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State & Local Health Perspective on Bioterrorism Role, Rex Archer, Kansas City Department of Health: · There is a need for increased training and resources for state and local public health departments. Public health officers should have a higher profile within the political infrastructure and the public. Laws are meaningless without the practical ability to carry them out. · Greater efforts are required in the areas of record collection and data sharing. States need to have clear procedures for reporting of diseases, collecting data on workplace absenteeism, and obtaining information from pharmacies. There is also a need to streamline licensing requirements for medical professionals across state lines. In addition, the practices of managed care organizations may impact negatively on disease surveillance; for example, by discouraging doctors from ordering confirmatory tests. · Local health officers are authorized to control the use of property in a public health emergency. For example, public health officers may need to commandeer hotel rooms, which may be useful during an event because these rooms generally operate on separate ventilation systems. In addition, public health officers may have to commandeer drive-through facilities, such as those found at fast food restaurants, that could be used to dispense medicines in an emergency. While public health authorities are relatively strong, there is little practical experience in using compulsory measures, as they have not been needed for more than 50 years. Increased authority may be needed. "Greater efforts are required with respect to management of persons. For example, few health facilities have the surge capacity to deal with a large number of casualties. In addition, the chain of command during a public health emergency must be clarified." State Emergency Health Powers and the Bioterrorism Threat "AIDS laws must not be based upon ignorance, fear and political expediency and pandering to the demand of the citizenry for 'tough' measures…. Good laws, like good ethics, will be founded in good data". THE CRIMINALISATION OF LIVES
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