In government—and particularly in the federal government—ideas normally come from the bottom up. When finally approved, proposals are reasonably well thought out in terms of what we are going to do and why we are going to do it. Sometimes knowledge of "what" we are going to do far exceeds the ability to explain why we are going to do it. However, for bioterrorism we are better able to talk about the "why" than the "what." When Congress received a request from the administration to address bioterrorism, we had only the vaguest idea what they wanted to do. As a result, the availability of funds was delayed until an operating plan was in place. We are still fleshing out exactly how to approach this problem, what the roles of the various agencies are, and what the legal issues are.

It is incumbent upon the community to spend more time studying the proposal and coming back to Congress with more detail.

As the scientific community examines the issues involved in bioterrorism, an education campaign should be undertaken to inform the public and the members of Congress at the local and national levels. Many people equate bioterrorism with chemical or explosive accidents that are obvious and identifiable. The insidious nature of bioterrorist attacks should be better explored and communicated.

Finally, over the last 20 or 25 years, efforts to bring about structural reform in state and local governments and in local public health departments have eroded. Efforts by Congress to fund the bioterrorism initiative may have a dual effect: they may not only improve our ability to respond to a bioterrorist incident but also may strengthen state and local health departments.

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