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U.S. Unprepared Despite Progress, Experts Say

One such case involved the Strategic National Stockpile, set up in 1999 as an arm of HHS's Centers for Disease Control and Prevention. It is a repository of tons of biodefense drugs and vaccines that can be flown anywhere in the nation within 12 hours.

Experts said the CDC did a good job managing the stockpile, and its employees grumbled when they were moved into Homeland Security last year, where officials have no expertise handling drugs or fashioning emergency medical doctrine. Every time CDC wanted to add drugs to the stockpile, the permission of Homeland Security lawyers was needed, slowing even basic functions. So with no public fanfare, the stockpile was returned to CDC in August.

Chris Schmidt, an emerging infectious disease fellow in the poxvirus section of the Centers for Disease Control in Atlanta, shows the use of a biohazard suit. (Ric Feld -- AP)

_____Rising Spending_____
Charts: Federal spending on biodefense grew rapidly after 2001, with large portions going to NIH and Bioshield program. Also, smallpox vaccination efforts fall well short of goal.
_____From This Series_____
Impervious Shield Elusive Against Drive-By Terrorists (The Washington Post, Aug 8, 2004)
U.S. Eyes Money Trails of Saudi-Backed Charities (The Washington Post, Aug 19, 2004)
In Search Of Friends Among The Foes (The Washington Post, Sep 11, 2004)
From a Virtual Shadow, Messages of Terror (The Washington Post, Oct 2, 2004)
Moroccans Gain Prominence in Terror Groups (The Washington Post, Oct 14, 2004)
About This Series

Three years after the Sept. 11, 2001, attacks, the U.S. government has undertaken extensive efforts to root out Islamic terrorists around the world and to defend the U.S. homeland. These articles are part of a series that considers the elusive nature of the threat and the problems authorities confront in battling it. Today's stories examine the difficulty of devising defenses and responses to bioterrorism. Previous parts of this series can be found at www.washingtonpost.com/nation.

___ Guide ___
Personal Preparedness Guide
Dirty bombs, anthrax and smallpox: an informative guide to understanding the threat and protecting you and your family.

_____Biotech Headlines_____
Helping Kids Cope In Parent's Illness (The Washington Post, Nov 9, 2004)
Shored Up for Disaster, Area Officials Still Fearful (The Washington Post, Nov 8, 2004)
Va. Tech, Research Group to Team Up (The Washington Post, Nov 8, 2004)
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The administration's most prominent action in bioterrorism -- the initiative last year to inoculate 500,000 health workers against smallpox -- fizzled. The plan was hatched in late 2002 as the country prepared to invade Iraq. Officials feared Iraq or terrorists might attack this country with the bioterrorism agent.

But workers, concerned about health risks, refused to sign up. Officials had failed to line up legal guarantees that the government would compensate workers sickened by immunizations. The worries gave way to complacency when U.S. troops failed to find smallpox or other biological weapons in Iraq.

In the end, about 40,000 people were inoculated -- 8 percent of the goal. The episode suggests the government continues to have trouble communicating with the health community and the public about bioterrorism dangers.

"The biggest consequence is the loss of credibility," Jerome M. Hauer, former director of HHS's Office of Public Health Emergency Preparedness, said of the episode. "How do you get people to trust you again?"

New Drugs Slow in Coming

To counteract the attack that officials are nearly certain will come one day, the nation needs long lists of new biowarfare antidotes and vaccines. But despite intense effort by NIH, the arrival of usable drugs has been slow, experts and U.S. officials said. Besides the complex science involved, NIH's tradition of academic-oriented basic research, and a lack of focus on creating new drugs are responsible, they said.

NIH's bioterrorism budgets have jumped from $53 million in 2001 to $1.7 billion in 2005, as Congress and other parts of the administration increased pressure on the agency to change.

"Some of the criticism of the past was valid," NIH's Fauci said. "But we've already shown we've been successful" in pushing scientific concepts toward becoming reality, he said. "This is a change in the culture."

Experts said NIH drags its feet researching such areas as skin patch vaccines, which could be given more quickly than shots, and vaccine-boosting compounds called adjuvants, which allow limited stocks to be used on more people. Fauci said NIH is working on these questions.

Even so, officials said, a top priority is persuading large drug firms to make big investments in biological warfare research -- in essence, creating a biodefense industry from scratch.

"Big pharma" is now not interested for several reasons, industry and government officials say. Big firms are accustomed to huge profits on their drugs for arthritis, ulcers, impotence and the like, and foresee returns a fraction of that size for biodefense work.

The industry also fears lawsuits against firms developing such drugs, and government temptation to nationalize patents on biodefense drugs in a crisis.

In July, Congress approved Project Bioshield, which allocates $5.6 billion over 10 years to induce the industry to begin investing in these drugs. But industry executives say they are waiting for much larger sums, as well as stronger legal liability and patent protections.

"The measures the U.S. government has taken to date (including Bioshield) will not be enough to entice pharmaceutical industry leaders into this field," according to a recent study by the University of Pittsburgh biosecurity center based on interviews with 30 top industry and government officials.

Health experts say that the recent loss of half the nation's flu vaccine supply because of contamination in a British plant does not bode well for future efforts on the more daunting scientific challenge of bioterrorism.

Some believe that Bush should publicly declare the seriousness of the government's bioterrorism concerns, name a bioterrorism "czar" to focus public attention, and initiate vastly expanded research into new drugs. Administration officials said that such steps are unnecessary and that the current arrangement works fine.

But the biosecurity center's O'Toole disagreed.

"The country cannot do what's needed to get prepared for bioattacks without very visible national leadership from the president," said O'Toole, who worked in the Clinton Energy Department. "We're not yet treating this like a national security emergency."

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