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Prepositioning Antibiotics for Anthrax (2012) / Chapter Skim
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6 Recommended Actions for Moving Forward
Pages 209-216

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From page 209...
... ACTIONS FOR STATE, LOCAL, AND TRIBAL PUBLIC HEALTH OFFICIALS The following recommendations are intended to assist state, local, and tribal public health officials in evaluating the potential benefits, health risks, and costs of developing prepositioning strategies in their community. Recommendation 5-2: Integrate ethical principles and public engage ment into the development of prepositioning strategies within the overall context of public health planning for bioterrorism response.
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From page 210...
... • T ransparency and accountability -- Maintain public accountability and transparency so that community members grasp relevant poli cies and know from whom they may request explanation, informa tion, or revision. • P roportionality -- Use burdensome measures, such as those that restrict liberty, only when they offer a commensurate gain in public health and when no less onerous alternatives are both available and feasible.
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From page 211...
... In public health planning efforts, state, local, and tribal jurisdictions should give priority to improving the dispensing capability of points of dispensing and push strategies and to developing forward-deployed or cached prepositioning strategies. The committee does not recommend the development of public health strategies that involve broad use of predispensed medical countermeasures for the general population.
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From page 212...
... Throughout this report, the committee has highlighted areas in which additional research is needed to better characterize the risk of an anthrax attack, the distribution and dispensing capability needed to provide prophylaxis for a population within an appropriate time period, what that time period is, and the role of prepositioning in an overall bioterrorism preparedness and response system. The remaining evidence gaps in each of these areas, as well as others identified below (see Table 6-1)
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From page 213...
... in a target community – Assessment of costs and effectiveness of alternative means to improve SNS distribution time – Accurate assessment of local dispensing capacity, including existing closed points of dispensing (PODs) – Assessment of populations not adequately served by PODs – Further assessment of existing prepositioning models, including the MedKit component of the postal model – Potential impact of behavior of the public on a dispensing system (e.g., if individuals with home stock piles also attempt to receive MCM from a public POD)
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From page 214...
... Safety – Adverse events and impact on adherence – Impact on general community antimicrobial resistance patterns – Influence of packaging of predispensed antibiotics on inappropriate use Cost-Effectiveness – Further assessment of the likely total costs of alternative prepositioning strategies in different communities – Further assessment of health benefits of alternative prepositioning strategies in different communities – Further assessment of cost-effectiveness of alternative prepositioning strategies in different communities await the research results, but those results should be used to refine plans in the future. Recommendation 6-1: Perform additional research to better inform decision making about prepositioning strategies.
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From page 215...
... In recognition of limited public health resources, Box 6-1 summarizes the research needs that are most critical. CONCLUDING REMARKS Prepositioning is just one potential component of a larger endeavor to enhance the nation's capability to prevent illness and death from an anthrax attack.
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Key Terms

  • medical countermeasures
  • anthrax attack
  • health benefits
  • dispensing capability
  • dispensing plans

  • health risks
  • tribal public
  • health planning
  • health officials
  • lack access

  • national guidance
  • medical issues
  • ethical principles
  • national stockpile
  • predispensed medical

  • tribal jurisdictions
  • distribution time
  • health resources
  • distribution strategies
  • developing prepositioning

  • strategic national
  • timely dispensing
  • planning efforts
  • anthrax prevention
  • local dispensing

  • qualitative research
  • leverage existing
  • conduct additional
  • assist state
  • provide prophylaxis


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