DHHS Eagle graphic
ASL Header
Mission Nav Button Division Nav Button Grants Nav Button Testimony Nav Button Other Links Nav Button ASL Home Nav Button
US Capitol Building
HHS Home
Contact Us
dot graphic Testimony bar

This is an archive page. The links are no longer being updated.

Testimony on Preparedness for Epidemics and Bioterrorism by Robert Knouss
Director, Office of Emergency Preparedness
U.S. Department of Health and Human Services

Before the Senate Committee on Appropriations, Subcommittee on Labor, Health and Human Services, Education and Related Agencies
June 2, 1998

Good afternoon. I am Dr. Robert Knouss, Director of the Office of Emergency Preparedness in the U.S. Department of Health and Human Services (HHS). I am pleased to have the opportunity to appear before the Senate Appropriations Subcommittee on Labor, Health and Human Services and Education on the very important topic of the Nation's Public Health Infrastructure Regarding Epidemics and Bioterrorism.

The Office of Emergency Preparedness is responsible for coordinating HHS' continuity of government, continuity of operations, and the provision of public health and medical services following emergencies and disasters that sufficiently degrade local capacity as to require national assistance. In this role we also work with other federal agencies and the private sector to develop capabilities and capacities for responding to the health and medical needs of affected populations.

HHS is actively participating in the Department of Justice led effort to develop a Five-Year Inter-Agency Counter-terrorism and Technology Plan. This effort will address specific strategies and requirements for all agencies involved in the counter-terrorism effort.

I am also the Director of the National Disaster Medical System (NDMS) which is a partnership between the Department of Defense, the Department of Veterans Affairs, the Federal Emergency Management Agency, HHS and the private sector. This system can provide medical response to an affected area, evacuate patients, and provide definitive care if local and state resources are overtaxed. Under the Federal Response Plan, NDMS assets are incorporated into Emergency Support Function #8, Health and Medical Services, and have been deployed to a wide variety of emergencies such as natural disasters, plane crashes, and terrorist incidents.

The Sarin gas attack on the Tokyo subway system and the Oklahoma City bombing of the Alfred P. Murrah Federal Building left the world shocked by these senseless and horrific acts of terrorism. One of our greatest challenges is addressing the complex preparedness issues posed by a terrorist use of a WMD on civilian populations. The human health impact of such a release or detonation is the primary consequence of such an attack.

HHS is taking a "systems" approach to building response capability and capacity at the local, state and federal levels. Our counter-terrorism strategy includes the following key elements: Enhancing local resources because disaster response in this country begins at the local level; developing partnerships to improve local and state health and medical system coordination and capability to respond effectively; and improving federal health and medical capability to rapidly augment state and local responses. Our resources include those of the National Disaster Medical System.

As part of this system, we have developed specialized national medical response teams (located in Washington, D.C., Winston-Salem, Denver and Los Angeles) that can augment local resources in the event of a WMD threat or event. Instances where these teams have been used include: (1) in response to the bombing in Centennial Olympic Park; (2) pre-positioned to respond if needed during the Summit of the Eight last year in Denver; (3) during the Inauguration in 1997; and (4) in the Capitol during the State of the Union Address this year. It was also one of these teams, the one in Winston-Salem, that responded under State auspices, to the event that occurred earlier this year in Charlotte, North Carolina.

In creating these resources, we have not been alone. Some of the key HHS agencies with which we have been working very closely to address counter-terrorism issues include the Centers for Disease Control and Prevention, the Agency for Toxic Substances and Disease Registry; the Food and Drug Administration, and the National Institutes of Health. External to HHS we have been working with other federal departments and agencies, the National Academy of Science's Institute of Medicine, and local and state governments, as well as with nationally recognized individual experts.

We have also supported 27 major metropolitan areas for the development of local Metropolitan Medical Strike Team Systems. These enhancements to existing local response systems are designed to provide initial on-site response and provide for safe patient transportation to hospital emergency rooms for treatment in the event of a WMD terrorist attack. These MMST Systems are characterized by specially trained responders for on-site triage and initial medical treatment; specialized pharmaceuticals and decontamination equipment; enhanced emergency medical transportation; definitive hospital care; and the provision of assistance from the National Disaster Medical System, if needed. Our plans are to continue developing local MMST Systems in conjunction with the Domestic Preparedness Program's 120-city initiative. Further system development is necessary to assure adequate surveillance, laboratory support and pharmaceutical distribution systems in the event of a biological weapon release.

The program of enhanced preparedness that the President called for in his Naval Academy commencement speech on May 22nd, and his recent signing of Presidential Decision Directive 62, will strengthen our nation's defenses against the growing threat of unconventional attacks against the people of the United States. This directive designates HHS as the lead Federal agency, in support of FEMA, to plan and prepare a national response to medical emergencies arising from the terrorist use of weapons of mass destruction. We will be supported by other Federal agencies in this effort. Together we plan to continue to provide enhanced local response through the strengthening of local systems and the provision of Federal supporting teams, if necessary -- for the prevention, detection, identification and public health response to the release of a weapon of mass destruction.

Of significant concern is how best to protect our civilian population from biological weapons. In response to the President's directive, HHS is exploring a range of approaches for upgrading our public health systems for detection and warning and for providing medical care for massive numbers of affected people. We are examining a broad spectrum of needs that includes research and development, pharmaceutical stockpiles, public health surveillance, and response capabilities.

Secretary Shalala recently requested that the Assistant Secretary for Planning and Evaluation convene a working group to develop a HHS strategic plan for strengthening and expanding our role in the Government-wide bioterrorism effort. Implementation of the plan and oversight of the resulting activities will be the responsibility of the Assistant Secretary for Health and Surgeon General.

Thank you for this opportunity to discuss our counter-terrorism initiatives with you. I would be glad to answer any questions .

Privacy Notice (www.hhs.gov/Privacy.html) | FOIA (www.hhs.gov/foia/) | What's New (www.hhs.gov/about/index.html#topiclist) | FAQs (answers.hhs.gov) | Reading Room (www.hhs.gov/read/) | Site Info (www.hhs.gov/SiteMap.html)