effort. Now that the recent anthrax release has entered a recovery stage, several workshop participants suggested that it is essential that we continue educating the public about the risks of bioterrorism. There is concern that many people do not realize how much damage a bioterrorist attack larger than what we have seen to date could inflict. In fact, we may be doing a disservice to the American public by not finding a way to educate them in a non-alarmist fashion about the serious nature of this problem.

An increased public awareness may help overcome the challenge of convincing those who allocate resources that new and substantial resources are needed at all levels of capacity-building, from multi-sector collaborative vaccine production to informed local first responders. Several workshop participants expressed the belief that increased public awareness will indirectly send the message to Congress that this is a serious issue that demands immediate attention. Currently, it is unclear whether policymakers and those who are in positions to lead the effort to fill the gaps in our response capabilities have fully realized the reality of what looms ahead.

It was described by one participant that a major challenge to public awareness, however, is the chance that this issue could diminish in importance if we are fortunate enough not to experience another attack in the near future. As such, it is crucial that we keep this issue in front of the nation and that we continue to develop our response to it.

There was much discussion about whether public awareness could somehow be manifest as civilian biodefense and whether civilian biodefense could someday serve to empower local communities and decentralize the response to an attack. That is, on the one hand, we do everything that we need to do to strengthen the infrastructure of public health. But on the other hand, civilians could be educated about what they can do as individuals in terms of protective measures. With the awareness and proper training, civilian biodefense could become an important part of the local response. Indeed, as one workshop participant envisioned, is it not imaginable that in the far, far future we might be able to treat ourselves?

Adel Mahmoud, M.D., Ph.D.

Chair, Forum on Emerging Infections

President, Merck Vaccines

Stanley Lemon, M.D.

Vice-Chair, Forum on Emerging Infections

Dean of Medicine, University of Texas, Galveston



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