a

GAO

United States General Accounting Office

Report to Congressional Committees

September 2001 BIOTERRORISM

Federal Research and 

Preparedness 

Activities

GAO-01-915

Page i GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

Contents

Letter 1

Results in Brief 4

Background 5

Departments and Agencies Reported a Variety of Actions and 

Funding for Research and Preparedness Activities 7

Despite Efforts to Coordinate Federal Programs, Fragmentation 

Remains 14

Despite Federal Efforts, Concerns Exist Regarding Preparedness at 

State and Local Levels 20

Agency Comments 23

List of Committees 26

Appendixes

Appendix I: Biological Agents and Pathogens Mentioned in This 

Report 28

Appendix II: Scope and Methodology 30

Appendix III: Summaries of Selected Federal Policy and Planning 

Documents 32

Federal Response Plan With Terrorism Incident Annex 32

Presidential Decision Directive 39, U.S. Policy on Counterterrorism 

33

Presidential Decision Directive 62, Combating Terrorism 33

U.S. Government Interagency Domestic Terrorism Concept of 

Operations Plan 34

Appendix IV: Department of Agriculture 35

Office of Crisis Planning and Management 35

Agricultural Research Service 36

Animal and Plant Health Inspection Service 36

Food Safety Inspection Service 37

Appendix V: Department of Commerce 38

Office of Law Enforcement Standards 38

Appendix VI: Department of Defense 39

Defense Advanced Research Projects Agency 40

Joint Task Force for Civil Support 41

National Guard 41

U.S. Army 42

Appendix VII: Department of Energy 46

The Office of Defense Nuclear Nonproliferation 46
Contents

Page ii GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

Appendix VIII: Department of Health and Human Services 48

Agency for Healthcare Research and Quality 48

Centers for Disease Control and Prevention 48

Food and Drug Administration 54

National Institutes of Health 60

Office of Emergency Preparedness 62

Appendix IX: Department of Justice 67

Office of Justice Programs 68

Federal Bureau of Investigation 70

Appendix X: Department of Transportation 72

Research Activities 72

Preparedness Activities 72

Appendix XI: Department of the Treasury 74

U.S. Secret Service 74

Appendix XII: Department of Veterans Affairs 75

Preparedness Activities 75

Appendix XIII: Environmental Protection Agency 76

Research Activities 76

Preparedness Activities 77

Appendix XIV: Federal Emergency Management Agency 78

Preparedness Activities 78

Appendix XV: Comments From the Department of Commerce 81

Appendix XVI: Comments From the Department of Defense 83

Appendix XVII: Comments From the Department of Health and Human 

Services 84

Appendix XVIII: Comments From the Department of Justice 87

Appendix XIX: GAO Contacts and Staff Acknowledgments 88

GAO Contacts 88

Acknowledgments 88

Related GAO Products 89

Tables Table 1: Total Reported Funding for Research on Bioterrorism and 

Terrorism by Federal Departments and Agencies, Fiscal 

Year 2000 and Fiscal Year 2001 (Dollars in millions) 8
Contents

Page iii GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

Table 2: Total Reported Funding for Preparedness Activities on 

Bioterrorism and Terrorism by Federal Departments and 

Agencies, Fiscal Year 2000 and Fiscal Year 2001 (Dollars in 

millions) 10

Table 3: Selected Federal Activities Providing Assistance to State 

and Local Governments for Emergency Planning Relevant 

to a Bioterrorist Attack 17

Table 4: Reported Funding for Activities on Bioterrorism at USDA 

(Dollars in millions) 35

Table 5: Reported Funding for Activities on Domestic Terrorism at 

DOD (Dollars in millions) 40

Table 6: Reported Funding for Activities on Terrorism at DOE 

(Dollars in millions) 46

Table 7: Reported Funding for Activities on Bioterrorism at CDC 

(Dollars in millions) 50

Table 8: Reported Funding for Activities on Bioterrorism at FDA 

(Dollars in millions) 55

Table 9: Reported Funding for Activities on Bioterrorism at NIH 

(Dollars in millions) 61

Table 10: Reported Funding for Activities on Terrorism at OEP 

(Dollars in millions) 62

Table 11: Reported Funding for Activities on Bioterrorism at DOJ 

(Dollars in millions) 67

Table 12: Reported Funding for Activities on Bioterrorism at EPA 

(Dollars in millions) 76

Table 13: Reported Funding for Activities on Terrorism at FEMA 

(Dollars in millions) 78
Contents

Page iv GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

Abbreviations

AHRQ Agency for Healthcare Research and Quality

CDC Centers for Disease Control and Prevention

CONPLAN U.S. Government Interagency Domestic Terrorism

Concept of Operations Plan

DOD Department of Defense

DOE Department of Energy

DOJ Department of Justice

DOT Department of Transportation

EPA Environmental Protection Agency

FBI Federal Bureau of Investigation

FDA Food and Drug Administration

FEMA Federal Emergency Management Agency

HHS Department of Health and Human Services

NIAID National Institute of Allergy and Infectious Diseases

NIH National Institutes of Health

OEP Office of Emergency Preparedness

OJP Office of Justice Programs

TOPOFF 2000 Top Officials 2000 exercise

USDA U.S. Department of Agriculture

VA Department of Veterans Affairs

WMD weapon of mass destruction
Page 1 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

United States General Accounting Office

Washington, D.C. 20548

A

September 28, 2001 Letr

Congressional Committees

A number of incidents involving biological agents, including at least one 

completed bioterrorist act and numerous threats and hoaxes,1

 have 

occurred domestically. In 1984, a group intentionally contaminated salad 

bars in local restaurants in Oregon with salmonella bacteria2

 to prevent 

people from voting in a local election.3 Although no one died, 751 people 

were diagnosed with foodborne illness. As was the case with this incident, 

determining whether an outbreak occurred naturally or was the product of 

an intentional release may be difficult unless someone announces the 

release beforehand or claims responsibility for it. Given the terrorist 

attacks of September 11, 2001, in addition to the terrorist bombings in New 

York City in 1993 and in Oklahoma City in 1995, some experts predict that 

domestic bioterrorist attacks are likely to occur. Others consider the 

likelihood of bioterrorist attacks to be low because of various difficulties, 

including those involved in processing the biological agents into lethal 

forms and successfully delivering them to achieve large-scale casualties. 

However, the ease with which these agents can be concealed and their 

potential to affect large segments of the population beyond those initially 

exposed may increase their appeal to terrorists.

Bioterrorism is the threat or intentional release of biological agents 

(viruses, bacteria, or their toxins) for the purpose of influencing the 

conduct of government, or intimidating or coercing a civilian population. 

These agents can be released by way of the air (as aerosols), food, water, or 

insects. The intentional release of a biological agent may not be recognized 

for several days, if ever, during which time a communicable biological 

agent (such as smallpox) can spread to others who were not initially 

exposed. Some biological agents (such as anthrax and plague) produce 

symptoms that can be easily confused with influenza or other, less virulent 

1

For example, in January 2000, threatening letters were sent to a variety of recipients, 

including the Planned Parenthood office in Naples, Florida, warning of the release of 

anthrax. Federal authorities found no signs of anthrax or any other traces of harmful 

substances and determined these incidences to be hoaxes.

2

See app. I for a description of salmonella and other biological agents and pathogens 

mentioned in this report.

3

See Food Safety: Agencies Should Further Test Plans for Responding to Deliberate 

Contamination (GAO/RCED-00-3, Oct. 27, 1999), p. 4.
Page 2 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

illnesses, leading to a delay in diagnosis or identification. In addition to 

widespread medical consequences, a bioterrorist attack also could bring 

about behavioral, social, economic, and psychological consequences, such 

as mass panic. Health care providers could be the first authorities to see 

victims as they seek treatment of their symptoms. If large numbers of 

people are affected, local and state officials may turn to the federal 

government for assistance with disease surveillance,4

 epidemiologic 

investigation,5

 health care delivery, quarantine management, remediation, 

and mass fatality management.

Many federal departments and agencies, including the Departments of 

Health and Human Services (HHS) and Justice (DOJ), would have roles in 

responding to a domestic bioterrorist attack against the U.S. population. 

These departments and agencies are involved in a range of activities related 

to the public health and medical consequences of a bioterrorist attack on 

the civilian population.6

 These activities are part of the federal 

government’s overall effort to combat terrorism.

Because of the concerns about bioterrorism, the Public Health 

Improvement Act of 2000 (P.L. 106-505, sec. 102) mandates that we describe 

federal activities related to the public health and medical consequences of 

a bioterrorist attack against the civilian population. We are therefore 

providing information on (1) federal activities and funding related to the 

public health and medical consequences of a bioterrorist attack against the 

civilian population, (2) how these activities are coordinated among federal 

agencies and whether there are any shortcomings in the current 

coordination structure, and (3) existing evaluations of the effectiveness of 

these activities in preparing state and local authorities. 

4

Disease surveillance systems provide for the ongoing collection, analysis, and 

dissemination of data to prevent and control disease.

5

Epidemiological investigation is the study of patterns of health or disease and the factors 

that influence these patterns.

6

Public health and medical consequences refers to the effects of a biological agent on the 

population as well as on the individual. See app. I for the medical effects of the biological 

agents and pathogens mentioned in this report.
Page 3 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

In carrying out our work, we relied on federal departments and agencies to 

identify relevant programs and provide budget information.7

 We have not 

audited or otherwise verified the information provided. We interviewed 

agency officials, obtained documents, and reviewed reports prepared by 

others (such as Ataxia: The Chemical and Biological Terrorism Threat 

and the U.S. Response8

 and Toward a National Strategy for Combating 

Terrorism9), as well as our previous reports (see Related GAO Products at 

the end of this report). Although there are generally no specific 

appropriations for activities on bioterrorism, some departments and 

agencies did provide estimates of the funds they were devoting to activities 

on bioterrorism. Other departments and agencies provided estimates for 

overall terrorism activities but were unable to provide funding amounts for 

activities on bioterrorism specifically. Still others stated that their activities 

were relevant for bioterrorism, but they were unable to specify the funding 

amounts. As a result, departments and agencies provided funding 

information in various forms—appropriations, obligations, expenditures. 

For a given fiscal year, this information is not necessarily additive across 

agencies.10 For this reason, we have summarized funding by agency, but not 

across the federal government.11 (See app. II for details regarding our scope 

and methodology.) We conducted our work from January through 

September 2001 in accordance with generally accepted government 

auditing standards.

7

We conducted interviews with and obtained information from the Departments of 

Agriculture, Commerce, Defense, Energy, Health and Human Services, Justice, 

Transportation, the Treasury, and Veterans Affairs; the Environmental Protection Agency; 

and the Federal Emergency Management Agency.

8

Amy Smithson and Leslie-Ann Levy, Ataxia: The Chemical and Biological Terrorism 

Threat and the U.S. Response (Washington, DC: The Henry L. Stimson Center, Oct. 2000).

9

Advisory Panel to Assess Domestic Response Capabilities for Terrorism Involving Weapons 

of Mass Destruction, Toward a National Strategy for Combating Terrorism, Second 

Annual Report (Arlington, VA: RAND, Dec. 15, 2000).

10For example, an agency providing appropriations is not necessarily indicating the level of 

its commitments (that is, obligations) or expenditures for that year—only the amount of 

budget authority made available to it by the Congress. Similarly, an agency which provided 

expenditure information for fiscal year 2000 may have obligated the funds in fiscal year 1999 

based on an appropriation for fiscal year 1998. To simplify presentation, we generally refer 

to the budget data we received from agencies as “reported funding” and report this 

information for the agencies separately.

11Funding levels for activities on terrorism, including bioterrorism, were reported for 

activities prior to September 11, 2001 and do not include any funds approved by the 

Congress after that date. 
Page 4 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

Results in Brief A variety of federal research and preparedness activities related to the 

public health and medical consequences of a bioterrorist attack are under 

way. Research activities focus on various biological agents that could be 

used as weapons of terrorism; detection of such agents; development of 

new or improved vaccines, antibiotics, and antivirals; and performance 

standards for emergency response equipment. Preparedness activities 

include increasing state and local response capabilities, improving federal 

response capacity, developing response teams, increasing the availability of 

medical treatments, participating in and sponsoring exercises, aiding 

victims, and providing support at special events, such as presidential 

inaugurations and Olympic games. Activities in many departments and 

agencies have a dual use, being not only relevant for bioterrorism but also 

for other types of terrorism, emergencies, and infectious disease 

surveillance. For example, the Federal Emergency Management Agency 

(FEMA) has a broad emergency and terrorist response system, which 

includes a bioterrorist response system. HHS has programs on emerging 

infectious diseases that benefit its activities on bioterrorism as well as 

research endeavors such as research on diagnoses, vaccines, and new 

therapies.

Federal departments and agencies use a variety of methods to coordinate 

their activities to combat terrorism. Departments and agencies are 

developing interagency response plans, participating in a variety of 

interagency work groups, and entering into formal agreements with other 

agencies to share resources and capabilities in order to improve 

coordination. However, coordination of federal terrorism research, 

preparedness, and response programs is fragmented, as we have discussed 

in a previous report.12 As we noted, several different agencies are 

responsible for various coordination functions, which limits accountability 

and hinders unity of effort. For bioterrorism, different agencies have 

developed separate threat lists of biological agents, several agencies have 

not been included in bioterrorism-related policy and response planning, 

and agencies have developed programs to provide assistance to state and 

local governments that are similar and potentially duplicative. However, 

the Office of Management and Budget and the National Security Council 

have created a process to reduce overlap and improve coordination as part 

of the annual budget cycle. In addition, the Vice President was asked by the 

12See Combating Terrorism: Selected Challenges and Related Recommendations (GAO-01-

822, Sept. 20, 2001), p. 40.
Page 5 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

President in May 2001 to lead an interagency effort to improve 

coordination. Also, on September 20, 2001, the President announced the 

creation of the Office of Homeland Security to lead, oversee, and 

coordinate a comprehensive national strategy to safeguard the country 

against terrorism.

The reports that we reviewed identified concerns about the preparedness 

of states and local areas to respond to a bioterrorist attack. These concerns 

include insufficient state and local planning for response to terrorist events 

and a lack of hospital participation in training on terrorism and emergency 

response planning. Some federal programs have begun to provide funding 

to state and local governments to improve preparedness. 

We provided a draft of this report to the eleven departments and agencies 

for their review in August 2001. HHS stated that many of the services 

needed in response to a bioterrorist attack would be needed to respond to 

other emergencies, including natural disasters and other types of terrorist 

attacks, and we added this information to the report. We also modified the 

report in response to a DOJ comment that it is appropriate for different 

agencies to maintain separate lists of biological threats, noting that such 

lists may have different purposes. Most agencies provided technical 

comments. 

Background Although the probability of a domestic bioterrorist attack has been 

considered to be low, some characteristics of biological agents may make 

them appealing to terrorists. The information for the production of agents 

is readily available on the Internet, and the agents are relatively easy to 

grow and conceal. According to intelligence agencies, the possibility that 

terrorists may use chemical or biological materials may increase over the 

next decade.13

However, other characteristics of biological agents may limit their appeal 

to terrorists. For example, they are difficult to obtain, process into a lethal 

form, and deliver to achieve large-scale casualties. Processing biological 

agents into the right particle size and delivering them effectively require 

expertise in a wide range of scientific disciplines. Additional hurdles to 

deployment include disruptions caused by environmental and 

13See Combating Terrorism: Need for Comprehensive Threat and Risk Assessments of 

Chemical and Biological Attacks (GAO/NSIAD-99-163, Sept. 14, 1999), p. 17.
Page 6 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

meteorological conditions. For example, if wind conditions are too strong 

or erratic, agents released as aerosols might dissipate rapidly or fail to 

reach the desired area. 

With any emergency, including natural disasters and terrorist attacks, 

states can call upon services related to emergency management, public 

safety, emergency medical services, health care delivery, and fatality 

management. Most states rely on local public health agencies to identify 

and respond to naturally occurring disease outbreaks, and these are the 

same agencies that are responsible for bioterrorism preparedness and 

response. Just as in naturally occurring outbreaks, a bioterrorist attack 

could involve public health officials in disease surveillance, epidemiologic 

investigation, health care delivery, quarantine management, remediation, 

and mass fatality management. 

Unless a terrorist announces the release of a biological agent, the cause of 

an outbreak might be detected only after an epidemiologic investigation 

and laboratory identification. Officials from the Centers for Disease 

Control and Prevention (CDC) and the National Association of County and 

City Health Officials have stated that the capacities needed by local public 

health agencies to prepare for a bioterrorist incident should be built on the 

systems used to respond to naturally occurring disease outbreaks. Such a 

“dual-use” response infrastructure improves the capacity of local public 

health agencies to respond to all hazards. 

In response to past domestic terrorist events and bioterrorism cases, 

including hoaxes, the federal government has become more involved in 

bioterrorism preparedness. From 1989 through 1996, Congress passed 

several laws aimed at preventing the acquisition and use of chemical or 

biological weapons by groups or individuals. In addition, the National 

Defense Authorization Act for Fiscal Year 1997 (P.L. 104-201) authorized 

$97 million for domestic emergency assistance programs, including the 

implementation of programs providing advice, training, and the loan of 

equipment to state and local emergency response agencies and assistance 

to major cities in establishing medical strike teams. The act also authorized 

the Department of Defense (DOD) to establish military domestic terrorism 

rapid response teams. In the event of a bioterrorist attack against the 

civilian population, DOD will use these teams to provide support to the 

primary federal agency as defined under the Federal Response Plan.

The Federal Response Plan, originally drafted in 1992 and updated in 1999, 

is authorized under the Robert T. Stafford Disaster Relief and Emergency 
Page 7 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

Assistance Act (Stafford Act; P.L. 93-288, as amended). The plan lays out 

the manner in which the federal government responds to domestic 

situations in which the President has declared an emergency requiring 

federal disaster assistance. Presidential Decision Directive 39, which was 

issued after the Oklahoma City bombing in 1995, provides a framework for 

how the federal government will respond to weapons of mass destruction 

(WMD)14 terrorism within the United States, reaffirming the Federal 

Response Plan. The plan is an “all-hazards” (that is, for any emergency or 

disaster) approach document, with an annex specific to terrorism, which 

was added by FEMA in 1997. In 1998, Presidential Decision Directive 62 

was issued, which describes federal agency roles in preparing for and 

responding to WMD terrorism. In 2001, the U.S. Government Interagency 

Domestic Terrorism Concept of Operations Plan was issued, which 

explains agencies’ responsibilities under Presidential Decision Directives 

39 and 62 in more detail. HHS is currently developing a bioterrorism annex 

to this plan. (See app. III for more information on these federal policy and 

planning documents.)

