On the local, state, and national level, the United States still lacks the capability to respond to natural pandemics and biological terrorism in a comprehensive way, according to David Heyman, director and senior fellow of the homeland security program at the Center for American Progress, a Washington think tanks headed by former President Bill Clinton's chief of staff John Podesta.

"We are in big trouble here," said Heyman. "We really do need a public health infrastructure in the United States."

According to Laura Segal, director of public affairs at the Trust for America's health, all the states were graded on a level from one to 10 on their preparedness for reacting to a biological disaster.

"Over half of the states scored under 5," said Segal. "A lot of states have a hope and pray attitude which is disconcerting."

Solving this problem must be done in a comprehensive manner, said Heyman. He named 4 D's including: dissuasion, denial, detection, and defense, which need to be considered to do so.

"How do you detect something malicious?" Heyman asked. "And how do you defend against it?"

In order to prepare for a disaster such as a pandemic flu in such a way, the effort must start on a local level, according to the panelists. The responsibility of being prepared for a major biological incident starts at the local level, said Segal.

"Fundamentally, disease needs to be fought on a local level," said Heyman.

Heyman addressed certain issues that exist at the local level in regard to defense against biological threats. The system locally is fragmented and we don't have the capability to coordinate it, he said.

The Bush administration has allowed the U.S. federal government to cotninue to play only a weak role in combating biological incidents, experts said.

Individual U.S. states are on their own, therefore they need to develop a strategy on their own without federal assistance, said Segal.

Heyman said the federal government had to at least impose national standards or guidelines. "The actual guidelines need to be national," he said.

The U.S. government needed to develop a strong and effective national and global health infrastructure according to Jonathan Tucker, senior fellow at the Center for Nonproliferation Studies.

Heyman said cooperation had to be international to be effective. Bugs will cross all boundaries, he said.

"We're all in this together, we have to take care of this together," said Heyman. "We need to bring communities, states, the nation, and the world together to fight this."

Greatly increased international cooperation was also essential to combat international health threats such as malaria and diarrhea, Heyman said. The U.S. government needed to bring different countries together to create different threat protection, he said.

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