Intended for healthcare professionals


Funding the public health response to terrorism

BMJ 2005; 331 doi: (Published 08 September 2005) Cite this as: BMJ 2005;331:526
  1. Erica Frank, professor (
  1. Department of Family and Preventive Medicine, Emory University School of Medicine, Atlanta, GA 30303-3219, USA

    Has cut funds for common chronic diseases—and for disaster relief in New Orleans

    On 11 September 2001, 3400 people died because of four horrific, intentional plane crashes. These individuals' only unifying characteristic was that they were in the wrong place in America at the wrong time. Their deaths, and those of Londoners killed on 7 July 2005, highlighted our vulnerability to terrorism and launched an avalanche of repercussions.

    As a response to these deaths, several subsequent deaths from anthrax, and other current and potential terrorist threats, the US government redefined and redirected its role in funding for public health. Governments must protect their citizens, and anticipating these possible future threats is appropriate and could prove essential to Americans' health. However, there is also an immediate and real threat that because of the US government's policy, enormous numbers of Americans will die unnecessarily. This threat is the redirection of funds away from basic, currently necessary public health services towards preventing potential bioterrorism in future.

    To estimate how many Americans died on 11 September 2001 from the major sources of mortality that many public health services aim to prevent and treat, I used national estimates of mortality attributable to various risk factors (over 3100 a day; see table 1 on and mortality data for specific diseases (over 5200 a …

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