National Bio-surveillance = Miserable Failure
Last week, the DHS’ Office of the Inspector General (OIG) released a report (pdf) on the federal effort to coordinate and consolidate the various means of detecting a biological event, be it naturally occurring or man-made. The gist of the report? Given the money spent, we’re worse off than we were the first time President Bush made this a priority.
According to the report, since 2001, an estimated $32 BILLION has been spent on federal bio-surveillance and bio-defense IT programs (e.g. CDC’s BioSense, DHS’ BioWatch, FDA’s CARVER+Shock, amongst others). To date, there is no coordinated effort to coalesce the data gathered into anything resembling intelligence – never mind injecting actual intelligence reports into the soup that is bio-surveillance. In April, 2004, HSPD-10 (Biodefense for the 21st Century) directed DHS to coordinate all of the disparate bio-surveillance programs that popped up since 9/11 with the goal of:
…creat[ing] a national bio-awareness system that will detect a biological attack at the earliest possible moment and permit initiation of a robust response to prevent unnecessary loss of life, economic impact, and social disruption.
In response to that directive, DHS’s Science and Technology Directorate (S&T) began the National Bio-Surveillance Integration System (NBIS) in 2004. This group was to coordinate with and between each of the agencies that was collecting biological surveillance data and in order to spot trends in adverse health trends and facilitate the development of an IT solution that would pool this information into a comprehensive and cogent format that would allow Health and Homeland Security planners to see what was normal, and thus identify those patterns that were unusual and possibly dangerous. The OIG stated that during this time under S&T, the program moved along very well. While money was not yet appropriated, S&T spent $1.6M on engaging stakeholders and an initial architecture design.
In January 2005, the NBIS was transferred to the Information Analysis and Infrastructure Protection Directorate (IAIP). The program was given a new program manager and very limited space. When the manager attempted to hire DHS officers and contractors, there was nowhere to house them, so they simply never staffed up. Under IAIP, counter to the manager’s recommendation, the program was set up for competitive bid. Developing the bid obviously set the program back by several months. By that time, however, IAIP was reorganized and NBIS was put under the Preparedness Directorate (PD), where it was perceived to be even less of a priority.
In his November 2005 speech to the National Institutes of Health, the President reiterated the need to get NBIS off the ground, and it became a priority again. NBIS was given ample secure office space, and the ability to hired the necessary contract personnel. While in PD, NBIS established a 24/7 watch and began developing and distributing daily and weekly status reports to a newly identified audience. The program seemed to finally be hitting its stride when it was decided that NBIS should use a new, untested contract vehicle which required a rewrite of bid. In September 2006, $14.3M was awarded – more than a year after the program was supposed to have begun.
The NBIS program was then – again – moved within DHS. Now housed in the Office of the Chief Medical Officer (CMO), the program took on a new focus. Instead of focusing on situation reports, the CMO decided that the program required trained medical personnel to review the incoming information and stopped issuing the daily and weekly reports. With the new support, however, the CMO was able to continue further staffing the program.
In March 2007, the Office of Health Affairs (OHA), was created in DHS to house all medical and health programs within the Department. The CMO leads the OHA, so the NBIS has yet another new home. This move, which comes nearly three years after President Bush’s call to consolidate our nation’s bio-surveillance efforts, has finally pulled BioShield, BioWatch and NBIS under one command, reporting directly to the DHS Secretary and Deputy Secretary. The Office has also seen the President request an increase in funding from $5M to $118M in FY2008.
Despite repeated calls to make this program a priority from the President himself, DHS has repeated under-funded, under-prioritized and under-staffed NBIS. After being housed in five locations in DHS, being overseen by four program managers in three years, there’s this:
Notice all the “Vacant” positions? Looking for a job? And of course, none of this even touches on the fact that:
…NBIS does not have an up-to-date plan at the tactical, more detailed level for managing day-to-day program activites…
…as of March 2007, the NBIS program plan was still in draft.
Without a tactical plan to guide program directions and decisions, NBIS program managers have been managing in an ad hoc manner. For example, without clear program milestones, NBIS managers have been unable to track accomplishments of program activities or monitor progress toward meeting long-term goals.
If you have the stomach, I implore you to download the report and see the scathing one page Executive Summary. After two calls directly from the President to make this happen, the fact that such a document needed to be written is a slap in the face of those of us who toil everyday in disease surveillance. We work our asses off with antiquated tools and DHS can’t find the time, space, manpower or desire to give us a hand at the federal level? This, ladies and gentlemen, is the essence of my problem with homeland security. The fact that it’s mostly just face time. Talk real big about these grandiose plans, sink a ton of money into it, and then – nothing. Quick, look busy, the American public is looking!
Image and bandwidth stolen from the feds.