Departments and 

Agencies Reported a 

Variety of Actions and 

Funding for Research 

and Preparedness 

Activities

The federal government is conducting a variety of activities related to 

research on and preparedness for the public health and medical 

consequences of a bioterrorist attack against the civilian population. 

Research activities focus on detection, treatment, vaccination, and 

emergency response equipment. Preparedness efforts include increasing 

state and local response capabilities, improving federal response capacity, 

developing response teams, increasing availability of medical treatments, 

participating in and sponsoring exercises, planning for victim aid, and 

providing support during special events such as presidential inaugurations 

and Olympic games.

Research Activities Focus 

on Detection, Treatment, 

Vaccination, and Equipment

The federal government is involved in a range of research activities related 

to the public health and medical consequences of a bioterrorist attack on 

the civilian population. Studies are currently being done to enable the rapid 

identification of biological agents in a variety of settings; develop new or 

improved vaccines, antibiotics, and antivirals to improve treatment and 

14Throughout this report, we use the term WMDs to refer to chemical, biological, 

radiological, or nuclear agents or weapons. Some agencies define it to include large 

conventional explosives as well.
Page 8 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

vaccination for infectious diseases caused by biological agents; and 

develop and test emergency response equipment. Table 1 provides 

information on the total reported funding for all the departments and 

agencies carrying out research and examples of this research for these 

departments and agencies. In addition, DOD and the Department of 

Transportation (DOT) have some relevant research activities, but were not 

able to specify the associated funding. More detail on each department’s 

and agency’s activities is provided in appendixes IV through XIV.

Table 1: Total Reported Funding for Research on Bioterrorism and Terrorism by Federal Departments and Agencies, Fiscal Year 

2000 and Fiscal Year 2001 (Dollars in millions)

Department or agency

Fiscal year

2000 funding

Fiscal year

2001 funding Sample activities

U.S. Department of 

Agriculture—Agricultural 

Research Service

0 $0.5 Improving detection of biological agents

Department of Energy $35.5 $39.6 Developing technologies for detecting and responding to a 

bioterrorist attack

Developing models of the spread of and exposure to a biological 

agent after release

HHS—Agency for 

Healthcare Research and 

Quality

$5.0 0 Examining clinical training and ability of front-line medical staff to 

detect and respond to a bioterrorist threat

Studying use of information systems and decision support systems 

to enhance preparedness for medical care in the event of a 

bioterrorist event

HHS—CDC $48.2 $46.6 Developing equipment performance standards

Conducting research on smallpox and anthrax viruses and 

therapeutics

HHS—Food and Drug 

Administration

$8.8 $9.1 Licensing of vaccines for anthrax and smallpox

Determining procedures for allowing use of not yet approved drugs 

and specifying data needed for approval and labeling

HHS—National Institutes of 

Health 

$43.0 $49.7 Developing new therapies for smallpox virus

Developing smallpox and bacterial antigen detection system

HHS—Office of Emergency 

Preparedness

0 $4.6 Overseeing a study on response systems

DOJ—Office of Justice 

Programs

$0.7 $4.6 Developing a biological agent detector

DOJ—Federal Bureau of 

Investigation

0 $1.1 Conducting work on detection and characterization of biological 

materials
Page 9 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

Note: Total reported funding refers to budget data we received from agencies. Agencies reported 

appropriations, actual or estimated obligations, or actual or estimated expenditures. An agency 

providing appropriations is not necessarily indicating the level of its commitments (that is, obligations) 

or expenditures for that year—only the amount of budget authority made available to it by the 

Congress. Similarly, an agency which provided expenditure information for fiscal year 2000 may have 

obligated the funds in fiscal year 1999 based on an appropriation for fiscal year 1998. 

Source: Information obtained from departments and agencies.

The U.S. Department of Agriculture (USDA), DOD, Department of Energy 

(DOE), HHS, DOJ, Department of the Treasury, and the Environmental 

Protection Agency (EPA) have all sponsored or conducted projects to 

improve the detection and characterization of biological agents. These 

detection devices and tests are designed to identify biological agents in 

food, the environment, and clinical samples (such as blood). For example, 

EPA is sponsoring research to improve its ability to detect biological agents 

in the water supply.

Departments and agencies are also conducting or sponsoring studies to 

improve treatment and vaccination for diseases caused by biological 

agents. These projects include basic research to develop drugs and 

diagnostics and applied research to improve health care delivery systems. 

Several agencies also reported working to develop vaccines to prevent 

infection caused by biological agents. For example, HHS funded research 

to determine if the currently available stock of smallpox vaccine could be 

extended by dilution and yet remain effective. HHS is also developing a 

new vaccine for smallpox and collaborating with DOD on the development 

of a new anthrax vaccine.

In addition, several agencies are conducting research that focuses on 

developing performance standards and methods for testing the 

performance of emergency response equipment, such as respirators, 

personal protective equipment, and chemical and biological agent 

detectors and decontamination equipment.

Department of the 

Treasury—Secret Service

0 $0.5 Developing a biological agent detector

Environmental Protection 

Agency

0 $0.5 Improving detection of biological agents

(Continued From Previous Page)

Department or agency

Fiscal year

2000 funding

Fiscal year

2001 funding Sample activities
Page 10 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

Preparedness Efforts 

Include Multiple Actions

Departments and agencies are undertaking activities to increase 

preparedness for the public health and medical consequences of a 

bioterrorist attack. Preparing for a bioterrorist attack includes activities 

such as planning, purchasing equipment, training, and participating in 

exercises simulating a bioterrorist attack. Federal departments and 

agencies have undertaken the following preparedness activities: increasing 

state and local response capabilities, improving federal response capacity, 

developing response teams, increasing availability of medical treatments, 

participating in and sponsoring exercises, planning for victim aid, and 

providing support during special events. Table 2 contains information on 

total reported funding for all the departments and agencies with 

bioterrorism preparedness activities in fiscal year 2000 and fiscal year 2001 

and examples of preparedness activities for these departments and 

agencies. In addition, the Department of the Treasury has some relevent 

preparedness activities, but was not able to specify the associated funding. 

More information on these activities is given in appendix IV through 

appendix XIV.

Table 2: Total Reported Funding for Preparedness Activities on Bioterrorism and Terrorism by Federal Departments and 

Agencies, Fiscal Year 2000 and Fiscal Year 2001 (Dollars in millions)

Department or agency

Fiscal year

2000

funding

Fiscal year

2001

funding Sample activities

USDA—Animal and Plant 

Health Inspection Service

0 $0.2 Developing educational materials and training programs 

specifically dealing with bioterrorism

DOD—Joint Task Force for Civil 

Support

$3.4 $8.7 Planning, and when directed, commanding and controlling DOD’s 

WMD and high-yield explosive consequence management 

capabilities in support of FEMA

DOD—National Guard $70.0 $93.3 Managing response teams that would enter a contaminated area 

to gather samples for on-site evaluation

DOD—U.S. Army $29.5 $11.7 Maintaining a repository of information about chemical and 

biological weapons and agents, detectors, and protection and 

decontamination equipment

HHS—CDC $124.9 $147.3 Awarding planning grants to state and local health departments 

to prepare bioterrorism response plans

Improving surveillance methods for detecting disease outbreaks

Increasing communication capabilities in order to improve the 

gathering and exchanging of information related to bioterrorist 

incidents
Page 11 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

Note: Total reported funding refers to budget data we received from agencies. Agencies reported 

appropriations, actual or estimated obligations, or actual or estimated expenditures. An agency 

providing appropriations is not necessarily indicating the level of its commitments (that is, obligations) 

or expenditures for that year—only the amount of budget authority made available to it by the 

Congress. Similarly, an agency which provided expenditure information for fiscal year 2000 may have 

obligated the funds in fiscal year 1999 based on an appropriation for fiscal year 1998.

Source: Information obtained from departments and agencies.

Several federal departments and agencies have programs to increase the 

ability of state and local authorities to successfully respond to a 

bioterrorist attack. Some of these programs have focused on developing 

plans for dealing with a terrorist attack or emergency in general. 

Departments and agencies also contribute to state and local jurisdictions 

by helping them pay for equipment, providing technical assistance, 

increasing communications capabilities, and conducting training courses. 

In addition to increasing the preparedness of state and local entities, 

federal departments and agencies have been increasing their own capacity 

HHS—Food and Drug 

Administration

$0.1 $2.1 Improving capabilities to identify and characterize foodborne 

pathogens

Identifying biological agents using animal studies and 

microbiological surveillance

HHS—Office of Emergency 

Preparedness

$35.3 $46.1 Providing contracts to increase local emergency response 

capabilities

Developing and managing response teams that can provide 

support at the site of a disaster

DOJ—Office of Justice 

Programs

$7.6 $5.3 Helping prepare state and local emergency responders through 

training, exercises, technical assistance, and equipment 

programs

Developing a data collection tool to assist states in conducting 

their threat, risk, and needs assessments, and develop their 

preparedness strategy for terrorism, including bioterrorism

EPA $0.1 $2.0 Providing technical assistance in identifying and decontaminating 

biological agents

Conducting assessments of water supply vulnerability to 

terrorism, including contamination with biological agents

FEMA $25.1 $30.3 Providing grant assistance and guidance to states for planning 

and training

Maintaining databases of safety precautions for biological, 

chemical, and nuclear agents

(Continued From Previous Page)

Department or agency

Fiscal year

2000

funding

Fiscal year

2001

funding Sample activities
Page 12 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

to identify and deal with a bioterrorist incident. They are improving 

surveillance methods for detecting disease outbreaks in humans and 

animals. They have also established laboratory response networks to 

maintain state-of-the-art capabilities for biological agent identification and 

characterization of human clinical samples, as well as attempted to 

increase their communications capabilities in order to improve the 

gathering and exchanging of information related to a bioterrorist incident 

as well as other events.

Some federal departments and agencies have developed teams to directly 

respond to terrorist events. HHS’ Office of Emergency Preparedness (OEP) 

and DOD have created response teams that would provide medical 

treatment and assistance in the event of a bioterrorist attack against the 

civilian population in the United States. Four teams led by OEP, known as 

National Medical Response Teams, are specially trained and equipped to 

respond to incidents involving WMDs—chemical, biological, radiological, 

or nuclear agents or weapons. The DOD teams would assist a local incident 

commander in case of a domestic bioterrorist incident. DOD coordinates 

with OEP in planning medical support for a civilian bioterrorist incident. 

Several agencies are involved in increasing the availability of medical 

supplies that could be used in the event of a bioterrorist attack. CDC and 

OEP maintain repositories of pharmaceutical and other supplies that can 

be delivered to the site of a terrorist incident. CDC’s National 

Pharmaceutical Stockpile Program consists of two components. The first 

component is the 12-Hour Push Packages, which contain pharmaceuticals, 

antidotes, and medical supplies and can be delivered to any site in the 

United States within 12 hours of a federal decision to deploy assets. These 

supplies are prepackaged and cannot be tailored to an individual incident.15

The second component is the Vendor Managed Inventory. Through the 

Department of Veterans Affairs (VA), CDC has contracted with vendors to 

store pharmaceutical and medical supplies that could be used in a terrorist 

incident. These products can be tailored to an individual incident (that is, 

only pharmaceuticals and supplies needed for a particular incident would 

be sent) and would be available 24 to 36 hours after the National

15The first emergency use of the National Pharmaceutical Stockpile occurred on September 

11, 2001. In response to the terrorist attack on the World Trade Center, CDC released one of 

the eight Push Packages. 
Page 13 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

Pharmaceutical Stockpile staff notifies the appropriate vendors.16 OEP’s 

National Medical Response Teams have stockpiles that can be deployed 

with the teams. Each team has the capability of carrying enough 

pharmaceutical and medical supplies to treat up to 5,000 people, with the 

focus on the medical response to chemical incidents. The Food and Drug 

Administration (FDA) also has initiatives to increase the availability of 

medical countermeasures. For example, FDA is developing an approach 

that would allow drugs still in the FDA approval system to be used in the 

field during a bioterrorist attack. FDA is also working with CDC to 

implement a shelf-life extension program for the maintenance of stockpiled 

pharmaceuticals and medical supplies. 

Bioterrorism response exercises are conducted across the country, both as 

on-site and as “tabletop” exercises. For example, in May 2000, many 

departments and agencies took part in the Top Officials 2000 exercise 

(TOPOFF 2000) in Denver, Colorado, which featured the simulated release 

of a biological agent.17 Participants included local fire departments, police, 

area hospitals, the Colorado Department of Public Health and the 

Environment, the Colorado Office of Emergency Management, the 

Colorado National Guard, the American Red Cross, the Salvation Army, 

HHS, DOD, FEMA, the Federal Bureau of Investigation (FBI), and EPA. 

DOJ reported funding that facilitated 52 tabletop exercises on bioterrorism 

in fiscal year 2001. These 1-day exercises involve public health, fire, law 

enforcement, and emergency management agencies. Participants work 

through a simulation of a bioterrorism incident, starting with the 

incubation period (the time between initial exposure to a biological agent 

and onset of symptoms), followed by the recognition and initial response, 

and finally the challenges of integrating federal assets with local response 

and recovery efforts. Medical surveillance, epidemiologic investigation, 

quarantine management, remediation, and mass fatality management are 

addressed.

16For more information on management of the National Pharmaceutical Stockpile Program, 

see Combating Terrorism: Accountability Over Medical Supplies Needs Further 

Improvement (GAO-01-463, Mar. 30, 2001).

17In addition to simulating a bioterrorism attack in Denver, the exercise also portrayed a 

chemical weapons incident in Portsmouth, New Hampshire. A concurrent exercise, referred 

to as National Capital Region 2000, simulated a radiological event in the greater Washington, 

D.C., area.
Page 14 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

Under the Victims of Crime Act of 1984, DOJ’s Office of Justice Programs 

(OJP) manages a program that provides assistance to victims of terrorism, 

including a bioterrorist attack. Under this program, funds can be used to 

provide mental health services. In addition, FEMA can provide 

supplemental funds to state and local mental health agencies to provide 

crisis counseling to eligible survivors of presidentially declared major 

disasters.18

Federal departments and agencies also provide support at special events to 

improve response in case of an emergency.19 For example, OEP deployed 

teams from the National Disaster Medical System to provide medical 

services if required during the presidential inauguration of 2001. In 

addition, CDC is developing a surveillance system to provide increased 

surveillance and epidemiological capacity before, during, and after a 

special event. Besides improving emergency response at the events, 

department and agency participation provides them with valuable 

experience working together to develop and practice plans to combat 

terrorism. OEP reported funding of $2 million in fiscal year 2001 for special 

events. It was the only agency that reported funding for these activities.

Despite Efforts to 

Coordinate Federal 

Programs, 

Fragmentation 

Remains

Federal departments and agencies are using a variety of methods to 

coordinate their activities to combat terrorism. Departments and agencies 

are developing interagency response plans, participating in a variety of 

interagency work groups, and entering into formal agreements with other 

agencies to share resources and capabilities in order to improve 

coordination. However, during this and our previous work we found 

evidence that coordination of federal terrorism research, preparedness, 

and response programs is fragmented. Several different agencies are 

responsible for various coordination functions, which limits accountability 

and hinders unity of effort. Different agencies have developed separate 

threat lists of biological agents, several agencies have not been included in 

18HHS can also address emotional and mental health consequences of terrorist attacks. On 

September 13, 2001, in response to the attack on the World Trade Center, HHS released $1 

million in funding for New York to support mental health services and strategic planning for 

comprehensive and long-term support.

19Presidential Decision Directive 62 created a category of special events called National 

Security Special Events, which are events of such significance that they warrant greater 

federal planning and protection than other special events. Such events include presidential 

inaugurations and major political party conventions.
Page 15 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

bioterrorism-related policy and response planning, and agencies have 

developed programs to provide assistance to state and local governments 

that are similar and potentially duplicative. For example, FEMA, DOJ, CDC, 

and OEP all offer separate assistance to state and local governments in 

planning for emergencies, including potential bioterrorist incidents. 

Congress and the President have recently taken steps to improve oversight 

and coordination. For example, in May 2001, the President asked the Vice 

President to lead an interagency effort to improve coordination of federal 

programs to deal with the consequences of a potential use of a WMD. 

Departments and Agencies 

Use a Variety of Methods to 

Coordinate Activities

Departments and agencies use several approaches to coordinate their 

activities on terrorism. Interagency plans for responding to a terrorist 

incident help outline agency responsibilities and identify resources that 

could be used during a response. For example, the Federal Response Plan, 

which has been in effect for almost a decade, provides a broad framework 

for coordinating the delivery of federal disaster assistance to state and 

local governments when a major disaster or emergency, including a 

bioterrorist attack, overwhelms their ability to respond effectively.20 The 

Federal Response Plan designates primary and supporting federal agencies 

for a variety of emergency support operations. For example, HHS is the 

primary agency for coordinating federal assistance to supplement state and 

local resources in response to public health and medical care needs in an 

emergency, including a bioterrorist attack. HHS could receive support from 

USDA, DOD, DOE, DOJ, DOT, VA, EPA, FEMA, and other agencies and 

organizations to assist state and local jurisdictions.

Interagency work groups are being used by federal departments and 

agencies to attempt to minimize duplication of funding and effort in federal 

activities on terrorism. For example, the Technical Support Working 

Group,21 which receives funds from DOD and other agencies, is chartered 

to coordinate interagency and international research and development 

requirements for combating terrorism—including efforts to reduce 

vulnerability, collect and disseminate terrorism-related information, and 

prevent, deter, and respond to terrorist acts of any kind—in order to 

20See app. III for more details on selected federal policy and planning documents. 

21A description of the funding for the Technical Support Working Group is not included in 

this report because it does not primarily focus on the public health and medical 

consequences of a bioterrorist attack.
Page 16 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

prevent duplication of effort between agencies.22 The Technical Support 

Working Group, among other projects, helped to identify research needs 

and fund a project to develop a means to detect biological agents in the 

food supply that can be used by both DOD and USDA. Another example of 

an interagency work group was provided by OEP officials, who told us that 

DOD, DOJ, DOE, OEP, FEMA, and VA meet as necessary to review 

equipment requests of state and local jurisdictions to ensure that 

duplicative funding is not being given for the same activities. 

Formal agreements between departments and agencies are being used to 

share resources and knowledge. For example, CDC contracts with VA to 

purchase drugs and medical supplies for the National Pharmaceutical 

Stockpile because of VA’s purchasing power and ability to negotiate large 

discounts from manufacturers that sell pharmaceuticals, equipment, and 

supplies to the VA hospital system. USDA’s Animal and Plant Health 

Inspection Service is negotiating an agreement with DOD’s Armed Forces 

Medical Intelligence Center to share information and expertise on tracking 

diseases that can be transmitted from animals to people and could be used 

in a bioterrorist attack.

