Friday, May 05, 2006

No surprise unfunded pandemic response

David over at Greenhammer has collected commentary links for the new US Flu Plan. Yesterday I said I liked the tone of the document and I think the assessment of what the feds are capable of substantively is realistic and sober (as well as sobering for those not paying attention). Their role in a pandemic would be far different than a localized natural disaster.

However as more people are examining the document two critiques are emerging. One is the leadership issue. How will Department of Homeland Security be able to manage anything, much less a public health emergency. I weighed in on that myself. The other is the burden being placed on states and local authorities. You can find links to these comments in the excellent Greenhammer post.

However I have somewhat mixed emotions about these latter complaints. It isn't that I don't think they have validity. It's one thing to say the burden will fall on local communities, yet another for the Bush administration and the Republican congress to have done so little to help them. But in addition the states have done little to help themselves. Along with cutting taxes and starving public services at the national level has come an orgy of the same at the state level, resulting in an enfeebled and anemic local public health infrastructure.

Democrats have gone along with this Republican initiative out of weakness or cowardice or stupidity or lack of principle. I simply won't give them a free pass on this. I hope now some true Opposition Party backbone is developing and that's to the good. But in addition there has been too little leadership and push back from the medical and public health communities. Indeed the latter stupidly embraced the promise of bioterrorism monies as a way to beef up public health infrastructure. Not only didn't that happen, but the bioterrorism follies hollowed out public health like a cancer, diverting personnel, energies and commitments. So now a real public health threat comes along and suddenly we discover we aren't prepared.