Red Cross Shelter volunteers discuss coordination of services for survivors of Hurricane Sandy

commentary

(The RAND Blog)

December 3, 2012

Far More U.S. Health Security Research Effort Aimed at Bioterrorism than Natural Disasters

Red Cross Shelter volunteers discuss coordination of services for survivors of Hurricane Sandy

photo by George Armstrong/FEMA

by Shoshana R. Shelton

A month ago the second costliest-storm in U.S. history wreaked havoc on the East Coast. New York is seeking $42 billion in federal aid, and New Jersey is seeking nearly $37 billion. While the federal government has distinct capabilities that are essential for disaster response and recovery, including disaster aid, it is also uniquely positioned to sponsor the research required to develop new technologies, strategies, and tactics to better deal with large-scale disasters.

One objective of the National Health Security Strategy of the United States of America is to ensure that all systems that support national health security are based on the best available science, evaluation, and quality improvement methods. A first step is to understand how research funds are currently being spent.

A new article in Health Affairs presents RAND's findings from the first-ever inventory of non-classified, civilian national health security research funded by the federal government.

Our analysis reveals that preparing for biological threats and bioterrorism dominates the U.S. government's portfolio of health security research. Of the 1,593 projects examined, 1,047 (66 percent) were directed towards biological threats. Fewer than 10 percent of the total pool of projects addressed natural disasters such as earthquakes, hurricanes, tornadoes, or floods. Eight of the 10 priorities identified in the National Health Security Strategy—including fostering informed, empowered individuals and communities and incorporating recovery into planning and response—receive scant attention.

Given the broad range of threats facing the United States, including those related to extreme weather, it is imperative that monies invested in enhancing health security be well spent. Biological threats certainly represent a risk to health security. But it is questionable whether these threats warrant more attention than all of the other threats combined.

To get more bang for the research buck, we recommend that priority setting be based on the nature of each threat, the probability that an incident will occur, the magnitude of damage it could inflict, and the availability of countermeasures to limit or reduce its consequences. We also recommend a voluntary process of information sharing between agencies to improve coordination, along with a shared approach to categorize research projects.

The resulting output would help government officials, researchers, and policymakers discern patterns of funding, track progress in the field, and avoid wasteful duplication of efforts. That, ultimately, could go a long way toward ensuring the nation's health security.


Shoshana Shelton is a project associate at the nonprofit, nonpartisan RAND Corporation.