With the 10th anniversary of the anthrax attacks in the United States coming up this October, Jeff Levi, PhD, Executive Director of the Trust for America's Health (TFAH) marked the occasion making the following statement:

"All of us at the Trust for America's Health want to take this anniversary to remember those we lost and their loved ones and to commemorate the public health community and other responders who worked tirelessly and heroically to respond and protect us.

Public health officials were at the lead of the anthrax response - diagnosing and treating victims and running more than a million tests on 125,000 potentially life-threatening samples around the country in a short period of time. These officials were often working without adequate resources or training to respond to these types of attacks and had limited knowledge of the science involved in weaponized anthrax and how widely it was dispersed through the U.S. mail system. This was truly the first time public health came to be viewed as central to emergency response and national security on a wide-scale basis.

Over the past decade, we made a lot of strategic, smart investments to improve preparedness in the United States. However, recent federal, state and local budget cuts threaten to put that progress into jeopardy. The most important way we can honor the past is to make sure we sustain enough resources to support the field of public health so they have the tools and expertise they need to do their jobs -- so we can prevent what we can and respond when we have to."

The TFAH and the Robert Wood Johnson Foundation (RWJF) released a report entitled "Remembering 9/11 and Anthrax: Public Health's Vital Role in National Defense" on the 1st September 2011. The report contains the evaluation progress and gaps of 10 years' public health preparedness and includes firsthand accounts from public health officials, laboratorians, clinicians and doctors who were on the frontlines after the anthrax attack. Features also include a timeline of the anthrax events and a summary of the lengthy criminal investigation to identify the perpetrator.

Over the past decade significant improvements have been achieved in the following key areas:
  • raising and upgrading staff and surge capacity
  • legal and liability protections
  • pharmaceutical and medical equipment distribution
  • preparedness planning and coordination
  • public health laboratories
  • surveillance communications
  • the Strategic National Stockpile
  • vaccine manufacturing
Ten years later, work is still underway to address some areas which still need to be improved, including recent budget cuts, a shortage of well trained public health workers, an urgent need for more vaccine and pharmaceutical research, finding better ways of supporting communities so they can cope and recover from disasters, responding more effectively for demand for mass care during emergencies, and creating an integrated nationwide approach to biosurveillance.

Below are sample excerpts of the report's reflections, which include quotes of some of the people who were involved during or after the anthrax attack:

"What stands out most to me about the 2001 anthrax attacks is the notion that from that point on, bioterror was a reality and no longer an abstract concept.... Today, we know and can dispassionately describe exactly what happened. We know that of the people potentially exposed to anthrax in 2001, 22 people were infected, five of whom died. We know now that the attacks were unlikely a concerted effort by a group or organization intended to broadly affect our society and large numbers of people. We know that the attacks likely stemmed from the actions of a single individual who was probably mentally unstable. Today we know the anthrax attacks had a relatively limited and short-lived impact in terms of morbidity and mortality. However, at the time the entire event was surrounded by uncertainty."
-- Anthony S. Fauci, M.D., Director, NIAID/NIH

"My biggest concern is that the country is getting complacent and we might be losing focus on the importance of being prepared. We, as a nation, invested in building an infrastructure to ensure that the public health program is better prepared to respond to a biological attack. As time passes without an event and the budget continues to shrink, so does our ability to be fully prepared. The failure to maintain the infrastructure we have built can result in reverting us back to where we started."
-- Dr. Segaran Pillai, Chief Medical and Science Advisor, Ph.D. MSc, SM (AAM), SM (ASCP), Science and Technology Directorate, Department of Homeland Security, who was in Florida during anthrax when anthrax was first detected

Written by Petra Rattue