GAO: Nonfederal Capabilities Should Be Considered in Creating a National Biosurveillance Strategy

We were reminded by one of our readers of the Oct 31, 2011 GAO report titled Nonfederal Capabilities Should Be Considered in Creating a National Biosurveillance Strategy, which is a somewhat misleading title.  One might think they finally "got it", but then fell short:

 In order to help build and maintain a national biosurveillance capability in a manner that accounts for the particular challenges and opportunities of reliance on state and local partnerships, the Homeland Security Council should direct the National Security Staff to ensure that the national biosurveillance strategy

(1) incorporates a means to leverage existing efforts that support nonfederal biosurveillance capabilities,

(2) considers challenges that nonfederal jurisdictions face in building and maintaining biosurveillance capabilities, and

(3) includes a framework to develop a baseline and gap assessment of nonfederal jurisdictions' biosurveillance capabilities as part of its implementation of our previous recommendation for a national biosurveillance strategy.

The GAO staff state the obvious: that local capacity, coupled to state capacity, is the base of the pyramid of support for a national capacity for integrated biosurveillance within the official hierarchical chain of bureaucracies.  However the insular Beltway bias continues to be directed along the axes of official bureaucracies, ignoring the reality of integrated operational biosurveillance: that a significant proportion of capabilities and capacities resides outside the federal, state, AND local official bureaucracies.

This should have been apparent when we provided ironically prophetic Congressional testimony directed specifically at the DHS National Biosurveillance Integration Center, which was of course ignored.  Then came the 2009 H1N1 influenza pandemic, for which NBIC was essentially impotent save for after-the-fact situational awareness.  It is unfortunate we were unable to provide them with assistance when it was offered.  At this time, analytic competency resided outside of the federal, state, and local governments.

Then we had Haiti.  Needless to say, it took a 1,000-member "village" to manage detection / recognition / warning / emergency response operations in Haiti via the Haiti Epidemic Advisory System (HEAS).  This too was another example of expertise residing outside of the federal, state, and local governments.  Let it be said that the official bureaucracies performed less than optimally in Haiti.  The HEAS provided a significant role in the initial detection of cholera in Haiti, recognition of the likely source of cholera, and multiple forecasts for multiple infectious disease events that guided responders to saving entire villages with enough precision to guide helo drops. 

Time for the GAO to understand a broader reality.  More "surprises" to come in the very near future that will further emphasize this point.