedness.
What problems do basic public health services try to address, and why is diversion of resources away from them of concern? Using national estimates of mortality attributable to various risk factors (table 1) and actual death counts by disease (table 2), I have estimated the number of Americans who likely died on September 11, 2001, not from terrorism but from the major sources of mortality that many basic public health services work to address.
And, this from the Public Health Blog of the LSU Law Center' Medical and Public Health Law Site and their LSU Law Center Program in Law, Science, and Public Health.
* Bioterrorism and the use of Fear in Public Health, Richards & Obrien Sphere: Related Content
0 comments:
Post a Comment