Coordination Remains 

Fragmented Within the 

Federal Government

Overall coordination of federal programs to combat terrorism, including 

bioterrorism, is fragmented within the federal government.23 For example, 

several agencies have coordination functions, including DOJ, FBI, FEMA, 

and the Office of Management and Budget. Officials from a number of the 

agencies that combat terrorism told us that the coordination roles of these 

various agencies are not always clear and sometimes overlap, leading to a 

fragmented approach. The Advisory Panel to Assess Domestic Response 

Capabilities for Terrorism Involving Weapons of Mass Destruction (also 

known as the Gilmore Panel) also concluded that the current coordination 

structure does not provide for the requisite authority or accountability to

22See GAO-01-822, Sept. 20, 2001, p. 79. Coordination of federal research and development 

efforts to combat terrorism is still limited by a number of factors, raising the potential for 

duplicative efforts among federal agencies.

23See also Combating Terrorism: Comments on Counterterrorism Leadership and 

National Strategy (GAO-01-556T, Mar. 27, 2001), p. 1.
Page 17 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

make policy changes and to impose the discipline necessary among the 

numerous federal agencies involved.24

The multiplicity of federal assistance programs requires focus and 

attention to minimize redundancy of effort.25 Table 3 describes some of the 

federal programs providing assistance to state and local governments for 

emergency planning that would be relevant to responding to a bioterrorist 

attack. While the programs vary somewhat in their target audiences, the 

potential redundancy of these federal efforts highlights the need for 

scrutiny. In a recent report, we recommended that the President, working 

closely with Congress, consolidate some of the activities of the DOJ’s OJP 

under FEMA.26

Table 3: Selected Federal Activities Providing Assistance to State and Local 

Governments for Emergency Planning Relevant to a Bioterrorist Attack

24See Advisory Panel to Assess Domestic Response Capabilities for Terrorism Involving 

Weapons of Mass Destruction, p. 7.

25See also Combating Terrorism: Issues in Managing Counterterrorist Programs (GAO/TNSIAD-00-145, Apr. 6, 2000), p. 8.

26See GAO-01-822, Sept. 20, 2001, p. 104.

Department 

or agency Activities Target audience

HHS—CDC Provides grants, technical support, and 

performance standards to support 

bioterrorism preparedness and response 

planning.

State and local health 

agencies

HHS—OEP Enters into contracts to enhance medical 

response capability. The program includes a 

focus on response to bioterrorism, including 

early recognition, mass postexposure 

treatment, mass casualty care, and mass 

fatality management.

Local jurisdictions, 

including fire, police, 

emergency medical 

services, hospitals, and 

public health agencies

DOJ—OJP Assists states in developing strategic plans. 

Includes funding for training, equipment 

acquisition, technical assistance, and exercise 

planning and execution to enhance state and 

local capabilities to respond to terrorist 

incidents.

States, including fire, law 

enforcement, emergency 

medical services, 

hazardous materials 

response services, 

hospitals, and public 

health departments
Page 18 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

Source: Information obtained from departments and agencies.

Fragmentation is also evident in the different threat lists of biological 

agents developed by federal departments and agencies. Several different 

agencies have or are in the process of developing biological agent threat 

lists, which differ based on the agencies’ focus. For example, CDC 

collaborated with law enforcement, intelligence, and defense agencies to 

develop a critical agent list that focuses on the biological agents that would 

have the greatest impact on public health. The FBI, the National Institute of 

Justice, and the Technical Support Working Group are completing a report 

that lists biological agents that may be more likely to be used by a terrorist 

group working in the United States that is not foreign sponsored. In 

addition, an official at USDA’s Animal and Plant Health Inspection Service 

told us that it uses two lists of agents of concern for a potential bioterrorist 

attack developed through an international process (although only some of 

these agents are capable of making both animals and humans sick). 

According to agency officials, separate threat lists are appropriate because 

of the different focuses of these agencies. In prior reports, we have 

recommended that the federal government conduct multidisciplinary and 

analytically sound threat and risk assessments to define and prioritize 

requirements and properly focus programs and investments in combating 

terrorism.27

Fragmentation has also hindered unity of effort. Officials at USDA, FDA, 

and DOT told us that their departments and agencies have often been 

overlooked in bioterrorism-related planning and policy. USDA officials told 

us that as federal policy and coordination were developed in Presidential 

Decision Directive 62, the department was not included even though it 

FEMA Provides grant assistance to support state 

and local consequence management 

planning, training, and exercises for all types 

of terrorism, including bioterrorism.

State emergency 

management agencies

27See Combating Terrorism: Threat and Risk Assessments Can Help Prioritize and Target 

Program Investments (GAO/NSIAD-98-74, Apr. 9, 1998), Combating Terrorism: Need for 

Comprehensive Threat and Risk Assessments of Chemical and Biological Attacks 

(GAO/NSIAD-99-163, Sept. 14, 1999), and Combating Terrorism: Selected Challenges and 

Related Recommendations (GAO-01-822, Sept. 20, 2001).

(Continued From Previous Page)

Department 

or agency Activities Target audience
Page 19 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

would have key responsibilities if terrorists targeted the food supply. FDA 

officials told us that FDA was involved in some issues with the National 

Pharmaceutical Stockpile, but was not involved in the selection of all items 

procured for the stockpile. DOT officials noted that even though its 

programs cross many areas and the nation’s transportation centers for a 

significant percentage of potential terrorist targets, the department was not 

part of the founding group of agencies that worked on bioterrorism issues 

and has not been included in bioterrorism response plans. DOT officials 

also told us that the department is supposed to deliver supplies for FEMA 

under the Federal Response Plan, but it was not brought in early enough to 

understand the extent of its responsibilities in the transportation process. 

It did not learn these details until its participation in TOPOFF 2000.

Recent Actions Seek to 

Improve Coordination 

Across Federal 

Departments and Agencies

In 1997, we reported that the amount of funds being spent to combat 

terrorism was unknown and difficult to determine and no priorities had 

been set for funding terrorism-related programs.28 As a result, there was no 

assurance that agencies’ requests were funded through a coordinated and 

focused approach. Subsequently, Congress required the Office of 

Management and Budget to establish a reporting system on the budgeting 

and expenditure of funds to combat terrorism.29 The Office of Management 

and Budget and the National Security Council created a process to reduce 

overlap and improve coordination as part of the annual budget cycle in 

1999. As part of this process, the Office of Management and Budget started 

issuing an Annual Report to Congress on Combating Terrorism, which 

details agency activities and funding. These reports potentially represent a 

significant step toward improved coordination by providing strategic 

oversight of the magnitude and direction of spending for activities on 

terrorism. However, as we have testified, we have not yet seen evidence 

that these reports have established priorities or identified duplication of 

effort.30 

28See Combating Terrorism: Spending on Governmentwide Programs Requires Better 

Management and Coordination (GAO/NSIAD-98-39, Dec. 1, 1997), pp. 3-5.

29Section 1051 of the National Defense Authorization Act for Fiscal Year 1998 (P.L. 105-85).

30See Combating Terrorism: Observations on Options to Improve the Federal Response

(GAO-01-660T, Apr. 24, 2001), p. 8.
Page 20 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

In May 2001, the President asked the Vice President to oversee the 

development of a coordinated national effort dealing with WMDs.31 At the 

same time, the President asked the Director of FEMA to establish an Office 

of National Preparedness to implement the results of this effort that deal 

with programs within DOD, HHS, DOJ, DOE, EPA, and other federal 

agencies that address consequence management resulting from the use of 

WMDs. The purpose of this effort is to better focus policies and ensure that 

programs and activities are fully coordinated and integrated in support of 

building the needed preparedness and response capabilities.32 We have 

previously recommended that the President appoint a single focal point for 

all critical leadership and coordination functions to combat terrorism.33

On September 20, 2001, the President announced the creation of the Office 

of Homeland Security. The head of the office will lead, oversee, and 

coordinate a comprehensive national strategy to safeguard the country 

against terrorism and respond to any attacks that may occur. 

Despite Federal 

Efforts, Concerns Exist 

Regarding 

Preparedness at State 

and Local Levels

The reports that we reviewed identified concerns about the preparedness 

of states and local areas to respond to a bioterrorist attack. These concerns 

include insufficient state and local planning for response to terrorist 

events, inadequacies in the public health infrastructure, a lack of hospital 

participation in training on terrorism and emergency response planning, 

insufficient capacity for treating mass casualties from a terrorist act, and 

the timely availability of medical teams and resources in an emergency. 

Some federal programs have begun to provide funding to state and local 

governments to try to improve preparedness. 

Questions exist regarding how much progress has been made in improving 

terrorism preparedness at the state and local levels. Most of the states 

surveyed by the National Governors’ Association in 1996 reported that they 

had neither the equipment and trained personnel to detect a biological 

hazard nor the protective equipment that would be necessary during an 

attack. In 1997, FEMA identified planning and equipment for response to 

31According to the Office of the Vice President, as of June 2001, details on the Vice 

President’s efforts had not yet been determined.

32See GAO-01-822, Sept. 20, 2001, p. 36.

33See GAO-01-822, Sept. 20, 2001, p. 41.
Page 21 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

nuclear, biological, and chemical incidents as an area in need of significant 

improvement at the state level. The federal government has several 

programs to train and equip state and local authorities to respond to 

terrorist WMD incidents.34 All 50 states and approximately 255 local 

jurisdictions will receive at least some federal assistance, including training 

and equipment grants, to help them prepare for a terrorist WMD incident. 

However, survey results presented in an October 2000 report indicated that 

even those cities receiving federal aid are still not adequately prepared to 

respond to a bioterrorist attack.35

According to the October 2000 report, components of the nation’s 

infectious disease surveillance system are still not well prepared to detect a 

covert bioterrorist attack.36 This report concluded that reductions in public 

health laboratory staffing and training have affected the ability of state and 

local authorities to identify biological agents. CDC began taking steps to 

improve the nation’s public health infrastructure for responding to 

bioterrorism in fiscal year 1999. In fiscal year 2000, CDC awarded grants 

totaling approximately $11 million to 48 states and four major urban health 

departments to improve and upgrade their surveillance and 

epidemiological capabilities. 

As we previously reported, even the initial West Nile virus outbreak in 1999, 

which was relatively small and occurred in an area with one of the nation’s 

largest local public health agencies, taxed the federal, state, and local 

laboratory resources.37 Both the New York state and CDC laboratories were 

quickly inundated with requests for tests during the West Nile outbreak, 

and because of the limited capacity at the New York laboratories, the CDC 

laboratory handled the bulk of the testing. Officials indicated that the CDC 

laboratory would have been unable to respond to another outbreak, had 

one occurred at the same time. In order to improve laboratory capacity for 

biological agents, CDC awarded grants during fiscal year 2000 totaling 

approximately $6 million to 42 states and two major urban health 

departments. At the same time, it began to upgrade its own laboratory 

34See GAO-01-822, Sept. 20, 2001, p. 90

35Smithson and Levy, p. 245.

36Smithson and Levy, p. 245.

37See West Nile Virus Outbreak: Lessons for Public Health Preparedness (GAO/HEHS-00-

180, Sept. 11, 2000), p. 21.
Page 22 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

capacity. CDC officials told us that the grants are beginning to improve 

state and local public health agencies’ abilities to detect and identify 

biological agents. We plan to examine the efforts in preparing state and 

local authorities to address the public health and medical consequences of 

a bioterrorist attack in a future report.

Inadequate training and planning for bioterrorism response by hospitals is 

a major problem, according to recent reports and to federal officials. The 

Gilmore Panel concluded that the level of expertise in recognizing and 

dealing with a terrorist attack involving a chemical or biological agent is 

problematic in many hospitals.38 Other recent reports have concluded that 

hospitals need to improve their preparedness for mass casualty incidents, 

such as a bioterrorist attack.39 In addition, a recent study found that 

hospitals often lack the basic tools, such as Internet access, to 

communicate effectively with field units, health departments, and 

laboratories.40 Local officials told us that it has been difficult to get 

hospitals and medical personnel to participate in local training, planning, 

and exercises to improve their preparedness.

Several federal and local officials reported that there is little or no excess 

capacity in the health care system in most communities for accepting and 

treating mass casualty patients. A recent study concluded that the patient 

load of a regular influenza season in the late 1990s overtaxed primary care 

facilities,41 and other studies have reported that emergency rooms in major 

metropolitan areas such as Boston are routinely filled and unable to accept 

patients in need of urgent care.42 According to a local official, the health 

care system might not be able to handle the aftermath of a disaster, attack, 

38Advisory Panel to Assess Domestic Response Capabilities for Terrorism Involving 

Weapons of Mass Destruction, p. 32.

39American Hospital Association, Hospital Preparedness for Mass Casualties, Summary of 

an Invitational Forum, Aug. 2000. D.C. Wetter, W.E. Daniell, and C.D. Treser, “Hospital 

Preparedness for Victims of Chemical or Biological Terrorism,” American Journal of Public 

Health, Vol. 91 (2001), pp. 710-16.

40Smithson and Levy, p. 273.

41Smithson and Levy, p. 262.

42J. Richards, M. Navarro, and R. Derlet, “Survey of Directors of Emergency Departments in 

California on Overcrowding,” Western Journal of Medicine, Vol. 172 (2000), pp. 385-388. R. 

Derlet, J. Richards, and R. Kravitz, “Frequent Overcrowding in U.S. Emergency 

Departments,” Academic Emergency Medicine, Vol. 8, No. 2 (2001), pp. 151-55.
Page 23 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

or epidemic because of the problems caused by overcrowding and the lack 

of additional capacity. OEP officials told us that its Metropolitan Medical 

Response System (a program to improve local medical response 

capabilities) can assist communities in planning, including identifying 

alternative care facilities for treating victims, identifying reserve medical 

personnel that could be brought in during an emergency, and planning to 

treat mass casualties within and outside of hospitals.43 CDC, working with 

the Association for Professionals in Infection Control and Epidemiology, 

has developed guidance for individual hospitals on how to plan for a 

sudden and significant increase in infectious disease patients, relevant for 

the handling of anthrax, botulism, plague, and smallpox cases.

According to one report, local officials are also concerned about whether 

the federal government could quickly deliver enough medical teams and 

resources to help after a biological attack.44 Federal officials said that 

assets, such as the Disaster Medical Assistance Teams, could be on site 

within 12 to 24 hours. Local officials who have deployed with such teams 

said that cities would probably be on their own for the first 24 to 72 hours, 

and that the number of medical workers that could arrive even in that time 

frame might fall far short of what would be needed.45 Local officials also 

told us that they were concerned about the time and resources required to 

prepare and distribute drugs from the National Pharmaceutical Stockpile 

during an emergency. Partially in response to these concerns, CDC has 

developed training for state and local officials on using the stockpile and 

will deploy a small staff with the supplies to assist the local jurisdiction 

with distribution. 

Agency Comments We provided a draft of this report to the eleven departments and agencies 

for their review in August 2001. The Department of Commerce, DOD, HHS, 

and DOJ submitted written comments that are provided in appendixes XV 

through XVIII. They also provided technical comments. The Department of 

the Treasury, VA, and FEMA provided technical comments only. The audit 

liaison from DOT provided oral technical comments on a draft of this 

43See app. VIII for a description of the Metropolitan Medical Response System.

44Smithson and Levy, p. 227.

45Disaster Medical Assistance Teams were dispatched to the New York City and Washington, 

D.C., areas on September 11, 2001. The initial units included more than 300 medical and 

mortuary personnel.
Page 24 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

report; the audit liaison from EPA responded that the agency had no 

comments on the report. The technical liaison from DOE provided oral 

comments noting the department’s concurrence with the draft report. 

USDA did not provide comments on the report. Written and oral comments 

from all of these agencies have been incorporated in the report, as 

appropriate. 

The Department of Commerce stated that the report did not sufficiently 

discuss its integrated efforts with DOD, DOJ, and FEMA to develop 

chemical and biological protective equipment standards. We have provided 

additional detail on this activity in appendix V. In its technical comments 

DOD expressed a concern that the report did not reflect some of DOD’s 

bioterrorism research and preparedness activities which are focused on 

battlefield scenarios and crisis management. We have not included these 

activities because they are outside the scope of our work, which focuses on 

the public health and medical consequences of a bioterrorist attack on the 

civilian population. HHS noted the importance of the systems and 

programs described in the report that could provide assistance to state and 

local governments in the event of a bioterrorist attack. HHS also stated that 

many of the services needed in response to a bioterrorist attack would be 

needed to respond to other emergencies, including natural disasters and 

other types of terrorist attacks, and we added this information to the 

report. In response to a DOJ technical comment, we also modified the 

report to indicate that the department stated it is appropriate for different 

agencies to maintain separate lists of biological threats, noting that such 

lists may have different purposes. 

We are sending copies of this report to the Secretaries of Agriculture, 

Commerce, Defense, Energy, Health and Human Services, Transportation, 

the Treasury, and Veterans Affairs; the Attorney General; the Administrator 

of the Environmental Protection Agency; the Director of the Federal 

Emergency Management Agency; and other interested officials.
Page 25 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

If you or your staffs have any questions about this report, please call me at 

(202) 512-7118. Another contact and key contributors are listed in appendix 

XIX.

Janet Heinrich

Director, Health Care—Public Health Issues
Page 26 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

List of Committees The Honorable Edward M. Kennedy

Chairman

The Honorable Judd Gregg

Ranking Minority Member

Committee on Health, Education, 

Labor, and Pensions

United States Senate

The Honorable Robert C. Byrd 

Chairman

The Honorable Ted Stevens

Ranking Minority Member

Committee on Appropriations

United States Senate

The Honorable W. J. “Billy” Tauzin

Chairman

The Honorable John D. Dingell

Ranking Minority Member

Committee on Energy and Commerce

House of Representatives

The Honorable C.W. Bill Young

Chairman

The Honorable David Obey

Ranking Minority Member

Committee on Appropriations

House of Representatives
Page 27 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities
Page 28 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

Appendix I

Biological Agents and Pathogens Mentioned in Apendxies

This Report ApendxiI

Agent/pathogen Description

Anthrax (Bacillus anthracis ) Transmission is possible through three different routes: 

direct skin contact with contaminated animals, ingestion 

of contaminated meat, or inhalation of airborne particles. 

