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Communication Failures Allowed TB Patients to Cross Borders Undetected

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Location: Washington, DC

COMMUNICATION FAILURES ALLOWED TB PATIENTS TO CROSS BORDERS UNDETECTED

The Departments of Homeland Security (DHS) and Health and Human Services (HHS) failed to communicate about the movement across U.S. borders of two travelers with drug resistant tuberculosis and DHS' process for inspecting people at the border was deficient, according to a report out Wednesday requested by Homeland Security and Governmental Affairs Committee Chairman Joe Lieberman, ID-Conn., Ranking Member Susan Collins, R-Me., Senator Hillary Rodham Clinton, D-N.Y., and Senator Chuck Grassley, R-Iowa.

The Government Accountability Office report entitled "Public Health and Border Security," focused on the cases of Andrew Speaker, an American citizen who crossed the Canadian border undetected in May 2007, even when health officials knew of his medical condition, and Amado Isidro Armendariz Amaya, a Mexican national who flew across the border and back undetected 21 times in April and May of 2007 despite warnings from the Centers for Disease Control and Prevention (CDC) to U.S. Customs and Border Protection (CBP) officials. The GAO report said that procedures for information sharing and coordination between DHS and HHS were not fully developed, hindering the effort to locate the two men. HHS also lacked procedures to coordinate with state and local health officials, GAO said, to determine whether federal intervention was warranted.

"GAO tells us what we have long suspected and urgently have sought to improve and that is basic communications among federal government agencies is essential to protect Americans from potential terrorists, natural disasters, and outbreaks of disease," Lieberman said. "Our border security and aviation controls must be stronger if we are to prevent repeats of these types of breaches. Both DHS and HHS have since taken steps to improve their ability to identify and intercept TB patients who are determined to pose a public health risk, but I urge them to accept and adopt all of GAO's recommendations."

Collins said: "To prevent individuals who pose public health threats from entering the country, the Department of Homeland Security and Department of Health and Human Services must increase their cooperation and coordination, whether the threats stem from naturally occurring outbreaks or terrorist plots. Information sharing is essential to stop health threats before they cross our borders, and I am pleased the Departments have made considerable improvements since our Committee first identified significant lapses in this area. I remain, however, concerned with the slow rate of progress on some critical information technology programs at DHS that could eliminate many problems identified by GAO, including upgrades that would help our Customs and Border Protection officers more quickly and effectively identify known threats."

Clinton said: "The TB incidents documented in this report expose glaring vulnerabilities in our border security and ability to protect the public's health. This report confirms what we have long suspected: there is a dangerous lack of communication and coordination between federal agencies and with state and local governments. I commend DHS and HHS for taking steps to address these vulnerabilities, but I would urge them to expedite efforts to ensure that state and local health departments have the tools and resources necessary to deal with future incidents."

Grassley said: "The United States can't afford for the health of its nation to be compromised because of bad interagency communication - especially when the threat involves a communicable disease, like tuberculosis. What's worse is that HHS and DHS had agreements in place to coordinate on public health emergencies but when tested, it appears that they failed. We just can't play Keystone cops in situations when innocent lives are at stake."

On July 24, 2007, the Senators asked GAO to investigate the circumstances of Mr. Speaker's case. Following media reports of Mr Amaya's travels, they asked GAO to add his case to their investigation.


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