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A month after the Christmas Day underwear bomber suspect
revealed a gravely ineffectual air travel terrorism prevention system, a new
report was released giving the federal government an “F” for its
failure to prepare for the nation’s most urgent threat: bioterrorism.
This was a breathtaking assessment from the bipartisan Commission on the
Prevention of Weapons of Mass Destruction, Proliferation and Terrorism. Even
more alarming was that the report focused almost exclusively on our ability
to protect adults. In other words, a quarter of the population —
children — weren’t even on the commission’s radar. In fact,
federal agencies have been aware of this gaping hole in our bioterrorism
response system but have done little to change it.
Consider this: Children are at a greater risk for death from nerve agents
than are adults. These agents stay low to the ground, where young children
can be found; children inhale them faster than adults do; young
children’s skin is more permeable to them; and they sicken and kill
children faster than they kill adults. But nerve agent antidotes have been
tested only on adults, and automatic anti-toxin kits (similar to EpiPens) are
approved by the Food and Drug Administration only for adults.
That means that if a nerve agent were released somewhere in the United States,
health care workers would be able to treat adults rapidly, while children
would be vulnerable to seizure and death. The only approved medications for
children have to be manually and individually drawn up from vials, while the
health care providers are in chemical protective gear.
Pediatric medications and their delivery mechanisms tend to be more difficult
and expensive to test, develop and acquire compared with those for adults
— and there’s not as much of a place in the market for them.
The root problem is that the necessary testing is unlikely to ever occur;
there are not adequate incentives or a large enough profit margin to
encourage pharmaceutical companies to invest in the production of these kits.
In its interim report delivered to the president and Congress just four months
ago, the National Commission on Children and Disasters called for sweeping
reforms:
• Dedicate more research dollars and revamp industry incentives to
speed the development and purchase of medical countermeasures specifically
for children.
• Call on leaders of the FDA to resolve long-standing calls from the
pediatric community to approve the use of auto-injectors specifically
designed for children and approve for use in children certain additional
medical countermeasures approved for adults, which may be the very best
preventive, diagnostic or therapeutic options available.
• Create a standing advisory committee of federal and external experts
to advise Health and Human Services Secretary Kathleen Sebelius on issues
pertaining to pediatric emergency medical countermeasures.
• Include a pediatric voice throughout decision-making bodies in the
federal government.
There has never been a more important moment, in need as well as potential
for catastrophic consequences, to secure an appropriate place for
children’s issues in the national disaster preparedness agenda.
The Obama administration and Congress should act on these two separate,
though not mutually exclusive, commission reports to generate a turning point
in the way the federal government, academia and industry take responsibility
for protecting our children during catastrophic events.
Mark Shriver is
chairman of the National Commission on Children and Disasters.
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