Cutaneous anthrax causes itching, followed by papular 

lesions (red elevation on skin) and then vesicular lesions 

(blisterlike elevation on skin containing fluid). Untreated 

infections may spread to lymph nodes and to the 

bloodstream, leading to septicemia (presence of 

pathogenic microorganisms in the blood). Untreated 

cutaneous anthrax has a case fatality rate between 5 

and 20 percent. Gastrointestinal anthrax has a mortality 

rate of 25 to 60 percent. Patients present with nausea, 

vomiting, severe diarrhea, fever, abdominal pain, and 

gastrointestinal bleeding. Inhalatory anthrax causes 

necrotizing hemorrhagic mediastinitis (destruction of the 

structures of the middle chest caused by the toxin). Initial 

presentation resembles viral syndrome—fever, malaise, 

fatigue, nonproductive cough. Treatment after onset of 

symptoms of inhalatory anthrax is not effective, with 

mortality of 90 percent.

Plague (Yersinia pestis) Transmission is through the bite of infected fleas or 

handling of tissues of infected animals, such as rodents 

and rabbits. After bite of infected flea, patient usually 

develops bubonic plague, in which patients present with 

malaise, high fever, and tender lymph nodes. This may 

progress spontaneously to septicemic plague, with fever, 

chills, absolute exhaustion, abdominal pain, shock, and 

bleeding into skin and other organs. Neither bubonic nor 

septicemic plague spreads person-to-person. A small 

percentage of patients go on to develop pneumonic 

plague, which can be spread by respiratory droplet. For 

untreated pneumonic plague, mortality approaches 100 

percent.

Salmonellosis (Salmonella) Transmission is by ingestion of infected food, including 

food contaminated by feces of an infected animal or 

person. Symptoms include headache, nausea, vomiting, 

chills, diarrhea, fever, and abdominal cramping. Deaths 

are uncommon.
Appendix I

Biological Agents and Pathogens Mentioned 

in This Report

Page 29 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

Smallpox (variola major) Transmission is person-to-person, and the disease is 

highly contagious. The disease was eradicated, and 

routine immunizations have ceased. Any immunity 

conferred by the vaccine has waned. Patients present 

with high fever, malaise, absolute exhaustion, headache, 

and backache. A maculopapular rash (discolored spots 

on skin; some raised, some not raised) appears on 

mucosa of the mouth and pharynx, face, and forearms 

and spreads to trunk and legs. Within 1 to 2 days, the 

rash becomes vesicular, and later, pustular (small 

elevation on skin containing pus), which leaves pitting 

scars after recovery. Mortality rate is 30 percent or more.

Tularemia (Francisella 

tularensis)

Transmission is through the bite of infected ticks, by 

drinking contaminated water, or rarely through the bite of 

coyote, squirrel, skunk, hog, cat, or dog whose mouth 

presumably was contaminated by eating an infected 

animal. Most times, patients present with painless ulcers 

at the site of introduction and swelling regional lymph 

node. Ingestion of organisms in contaminated water or 

food may produce painful pharyngitis (inflammation of 

the throat area), abdominal pain, diarrhea, and vomiting. 

Inhalation of infectious material may be followed with 

pneumonic involvement or a primary septicemic 

syndrome with a 30 to 60 percent mortality rate if 

untreated.

West Nile virus (flavivirus) Transmission is through the bite of an infected mosquito. 

Most infections are mild, and symptoms include fever, 

headache, and body aches, often with skin rash and 

swollen lymph glands. More severe infections may be 

marked with headache, high fever, neck stiffness, stupor, 

disorientation, coma, tremors, convulsions, muscle 

weakness, and paralysis. The virus is rarely fatal.

(Continued From Previous Page)

Agent/pathogen Description
Page 30 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

Appendix II

Scope and Methodology ApendxiI

We began our work by identifying the federal departments and agencies 

that have a role in the public health and medical consequences of a 

bioterrorist attack on the civilian population. We reviewed the Office of 

Management and Budget’s Annual Report to Congress on Combating 

Terrorism to determine which federal agencies receive funding for 

activities on terrorism.1

 We then reviewed the Federal Response Plan to 

understand the roles of each agency in the consequence management of a 

possible bioterrorist attack. See appendix III for more information 

regarding the Federal Response Plan. We also reviewed each agency’s 

performance plan to determine its specific activities on bioterrorism.

We identified the following federal departments and agencies as having a 

role in the public health and medical consequences of a bioterrorist attack 

on the civilian population: the Departments of Agriculture (USDA), 

Commerce, Defense (DOD), Energy (DOE), Health and Human Services 

(HHS), Justice (DOJ), Transportation (DOT), the Treasury, and Veterans 

Affairs (VA); the Environmental Protection Agency (EPA); and the Federal 

Emergency Management Agency (FEMA). We interviewed program 

directors at each department and agency about their activities related to 

the research on and preparedness for the public health and medical 

consequences of a bioterrorist attack against the civilian population in 

fiscal year 1998 through fiscal year 2001. We asked them to identify 

activities with dual-use purposes, such as preparedness activities for 

biological and chemical attacks, and surveillance activities for emerging 

infectious diseases. We also asked program directors about the 

coordination of interagency activities and requested copies of 

memorandums of understanding and memorandums of agreement to 

identify working relationships between departments and agencies.

We asked the program directors to provide the amount of authorized, 

appropriated, and obligated federal funds for activities on bioterrorism in 

fiscal year 1998 through fiscal year 2001. Some departments and agencies 

could not provide the categories of funding we requested. For example, 

some agencies could only provide appropriations estimates, while others 

could only provide expenditure data. Because these different 

characterizations of budget data are not necessarily additive across 

agencies for specific fiscal years, we have provided budgetary information 

summarized only by agency and refer to this generally as “funding 

1

The report does not differentiate between biological, chemical, nuclear, and radiological 

terrorism.
Appendix II

Scope and Methodology

Page 31 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

information.” We relied on the departments and agencies to identify 

relevant programs and to provide funding information. We have not audited 

or otherwise verified the information provided. 

Information concerning the effectiveness of federal efforts to prepare state 

and local authorities for a bioterrorist event was obtained by reviewing our 

previous work, as well as reports from training exercises, including the 

multiagency Top Officials 2000 exercise (TOPOFF 2000). We interviewed 

officials who participated in TOPOFF 2000. We also reviewed reports by 

the Advisory Panel to Assess Domestic Response Capabilities for Terrorism 

Involving Weapons of Mass Destruction (also known as the Gilmore Panel), 

and the Henry L. Stimson Center and articles from peer-reviewed journals. 

We conducted our work from January through September 2001 in 

accordance with generally accepted government auditing standards.
Page 32 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

Appendix III

Summaries of Selected Federal Policy and 

Planning Documents ApendxiI

The Federal Response Plan, originally drafted in 1992 and updated in 1999, 

is authorized under the Robert T. Stafford Disaster Relief and Emergency 

Assistance Act (P.L. 93-288, as amended). The Stafford Act authorizes the 

President to provide financial and other forms of assistance to state and 

local governments, certain private nonprofit organizations, and individuals 

to support response, recovery, and mitigation efforts following 

presidentially declared major disasters and emergencies. The Federal 

Response Plan lays out the manner in which the federal government 

responds to domestic situations in which the President has declared an 

emergency requiring federal disaster assistance. Presidential Decision 

Directive 39 was issued after the Oklahoma City bombing in 1995, and it 

provides a framework for how the federal government will respond to 

weapons of mass destruction (WMD) terrorism within the United States, 

reaffirming the Federal Response Plan. The Federal Response Plan is an 

all-hazards approach document, with an annex specific to terrorism added 

by FEMA in 1997. In 1998, Presidential Decision Directive 62 was issued, 

which further describes the federal agency roles in preparing for and 

responding to WMD terrorism. In 2001, the U.S. Government Interagency 

Domestic Terrorism Concept of Operations Plan (CONPLAN) was issued, 

which explains agencies’ responsibilities under Presidential Decision 

Directives 39 and 62 in more detail.1

Federal Response Plan 

With Terrorism 

Incident Annex

The Federal Response Plan lays out the manner in which the federal 

government responds to domestic situations in which the President has 

declared an emergency requiring federal disaster assistance. The plan 

outlines the planning assumptions, policies, concept of operations, 

organizational structures, and specific assignment of responsibilities to 

lead departments and agencies in providing federal assistance. The plan is 

intended to be the single source for an all-hazards response to terrorism, 

categorizing the types of federal assistance into specific emergency 

support functions. Primary and supporting agencies are listed for each 

emergency support function. Emergency support function number 8 is the 

Health and Medical Services Annex. HHS is the primary agency for this 

annex and could receive support from USDA, DOD, DOE, DOJ, DOT, VA, 

EPA, FEMA, and other agencies and organizations to assist state and local 

jurisdictions. Through the Health and Medical Services Annex, coordinated 

1

For a more complete discussion on these and other documents, see Combating Terrorism: 

Selected Challenges and Related Recommendations (GAO-01-822, Sept. 20, 2001), pp. 131-

136.
Appendix III

Summaries of Selected Federal Policy and 

Planning Documents

Page 33 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

federal assistance is provided to supplement state and local resources in 

response to public health and medical care needs following a major 

disaster or emergency. The Terrorism Incident Annex establishes a general 

concept of operations for the federal response to a terrorist incident, 

including the concurrent operation under other federal plans.

Presidential Decision 

Directive 39, U.S. 

Policy on 

Counterterrorism

Under Presidential Decision Directive 39, which was issued in 1995, DOJ, 

acting through the Federal Bureau of Investigation (FBI), is the overall lead 

federal agency for domestic terrorist incidents. The FBI is the lead agency 

for crisis management and FEMA is the lead agency for consequence 

management in cases of terrorism.2

 This directive states that the director of 

FEMA shall ensure that the Federal Response Plan is adequate to respond 

to the consequences of terrorism, including terrorism involving WMDs 

directed against the U.S. population.

Presidential Decision 

Directive 62, 

Combating Terrorism

Presidential Decision Directive 62, which was issued in 1998, organizes and 

clarifies the roles and activities of many agencies responsible for 

combating a wide range of terrorism preparedness and response activities. 

This directive calls for the provision of necessary equipment and training to 

state and local responders and the development of stockpiles of vaccines 

and specialized medicines. It also created a category of special events 

called National Security Special Events, which are events of such 

significance that they warrant greater federal planning and protection than 

other special events. Such events have included presidential inaugurations, 

major political party conventions, and Olympic games. The U.S. Secret 

Service is responsible for the design, planning, and implementation of 

security at designated National Security Special Events.

2

Crisis management is predominantly a law enforcement function and includes measures to 

identify, acquire, and plan the use of resources needed to anticipate, prevent, and/or resolve 

a threat or act of terrorism. Crisis management also includes assurance of public health and 

safety. Consequence management includes measures to protect public health, safety, and 

the environment; to restore essential government services; and to provide emergency relief 

to governments, businesses, and individuals affected by the consequences of terrorism.
Appendix III

Summaries of Selected Federal Policy and 

Planning Documents

Page 34 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

U.S. Government 

Interagency Domestic 

Terrorism Concept of 

Operations Plan

The U.S. Government Interagency Domestic Terrorism Concept of 

Operations Plan (CONPLAN) was primarily developed through the efforts 

of DOD, DOE, HHS, DOJ, EPA, and FEMA. It was ratified in January 2001 

and is designed to provide overall guidance to federal, state, and local 

agencies concerning how the federal government would respond to a 

potential or actual terrorist threat or incident that occurs in the United 

States, particularly one involving a WMD. As a follow-up to the Federal 

Response Plan Terrorism Incident Annex, it facilitates interdepartmental 

coordination of crisis and consequence management activities and states in 

more detail the responsibilities of primary and supporting agencies during 

a terrorist attack. HHS is currently developing a bioterrorism annex to this 

plan, which will address issues concerning the appropriate response to acts 

of bioterrorism.
Page 35 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

Appendix IV

Department of Agriculture ApendxiIV

USDA has become involved in activities on bioterrorism because of the 

increasing realization that the food supply may become a vehicle for a 

biological attack against the civilian population.1

 Biological attacks on the 

health of animals and plants are also important to recognize because there 

are a number of diseases and toxins that can cause illness or death in 

humans, such as West Nile virus, that can be carried or spread by animals 

and plants. However, USDA receives little funding specifically for activities 

on bioterrorism. Most of the agency’s activities on terrorism are conducted 

using general program funds (see table 4). 

Table 4: Reported Funding for Activities on Bioterrorism at USDA (Dollars in millions)

Note: We have not audited or otherwise verified the information provided.

Source: USDA.

Office of Crisis 

Planning and 

Management

The Office of Crisis Planning and Management is a department-level office 

under the Assistant Secretary for Administration. The office is responsible 

for coordinating activities on terrorism across USDA. The Director of the 

Office of Crisis Planning and Management serves as the department’s 

Emergency Coordinator and coordinates USDA’s response to all disasters, 

crises, and emergencies. The office coordinates emergency management 

activities with other federal agencies, including FEMA, and coordinates 

USDA’s role under the Federal Response Plan. The office also operates the 

1

For example, USDA and DOD jointly planned and conducted a multiagency simulation of a 

terrorist deliberately contaminating food with a biological agent. See Food Safety: Agencies 

Should Further Test Plans for Responding to Deliberate Contamination (GAO/RCED-00-3, 

Oct. 27, 1999).

Program/initiative

Fiscal year

1998

Fiscal year

1999

Fiscal year

2000

Fiscal year

2001

Agricultural Research Service

Research activities

 Detection of biological agents 0 0 0 $0.5

Animal and Plant Health Inspection Service

Preparedness activities

Education and training programs 0 0 0 $0.2

Total 0 0 0 $0.7
Appendix IV

Department of Agriculture

Page 36 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

department’s Emergency Operations Centers, where representatives of 

organizational elements of USDA gather to manage and coordinate 

emergency response functions.

Agricultural Research 

Service 

The Agricultural Research Service conducts research for several federal 

agencies, including agencies within USDA, such as the Animal and Plant 

Health Inspection Service and the Food Safety and Inspection Service. 

Research Activities The Agricultural Research Service is working on a system to improve onsite rapid detection of biological agents in animals, plants, and food in 

cooperation with DOD and HHS. The agency received $500,000 in fiscal 

year 2001 to sponsor this research (see table 4).

Preparedness Activities The Agricultural Research Service is also repairing and modernizing the 

Plum Island Animal Disease Center in New York state to improve detection 

capacity for diseases and toxins that could affect animals and humans. The 

center provides definitive diagnoses of foreign animal diseases in North 

America. 

Animal and Plant 

Health Inspection 

Service

The Animal and Plant Health Inspection Service is responsible for the 

health of animals and plants and has a role in responding to biological 

agents that are zoonotic, that is, capable of infecting both animals and 

humans. 

Preparedness Activities If a disease outbreak occurred in humans, this agency would work with 

other federal, state, and local departments and agencies to determine the 

source of the exposure to the disease. If the exposure was determined to be 

related to an animal, the agency’s veterinary epidemiologists would be 

responsible for tracing back the source of the animal exposure. They would 

then be responsible for controlling and eradicating the outbreak to 

minimize further exposure to both animals and humans. The Animal and 

Plant Health Inspection Service reported funding of $150,000 in fiscal year 

2001 to develop educational materials and training programs specifically 

dealing with activities on bioterrorism (see table 4).
Appendix IV

Department of Agriculture

Page 37 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

Food Safety Inspection 

Service

The Food Safety Inspection Service provides emergency preparedness for 

foodborne incidents, including a bioterrorist attack.

Preparedness Activities The Food Safety Inspection Service routinely responds to actual and 

potential food-borne disease outbreaks. Its response to a bioterrorist 

incident would be the same as its response to any food-borne disease 

outbreak. The Food Safety Inspection Service has not received any funding 

for activities on bioterrorism.
Page 38 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

Appendix V

Department of Commerce ApendxiV

Activities on bioterrorism within the Department of Commerce center on 

developing performance standards for emergency response equipment and 

are carried out in conjunction with DOD, DOJ, and HHS.

Office of Law 

Enforcement 

Standards

The Office of Law Enforcement Standards at the Department of 

Commerce’s National Institute of Standards and Technology is the principal 

agent for equipment standards development for the criminal justice and 

public safety communities, including biological response equipment. The 

office develops standards, test procedures, and user guides that helps

ensure that the equipment the communities purchase and the technologies 

they use are safe, dependable, and effective. The department reported 

receiving $0.5 million in fiscal year 2000 and $4.6 million in fiscal year 2001 

from DOJ for research. It reported funding, also from DOJ, of $0.3 million 

annually in fiscal year 1999 and fiscal year 2000 for preparedness activities.

Research Activities The Office of Law Enforcement Standards develops performance standards 

and evaluates test methods and procedures for WMD and explosive 

emergency response equipment. The office manages research projects with 

the National Institute for Occupational Safety and Health and the U.S. Army 

Soldier Biological and Chemical Command to develop standards for 

respiratory and other personal protective equipment, and detectors and 

decontamination equipment designed to protect against biological and 

chemical agents

Preparedness Activities The Office of Law Enforcement Standards also issues technical reports and 

publishes user guides for WMD and explosive response equipment. The 

office is the executive agent of the Standards Coordination Committee of 

the Interagency Board for Equipment Standardization and Interoperability. 

The Interagency Board, which is co-chaired by DOD and DOJ, develops and 

maintains a Standardized Equipment List, which lists essential items for 

responding to terrorist WMD attacks. Other agencies participating in this 

effort include HHS, DOE, DOT, EPA, and FEMA. The Standardized 

Equipment List can be used by local public safety organizations when 

developing response plans and acquiring response equipment.
Page 39 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

Appendix VI

Department of Defense ApendxiVI

Although DOD is primarily responsible for service members in the 

battlefield, it would provide support to the primary federal agency under 

the Federal Response Plan in the event of an emergency, including a 

bioterrorist attack on the civilian population. Research at DOD is targeted 

for the battlefield, but is often shared with other agencies to benefit the 

civilian population. DOD has civil support responsibilities through the 

Defense Advanced Research Projects Agency, the Joint Task Force for Civil 

Support, the National Guard, and the U.S. Army. The Assistant Secretary of 

Defense for Special Operations and Low-Intensity Conflict provides 

oversight by supervising policy, requirements, priorities, resources, and 

programs to ensure adherence to approved policy and planning guidelines. 

See table 5 for DOD’s reported funding for activities on domestic terrorism. 

In addition, we provide information on other activities for which DOD 

could not provide funding data
Appendix VI

Department of Defense

Page 40 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

Table 5: Reported Funding for Activities on Domestic Terrorism at DOD (Dollars in millions)

Note: We have not audited or otherwise verified the information provided.

a

Funding for preparedness activities has decreased over time due to a transfer of responsibility for 

these activities under the Domestic Preparedness Program from DOD to DOJ beginning October 1, 

2000.

