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Restructuring Bioshield

September 02, 2008
Modern Healthcare Restructuring BioShieldMove aims for better organization, as hospitals cooperate on preparedness By: Jessica Zigmond Story posted: July 21, 2008 - 5:59 am EDT In a new report to Congress, HHS said it has advanced research, development and acquisition activities to prepare the nation for biological, chemical, nuclear and radiological threats while significantly reorganizing to lead those efforts. Public health experts said this restructuring is an important finding in HHS’ annual report on Project BioShield, the scientific endeavor created in the Project BioShield Act of 2004. The act set aside $5.6 billion over 10 years for HHS to develop and acquire medical countermeasures—diagnostics, medicines and vaccines—to prepare for threats to public health from unconventional events. Each year since, HHS has been responsible for submitting to Congress a report on its efforts and accomplishments. The most recent report, which covers the period from August 2006 to July 2007, said the frequency of some Project BioShield activities was lower compared with the previous year, primarily because initial acquisitions and development activities were already in advanced stages. Also during this time, HHS reorganized the BioShield structures as part of a broader plan to advance efforts in acquisition, deployment, development, research and eventual use of emergency medical countermeasures. And it’s this reorganization that could ultimately prove effective, according to public health specialists. “To me, what’s the most important part is they’ve done their restructuring within ASPR to become more organized and well-defined to take the next big steps to give out this money,” said Ira Nemeth, assistant professor of emergency medicine at University of Texas Southwestern in Dallas, referring to the assistant secretary for preparedness and response’s office. Nemeth also serves as medical director for public health preparedness for the Dallas County Health and Human Services Department. Regarding the Pandemic and All-Hazards Preparedness Act: “The major thing it did was create the office of ASPR. That law came into effect in December 2006. Since then it has been a huge organizational issue to get that structured appropriately,” he said, adding that the office is “working more like a team now.” The late 2006 act also established the Biomedical Advanced Research and Development Authority, or BARDA, when it created ASPR. That office has grown considerably, the report noted. As of July 2007, BARDA had 81 federal employees compared with the 29 full-time employees that its predecessor, the Office of Public Health Emergency Medical Countermeasures Enterprise, had in August 2006. Brad Smith, a molecular biologist who is a senior associate at the University of Pittsburgh Medical Center’s Center for Biosecurity in Baltimore, explained it this way: BARDA oversees Project BioShield, which buys the nation’s countermeasures—an anthrax vaccine, for example—and then transfers those to the Strategic National Stockpile, which is managed by the Centers for Disease Control and Prevention. Meanwhile, the nation’s hospitals continue their own efforts to prepare against both natural and intended disasters. “One of the ‘good news’ stories about hospital preparedness is that most of the things that a hospital would need to do for a bioterrorist attack or influenza would be relevant for a natural disaster,” Smith said. And even though a hurricane would result in trauma injuries, whereas anthrax exposure would lead to respiratory problems, the skills and resources for both are “pretty transferable,” according to Smith. As the effects of Katrina continue to haunt hospitals, facilities such as 436-bed Exempla-St. Joseph Hospital, Denver, are working to prepare for a major disaster of any kind. “The expectations have increased substantially from the city and county about hospital preparedness for emergencies,” said Brad Steininger, the hospital’s environmental health and safety officer. “It used to be, ‘Be ready for a bus crash.’ Since Katrina, there is a lot more focus on healthcare readiness.” Last year, Exempla budgeted more than $100,000 for emergency preparedness, Steininger said, adding that most of the funding was spent to train staff. Improving staff competency in emergencies is the hospital’s primary goal, he said. In addition, Exempla has formed a coalition with other area hospitals and meets with those facilities about every other month. “If something happens, we’re all impacted,” Steininger said. “We’re talking to each other now.” This integrated approach is an effective one, according to Smith, who works with other researchers who concentrate on the role of hospitals in disasters. “One of the most important things that my colleagues have identified is the need for hospitals to cross the competitive institutional boundaries between hospitals,” Smith said. “Break out of those barriers and work together. There are parts of the country doing that,” he added. “Lessons from Katrina make it pretty clear that hospitals should not prepare in an island.”