WASHINGTON – Senate Homeland Security and Governmental Affairs Committee Chairman Joe Lieberman, ID-Conn., Ranking Member Susan Collins, R-Me., and Senator Hillary Clinton, D-NY, are asking the Government Accountability Office to determine how a man believed to be infected with extensively drug-resistant tuberculosis (XDR-TB) was able to slip past government officials and reenter the United States even when health officials knew of his medical condition.
The request came in a letter sent July 24, 2007, to GAO Comptroller General David Walker, asking the agency to review and assess the coordination and response of the federal government to a May incident in which Andrew Speaker, infected with a rare and difficult to treat form of TB, was permitted to enter the United States from Canada.
The senators said the incident “exposed a disturbing picture of the federal government’s ability to respond to a known public health incident and protect our homeland security.”
“Mr. Speaker’s ability to cross our borders raises questions not only about events that transpired at that inland port but in the federal government’s overall approach to safeguarding our nation from public health threats before they reach our borders.
“We should never again have a situation where delays and failures in communication between the federal government, other domestic public heath officials, and relevant commercial entities lead to needless exposure and risk. We need to assure the American people that our government can respond in a coordinated manner to these types of public health incidents. This incident should serve as a wake-up call that we need to establish and exercise effective plans to deal with the travel of known public health threats.”
The senators called on GAO to review and describe the sequence of events surrounding the incident and establish a timeline, assess what systems and processes were in place to respond to the health threat, and determine the extent to which federal agencies and other key organizations shared important information and followed established protocols.
The full text of the letter is below:
July 24, 2007
The Honorable David Walker, Comptroller General
U.S. Government Accountability Office
441 G Street, NW
Washington, DC 20548
Dear Mr. Walker,
The recent case involving Andrew Speaker’s putative extensively drug-resistant tuberculosis (XDR-TB) has exposed a disturbing picture of the federal government’s ability to respond to a known public health incident and protect our homeland security. Thankfully it appears unlikely that this incident has resulted in the infection of more individuals with TB, but we must determine exactly what went wrong and do all that we can to ensure this does not happen again. The miscommunication, insufficient coordination and the ultimate response on the part of the agencies involved are troubling.
We, like many others, are concerned by the public health threat posed by both XDR-TB and multidrug-resistant tuberculosis (MDR-TB), and we believe the events of the past few weeks highlight the lack of preparedness on the part of our government in responding to a public health incident. Although both XDR-TB and MDR-TB make up less than 2% of the over 13,000 cases of tuberculosis reported in the United States on an annual basis, they present a grave public health threat. In addition to the individual threat that is posed by drug-resistant TB, this incident goes to the heart of our nation’s response to serious public health threats.
Mr. Speaker’s ability to cross our borders raises questions not only about events that transpired at that inland port but in the federal government’s overall approach to safeguarding our nation from public health threats before they reach our borders.
We should never again have a situation where delays and failures in communication between the federal government, other domestic public health officials and relevant commercial entities lead to needless exposure and risk. We need to assure the American people that our government can respond in a coordinated manner to these types of public health incidents. This incident should serve as a wake-up call that we need to establish and exercise effective plans to deal with the travel of known public health threats.
To help us better understand this incident, we would like GAO to (1) review and describe the sequence of events, establishing a thorough chronological account of the significant events and communications that occurred, and (2) assess the sequence to answer the following questions:
To what extent did responsible federal agencies and other key organizations–including CDC, DHS, DOT, and relevant state and local health departments, international health organizations, foreign governments, and airlines–have plans, protocols, agreements, and processes in place to provide for effective coordination and information sharing and for prompt notification and response to the incident?
To what extent were these followed?
What information systems, databases, and networks were used in responding to this incident? To what extent did they provide needed information in a timely manner?
What lessons learned did the incident reveal about the systems, processes, and protocols used to respond and how are agencies integrating these lessons learned to prevent future such incidents? What quarantine protocols or procedures are applicable to similar incidents? How are agencies safeguarding civil liberties when implementing changes?
As you proceed with this study, we ask that GAO apprise us of any external impairment that could potentially delay its completion in a timely manner. If you have any questions regarding this request, please contact us or our staff.
Sincerely,
Joseph I. Lieberman Susan M. Collins
United States Senator United States Senator
Hillary Rodham Clinton
United States Senator
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