Source: DOD.

Defense Advanced 

Research Projects 

Agency

The Defense Advanced Research Projects Agency is the central research 

and development organization for DOD. It manages and directs basic and 

applied research and development projects for the department. Success of 

the projects may provide military advances as well as civilian applications.

Research Activities The Defense Advance Research Projects Agency’s current work includes 

genetic sequencing to enable the identification of molecular targets for the 

design of detection, diagnostic, and therapeutic strategies that will aid 

service members and may be used for the civilian population. The agency’s 

objectives include developing the capacity to detect the presence of 

infection by a biological agent, differentiate the agent from other 

Program/initiative

Fiscal year

1998

Fiscal year

1999

Fiscal year

2000

Fiscal year

2001

Joint Task Force for Civil Support

Preparedness activities

Training, exercises, travel, contingency operations, garrison 

support, communications, support contracts 

0 0 $3.4 $6.5

Communication link system 0 0 0 $2.2

National Guard

Preparedness activities

Weapons of Mass Destruction—Civil Support Teams 0 $73.0 $70.0 $93.3

U.S. Army

Preparedness activitiesa

Program management $3.0 $2.5 $3.3 $0.9

Expert assistance $6.3 $4.8 $4.7 $1.9

Training $21.6 $30.8 $10.9 0

Director of military support travel 0 0 $0.3 $0.1

Exercises and testing $10.2 $7.9 $8.4 $6.2

Chemical Biological—Rapid Response Teams $1.9 $1.9 $1.9 $2.6

Total $43.0 $120.9 $102.9 $113.7
Appendix VI

Department of Defense

Page 41 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

pathogens, and identify the pathogen in the absence of recognizable 

clinical signs. The agency often shares research results with other agencies 

to benefit the civilian population. DOD has initiated discussions on how 

best to evaluate and transition select technology for bioterrorism defense. 

The agency does not receive funding to conduct research on the public 

health and medical consequences of a bioterrorist attack against civilian 

populations.

Joint Task Force for 

Civil Support

The mandate of the Joint Task Force for Civil Support at the Joint Forces 

Command is to plan for and integrate DOD’s support to FEMA for WMD 

events in the continental United States.

Preparedness Activities The Joint Task Force for Civil Support plans and, when directed, 

commands and controls DOD’s WMD and high-yield explosive consequence 

management capabilities in providing support during a domestic 

bioterrorist incident. The Joint Task Force for Civil Support provides 

support through FEMA and the Federal Response Plan during an incident 

and works with other federal agencies on planning and exercises. The Joint 

Task Force for Civil Support and the Joint Forces Command are working in 

support of FEMA and HHS’ Office of Emergency Preparedness (OEP) to 

plan Force Packages, which are groupings of units that the military would 

designate to respond to an incident. It also coordinates with OEP on the 

planning for medical support for any WMD incident. Reported funding for 

Joint Task Force activities on terrorism was $3.4 million for fiscal year 2000 

(see table 5). It rose to $8.7 million for fiscal year 2001, including $6.5 

million for individual unit training, exercises, travel, contingency 

operations, garrison support, purchased communications, and general 

support contracts, and $2.2 million for the establishment of a 

communication link system.

National Guard The National Guard Weapons of Mass Destruction—Civil Support Teams 

are meant to deploy to assist local responders in determining the precise 

nature of an attack and provide medical and technical advice. The teams 

also help pave the way for the identification and arrival of follow-on state 

and federal military response assets.
Appendix VI

Department of Defense

Page 42 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

Preparedness Activities The National Guard Weapons of Mass Destruction—Civil Support Team 

program is intended to help prepare the United States against terrorist use 

of WMDs. Originally, 10 civil support teams (formerly called Rapid 

Assessment and Initial Detection teams) were located in alignment with the 

10 FEMA regional offices.1

 Congress authorized an additional 17 civil 

support teams in fiscal year 2000, and another 5 in fiscal year 2001.2

 DOD 

reported funding of $70 million and $93.3 million for these teams in fiscal 

year 2000 and fiscal year 2001, respectively (see table 5).

Although the teams are federally funded and trained, they are primarily 

under the command and control of the governors of the states in which 

they are located, to facilitate their rapid deployment. Their roles can 

include entering a contaminated area to gather air, soil, and other samples 

for on-site evaluation. They also are to assist a local incident commander in 

determining the nature and extent of an attack or incident, provide expert 

technical advice on WMD response operations, and help identify and 

support the arrival of follow-on state and federal military response assets. 

Teams are designed to be ready to deploy within 4 hours to anywhere 

within their area of responsibility, with their own detection and 

decontamination equipment, medical supplies, and protective gear. As of 

August 15, 2001, six civil support teams have been certified as fully mission 

capable.

U.S. Army The U.S. Army engages in research and preparedness activities on 

bioterrorism that have benefits for both military and civilian populations.

Research Activities The U.S. Army Medical Research Institute of Infectious Diseases is a 

biological research facility that deals with militarily relevant infectious 

diseases and biological agents. The institute conducts research to develop 

vaccines, drugs, and diagnostics for laboratory and field use, as well as 

1

The civil support teams are located in California, Colorado, Georgia, Illinois, 

Massachusetts, Missouri, New York, Pennsylvania, Texas, and Washington.

2

The 17 additional teams for fiscal year 2000 are located in Alaska, Arizona, Arkansas, 

California (creating a second team), Florida, Hawaii, Idaho, Iowa, Kentucky, Louisiana, 

Maine, Minnesota, New Mexico, Ohio, Oklahoma, South Carolina, and Virginia. As of 

January 2001, team locations had not been determined for the additional five teams for 

fiscal year 2001. 
Appendix VI

Department of Defense

Page 43 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

formulates strategies, information, procedures, and training programs for 

medical defense against biological agents. The institute has a Biosafety 

Level 4 laboratory, which is used for dangerous, exotic agents that pose a 

high risk of life-threatening diseases and have no vaccines or drugs 

available for treatment. The institute also provides definitive identification 

of biological agents and diagnosis of the diseases they produce. It provides 

professional expertise on issues related to technologies, therapeutics, 

prophylactics, and education that could be used to support readiness for a 

bioterrorist incident.

The institute helps supply diagnostic reagent3

 sets to the Centers for 

Disease Control and Prevention (CDC) and serves CDC’s Laboratory 

Response Network as a confirmatory diagnostic laboratory and subject 

matter expert.4

 It provides support for the development of an anthrax 

vaccine by the National Institutes of Health (NIH). Other ongoing work 

with CDC and NIH includes the development of a database for genetically 

engineered threats. It works with CDC and the FBI to assist with potential 

bioterrorism incidents on a consultation or confirmatory basis. The 

institute, along with the U.S. Army Soldier Biological and Chemical 

Command, the Director of Military Support, and the Joint Task Force for 

Civil Support, is currently working on plans to provide support in the event 

of a domestic bioterrorist incident. The institute does not receive funding 

to conduct research on the public health and medical consequences of a 

bioterrorist attack against civilian populations.

Preparedness Activities The Domestic Preparedness Program5

 was formed in response to the 

National Defense Authorization Act of Fiscal Year 1997 (P.L. 104-201) and 

required DOD to enhance the capability of federal, state, and local 

emergency responders regarding terrorist incidents involving WMDs and 

high-yield explosives. 

The program was developed through work groups with expertise with 

WMD response skills. Work groups were composed of experts from 

3

A reagent is a substance used to detect the presence of another substance.

4

For more information on the Laboratory Response Network, see app. VIII.

5

For more information concerning the Domestic Preparedness Program, see Combating 

Terrorism: Opportunities to Improve Domestic Preparedness Program Focus and 

Efficiency (GAO/NSIAD-99-3, Nov. 12, 1998).
Appendix VI

Department of Defense

Page 44 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

municipalities, counties, and states and federal first responders having 

responsibility for responding to WMD terrorism incidents. The work 

groups developed courses and training in accordance with the 

Occupational Safety and Health Administration, the National Fire 

Protection Agency, and standards set by the Joint Commission for the 

Accreditation of Healthcare Organizations. 

DOD created the Domestic Preparedness Program with four major 

elements: the City Training Program, the Exercises Program, the Expert 

Assistance Program, and the Chemical Biological—Rapid Response Team. 

The City Training Program provides training for senior local officials and 

emergency first responders and trainers in 120 cities. It includes equipment 

loans to the local areas by DOD.

The Exercises Program includes the federal, state, and local exercise and 

the Biological Warfare−-Improved Response Program. The Improved 

Response Program is a multiagency, intergovernmental, and 

interdisciplinary effort designed to improve our nation’s ability to respond 

to domestic acts of terrorism involving biological agents. Program 

activities include testing and evaluating biological agent response 

concepts, developing technical and operational requirements for first 

responder equipment, and conducting exercises to test the major 

components and integrated response plan. Lessons learned from biological 

weapons tabletop exercises6

 on the medical consequence management of a 

biological attack have been applied to the Improved Response Program.

Expert Assistance Program activities include the emergency responders’

WMD help line (which provides nonemergency planning and technical 

information), a hot line (a component of the National Response Center, 

which is located at the Coast Guard’s Headquarter Command Center and 

allows the caller to alert federal agencies and speak with technical experts 

who can provide critical incident management information), a Web page 

(which provides information about the Domestic Preparedness Program), 

equipment testing and reports, a chemical-biological database (a repository 

of information about chemical and biological weapons and agents, 

6

With tabletop exercises, participants work through a simulation of a bioterrorism incident, 

starting with the incubation period (the time between initial exposure to a biological agent 

and the onset of symptoms), followed by the recognition and initial response, and finally the 

challenges of integrating federal assets in the response and recovery efforts.
Appendix VI

Department of Defense

Page 45 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

detectors, and protection and decontamination equipment), and subject 

matter experts (who provide support for technical inquiries).

The Chemical Biological—Rapid Response Team coordinates and manages 

all DOD technical capabilities tasked to support a crisis response or 

consequence management operation. The Rapid Response Team delivers 

skills, training, and equipment to the scene of a chemical or biological 

incident.

As of October 1, 2000, the City Training Program, portions of the Improved 

Response Program, and the help line, hot line, and Web page elements of 

the Expert Assistance Program were transferred from DOD to DOJ. DOD 

will retain responsibility for the chemical-biological database and 

equipment testing and the Chemical Biological—Rapid Response Team. 

DOD also will retain responsibility for the annual federal, state, and local 

exercise through fiscal year 2001. DOD will share responsibility for the 

Improved Response Program with DOJ. 
Page 46 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

Appendix VII

Department of Energy ApendxiVI

DOE is developing new capabilities to counter chemical and biological 

threats. DOE expects the results of its research to be public and possibly 

lead to the development of commercial products in the domestic market. 

Table 6 lists funding for DOE’s research activities on terrorism.

Table 6: Reported Funding for Activities on Terrorism at DOE (Dollars in millions)

Note: We have not audited or otherwise verified the information provided.

Source: DOE.

The Office of Defense 

Nuclear 

Nonproliferation

Among other duties, the Office of Defense Nuclear Nonproliferation is 

responsible for reducing global danger from WMDs. Within this office is the 

Chemical and Biological National Security Program, which participates in 

research related to bioterrorism. 

Research Activities The mission of the Chemical and Biological National Security Program is to 

develop, demonstrate, and deliver technologies and systems that will lead 

to major improvements in the United States’ capability to prepare for and 

respond to chemical or biological attacks. The program was begun in 1997 

to involve DOE and its laboratories in research and demonstrations of 

terrorism preparedness, including, but not limited to, bioterrorism. 

The Chemical and Biological National Security Program is divided into 

three components: analytical studies, technology development, and 

Domestic Demonstration and Application Programs. Analytical studies 

Program/initiative

Fiscal year

1998

Fiscal year

1999

Fiscal year

2000

Fiscal year

2001

Chemical and Biological National Security Program

Research activities

Chemical and biological detection $7.3 $7.5 $9.5 $10.9

Modeling and prediction $2.3 $3.0 $4.7 $5.5

Decontamination and restoration $1.8 $1.7 $2.2 $1.5

Biological foundations $4.5 $5.0 $10.0 $10.9

System analysis (includes Domestic Demonstration and 

Application Programs)

$1.7 $1.8 $5.5 $9.1

Other $0.4 0 $3.6 $1.7

Total $18.0 $19.0 $35.5 $39.6
Appendix VII

Department of Energy

Page 47 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

help guide the overall program direction as well as individual technical 

areas. In general, these studies use analytical and simulation models to 

assess the value of technology in system applications. Technology 

development is the core research and development program element, with 

the purpose of enhancing response capabilities across the full spectrum of 

chemical and biological terrorism. In general, development is focused on 

technologies for which the basic science is already understood. Technology 

development is categorized into four areas: (1) chemical and biological 

detection, (2) modeling and prediction, (3) decontamination and 

restoration, and (4) biological foundations (that is, molecular biologybased capabilities to support efforts in advanced detection, attribution, and 

medical countermeasures). Finally, Domestic Demonstration and 

Application Programs seek to integrate current technology into capable, 

prototype operational systems directed at specific applications in 2 to 3 

years. 

One current demonstration project is the Biological Aerosol Sentry and 

Information System. This portable system is intended to provide early 

warning of airborne biological incidents for special events such as large 

assemblies and dignitary visits. This system is planned for use in civilian 

settings to detect a biological incident within a few hours of an attack, early 

enough to mount an effective medical response. This system is intended to 

estimate where an attack occurred, exposure levels, and duration, all of 

which would assist the public health system in identifying the population 

requiring treatment.
Page 48 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

Appendix VIII

Department of Health and Human Services ApendxiVI

Within HHS, five agencies or offices work on bioterrorism issues. The 

Agency for Healthcare Research and Quality (AHRQ), the Food and Drug 

Administration (FDA), and NIH are primarily involved in research 

activities, and CDC and OEP are primarily concerned with preparedness 

activities. HHS is the primary federal agency for the medical and public 

health response to emergencies, including major disasters and terrorist 

events, under the Federal Response Plan. In addition, the Secretary of HHS 

has recently appointed a Special Assistant for Bioterrorism to coordinate 

antibioterrorism efforts across the department.

The Secretary of HHS was authorized $221 million in fiscal year 2001 

through the Public Health Improvement Act of 2000 for the medical and 

public health consequences of a bioterrorist attack. However, despite this 

authorization, there were no specific appropriations for such activities.

Agency for Healthcare 

Research and Quality

AHRQ’s mission is to support research designed to improve the outcomes 

and quality of health care, reduce its costs, address safety and medical 

errors, and broaden access to effective services. Working through an 

informal interagency workgroup, AHRQ included officials across HHS 

(such as those in CDC, OEP, and the Office of the Assistant Secretary for 

Planning and Evaluation) in its anti-bioterrorism research planning efforts. 

Research Activities AHRQ received $5 million in fiscal year 2000 to develop research initiatives 

to identify effective and specific strategies for improving the clinical 

preparedness of health care providers and health care systems for a 

bioterrorist attack. For example, the agency funded research on the use of 

information systems and decision support systems to enhance 

preparedness for the delivery of medical care in the event of such an 

attack. AHRQ, along with other HHS agency partners, also provided 

funding to support a bioterrorism symposium sponsored by the Center for 

Civilian Biodefense Studies at Johns Hopkins University.

Centers for Disease 

Control and Prevention

HHS was designated to lead an effort to work with governmental and 

nongovernmental partners to upgrade the nation’s capacity to respond to 

bioterrorism. Several centers, institutes, and offices within CDC work 

together on bioterrorism preparedness and response efforts. The principal 

priority of the Bioterrorism Preparedness and Response Program is to 

upgrade infrastructure and capacity to respond to a large-scale epidemic, 
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Department of Health and Human Services

Page 49 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

regardless of whether it is the result of a bioterrorist attack or a naturally 

occurring infectious disease outbreak. The program was started in fiscal 

year 1999 and was tasked with building and enhancing national, state, and 

local capacity; developing a national pharmaceutical stockpile; and 

conducting several independent studies on bioterrorism. It has focused on 

helping states with planning for a bioterrorist event; enhancing surveillance 

and laboratory capacity at the national, state, and local levels; and 

improving communications and training for bioterrorism preparedness. 

Examples of CDC’s internal research activities include work on anthrax 

and smallpox. The agency also oversees a number of studies being 

conducted by universities and hospitals. Table 7 lists CDC’s reported 

bioterrorism funding for fiscal years 1998 through 2001.
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Department of Health and Human Services

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Table 7: Reported Funding for Activities on Bioterrorism at CDC (Dollars in millions)

Note: We have not audited or otherwise verified the information provided.

a

CDC received funding in fiscal year 1999, fiscal year 2000, and fiscal year 2001 for bioterrorism 

deterrence activities, such as implementing regulations restricting the importation of certain biological 

agents. However, since deterrence is outside the scope of our study, that funding is not included here.

b

For instance, $1 million was specified in the fiscal year 2000 appropriations conference report for the 

Carnegie Mellon Research Institute to study health and bioterrorism threats.

Source: CDC.

The Bioterrorism Preparedness and Response Program was placed within 

the National Center for Infectious Diseases because of the likely similarity 

between a bioterrorist attack and a naturally occurring infectious disease 

outbreak. The National Center for Infectious Diseases oversees research, 

surveillance, laboratory, and epidemiological response efforts. The 

National Center for Environmental Health manages the National 

Pharmaceutical Stockpile Program and associated emergency 

preparedness and planning activities. Several other offices and institutes 

also contribute to the Bioterrorism Preparedness and Response Program, 

including the Epidemiology Program Office; the Public Health Practice 

Program Office, which focuses on communications and training; and the 

National Institute of Occupational Safety and Health. Program staff are 

Program/initiativea

Fiscal year

1998

Fiscal year

1999

Fiscal year

2000

Fiscal year

2001

Research activities

 Research and development 0 0 $40.5 $42.9

 Independent studiesb 0 $1.8 $7.7 $2.6

 Worker safety 0 0 0 $1.1

Preparedness activities

 Upgrading state and local capacity 0 $55.0 $56.9 $66.7

 Preparedness planning 0 $2.0 $1.9 $5.8

 Surveillance and epidemiology 0 $12.0 $15.8 $16.1

 Laboratory capacity 0 $13.0 $9.5 $12.8

 Communications 0 $28.0 $29.7 $32.0

 Upgrading CDC capacity 0 $12.0 $13.9 $20.4

 Epidemiologic capacity 0 $2.0 $1.8 $4.0

 Laboratory capacity 0 $5.0 $7.6 $11.4

 Rapid toxic screen 0 $5.0 $4.5 $5.0

 Preparedness and response planning 0 $1.0 $2.3 $9.2

 Building the National Pharmaceutical Stockpile 0 $51.0 $51.8 $51.0

Total 0 $120.8 $173.1 $193.9
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Department of Health and Human Services

Page 51 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

responsible for coordination within CDC and with other federal agencies 

and for policy development.

