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xiv Preface detriment of developing sound policy in this area. The concept of coun- terproliferation was born in the mid-1990s and evolved into combating WMD during the Bush 43 administration. Almost immediately after the Iraq War, interest in advancing policy in combating WMD began to drop off, and today, it has practically vanished from Beltway discussions, with the exception of arms control talks that its advocates never considered as part of counter-WMD policy. So it alarmed me to see very senior officials in the U.S. military talk about the need to replenish chemical and biologi- cal defense skills because of perceived vulnerabilities in the U.S. public health system, rather than because of the need to address the possibility of nation-state adversaries using biological weapons. The logic was twisted. While my background is not in public health, I have seen the public health community push into discussions on addressing deliberate biologi- cal threats, more to make the case of how their programs should be better funded than to champion a better U.S. policy approach to biological threats in general. Ironically, at the same time, the Department of Defense’s tech- nical specialists in the chemical-biological defense program have made the reverse argument that they need to be engaged in programs to develop countermeasures for natural disease outbreaks because of their technical capabilities and the need to enhance public health programs. And there are, by my observation, no senior leaders in the U.S. government’s policy- making community willing or able to step up and direct these two techni- cal communities in appropriate directions. Even given the very technical nature of this policy area, there is no excuse for the national security com- munity to be uninformed or to give over its responsibilities for policy mak- ing to the technical communities. And make no mistake, we have had a lot of failures in the area of policy making with regard to biological threats. There are frameworks for evaluating failures in U.S. public policy, and certainly there are a number of academics and think tanks that evaluate U.S. defense policy. There are many other books and groups that study U.S. health policy, unsurprising in that health and medical issues are funded at about three times the U.S. defense program. But there are prac- tically no policy assessments as to the perceived overlap of the national security community and public health community in the effort to address deliberate, natural, and accidental biological threats. This is to our nation’s detriment, given the thirty years of political maneuvering and discussions in this area. We have a lot of program initiatives and no policy assess- ments to ensure that the government is appropriately funding programs that advance the nation’s preparedness for biological threats. A signifi- cant part of the problem has been how the technical agencies in the public health and national security communities lead the policy discussions. This book is an attempt to redirect those interested parties toward constructive solutions.