Health and Human Services

Unprepared for the Attacks; Preparing for Flu Pandemic

Operations center deputy director Daniel Coviello at work in the
Operations center deputy director Daniel Coviello at work in the "war room" near the office of the HHS secretary. (By Linda Davidson -- The Washington Post)
Sunday, July 16, 2006

Whatever it meant for politics, for many government agencies and those who ran them, Sept. 11, 2001, was a life-changing experience. Tommy G. Thompson, then the secretary of health and human services, had called a meeting that morning with a group of scientists to discuss the threat of pandemic flu.

The meeting was canceled as Thompson struggled to organize a delivery of emergency medical supplies to New York City. But in the aftermath of 9/11 and that fall's anthrax scare, it became clear to him that the United States was seriously unprepared for major emergencies.

"For the first time," Thompson said in a recent interview, "state and federal governments began looking at how we might rebuild public health facilities" that had suffered from years of budgetary neglect. Inside the Department of Health and Human Services, he said, "we realized how disjointed we were and how the various divisions were completely independent."

In response, an organization that had been preoccupied with the bureaucratic demands of Medicare, Medicaid and welfare began to refocus on urgent threats to homeland security and the need for rapid response. The changes included a centralization of authority symbolized by the creation of a "war room" crammed with the latest communications equipment on the same floor as the secretary's office, to coordinate information from all the divisions and issue orders to all hands.

As the threat has grown in scale, the budget of HHS has grown apace. Official figures show the department's bioterrorism and emergency preparedness budget went from $237 million in fiscal 2000 to $9.7 billion in fiscal 2006.

Now, said Mike Leavitt, Thompson's successor as HHS secretary, the department is focused on what could be an even bigger challenge: the threat of pandemic flu, the very subject that Thompson was planning to discuss on the morning of Sept. 11.

"It has created a need for an even deeper inspection of our readiness throughout the country," Leavitt said. "The people of Salina, Kansas, weren't really worried about terrorists coming to their town, but they have reason to be concerned about a pandemic."

What was true of HHS was repeated throughout the government, and the result was a rapid increase in the overall federal budget. In the fiscal year that ended three weeks after Sept. 11, Washington spent $1.86 trillion; this year, the comparable figure is $2.71 trillion, an increase of 46 percent.

And the attention of government officials, from the president down, shifted from routine matters, especially from their domestic policy concerns.

"I feel certain that I have spent a substantially higher percentage of my time focusing on matters related to the security of the homeland than I would have five years before," Leavitt said. "It became evident to me early on that this was a major part of my responsibility."

-- David S. Broder

© 2006 The Washington Post Company