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Despite steady progress, biodefenses still unsettled


Five years after mailed anthrax killed five people, experts give the nation's biodefenses mixed marks.

"We're safer than we were in 2001. We've come a long way. But there's still a lot of work to do," said Michael Mair of the Center for Biosecurity at the University of Pittsburgh Medical Center.

The center estimated the government has spent at least $26 billion on detection, vaccines, antibiotics and training since the attacks. The figure doesn't include military research.

The General Accounting Office, the investigative arm of Congress, reported in May that "deficiencies remain" in anthrax vaccine and detection programs. The government "still lacks a strategic plan" to validate sampling methods, the GAO said.

The Department of Health and Human Services concedes two gaps: Antitoxins, for treating anthrax victims beyond help from antibiotics and vaccines; and defenses against anthrax strains engineered to resist antibiotics.

A Homeland Security program called BioWatch deploys air sensors around urban areas. They are meant to alert officials to a biological attack in time for public inoculations and antibiotics, which must start within days of exposure to be effective. BioWatch is a work in progress, Mair said.

"We still feel the most likely thing would be detection by an astute clinician," he said.

Heightened medical awareness and the emergence of microbial forensics, a field blending science and law enforcement, are the biggest advances in biopreparedness, said Ronald Atlas, co-director of the Center for Health Hazards Preparedness at the University of Louisville.

The Postal Service has spent about $1 billion decontaminating postal facilities in New Jersey and Washington, installing biohazard detection gear at 272 processing and distribution centers and irradiating mail sent to federal agencies in the capital, spokesman Bob Anderson said.

Still, only envelope-sized letters sent from mailboxes are screened for anthrax. And the Postal Service can't detect poisons such as ricin, which caused a shutdown of Senate offices in an unsolved 2004 incident.

Health and Human Services said it has enough smallpox vaccine for every American, and the federal Centers for Disease Control and Prevention have vastly increased their stockpile of antibiotics for anthrax.

Even so, that stockpile is only enough for about 41.5 million people, or one in seven Americans. And intravenous antibiotics, for treating symptoms of anthrax infection, are available in sufficient quantities for just 831,000 people.

Experts worry about how swiftly stockpiles could be tapped in a crisis. Government relief efforts after Hurricane Katrina have not inspired confidence.

A report last year by the nonprofit Trust for America's Health found only seven states and two cities ready to distribute medicine from the stockpile in an emergency. New Jersey did not make that list. The Trust gave the federal government a grade of D+ for its post-9/11 emergency public health preparedness.

BioShield, a $5.6 billion federal program, has allocated $877.5 million for 75 million doses of an improved anthrax vaccine. Contractor delays have pushed back delivery for at least two more years, however.

BioShield was intended to woo big drug companies, which see little profit potential in vaccines. But the industry still is balking because of liability questions and quirks in program funding, Mair said.

Some analysts think federal agencies should scrap their "'one bug, one drug" approach and follow the lead of defense labs, which are searching for therapies to handle multiple biological threats.

Other scientists warn ramped-up research is raising risks of accidents and terrorism.

From 1997 through 2001, the National Institute of Allergy and Infectious Diseases funded $5.4 million of anthrax projects at a dozen labs, according to Richard Ebright, a Rutgers University microbiologist. Since the anthrax attacks, he said, 302 institute grants totaling $547 million were awarded to 264 researchers.

"The Bush administration has now made this material very widely distributed. That was very irresponsible," said Ebright, a critic of safety and security measures at biohazard labs.

Atlas counters that the potential rewards outweigh the risks.

"The more we know about how to develop vaccine and therapeutics, the better off we are," he said.