Stokes Evans has identified several steps to improve our national capability to respond to and recover from a wide-spread biological attack. In the 10 years since the attacks of September 11, 2001 and subsequent antrax letter attacks, billions of dollars have been spent to improve our national ability to protect our population and economy from the effects of a biological attack. In today’s budget constrained environment, doing less of the same thing and expecting better results is not an acceptable answer.

We recommend clearly identifying a single federal agency to lead planning and response activities including the development of a biological attack response architecture and performance model. Pre-event communications and strategic risk communications must be improved to increase the likelihood of population compliance with medical and other directives. Complimentary distribution and dispensing modes must be developed and implemented to improve resiliency and leverage private sector capabilities. And finally, planning should be expanded to include contingencies like multi-drug resistance and shelter-in-place.