United States health officials now think that the anthrax attacks that killed 5 people were likely the work of an individual, not a state-sponsored terrorist plot, but the experience of coping with these attacks has left even Secretary of Health Tommy Thompson describing the nation's public health system as "in tatters".

The relatively small bioterrorist attack exposed weaknesses in the American public health system that suggest the nation would be hard-put to recover from assault with a more dangerous organism such as smallpox or plague, or from an attack on a chemical or nuclear facility.

The public health system has suffered decades of budget cuts, privatization and forced economic competition. The anthrax cases revealed an almost complete breakdown at local and state levels in the ability to detect and respond to large-scale disease outbreaks or threats, whether launched by man or nature. Although Thompson initially defended the government's ability to...

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