Challenges to Leadership

Experts have been warning of the threat of a biological attack on the United States for many years. In the aftermath of the 2001 anthrax release, various agencies within the Federal government initiated a series of programs intended to prevent incidents and ameliorate the perceived threat. State and local first responders have also invested heavily in systems and mechanisms for responding to an unanticipated disease outbreak. Private sector actors (hospitals, doctors, vaccine providers, and others) have mobilized to enhance their readiness, resilience, and capacity to respond. After nearly 10 years of political, legal and practical ferment, many have recognized the need to take stock of our efforts thus far and to assess how effective they have been. The proliferation of authorities and responsibilities in the arena of biological threats is not well documented. No comprehensive survey of programs and responsibilities exists.1 Indeed, the field is so broad that any review of modest length risks either degenerating into platitudes or reviewing efforts at such a high level of generality that any conclusions and recommendations are of little practical value. Accordingly, this monograph has set a more modest goal. It seeks to identify a series of gaps and overlaps in existing structures and mechanisms and to advance potential solutions that can be implemented. In particular, this monograph examines two issues of concern: • Federal Coordination Structure—Any fair examination suggests that at this juncture the proliferation of responsible Federal entities has bred a form of bureaucratic gridlock that is detrimental to effective decision-making. The Federal government lacks an effective centralizing coordinating function for biological incidents. Roles and responsibilities can be readily confused and authorities to act are often ambiguous. • Federal/State Coordination—Few fully understand when, and how, a transition from an event of local significance to one constituting an event of national significance occurs. No concerted effort has been made to understand where the threshold for dividing Federal responsibility from State/local/private responsibility lies, nor when transitions of responsibility within the Federal government should occur. With respect to both of these areas, this monograph seeks to identify certain gaps and overlaps that need resolution if the goal is effective action. In doing so, the paper seeks as well to outline some suggested solutions. In particular, the paper recommends that a more comprehensive set of planning and response exercises be developed in order to better understand and develop a doctrine of incident leadership suitable for a biological crisis. 1 1 One useful survey, limited to international programs, can be found in Barry Kellman, Michael Kraft, Zachary Clopton & Orley Lindgren, United States Policies and Programs to Reduce Bio-Dangers (ISBI, March 2010) [available at http://www.biopolicy.org/sites/default/files/documents/ISBI%20Congressional%20Report%20Final.pdf]. I. A Prelude—The Biological Threat In Context There is, of course, a substantial debate regarding the scope and nature of the threat of a biological attack. Some observers consider the threat to be significant and, to a large degree, greater than has been recognized.

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