EDITORIAL
Here's opportunity to elevate public health

Congress is poised to pump big bucks into America's campaign against bioterrorism. The House has passed a $3 billion bill toward the effort, and the Senate is considering legislation that would provide $3.2 billion to stockpile medicines and provide grants to states to improve their defenses.

And there's good reason to remain on the defensive when it comes to bioterrorism. Though "Operation Enduring Freedom" is winding down in Afghanistan, the war against terrorism is far from over. The latest hotspot receiving focused American attention is Southeast Asia, where U.S. troops are supporting their allies in the Philippines in their attempt to root out Muslim extremist groups linked to al-Qaida and Osama bin Laden.

But what does all this mean to Hawai'i? For starters, as the war on terrorism shifts to Asia, it means more involvement by troops stationed here. And it puts this global battle more directly in Hawai'i's "backyard."

It also elevates our awareness and concern over bioterrorism. The increase in federal support for bioterrorism preparedness will mean more money not just for this narrow concern but for public health in general.

The question is, how do we spend it? State Health Director Bruce Anderson says Hawai'i must start by setting its own public health priorities, and that's a debate we encourage.

Do we invest everything in facilities and plans against the possibility that Hawai'i might one day be hit by a major anthrax or smallpox attack? And if we do that, what happens to other pressing health matters such as AIDS, hepatitis, diabetes and heart disease?

Despite the doomsday scenarios that have sprouted from the 9-11 terrorist attacks, we recommend a balanced approach to public health, with a keener focus on disaster preparedness and the public health issues that are already taking lives today.

While Hawai'i responded relatively promptly to last year's dengue fever outbreak and anthrax false alarms, the state's public health system has yet to be tested by a major bioterrorism attack. The last thing we need in the face of disaster is a fragmented response system.

We need a coordinated effort from a host of federal and state agencies, including the military and the University of Hawai'i's rebuilt School of Public Health.

Let's take advantage of the federal focus on bioterrorism to improve the state's overall public health and emergency response infrastructure. That means everything from upgrading the quality and abilities of our laboratories to improving the communication and response system that links hospitals, clinics, public health agencies and individual doctors.

And along the way, let's not neglect the pressing everyday health issues such as smoking, drinking and diet that right now afflict tens of thousands of Hawai'i residents.