title: U.S. medical countermeasure development since 2001: a long way yet to go.
abstract: The U.S. government has taken significant steps toward developing and acquiring vaccines, drugs, and other medical countermeasures (MCMs) to protect and treat the population after a biological attack. In contrast to 2001, there is now a procedure for the Department of Health and Human Services (HHS) to develop, license, and stockpile MCMs for civilian use. Another major accomplishment is smallpox preparedness: There is now an adequate supply of vaccine for every person in the U.S., and there is an alternative vaccine meant for immunocompromised people and those with close contact with them. In spite of these and other accomplishments, the U.S. government MCM effort has been criticized by federal advisory committees, National Academy of Sciences reports, a congressional commission, and outside analysts who state that the efforts lack central leadership and accountability and that the pace of progress has been slow. A clear operational strategy for using MCMs, which would guide their development and acquisition, is also lacking. In this article, we review key areas of progress made since 2001 to develop and acquire MCMs, and we summarize what we judge to be the most critical and often mentioned areas where improvements are needed.
authors.affiliation: Office of Research and Development Coordination, Office of the Assistant Secretary for Preparedness and Response, US Department of Health and Human Services, Washington, DC, USA. PKRUSSELL@aol.com
authors.forename: Philip K
authors.initials: PK
authors.lastname: Russell
authors.forename: Gigi Kwik
authors.initials: GK
authors.lastname: Gronvall
mesh_terms: D000881:Anthrax / Q000517:prevention & control; D022122:Anthrax Vaccines; D023482:Bioterrorism / Q000517:prevention & control*; D002959:Civil Defense / Q000379:methods* / Q000458:organization & administration; D003140:Communicable Disease Control / Q000379:methods / Q000458:organization & administration; D004189:Disaster Planning / Q000379:methods* / Q000458:organization & administration; D006801:Humans; D007857:Leadership; D012899:Smallpox / Q000517:prevention & control; D012900:Smallpox Vaccine; D012941:Social Responsibility; D014481:United States; D059030:United States Department of Defense; D014483:United States Dept. of Health and Human Services; D014612:Vaccines
chemical_list: D022122:Anthrax Vaccines; D012900:Smallpox Vaccine; D014612:Vaccines