Research Activities In fiscal year 2001, CDC was allocated $18 million to continue research on 

an anthrax vaccine and associated issues, such as scheduling and dosage. 

The agency also received $22.4 million in fiscal year 2001 to conduct 

smallpox research. In addition, CDC oversees a number of independent 

studies, which are specific lines in the budget that fund specific universities 

and hospitals to do research and other work on bioterrorism. For example, 

the Carnegie Mellon Research Institute received $1 million in fiscal year 

2000 to study health and bioterrorism threats. Finally, CDC’s National 

Institute for Occupational Safety and Health is developing standards for 

respiratory protection equipment used against biological agents by 

firefighters, laboratory technicians, and other potentially affected workers.

Preparedness Activities Most of CDC’s activities to counter bioterrorism are focused on building 

and expanding multipurpose public health infrastructure at the national, 

state, and local levels. For example, CDC reported receiving funding of 

$66.7 million in fiscal year 2001 to upgrade state and local capacity to 

detect and respond to a bioterrorist attack. CDC received an additional 

$20.4 million to upgrade its own capacity in these areas, $9.2 million for 

planning and response, and another $51 million for developing the National 

Pharmaceutical Stockpile. These activities may have a dual use, such as 

identifying and containing a naturally occurring emerging infectious 

disease in addition to responding to a bioterrorism attack. 

Upgrading State and Local 

Capacity

In fiscal year 2000, CDC received $56.9 million to award to 50 states and 4 

major metropolitan health departments for preparedness and response 

activities. CDC also provides technical assistance to these agencies to 

assist preparedness efforts. CDC is developing planning guidance for state 

public health officials to upgrade state and local public health departments’

preparedness and response capabilities. In addition, CDC has worked with 

DOJ to complete a public health assessment tool, which is being used to 

determine the ability of state and local public health agencies to respond to 

biological and chemical agents, as well as other public health emergencies.

States have received funding from CDC to increase staff, provide better 

access to data sources, enhance capacity to detect the release of a 

biological agent or an emerging infectious disease, and improve 
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Department of Health and Human Services

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communications infrastructure. In fiscal year 1999, for example, a total of 

$7.8 million was awarded to 41 state and local health agencies to improve 

the state and local public health agencies’ ability to link different sources of 

data, such as sales of certain pharmaceuticals, which could be helpful in 

detecting a covert bioterrorist event. 

Rapid identification and confirmatory diagnosis of biological agents are 

critical to ensuring that prevention and treatment measures can be 

implemented quickly. CDC was allocated $13 million in fiscal year 1999 to 

enhance state and local laboratory capacity. CDC has established a 

Laboratory Response Network that maintains state-of-the-art capabilities 

for biological agent identification and characterization. CDC has provided 

technical assistance and training in identification techniques to state and 

local public health laboratories. In addition, five state health departments 

received awards totaling $3 million in fiscal year 2000 to enhance chemical 

laboratory capabilities. These funds were used to purchase equipment and 

provide training. 

CDC is working with state and local health agencies to build a modern 

electronic infrastructure for public health communications that will 

improve the collection and transmission of information related to a 

bioterrorism incident as well as other events. For example, $21 million was 

awarded to states in fiscal year 1999 to begin implementation of the Health 

Alert Network, which will support the exchange of key information over 

the Internet and provide a foundation for distance training that could 

potentially reach a large segment of the public health community.

Upgrading CDC Capacity CDC is upgrading its own epidemiologic and disease surveillance capacity. 

It has deployed, and is continuing to develop, a surveillance system to 

increase surveillance and epidemiological capacities before, during, and 

after special events (such as the 1999 World Trade Organization meeting in 

Seattle, Washington). The agency is also increasing its veterinary 

surveillance. In addition, CDC monitors unusual clusters of illnesses, such 

as influenza in June. While these clusters may not be a cause for concern, 

they can indicate a potential problem.

CDC has strengthened its own laboratory capacity. For example, it is 

developing and validating diagnostic tests as well as creating agent-specific 

protocols. In collaboration with the Association of Public Health 

Laboratories and DOD, CDC has operationalized a secure Internet-based 

network that allows state, local, and other public health laboratories access 

to guidelines for analyzing biological agents. The site also allows 
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Department of Health and Human Services

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authenticated users to order critical reagents needed in performing 

laboratory analysis of samples.

The agency has also operationalized a Rapid Response and Advance 

Technology Laboratory, which screens samples for the presence of 

suspicious biological agents and evaluates new technology and protocols 

for the detection of biological agents. These technology assessments and 

protocols, as well as reagents and reference samples, are being shared with 

state and local public health laboratories.

Preparedness and Response 

Planning

In fiscal year 1999, at the start of CDC’s bioterrorism program, the agency 

received funding to develop an overall preparedness plan. CDC received 

$2.3 million in fiscal year 2000 for preparedness and response training and 

$9.2 million in fiscal year 2001. Among the activities to be undertaken is the 

initial implementation of a national bioterrorism response training plan. 

This plan will focus on preparing CDC officials to respond to bioterrorism 

and will include the development of exercises to assess progress in 

achieving bioterrorism preparedness at the federal, state, and local levels. 

The agency will also develop a crisis communications/media response 

curriculum for bioterrorism as well as core capabilities guidelines to assist 

states and localities in their efforts to build comprehensive antibioterrorism programs.

CDC has developed a bioterrorism Web site. This site provides emergency 

contact information for possible bioterrorism events, a list of critical 

agents, summaries of state and local bioterrorism projects, general 

information about CDC’s bioterrorism initiative, and links to documents on 

bioterrorism preparedness and response.

Building the National 

Pharmaceutical Stockpile 

Program

The National Pharmaceutical Stockpile Program maintains a repository of 

life-saving pharmaceuticals, antidotes, and medical supplies, known as 12-

Hour Push Packages, that can be delivered to the site of a biological (or 

other) attack within 12 hours of deployment for the treatment of civilians. 

These Push Packages are prepackaged and contain products that could be 

used in a variety of scenarios.1

 Additional antibiotics, antidotes, other 

drugs, medical equipment, and supplies known as Vendor Managed 

Inventory, can be delivered within 24 to 36 hours after the appropriate 

1

The first emergency use of the National Pharmaceutical Stockpile occurred on September 

11, 2001. In response to the terrorist attack on the World Trade Center, CDC released one of 

the eight Push Packages.
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Department of Health and Human Services

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vendors are notified. The Vendor Managed Inventory can be tailored to an 

individual incident (that is, only products needed for a particular incident 

would be sent). The program received $51.0 million in fiscal year 1999, 

$51.8 million in fiscal year 2000, and $51.0 million in fiscal year 2001. CDC 

and OEP have encouraged state and local representatives to consider 

stockpile assets in their emergency planning for a biological attack and 

have trained representatives from state and local authorities in using the 

stockpile. The program also provides technical advisers in response to an 

event to ensure the appropriate and timely transfer of stockpile contents to 

authorized state representatives.2

Food and Drug 

Administration

FDA’s responsibilities and activities on bioterrorism are spread throughout 

the agency. These activities include safeguarding the food supply, ensuring 

that new vaccines and drugs are safe and effective, and conducting 

research for diagnostic tools and treatment of disease outbreaks. 

Under the Health and Medical Services Annex of the Federal Response 

Plan, FDA is the lead HHS agency for ensuring the safety of regulated 

foods, drugs, medical devices, and biological products. In an emergency, 

FDA would arrange for the seizure, removal, and/or destruction of any 

contaminated and unsafe products. FDA is revising its Emergency 

Operations Response Plan to include bioterrorism preparedness and 

response elements.

Congress has earmarked $5 million for FDA for activities on bioterrorism in 

fiscal year 2001. These funds were for FDA to continue previously initiated 

work on bioterrorism that had been supported by departmental and general 

purpose funds. HHS has allocated other funds to FDA’s activities on 

bioterrorism. For example, the Center for Biologics Evaluation and 

Research received $7.5 million in fiscal year 2000 from departmental funds 

specifically for vaccine projects (see table 8). 

2

For more information on the National Pharmaceutical Stockpile Program, see Combating 

Terrorism: Accountability Over Medical Supplies Needs Further Improvement (GAO-01-

463, Mar. 30, 2001).
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Department of Health and Human Services

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Table 8: Reported Funding for Activities on Bioterrorism at FDA (Dollars in millions)

Note: We have not audited or otherwise verified the information provided.

a

Agency officials told us that in fiscal year 1998 funds were expended on bioterrorism-related activities, 

but they did not report these levels to us.

b

We were unable to allocate funding within this program for research and preparedness based on the 

information provided by FDA. Instead, we list all the funding under research because the 

preponderance of activities within that program are best categorized there.

Program/initiative

Fiscal year

1998a

Fiscal year

1999

Fiscal year

2000

Fiscal year

2001

Center for Biologics Evaluation and Research

 Research activities

 Premarket evaluation of vaccines,

 develop vaccines

a $1.2 $7.5 $7.0

Center for Devices and Radiological Health

 Research activities

Develop data requirements for approving devices intended to 

detect exposure to or infection with biological agents

a $0.1 $0.8 $0.9

Center for Drug Evaluation and Research

 Research activities

Determine procedures for allowing use of not-yet-approved 

drugs, specify data needed for approval and labeling, gather 

and supply information

a $0.2 $0.4 $0.7

Center for Food Safety and Applied Nutrition

 Preparedness activities

Monitor food supply, communicate with state and local officials a 0 0 $0.3

Center for Veterinary Medicine

Preparedness activities

Communicate with state officials, held meeting on bioterrorism 

risk

a $0.1 $0.1 $0.3

National Center for Toxicological Research

Research activities

Define biological mechanisms of action underlying toxicity of 

products, identify indications of toxicity associated with 

biological agents

a $0.2 $0.1 $0.5

 Preparedness activities

Participate in training meetings a b bb

Office of Regulatory Affairs

 Preparedness activities

Communicate with other agencies and the public, conduct 

investigations

ccc $1.5

Totald a $1.9 $9.0 $11.2
Appendix VIII

Department of Health and Human Services

Page 56 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

c

FDA reported that activities on bioterrorism were conducted by the Office of Regulatory Affairs, but it 

did not specify how much was spent on them.

d

Individual entries may not sum to totals because of rounding.

Source: FDA.

Center for Biologics 

Evaluation and Research

The mission of the Center for Biologics Evaluation and Research is to 

ensure the safety, efficacy, potency, and purity of biological and related 

products, including vaccines, that could be used in case of a bioterrorist 

attack.

Research Activities Among its responsibilities, the Center for Biologics Evaluation and 

Research regulates the development and licensure of new vaccines for 

anthrax, smallpox, and the associated vaccinia immune globulin used to 

treat serious vaccinia infections or other adverse events caused by the 

smallpox vaccine. In addition to premarketing evaluation, vaccine products 

require review of lot release data, inspection of manufacturing facilities, 

assessment of product availability, and surveillance and compliance 

activities. The center works closely with other government agencies such 

as CDC and DOD to assist in ensuring that sufficient quantities of medical 

products are available for military and civilian use during a bioterrorism 

attack, and that the use is controlled under an acceptable clinical protocol 

when the biological product is not licensed by FDA or is being used “off 

label.”

3

 It also coordinates with industry and government agencies to 

prepare surveillance methods for adverse event monitoring associated with 

the use of biological products in a bioterrorism attack. The center engages 

in vaccine research activities related to the regulation of the development 

of vaccines for plague, tularemia, and encephalitis-causing viruses.4

 (See 

app. I for a discussion of specific biological agents mentioned in this 

report.)

Since high-risk bioterrorism pathogens either do not exist naturally or do 

not cause significant disease in large populations, the traditional human 

testing and ultimate approval of products for mitigating a disease in 

humans caused by a bioterrorist pathogen is neither ethical nor feasible. 

The center is working with CDC, NIH, and DOD, as well as academia and 

3

“Off label” refers to the treatment of conditions other than those listed on FDA’s approved 

drug label.

4

Encephalitis is inflammation of the brain.
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Department of Health and Human Services

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industry to develop regulations that will define the type of nonhuman 

research data required to demonstrate the potential efficacy of new 

products on humans affected by biological WMDs.

Officials have noted that while there is a clear need to develop vaccines for 

biological agents, there are limited commercial interests or market 

incentives for addressing the problem. Consequently, it falls upon the 

federal government to develop such vaccines. The Center for Biologics 

Evaluation and Research has research projects under way dealing with 

vaccines for anthrax, plague, and smallpox.

Center for Devices and 

Radiological Health

The mission of the Center for Devices and Radiological Health is to ensure 

the safety and effectiveness of medical devices, including those that could 

be used in the event of a bioterrorist attack.

Research Activities The center provided comments on a research protocol to evaluate a device 

intended to identify anthrax in human specimens. It has also conducted an 

advisory panel meeting to discuss data requirements for approval of 

devices intended to detect exposure to or infection with biological agents. 

In addition, the center is working with CDC on a process that would allow 

the use of investigational diagnostic devices in the event of a bioterrorist 

attack.

Center for Drug Evaluation 

and Research

The Center for Drug Evaluation and Research helps ensure the availability 

of safe and effective human drugs. The center reviews research to take 

appropriate action on the marketing of drugs, including those that would 

be used in the event of a bioterrorist attack. 

Research Activities The center is working with CDC on a process that would satisfy the 

requirements for allowing the use of investigational drugs (not approved by 

FDA) in the event of a bioterrorist attack. Testing drugs that might be used 

in case of a bioterrorist attack is difficult because the diseases caused by 

the biological agents rarely occur naturally and it would be unethical to 

infect healthy volunteers with the disease when there is no known cure. 

The center is working with other government agencies and the 

manufacturers of these drugs to determine what studies are needed to 

generate sufficient safety and efficacy data to permit labeling of these 

drugs. For products that might still be in the investigational stage, but 

potentially the only therapies available for a specific disease caused by a 
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Department of Health and Human Services

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bioterrorist event, the center is working with CDC to determine additional 

methods of data collection and analysis to evaluate the products’ safety and 

efficacy if it were necessary for them to be used.

Although some drugs that would be used in the case of a bioterrorist attack 

have been approved to treat diseases caused by a biological agent, use of a 

number of these drugs would be “off-label.” The center is determining what 

data are needed to enable approval of a label indicating that a drug would 

treat a disease that might be caused by a bioterrorist attack. It has a 

program in this area, but there has been limited funding for these activities. 

The center has worked to facilitate the labeling of ciproflaxacin for the 

treatment of inhalational anthrax and is now working to assess what is 

needed in the way of studies to produce sufficient data for labeling 

gentamicin to treat pneumonic plague. It is also determining what types of 

nonclinical (nonhuman) data are acceptable for product marketing 

approval if traditional clinical studies are not feasible or ethical.

At the request of the National Security Council, the center has compiled a 

list of and information on drugs that might be effective in case of a 

bioterrorist attack. The information includes manufacturers, inventories, 

lead time for producing the drugs, and bulk suppliers. Center officials 

noted that they do not regularly collect this information. It is also working 

with CDC to implement a shelf-life extension program for the maintenance 

of stockpiled supplies.

Center for Food Safety and 

Applied Nutrition

The Center for Food Safety and Applied Nutrition is responsible for 

promoting and protecting the public’s health by ensuring that the nation’s 

food supply is safe, sanitary, wholesome, and appropriately labeled. The 

center has been involved in preparing for a bioterrorist attack on the food 

supply.

Preparedness Activities The Center for Food Safety and Applied Nutrition has undertaken activities 

regarding contaminated food that are important for bioterrorism response 

readiness. For example, the agency has developed a procedures manual for 

dealing with foodborne attacks. The center works with other federal and 

state agencies to monitor the safety of the U.S. food supply. The agency has 

been involved in the development and support of two surveillance systems 

for identifying and characterizing contaminated food, FoodNet and 

PulseNet. FoodNet is a collaborative project of FDA, CDC, USDA, and nine 

state health departments. It is an effort to capture a more accurate and 

complete picture of trends in the occurrence of foodborne illness and 
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provides information about the number of persons who were diagnosed 

with specific infections that are likely to be foodborne. PulseNet is a 

collaborative project of FDA, CDC, USDA, and state health department 

food safety laboratories to facilitate subtyping bacterial foodborne 

pathogens for epidemiological purposes.

The center (along with the Office of Regulatory Affairs) is leading an effort 

to improve coordination and communication among federal, state, and 

local public health and food regulatory officials. The efforts are targeted at 

outbreaks of illness caused by foodborne pathogens and are meant to 

contribute to more effective implementation of existing food safety 

programs.

Center for Veterinary 

Medicine

The Center for Veterinary Medicine regulates the manufacture and 

distribution of food additives and drugs that will be given to animals. These 

include animals from which human foods are derived as well as food 

additives and drugs for pet (or companion) animals. Since animals raised 

for food are a potential target for a bioterrorist attack, the center has 

initiated activities to increase its preparedness.

Preparedness Activities The Center for Veterinary Medicine has established and maintains lines of 

communication with state regulatory officials and personnel in state 

veterinary diagnostic laboratories. The center co-sponsored a meeting to 

review the risks to U.S. and world food and agriculture from plant and 

animal disease and bioterrorism.

National Center for 

Toxicological Research

The National Center for Toxicological Research conducts scientific 

research that supports and anticipates FDA’s current and future regulatory 

needs. This involves fundamental and applied research on biological 

mechanisms of action underlying the toxicity of products regulated by 

FDA.

Research Activities The National Center for Toxicological Research has examined proteins in 

food to determine the existence of bacteria. It has also worked on 

approaches to identify indications of toxicity associated with biological 

agents. 

Preparedness Activities In the event of an attack, the center has the ability to respond with animal 

studies and microbiological surveillance to identify the agent. 
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Representatives from the National Center for Toxicological Research 

participate in meetings with FEMA and Arkansas public health officials to 

plan training activities for responding to bioterrorism threats.

Office of Regulatory Affairs Among its responsibilities, the Office of Regulatory Affairs responds to 

emergencies involving products regulated by FDA. If a bioterrorist event 

were to take place, the office would be involved in the investigation. 

Preparedness Activities FDA would be involved in the management of a response to any attack that 

targets a FDA-regulated product. The Office of Regulatory Affairs’ Office of 

Criminal Investigations would conduct the criminal investigation and serve 

as the liaison to the FBI and other law enforcement agencies.

