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GAO-01-21 State Department: Serious Problems in the Anthrax Vaccine Immunization Program
In 1998, the State Department stockpiled anthrax vaccine and antibiotics at several diplomatic posts near Iraq. In the event of an anthrax attack by Iraq, this stockpile was to be used for post-exposure immunization and treatment. In 1999, the State announced that it was starting a voluntary Anthrax Immunization Program for U.S. government employees, their dependents, and other personnel overseas. According to the Food and Drug Administration (FDA), full pre-exposure protection from anthrax requires six vaccinations given over an 18-month period, followed by an annual booster. Because the supplies of vaccines approved by FDA were insufficient, State decided to suspend plans to expand the program beyond the pilot site until more vaccine was available. GAO found that both the State Department's prepositioning of anthrax vaccine at diplomatic missions and the voluntary anthrax immunization program have been poorly implemented. Specifically, the vaccine was not properly stored or refrigerated, requirements for the voluntary program were not accurately estimated, and surveillance procedures used in the pilot program to monitor reactions to the vaccine were inadequate.
High-Containment Laboratories: National Strategy for Oversight Is Needed
The anthrax incidents following the 9/11 terrorist attacks put the spotlight on the nation's public health agencies, placing it under an unprecedented scrutiny that added new dimensions to the complex issues considered in this report. The Future of the Public's Health in the 21st Century reaffirms the vision of Healthy People 2010, and outlines a systems approach to assuring the nation's health in practice, research, and policy. This approach focuses on joining the unique resources and perspectives of diverse sectors and entities and challenges these groups to work in a concerted, strategic way to promote and protect the public's health. Focusing on diverse partnerships as the framework for public health, the book discusses: The need for a shift from an individual to a population-based approach in practice, research, policy, and community engagement. The status of the governmental public health infrastructure and what needs to be improved, including its interface with the health care delivery system. The roles nongovernment actors, such as academia, business, local communities and the media can play in creating a healthy nation. Providing an accessible analysis, this book will be important to public health policy-makers and practitioners, business and community leaders, health advocates, educators and journalists.
The vaccine used to protect humans against the anthrax disease, called Anthrax Vaccine Adsorbed (AVA), was licensed in 1970. It was initially used to protect people who might be exposed to anthrax where they worked, such as veterinarians and textile plant workers who process animal hair. When the U. S. military began to administer the vaccine, then extended a plan for the mandatory vaccination of all U. S. service members, some raised concerns about the safety and efficacy of AVA and the manufacture of the vaccine. In response to these and other concerns, Congress directed the Department of Defense to support an independent examination of AVA. The Anthrax Vaccine: Is It Safe? Does It Work? reports the study's conclusion that the vaccine is acceptably safe and effective in protecting humans against anthrax. The book also includes a description of advances needed in main areas: improving the way the vaccine is now used, expanding surveillance efforts to detect side effects from its use, and developing a better vaccine.
In a world where advanced knowledge is widespread and low-cost labor is readily available, U.S. advantages in the marketplace and in science and technology have begun to erode. A comprehensive and coordinated federal effort is urgently needed to bolster U.S. competitiveness and pre-eminence in these areas. This congressionally requested report by a pre-eminent committee makes four recommendations along with 20 implementation actions that federal policy-makers should take to create high-quality jobs and focus new science and technology efforts on meeting the nation's needs, especially in the area of clean, affordable energy: 1) Increase America's talent pool by vastly improving K-12 mathematics and science education; 2) Sustain and strengthen the nation's commitment to long-term basic research; 3) Develop, recruit, and retain top students, scientists, and engineers from both the U.S. and abroad; and 4) Ensure that the United States is the premier place in the world for innovation. Some actions will involve changing existing laws, while others will require financial support that would come from reallocating existing budgets or increasing them. Rising Above the Gathering Storm will be of great interest to federal and state government agencies, educators and schools, public decision makers, research sponsors, regulatory analysts, and scholars.