One year later, physicians remember -- and prepare

AMA Leader Commentary. By Yank D. Coble Jr., MD. Sept. 16, 2002.

AMA LEADER COMMENTARY

A few words about current events in medical practice

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A message to all physicians from AMA President Yank D. Coble Jr., MD.

By the time many of you read this column, our nation will have marked the one-year anniversary of the tragic events of Sept. 11. We will have paused and reflected, and especially remembered those who perished -- the airline passengers, firefighters, police officers and office workers, the husbands and wives, the daughters and sons.

Many of us will also remember those who died in the anthrax attacks of October 2001, the victims who opened our nation's eyes to the frightening potential of bioterrorism.

Topic: Terrorism in America

This October, these victims will be in the thoughts of the physicians who are attending the 2002 General Assembly of the World Medical Assn. in Washington, D.C. These physician leaders, who represent 80 national medical associations, will listen as experts discuss the threat of weaponized anthrax and smallpox -- and how the physician community can prepare.

They also will vote to approve a draft declaration, titled "Responding to the Growing Threat of Biological Weapons." For all those who attend, especially AMA leaders, it will be a fitting way to remember those who lost their lives last year.

The WMA meeting is not a response to the events of one year ago, however. In 1999, AMA leaders and senior staffers recognized the need for a world focus on the threat of bioterrorism and proposed that the WMA address this topic at its 2002 meeting. Our reasoning? Smallpox can cross national borders. Anthrax can travel for miles. Evil people have access to these and other dangerous biological agents; what's more, they have the will to use them. Global threats demand a coordinated global response, and the WMA is the appropriate organization to take the lead on behalf of the international community of physicians.

The proposed WMA declaration represents an important step forward. First and foremost, it calls for the creation of an international consortium of medical and public health leaders, including representatives from the World Health Organization and the United Nations. The leaders of the consortium would be charged with monitoring the threat of biological weapons and identifying strategies for limiting their proliferation.

These leaders also would develop a coordinated plan for tracking the emergence of infectious disease worldwide. This daunting but imperative task would involve creating international reporting systems, enhancing physician education throughout the globe, and expanding laboratory capacity, among other objectives. The good news is, if these leaders can develop and implement such a plan, every nation will reap the benefits. With improved monitoring in place, countries will be able to recognize and respond to acts of bioterrorism more effectively. They also will be better prepared to respond to naturally occurring outbreaks of disease -- and to reduce the global disease burden.

Preparation also depends on the ongoing efforts of individual physicians and professional associations. The WMA's proposed declaration calls on physicians to remain alert to unusual deaths or illnesses and to continue their work with public health authorities at the local, national or even international levels.

In our own country, the tragic events of last year have reinvigorated the alliance between medicine and public health. State and county associations offer us inspiring examples of coordination and cooperation between physicians and public health officials. At the AMA, the tragedies of last year have lent a sense of urgency to our work with the American Public Health Assn., especially the Medicine and Public Health Initiative, a joint AMA-APHA project.

The AMA is also part of a coalition known as The Partnership for Community Safety: Strengthening America's Readiness, made up of organizations that represent physicians, hospitals, firefighters, nurses and public health officials, among others. Part of its mission is to urge federal policy-makers to support comprehensive readiness efforts. But it also promotes collaboration among its members, working to strengthen existing disaster plans while reducing unnecessary duplication of effort.

Information, of course, remains the cornerstone of physician preparedness -- internationally and locally. At the WMA's upcoming scientific session on bioterrorism, which the AMA helped develop, attendees will learn about topics such as "The Promise and Peril of the Biotechnology Revolution" and "Communicating Bioterrorism Threats to the Public." The physician leaders who attend these sessions will bring what they learn back home to colleagues, health groups, governments and the public.

In the United States, the state, county and specialty societies, along with the AMA, also continue to provide information about bioterrorism to physicians, especially over the Internet. The AMA Web site offers up-to-the-minute scientific information on disaster response and biological weapons, as well as Web-based education programs. Our site also links to other groups -- from medical specialty societies to the National Institutes of Health. The AMA has a special disaster preparedness Web site, with related links (http://www.ama-assn.org/go/disasterpreparedness).

These are just some of the ways all of us in organized medicine are remembering the lives that were lost in the dark autumn of 2001. Though none of us can bring back those who died on Sept. 11 or those who succumbed to anthrax, we must continue to do all that we can to prevent such loss of life in the future.

Much of the rest of the world is depending on us to play a part in responding to this latest threat to human health, much as we have responded to other threats in the past -- through science, leadership and partnership. It is imperative that we participate in national and international readiness efforts -- as organizations and as individual physicians. Nothing less than the health of the world depends on our efforts.

So stay informed -- and stay involved. Keep checking for new research and clinical information on the AMA Web site or the sites of your state, county or specialty society. Get involved in your hospital's disaster preparedness efforts or those of your local medical association. One year later, these are still the most powerful ways that we, as physicians, can honor those who lost their lives to acts of terrorism.

Dr. Coble, an endocrinologist in private practice in Jacksonville, Fla., was president of the AMA during 2002-03.