The Office of Regulatory Affairs maintains a 24-hour emergency hotline, in 

part for receiving information about a bioterrorist attack. It has also 

established a notification system with the FBI for bioterrorist events.

National Institutes of 

Health

NIH conducts medical research in its own laboratories and supports the 

research of nonfederal scientists in universities, medical schools, hospitals, 

and research institutions throughout the United States and abroad. NIH is 

composed of 27 separate institutes and centers. One of these is the 

National Institute of Allergy and Infectious Diseases (NIAID), which has a 

program to support research related to organisms likely to be used as 

biological weapons. This program includes research devoted to the 

development of (1) rapid, accurate diagnostics, (2) effective therapy for 

those infected, and (3) vaccines for those at risk of exposure.

All of NIH’s research on bioterrorism has been funded out of general 

appropriations. Table 9 gives the amounts of reported funding for NIH’s 

activities on bioterrorism for fiscal year 1998 through fiscal year 2001.
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Table 9: Reported Funding for Activities on Bioterrorism at NIH (Dollars in millions)

Note: We have not audited or otherwise verified the information provided.

a

Individual entries may not sum to totals because of rounding.

Source: NIH.

Research Activities The initial focus of NIAID’s research efforts on bioterrorism was on 

smallpox and anthrax. The agency collaboratively funded (along with DOD, 

DOE, and CDC) activities on smallpox, including research to develop and 

test antiviral drugs against smallpox viruses, extend the usefulness of the 

currently available, older vaccine, and to develop a vaccine that can be 

used in all segments of the civilian population (for instance, pregnant 

women and the immune-suppressed). For anthrax, NIAID has formed the 

Working Group on Anthrax Vaccines to develop and test a new vaccine that 

could be used to replace the currently licensed vaccine.

In addition to these ongoing activities, NIAID provided support to sequence 

the genomes of all bacterial pathogens considered by CDC to have the 

potential to be used as bioterrorism agents. The results of such research, 

along with other information, are expected to facilitate pursuit of a variety 

of critical goals, including the development of rapid diagnostic methods, 

antimicrobial therapies, and new vaccines for the most likely bioterrorist 

agents.

NIAID also conducts and sponsors research in the areas of diagnostics, 

therapeutics, and vaccines, as well as basic research on the origination and 

development of diseases from biological agents. In diagnostics research, 

the development of detection systems for smallpox antigens has been 

emphasized. Therapeutics research has covered a number of areas 

including the development of a replacement therapy for treating the serious 

complications that would result from immunizing the civilian population 

Program/initiative

Fiscal year

1998

Fiscal year

1999

Fiscal year

2000

Fiscal year

2001 (estimate)

Research activities

Diagnostics $0.3 $1.3 $0.9 $1.1

Vaccines $3.0 $6.6 $6.8 $7.0

Antibiotics/antivirals $0.4 $3.3 $5.6 $6.1

Basic research (genomics and pathogenesis) $13.2 $21.4 $29.7 $35.4

Totala $17.0 $32.6 $43.0 $49.7
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Department of Health and Human Services

Page 62 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

against smallpox. NIAID continues to work on vaccines for smallpox and 

anthrax to prevent illness resulting from a terrorist attack. The agency has 

collaborated with the U.S. Army Medical Research Institute of Infectious 

Diseases on the development of a new anthrax vaccine to protect the 

American public. NIAID is also conducting basic research in a number of 

areas, including the genetic basis for the virulence of potential bioterrorist 

agents.

Office of Emergency 

Preparedness

OEP coordinates the medical and public health response to emergencies, 

including all kinds of terrorist attacks and natural disasters. OEP has taken 

an “all-hazards” approach to emergency preparedness and response 

because it is involved in the health response to many different types of 

situations, including bioterrorism. See table 10 for OEP’s reported funding 

for activities on terrorism.

Table 10: Reported Funding for Activities on Terrorism at OEP (Dollars in millions)

Program/initiative

Fiscal year

1998

Fiscal year

1999

Fiscal year

2000

Fiscal year

2001

Research activities

Infrastructure—research and 

development

$0.1 $0.1 0 0

Smallpox study $0.1 0 0 0

Special activities 0 0 0 $4.6

Preparedness activities

 Combating terrorism $0.3 $19.0 $20.0 $27.2

National Medical Response Teams 0 $1.5 $1.5 $1.5

U.S. Public Health Service Noble Training Center 0 $3.0 $1.0 $2.9

VA WMD training 0 0 0 $0.8

Pharmaceutical Cache 0 0 $1.0 $1.2

Metropolitan Medical Response

System

0 $14.5 $16.5 $17.4

Special events 0 0 0 $2.0

Surveillance and laboratory support $0.3a 000

Special activities 0 0 0 $1.4
Appendix VIII

Department of Health and Human Services

Page 63 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

Note: We have not audited or otherwise verified the information provided.

a

This money was transferred to CDC, FDA, and HHS’ Agency for Toxic Substances and Disease 

Registry. This funding stopped once these agencies began receiving bioterrorism funding.

b

Individual entries may not sum to totals because of rounding.

Source: OEP.

Research Activities OEP has participated in research and evaluation activities. It has worked 

with the Institute of Medicine to develop an assessment methodology and 

performance measures for the Metropolitan Medical Response System. 

OEP also oversees $4.6 million in fiscal year 2001 for research special 

activities, which are earmarks in the budget for specific universities, 

hospitals, or response systems to conduct studies (see table 10).

Preparedness Activities HHS coordinates many of its medical response activities with other 

agencies through the National Disaster Medical System. OEP leads this 

system, a partnership among HHS, DOD, VA, FEMA, state and local 

governments, and the private sector, which is intended to ensure that 

resources are available to provide medical services following a disaster 

that overwhelms the local health care resources. The overall purpose of the 

system is to establish a single, integrated national medical response 

capability to (1) assist state and local authorities in dealing with the 

medical and health effects of major peacetime disasters and (2) provide 

support to the military and VA medical systems in caring for casualties 

evacuated to the United States from overseas armed conflicts. About 2,000 

civilian hospitals have pledged resources that could be marshaled in any 

domestic emergency under the system.

In addition to providing additional capacity in the event of an emergency, 

the National Disaster Medical System also has response teams that can 

Infrastructure $9.7 $12.6 $15.3 $18.9

Office/regions $5.0 $7.5 $8.8 $12.3

Planning and evaluation $1.2 $1.0 $1.0 $1.0

Training and exercises 0 $0.8 $2.5 $2.5

Disaster Medical Assistance Team development $2.5 $2.5 $2.5 $2.6

Communications $1.0 $0.8 $0.5 $0.5

Totalb $10.2 $31.7 $35.3 $50.7

(Continued From Previous Page)

Program/initiative

Fiscal year

1998

Fiscal year

1999

Fiscal year

2000

Fiscal year

2001
Appendix VIII

Department of Health and Human Services

Page 64 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

provide support at the site of a disaster. Disaster Medical Assistance Teams 

can deploy to disaster sites with sufficient supplies and equipment to 

sustain themselves for 72 hours while providing medical care at a fixed or 

temporary site.5

 In mass casualty events, the teams would perform triage, 

provide medical care, and prepare patients for evacuation. In other types of 

situations, the teams may also provide primary health care and/or serve to 

augment overloaded local health care staffs. 

There are also specialized Disaster Medical Assistance Teams. Some of the 

specialized teams deal with specific medical conditions, such as burns or 

mental health. Disaster Mortuary Operational Response Teams provide 

mortuary services and victim identification. There are four National 

Medical Response Teams located around the country that are specially 

equipped and trained to provide medical care for victims of WMDs. Three 

of these are deployable anywhere in the country, and all four teams have a 

stockpile of pharmaceuticals and medical supplies to treat up to 5,000 

people. However, these stockpiles are primarily for treating victims of a 

chemical weapon.

OEP received $2 million in fiscal year 2001 that was transferred to VA to 

provide funding for VA to manage caches of pharmaceuticals for the 

National Medical Response Teams and for training of National Disaster 

Medical System hospitals in response to WMD events. OEP also received 

approximately $2.9 million in fiscal year 2001 to provide management staff 

and operating funds for the U.S. Public Health Service Noble Training 

Center in Alabama. This center is developing curricula and providing 

training activities for physicians, nurses, and emergency medical 

technicians. This facility will primarily provide training in response to a 

chemical incident, but will also have some bioterrorism response duties.

The office received $2.6 million in fiscal year 2001 for Disaster Medical 

Assistance Team development, which funds training programs for the 

teams and other specialty teams (see table 10 for detailed budget 

information). OEP received an additional $1.5 million to expand the 

National Medical Response Teams, primarily by providing additional team 

members and purchasing equipment. Some funding from both of these 

5

Disaster Medical Assistance Teams were dispatched to the New York City and Washington, 

D.C., areas on September 11, 2001. The initial units included more than 300 medical and 

mortuary personnel.
Appendix VIII

Department of Health and Human Services

Page 65 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

sources was also used to provide management and oversight of the annual 

National Disaster Medical System conference. 

OEP was allocated received $2.5 million in fiscal year 2001 to provide 

additional training and exercise activities for Disaster Medical Assistance 

Teams and local responders to ensure that teams are operational in a field 

setting, and that the community and response teams can work together to 

achieve an integrated approach to medical care during a terrorist event. 

These funds also provide for coordinated training and exercises with other 

departments, such as DOD and DOE, during response to special events.

The office also deploys teams from the National Disaster Medical System to 

high-security events, such as visits by heads of state. In fiscal year 2001, 

OEP received $2 million to support the costs of deploying teams to a 

number of special events, including $1 million for the Olympic games and 

$1 million for other special events, such as the presidential inauguration. 

OEP’s Metropolitan Medical Response System emphasizes enhancement of 

local planning and response capability, tailored to each jurisdiction, to care 

for victims of a terrorist incident involving WMDs. The program includes a 

focus on response to bioterrorism, including disease surveillance, mass 

casualty care, and mass fatality management. OEP, under the Metropolitan 

Medical Response System, has entered into contracts with 97 local areas to 

develop and coordinate local medical response capabilities. This program 

works at the local level because of the rapid response time that would be 

required to manage the consequences of a terrorist attack. OEP received 

approximately $17 million in fiscal year 2001 to expand the program to 25 

additional communities and continue development in 25 existing areas 

begun in fiscal year 2000. In addition, 47 of the areas received additional 

funding to plan for an appropriate health system response to a bioterrorist 

attack. Planning and evaluation funds were used, in part, to provide 

oversight and technical assistance for response system activities. In fiscal 

year 2001, OEP is overseeing $1.4 million that was earmarked in the budget 

for the Charlotte, North Carolina, Metropolitan Medical Response System. 

The funds will be used to coordinate and enhance preparedness of 

community health care facilities, for provider training, and to integrate the 

public health system into a mass casualty response system.

OEP received approximately $12 million in fiscal year 2001 for general 

emergency preparedness infrastructure development and maintenance. 

This includes headquarters and regional staff salaries, rent, and other 
Appendix VIII

Department of Health and Human Services

Page 66 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

operating costs. It also received $500,000 to maintain and enhance systems 

to communicate during disasters and special events. 
Page 67 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

Appendix IX

Department of Justice ApendxiIX

DOJ has a variety of responsibilities for combating terrorism. The Office of 

Justice Programs (OJP) administers programs to provide equipment, 

training, exercises, and technical assistance to first responders, including 

some components of the Domestic Preparedness Program that were 

transferred from DOD,1

 and to provide assistance to victims of terrorism. 

Under Presidential Decision Directive 39, DOJ, acting through the FBI, is 

the overall lead federal agency for domestic terrorism incidents. The FBI is 

the lead agency for crisis management of any terrorist incident within the 

domestic United States and houses the National Domestic Preparedness 

Office, which was established to coordinate all federal efforts to assist 

state and local first responders in preparing for a terrorist incident. See 

table 11 for DOJ’s reported funding for activities on bioterrorism.

Table 11: Reported Funding for Activities on Bioterrorism at DOJ (Dollars in millions)

1

See app. VI for more information on the Domestic Preparedness Program.

Program/initiative

Fiscal year

1998

Fiscal year

1999

Fiscal year

2000

Fiscal year

2001

OJP

Research activities

Biological agent detection $0.2 $1.1 $0.2 0

Development of equipment performance standards and test protocols 

for emergency response equipment

0 0 $0.5 $4.6

Preparedness activities

Development of chemical/biological agent list $0.3 0 0 0

Exercises 0 0 $6.1a $3.2

Development of an emergency response to domestic biological 

incidents

0 0 $0.5 $1.0

Metropolitan Medical Response System outreach plan 0 0 $0.3 0

Veterinary Laboratory Network for rapid analysis of biological agents 0 0 $0.4 0

Hospital Provider Course Development And Delivery 0 0 0 $0.9

Biological Planning Guide 0 0 0 $0.2

Development of equipment guides 0 $0.3 $0.3 0
Appendix IX

Department of Justice

Page 68 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

Note: We have not audited or otherwise verified the information provided.

a

OJP could not report how much of $6.1 million for exercises was only for activities on bioterrorism.

Source: DOJ.

Office of Justice 

Programs

OJP sponsors research on emergency response equipment, provides grants 

and technical assistance, and can provide assistance to victims of 

terrorism. 

Research Activities The National Institute of Justice within OJP conducts research activities on 

terrorism. Among its programs, the institute conducts operational testing 

and assessment of new technologies and supports efforts to develop lower 

cost, more effective emergency response equipment. It is also working with 

the Office of State and Local Domestic Preparedness Support, the FBI, and 

the Technical Support Working Group on a study to determine the chemical 

and biological agents that terrorists are most likely to use.

Preparedness Activities The Anti-Terrorism and Effective Death Penalty Act of 1996 (P.L. 104-132, 

sec. 822) authorized OJP and FEMA to fund and develop a terrorism 

emergency response training program for fire, emergency medical service, 

and public safety personnel. The 1998 Commerce, Justice, and State 

Appropriations Act (P.L. 105-119) provided funding used to create an 

equipment acquisition grant program as well as two training centers for 

emergency responders. The grant and training programs target the nation’s 

120 largest metropolitan jurisdictions. The Office for State and Local 

Domestic Preparedness Support administers the Domestic Preparedness 

Program and the grant and training programs. This office assists state and 

local jurisdictions in enhancing their domestic preparedness capabilities by 

providing assistance to jurisdictions to acquire equipment, technical 

assistance, exercises, and training. For example, this office has developed 

an on-line data collection tool to assist states in conducting their threat,

FBI

Research activities

Detecting and characterizing biological agents 0 0 0 $1.1

Total $0.5 $1.4 $8.3 $11.0

(Continued From Previous Page)

Program/initiative

Fiscal year

1998

Fiscal year

1999

Fiscal year

2000

Fiscal year

2001
Appendix IX

Department of Justice

Page 69 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

risk, and needs assessments2 and to develop their WMD preparedness 

strategy, which is designed to be used by the states to target grant funds in 

order to improve preparedness. 

OJP reported $5.3 million in fiscal year 2001 as being related to the public 

health and medical consequences of a bioterrorist attack against the 

civilian population, as shown in table 11. However, the funding in table 11 

represents only part of DOJ’s more general-purpose spending on activities 

on terrorism, which could also benefit preparedness for a bioterrorism 

event. DOJ reported $3.2 million was used to facilitate biological tabletop 

exercises in 52 cities in fiscal year 2001. These 1-day exercises involve 

public health, fire, law enforcement, and emergency management agencies. 

Participants work through a simulation of a bioterrorism incident, starting 

with the incubation period (the time between initial exposure to a 

biological agent and the first onset of symptoms), followed by the 

recognition and initial response, and finally the challenges of integrating 

federal assets in the response and recovery efforts. Medical surveillance, 

epidemiology, quarantine, patient tracking, remediation, and mass fatality 

management are addressed.

OJP also reported funding of $1.0 million in fiscal year 2001 to develop and 

deliver a course on planning a response to a bioterrorist attack (see table 

11). The office reported about $0.3 million to develop a plan to enhance 

awareness of the Metropolitan Medical Response System and 

approximately $0.4 million to establish a Veterinary Laboratory Network 

for the rapid analysis of biological and infectious disease agents in fiscal 

year 2000.3

OJP may also provide assistance to victims of terrorism under the Victims 

of Crime Act of 1984 (P.L. 98-473, ch. 14, as amended). These funds could be 

used, for example, to provide mental health treatment to victims of 

terrorism.

2

During the threat and risk assessment process, states identify the threat and risk posed to a 

community by the terrorist use of a WMD device and integrate vulnerability, threat, and 

public health performance information to yield a risk profile. The needs assessment outlines 

a state’s needs for training, equipment, and other resources.

3

See app. VII for more information on the Metropolitan Medical Response System.
Appendix IX

Department of Justice

Page 70 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

Federal Bureau of 

Investigation

The FBI conducts some bioterrorism-related research, is the lead agency 

for crisis management, and houses the National Domestic Preparedness 

Office. 

Research Activities The Hazardous Materials Response Unit conducts research on detecting 

and characterizing biological materials for law enforcement reasons, such 

as associating some person, group, or geographical region with the 

biological material. This research could also have benefits in identifying 

biological agents for public health and medical systems. In fiscal year 2001, 

the Hazardous Materials Response Unit awarded $500,000 for research 

activities related to detection and characterization of biological materials 

($250,000 each to the Massachusetts Institute of Technology and the U.S. 

Soldier Biological and Chemical Command). It has an additional $585,000 

in awards pending. This amount includes $150,000 for CDC’s Laboratory 

Response Network for bioterrorism.4

 The FBI participated in the creation 

of protocols used by the Laboratory Response Network to ensure 

uniformity in testing and the establishment of the proper chain of custody 

for biological, evidentiary samples.

Preparedness Activities In the FBI’s role as lead agency for crisis management, it conducts 

interagency threat assessments of WMDs (a process established to 

determine the credibility of WMD threats), and provides a situational 

assessment during a WMD incident. The FBI has designated a WMD 

coordinator in each of its 56 field offices. If necessary, the FBI coordinates 

deployment of the Domestic Emergency Support Team in response to an 

emergency under the U.S. Government Interagency Domestic Terrorism 

Concept of Operations Plan (CONPLAN).

The FBI also houses the National Domestic Preparedness Office, which 

was established to coordinate all federal efforts to assist state and local 

emergency responders with planning, training, equipment, medical and 

health, and exercise needs necessary to respond to a WMD incident. The 

office serves as a single point of contact and clearinghouse for WMDrelated information for state and local responders, including fire, 

hazardous materials, law enforcement, public health, and medical 

4

See app. VII for more information on the Laboratory Response Network.
Appendix IX

Department of Justice

Page 71 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

personnel. It also provides emergency responders with access to subject 

matter experts and links to federal resources. 

