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The success or failure of any government in the final analysis must be measured by the well-being of its citizens. Nothing can be more important to a state than its public health; the state's paramount concern should be the health of its people.
Franklin Delano Roosevelt
(quoted in Gostin, 2000)
An effective public health system that can assure the nation's health requires the collaborative efforts of a complex network of people and organizations in the public and private sectors, as well as an alignment of policy and practice of governmental public health agencies at the national, state, and local levels. In the United States, governments at all levels (federal, state, and local) have a specific responsibility to strive to create the conditions in which people can be as healthy as possible. For governments to play their role within the public health system, policy makers must provide the political and financial support needed for strong and effective governmental public health agencies.
Weaknesses in the nation's governmental public health infrastructure were clearly demonstrated in the fall of 2001, when the once-hypothetical threat of bioterrorism became all too real with the discovery that many people had been exposed to anthrax from letters sent through the mail. Communication among federal, state, and local health officials and with political leaders, public safety personnel, and the public was often cumbersome, uncoordinated, incomplete, and sometimes inaccurate. Laboratories were overwhelmed with testing of samples, both real and false. Many of these systemic weaknesses were well known to public health professionals, but resources to address them had been insufficient. A strong and effective governmental public health infrastructure is essential not only to respond to crises such as these but also to address ongoing challenges such as preventing or managing chronic illnesses, controlling infectious diseases, and monitoring the safety of food and water.
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