Wednesday, June 6, 2007
Protecting the Public Health
I am sure everyone has heard by now about the case of Andrew Speaker, who was diagnosed with an active, drug-resistant form of tuberculosis. On May 10, Mr. Speaker flew from Atlanta on a 12-day international odyssey, which he continued despite warnings from the Centers for Disease Control and Prevention (CDC). Then he reentered the U.S. at the Canadian border when a customs agent allowed him to pass despite knowing that Mr. Speaker was being sought by health authorities. During this hearing, we will hear testimony from Mr. Speaker by live hook-up from his hospital room in Denver, Colorado, where he is under quarantine.
Obviously, this case raises grave questions as to how prepared we are as a nation to prevent the spread of a dangerous infectious disease.
This Subcommittee has made it one of its top priorities — if not the top priority — to make sure that our public health infrastructure is adequately funded to respond to natural or man-made biological threats. We have provided funds for disease surveillance, here and abroad. We have invested in CDC and our state and local public health systems. We have funded research and vaccine development. We have held hearings on bioterrorism and on pandemic flu.
We did this because we know that public health, both on the federal and local levels, is our first line of defense against new and existing infectious diseases. We did this because we knew the threats we faced from both bioterrorism and emerging infectious diseases - for example, SARS or pandemic flu. In the case of pandemic flu, we know that we have to count on our public health system because we will not have a vaccine for months after an outbreak.
That is why I am dismayed and concerned that so many things went wrong in this case of drug-resistant tuberculosis. This is not the first and will not be the last time that we count on our public health system to keep us safe. Some things went right: The doctor who first diagnosed the TB in the Atlanta man did, indeed, report the case to the local health department. The local health department did respond, and either suggested or directed - I don't know which - the patient not to travel overseas. But then the records get less clear. Clearly, there are gaps in planning on how to control the travel of persons with dangerous infectious diseases. It's as though the issue had never been raised before. We are told that there were legal issues to resolve. But sound planning calls for resolving those issues in advance.
The purpose of this hearing is to learn more about what happened in this particular case, and, more importantly, to learn what is being done to prevent something similar from happening again. Bear in mind that an incident like this could have happened on a cruise ship, a train, on a busy commuter subway. We need to be planning for these kinds of possibilities, and we need to test those plans to see if they will work in the real world.
This hearing will also give us an opportunity to learn more about the growing problem of drug-resistant tuberculosis, and other drug-resistant infections diseases, and what is begin done and should be done to address those threats.
