Hostname: page-component-84b7d79bbc-rnpqb Total loading time: 0 Render date: 2024-07-29T22:42:37.085Z Has data issue: false hasContentIssue false
  • English
  • Français

National Health Preparedness and Response Centers: Revisiting the Increasingly Critical Need to Expand Cooperative Emergency Response Capabilities in the United States

Published online by Cambridge University Press:  15 April 2020

Donald A. Donahue ,
Frederick M. Burkle Jr.  and
Ronald R. Blanck
Donald A. Donahue*
Affiliation:
University of Maryland Baltimore, The Graduate School; University of Maryland Global Campus, The Business School
Frederick M. Burkle Jr.
Affiliation:
Harvard School of Public Health; Harvard Humanitarian Initiative
Ronald R. Blanck
Affiliation:
Uniformed Services University of the Health Sciences, Chair, Board of Regents
*
Correspondence and reprint requests to Donald Donahue, 18823 New Hampshire Avenue, Ashton, MD20861 (e-mail: donald.donahuejr@verizon.net).
Get access Rights & Permissions [Opens in a new window]

Abstract

In 1999, a robust National Health Preparedness and Response Center was conceptualized and piloted, but never fully operationalized. This study revisits the expansive, coordinated efforts invested in this concept, considered an overdue remedy for persistent shortfalls in medical Chemical, Biological, Radiological, Nuclear, and High Yield Explosives training, proficiency, and preparation. The concept defined a robust mission for longstanding, proven programs for prepositioning equipment and associated training of personnel. This study explores the reasons that ended military and governmental support, attendant funding, and operations of the created Joint/Interagency Civil Support Center, which ceased on September 30, 2006. Unfortunately, the concept remains relevant. Major gaps in disaster medical response capabilities have been recognized for decades. Experts from the Institute of Medicine, United States Northern Command, and multiple academic centers and professional organizations have identified these shortcomings, but the national response posture remains disjointed, under-resourced, and based upon obsolete planning premises. Given increasing threats, the authors recommend revisiting the collaboration of military, civilian, academic, and governmental resources that once established the Joint/Interagency Civil Support Center as a multidisciplinary and trans-disciplinary model for a new National Health Preparedness and Response Center coordinated framework for enhanced resilience and operational response capabilities on a national level.

Keywords

chemicalbiological and radiation disastersdisaster preparednessdisaster responsemultidisciplinary national response
Type
Concepts in Disaster Medicine
Information
Disaster Medicine and Public Health Preparedness , Volume 15 , Issue 3 , June 2021 , pp. 358 - 366
Copyright
Copyright © 2020 Society for Disaster Medicine and Public Health, Inc.

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Operational Requirements Document. Action Memo: Office of the Assistant Secretary of Defense, Subject: Joint Interagency Civil Support Training Center, March 9, 2004 Google Scholar
Testimony: “Chemical and Biological Defense: Emphasis Remains Insufficient to Resolve Continuing Problems” (GAO/T-NSIAD-96-123), March 12, 1996.Google Scholar
Testimony: “Chemical and Biological Defense: Emphasis Remains Insufficient to Resolve Continuing Problems” (GAO/T-NSIAD-96-154), May 1, 1996.Google Scholar
Report: “Chemical and Biological Defense – DoD Need to Clarify Expectations for Medical Readiness” (GAO 02-38), October 2001.Google Scholar
FY00 Medical NBC Defense Readiness Conference and FY01 Medical NBC Defense Readiness Conference -- Joint Professional Medical NBC Training, April 30-May 4, 2001.Google Scholar
DoD Directive 1322.18, “Military Training”, January 9, 1987.Google Scholar
DoD Directive 1215.6, “Uniform Reserve, Training and Retirement Category,” March 14, 1997.Google Scholar
DoD Instruction 1322.24, “Medical Readiness Training,” July 12, 2002.Google Scholar
Draft Department of Defense Instruction, Number XXXX.XX, Subject: Chemical, Biological, Radiological, Nuclear, and (High Yield) Explosives (CBRNE) Training for Military Medical Personnel.Google Scholar
DoD. Chemical and Biological Defense Program – Annual Report to Congress. https://archive.defense.gov/pubs/chembio02012000.pdf (2000).Google Scholar
The United States Army Reserve and Homeland Security Operations, October 15, 2004, https://www.powershow.com/view1/88f71-ZDc1Z/31-Dec-14-_1_powerpoint_ppt_presentation?varnishcache=1.Google Scholar
Donahue, DA, Godwin, EA, Cunnion, SO. Medical response capabilities to a catastrophic disaster: “house” or house of cards? J Homel Secur Emerg Manag. 2012;9(2). doi: 10.1515/1547-7355.2029 Google Scholar
McCann, DG. National Disaster Medical System: NDMS—Do Not Go Gentle into That Good Night. The National Emergency Management Summit; Agenda Day One, Monday February 4, 2008. http://www.emergencymanagementsummit.com/past2008/agenda/day1.html.Google Scholar
Burkle, FM Jr, Dallas, CE. Developing a nuclear global health workforce amid the increasing threat of a nuclear crisis” disaster medicine and public health preparedness. 2016;10(1):129-144. doi: 10.1017/dmp.2015.125 CrossRefGoogle Scholar
World Health Organization. The World health Report 2007--a safer future: global public health security in the 21st century. Geneva: World Health Organization. 2007 Google Scholar
“You can’t get there from here… Shortfalls in post-disaster patient evacuation planning.” Nationwide Response Issues After an Improvised Nuclear Device Attack: Medical and Public Health Considerations for Neighboring Jurisdictions Workshop, January 24, 2013, the IOM Forum on Medical and Public Health Preparedness for Catastrophic Events, Washington, DC: Institute of Medicine and National Association of County and City Health OfficialsGoogle Scholar
“EMP and the Resilient Hospital,” Panel presentation: “Resilient Hospitals in Large Scale Disasters (The role of alternative technologies and sustainability in electric power grid mitigation,” National InfraGard EMP Special Interest Group: Planning Resilience for High Impact Threats to Critical Infrastructure in 2015, Washington, DC, December 5, 2014 Google Scholar
Franco, C, Toner, E, Waldhorn, R, et al. The National Disaster Medical System: past, present, and suggestions for the future. Biosecur Bioterror. 2007;5(4):319-325.CrossRefGoogle ScholarPubMed
Bipartisan Commission on Biodefense. http://www.biodefensestudy.org/ Google Scholar
Winters, A. One Year Later: Two Hospitals on Road to Recovery. Joplin Globe Video. 2011. https://www.youtube.com/watch?v=Ikx3pNLQ9e0.Google Scholar
Robles, F, Fink, S. Amid Puerto Rico Disaster, Hospital Ship Admitted Just 6 Patients a Day. New York Times. 2017, December 6. https://www.nytimes.com/2017/12/06/us/puerto-rico-hurricane-maria-hospital-ship.html.Google Scholar
Burkle, FM Jr. Challenges of global public health emergencies: development of a health-crisis management framework. Tohoku J Exp Med. 2019;249:33-41.CrossRefGoogle ScholarPubMed