The FBI and CDC are engaged in a series of four regional meetings to 

identify the core capacities required to prepare for and respond to an act of 

bioterrorism. These sessions will assist in prioritizing the capabilities of the 

public health community and identify how law enforcement can promote 

and benefit from these programs. The FBI and CDC are also developing 

guidelines that will assist CDC in disseminating information to the public 

health departments through the communications system, Epi-X. Epi-X is a 

secure, moderated, Web-based communications network for public health 

officials that is intended to simplify and expedite the exchange of routine 

and emergency public health information between CDC and state health 

departments. Following the guidelines should allow the public health 

community to obtain necessary information without releasing case specific 

or law enforcement sensitive information not relevant to the health related 

concerns.
Page 72 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

Appendix X

Department of Transportation ApendxiX

DOT is responsible for reducing vulnerabilities to terrorism affecting the 

security of all airports in the United States, all aircraft and passengers, and 

all maritime shipping under the U.S. flag or registration, or operating within 

the territory of the United States. DOT also coordinates security measures 

for rail, highway, mass transit, and pipeline facilities. Through the National 

Response Center, which is staffed by the Coast Guard and located in the 

Coast Guard’s Headquarters Command Center, DOT also serves as the sole 

national point of contact for reporting all biological, oil, chemical, 

radiological, and disease-causing discharges into the environment 

anywhere in the United States and its territories. DOT received $800,000 in 

fiscal year 1999 and $800,000 in fiscal year 2000 for preparedness activities 

on bioterrorism from DOD. 

Research Activities DOT is conducting research on the ability of metropolitan areas to respond 

to attacks on local transit systems. Most of the WMD research at DOT is 

focused on chemical, not biological, agents.

Preparedness 

Activities

The National Response Center serves as the first-alert center for all 

releases of biological agents, maintains incident databases, and provides 

private and secure conferencing for the law enforcement, emergency 

response, and public health sectors on an incident-specific basis. It is also 

the communications and operations center for the National Response 

Team. Both the National Response Center and the National Response Team 

are components of the National Response System. The system is the 

government’s mechanism for emergency response to discharges of oil and 

the release of chemicals into the navigable waters or environment of the 

United States and its territories. It provides a framework for coordination 

among federal, state, and local responders and responsible parties. The 

National Response Team provides a national planning, policy, and 

coordinating body to provide guidance before and assistance during an 

incident. Its membership consists of 16 federal agencies1

 with expertise in 

various aspects of emergency response to pollution incidents. The National 

Response Center participates in terrorism exercises as requested by other 

1

The 16 federal agencies are the Departments of Agriculture, Commerce, Defense, Energy, 

Health and Human Services, the Interior, Justice, Labor, State, Transportation, and the 

Treasury; the Environmental Protection Agency; the Federal Emergency Management 

Agency; the General Services Administration; the Nuclear Regulatory Commission, and the 

U.S. Coast Guard.
Appendix X

Department of Transportation

Page 73 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

agencies. Some emergency response and management training courses at 

DOT have a bioterrorism component, but there are no training courses 

dedicated to bioterrorism.
Page 74 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

Appendix XI

Department of the Treasury ApendxiXI

Within the Department of the Treasury, the U.S. Secret Service receives 

funding for activities on bioterrorism.

U.S. Secret Service The U.S. Secret Service is responsible for the protection of the President, 

the Vice President, and their families; heads of state and other designated 

individuals; the investigation of threats against these protectees; and 

protection of the White House, the Vice President’s Residence, foreign 

missions, and other buildings within Washington, D.C. The U.S. Secret 

Service is also responsible for design, planning, and implementation of 

security at designated National Security Special Events.

Research Activities The U.S. Secret Service reported funding of $450,000 for fiscal year 2001 to 

support the development of a biological agent detector. It reported funding 

of an additional $60,000 for laboratory identification of biological and 

chemical agents.

Preparedness Activities The Hazardous Agent Mitigation and Medical Emergency Response teams, 

which are part of the Secret Service’s Chemical, Biological, Radiological, 

and Nuclear Countermeasures program, travel with the presidential 

motorcade and respond to chemical and biological events. The Secret 

Service has a role to protect the civilian population in special events such 

as the Olympic games. 
Page 75 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

Appendix XII

Department of Veterans Affairs ApendxiXI

VA manages one of the nation’s largest health care systems and is the 

nation’s largest drug purchaser. The department purchases 

pharmaceuticals and medical supplies for the National Pharmaceutical 

Stockpile Program and the National Medical Response Team stockpiles and 

it participates in other bioterrorism preparedness activities. 

Preparedness 

Activities

VA purchases pharmaceuticals and medical supplies for federal stockpiles 

because of its purchasing power and ability to negotiate large discounts 

from manufacturers that sell pharmaceuticals, equipment, and supplies to 

the VA hospital system.1

 VA is under contract with CDC to purchase drugs 

for the National Pharmaceutical Stockpile Program and manages a 

spectrum of contracts for the storage, rotation, security, and transportation 

of the stockpile. The CDC contracts included an estimated $14 million for 

fiscal year 2000 and another $60 million for fiscal year 2001. 

VA also works with OEP by agreement to purchase, store, and maintain 

drugs for the four National Medical Response Teams, and to train the 

National Disaster Medical System civilian hospital staff. VA received $0.9 

million in fiscal year 2000 and $1.2 million in fiscal year 2001 from OEP for 

the purchase, storage, and maintenance of drugs. Also in fiscal year 2001, 

VA received $0.8 million from OEP to begin developing training for staff in 

the National Disaster Medical System hospitals. 

In addition, VA hospitals throughout the United States participate in local 

community emergency planning. VA personnel have been deployed to 

many presidentially declared emergencies (for example, the Oklahoma City 

bombing). 

1

See app. VIII for more information on the stockpiles.
Page 76 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

Appendix XIII

Environmental Protection Agency ApendxXiI

EPA has responsibilities to prepare for and respond to emergencies 

involving oil, hazardous substances, pollutants, or contaminants (which 

include chemical, biological, and radiological materials) that also could be 

components of a WMD attack. If necessary, EPA can assist the FBI in 

determining what sort of hazardous substance may be, or has been, 

released in a terrorist incident. Following an incident, EPA can help with 

environmental monitoring, sampling, decontamination efforts, and longterm site cleanup activities. In addition, Presidential Decision Directive 63 

gives EPA responsibility for the protection of the U.S. water supply from 

terrorist attack, including the protection of water supplies from biological 

contamination. 

EPA’s participation in a potential bioterrorist event would vary on a caseby-case basis. EPA might advise the national, state, or local government on 

what the agent might be and could have a role in the potential cleanup and 

decontamination if asked to assist by other agencies. For example, this 

might include testing the water system for contaminants, including 

biological agents, if an outbreak of a disease occurred. EPA works with 

CDC on a case-by-case basis to tailor its response to address the specific 

agent. 

EPA received little funding specifically for activities on bioterrorism during 

fiscal year 1998 through fiscal year 2001 (see table 12).

Table 12: Reported Funding for Activities on Bioterrorism at EPA (Dollars in millions)

Note: We have not audited or otherwise verified the information provided.

Source: EPA.

Research Activities EPA reported funding of $500,000 in fiscal year 2001 to sponsor research to 

investigate methods to detect and identify biological agents in water. 

Program/initiative

Fiscal year

1998

Fiscal year

1999

Fiscal year

2000

Fiscal year

2001

Research activities

Detection of biological agents 0 0 0 $0.5

Preparedness activities

Vulnerability assessments $0.01 0 $0.1 $2.0

Total $0.01 0 $0.1 $2.5
Appendix XIII

Environmental Protection Agency

Page 77 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

Preparedness 

Activities

EPA is training its staff to respond to a WMD incident. EPA has 

approximately 220 On-Scene Coordinators across the country, who are the 

on-location staff responsible for coordinating EPA’s response to a 

hazardous material spill or release into the environment. The coordinators 

are responsible for bringing in the necessary resources, including EPA 

contractors, or tasking other agencies for support. The coordinators and 

EPA contractors are receiving training on WMD agents, especially 

biological agents, in order to get more specific, in-depth knowledge to 

enhance their overall ability to handle a bioterrorist incident. EPA is 

coordinating with CDC to add a bioterrorism module to EPA’s training on 

terrorism. EPA is considering additional training for its coordinators to 

provide them with the in-depth knowledge they need to lead an appropriate 

response. However, because situations with biological agents are unique, it 

is hard to make generalizations about how to respond. For example, 

weather conditions can alter the need to decontaminate a site because 

temperature, among other factors, can render biological agents harmless. 

EPA has also been working with DOE and the American Water Works 

Association—Research Foundation to develop a vulnerability assessment 

methodology for the water supply sector. In fiscal year 1998, EPA received 

$10,000 to partially fund the development of the National Infrastructure 

Assurance Plan—Water Supply (see table 12). EPA received $66,000 in 

fiscal year 2000 to fund the development of the vulnerability assessment 

methodology and to co-sponsor a workshop on water infrastructure 

protection with DOE. EPA reported funding of $2.0 million to continue the 

development of this methodology and related water issues in fiscal year 

2001. 
Page 78 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

Appendix XIV

Federal Emergency Management Agency ApendxXiIV

FEMA is the lead federal agency for consequence management 

preparedness and response to terrorist incidents involving WMDs, and it is 

helping to build a bioterrorist response system that is part of a broader 

terrorist response system. FEMA reported funding for activities on 

terrorism of $25.1 million for fiscal year 2000 and $30.3 million for fiscal 

year 2001 (see table 13). 

Table 13: Reported Funding for Activities on Terrorism at FEMA (Dollars in millions)

Note: We have not audited or otherwise verified the information provided.

a

FEMA did not supply us with funding amounts for fiscal year 1998. 

Source: FEMA.

Preparedness 

Activities

At the federal level, FEMA is involved with preparedness activities in 

coordination with other departments and agencies, using the structures of 

the Federal Response Plan. At the state and local levels, preparedness 

activities include the provision of grants to the states and the delivery of 

first-responder and emergency management training programs to support 

their terrorism-related planning, training, exercise, equipment, and 

assessment requirements.

Planning FEMA works with other departments and agencies to support consequence 

management planning at the national and regional levels. FEMA 

coordinates the federal response planning through the Emergency Support 

Functions Leaders Group, which is the principal body that addresses 

Federal Response Plan planning and implementation at the working level, 

and the Catastrophic Disaster Response Group, which provides guidance 

and policy direction on response coordination and operational issues. Also, 

FEMA plans and participates in activities to address consequence 

Program/initiative

Fiscal year

1998

Fiscal year

1999

Fiscal year

2000

Fiscal year

2001

Preparedness activities

Response and recovery a $2.0 $2.0 $6.3

Preparedness, training, and exercises a $0.5 $1.8 $2.3

Fire prevention and training a $4.0 $4.9 $5.1

Emergency management planning grants a $8.3 $16.4 $16.6

Total $14.8 $25.1 $30.3
Appendix XIV

Federal Emergency Management Agency

Page 79 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

management for special events such as the Olympic games. FEMA has been 

actively engaged in the development and review of major organizational 

and operational support documents, such as the CONPLAN (see app. III for 

details regarding the CONPLAN). FEMA and DOJ’s OJP are working to 

incorporate a bioterrorist response element into their terrorist response 

system.

At the state and local levels, FEMA provides assistance to support 

terrorism-related emergency response planning. FEMA gives Emergency 

Management Planning grants to support the development of terrorismspecific annexes to existing state and local emergency operations plans. 

The grant money can be used for activities such as planning, training, and 

conducting exercises. FEMA negotiates a work plan for funding with each 

state, and states have been given wide latitude in targeting this assistance. 

FEMA can also provide supplemental funds to state and local mental health 

agencies to provide crisis counseling to eligible survivors of presidentially 

declared major disasters. 

FEMA also updates and maintains the Rapid Response Information System, 

which is authorized under the National Defense Authorization Act of Fiscal 

Year 1997 (P.L. 104-201, sec. 1417). This information system contains 

databases of characteristics and safety precautions for nuclear, biological, 

and chemical agents and materials and can be used as a resource guide for 

response to such an incident.

Training FEMA has developed and delivered terrorism-related courses for state and 

local emergency management personnel and first responders. It has 

provided grant assistance to the states to support this training. Training is 

provided through the Emergency Management Institute and the National 

Fire Academy. The Institute also conducts a Senior Officials Course for 

local government officials as part of the Domestic Preparedness Program.1

Exercises FEMA participates in federal interagency terrorism response exercises 

sponsored by the FBI, DOD, and others. FEMA also provides funding to 

states to support terrorism response exercises. FEMA participates in 

1

See app. VI for more information on the Domestic Preparedness Program.
Appendix XIV

Federal Emergency Management Agency

Page 80 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

special events such as the Olympic games, where it has the opportunity to 

detect and correct weaknesses in its system. 

Equipment FEMA, in conjunction with DOD and DOJ, assisted in the development and 

is currently helping to refine the Standardized Equipment List to support 

acquisition of equipment for fire, police, and emergency medical 

responders. This equipment will conform to appropriate and applicable 

laws, regulations, and to-be-developed national standards including those 

issued by the National Institute of Justice, the National Institute for 

Occupational Safety and Health, and the National Fire Protection 

Association.

Assessment FEMA and the National Emergency Management Association have created 

a partnership to develop an emergency management readiness and 

capability assessment system for state and local emergency managers. This 

self-assessment is intended to help governments determine strengths and 

weaknesses of their emergency management program. The baseline report 

was released on March 2, 1998. In summary, it found that although states 

have the basic capabilities in place to effectively respond to disasters that 

normally confront them, there are areas that require attention and 

improvement, such as planning and equipment for response to a terrorist 

incident.
Page 81 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

Appendix XV

Comments From the Department of 

Commerce ApendxXiV
Appendix XV

Comments From the Department of 

Commerce

Page 82 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities
Page 83 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

Appendix XVI

Comments From the Department of Defense ApendxXiVI
Page 84 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

Appendix XVII

Comments From the Department of Health 

and Human Services ApendxiXVI
Appendix XVII

Comments From the Department of Health 

and Human Services

Page 85 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities
Appendix XVII

Comments From the Department of Health 

and Human Services

Page 86 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities
Page 87 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

Appendix XVIII

Comments From the Department of Justice ApendxiXVI
Page 88 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

Appendix XIX

GAO Contacts and Staff Acknowledgments ApendxiXIX

GAO Contacts Janet Heinrich, (202) 512-7118

Marcia Crosse, (202) 512-3407

Acknowledgments In addition to those named above, Barbara Chapman, Robert Copeland, 

Greg Ferrante, LaKesha Jimmerson, Deborah Miller, and Roseanne Price 

made key contributions to this report.
Page 89 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

Related GAO Products

Combating Terrorism: Selected Challenges and Related 

Recommendations (GAO-01-822, Sept. 20, 2001).

Combating Terrorism: Comments on H.R. 525 to Create a President’s 

Council on Domestic Terrorism Preparedness (GAO-01-555T, May 9, 

2001).

Combating Terrorism: Accountability Over Medical Supplies Needs 

Further Improvement (GAO-01-666T, May 1, 2001).

Combating Terrorism: Observations on Options to Improve the Federal 

Response (GAO-01-660T, Apr. 24, 2001).

Combating Terrorism: Accountability Over Medical Supplies Needs 

Further Improvement (GAO-01-463, Mar. 30, 2001).

Combating Terrorism: Comments on Counterterrorism Leadership and 

National Strategy (GAO-01-556T, Mar. 27, 2001).

Combating Terrorism: FEMA Continues to Make Progress in 

Coordinating Preparedness and Response (GAO-01-15, Mar. 20, 2001).

Combating Terrorism: Federal Response Teams Provide Varied 

Capabilities; Opportunities Remain to Improve Coordination (GAO-01-

14, Nov. 30, 2000).

West Nile Virus Outbreak: Lessons for Public Health Preparedness

(GAO/HEHS-00-180, Sept. 11, 2000).

Combating Terrorism: Linking Threats to Strategies and Resources

(GAO/T-NSIAD-00-218, July 26, 2000).

Chemical and Biological Defense: Observations on Nonmedical Chemical 

and Biological R&D Programs (GAO/T-NSIAD-00-130, Mar. 22, 2000).

Combating Terrorism: Need to Eliminate Duplicate Federal Weapons of 

Mass Destruction Training (GAO/NSIAD-00-64, Mar. 21, 2000).

Combating Terrorism: Chemical and Biological Medical Supplies are 

Poorly Managed (GAO/T-HEHS/AIMD-00-59, Mar. 8, 2000).
Related GAO Products

Page 90 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

Combating Terrorism: Chemical and Biological Medical Supplies Are 

Poorly Managed (GAO/HEHS/AIMD-00-36, Oct. 29, 1999).

Food Safety: Agencies Should Further Test Plans for Responding to 

Deliberate Contamination (GAO/RCED-00-3, Oct. 27, 1999).

(290018) Letr
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Page 3 GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

Contents

Table 1: Total Reported Funding for Research on Bioterrorism and 

Terrorism by Federal Departments and Agencies, Fiscal 

Year 2000 and Fiscal Year 2001 (Dollars in millions) 8

Table 2: Total Reported Funding for Preparedness Activities on 

Bioterrorism and Terrorism by Federal Departments and 

Agencies, Fiscal Year 2000 and Fiscal Year 2001 (Dollars in 

millions) 10

Table 3: Selected Federal Activities Providing Assistance to State 

and Local Governments for Emergency Planning Relevant 

to a Bioterrorist Attack 17

Table 4: Reported Funding for Activities on Bioterrorism at USDA 

(Dollars in millions) 35

Table 5: Reported Funding for Activities on Domestic Terrorism at 

DOD (Dollars in millions) 40

Table 6: Reported Funding for Activities on Terrorism at DOE 

(Dollars in millions) 46

Table 7: Reported Funding for Activities on Bioterrorism at CDC 

(Dollars in millions) 50

Table 8: Reported Funding for Activities on Bioterrorism at FDA 

(Dollars in millions) 55

Table 9: Reported Funding for Activities on Bioterrorism at NIH 

(Dollars in millions) 61

Table 10: Reported Funding for Activities on Terrorism at OEP 

(Dollars in millions) 62

Table 11: Reported Funding for Activities on Bioterrorism at DOJ 

(Dollars in millions) 67

Table 12: Reported Funding for Activities on Bioterrorism at EPA 

(Dollars in millions) 76

Table 13: Reported Funding for Activities on Terrorism at FEMA 

(Dollars in millions) 78
Page i GAO-01-915 Bioterrorism: Federal Research and Preparedness Activities

Contents