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A Bush administration plan to turn the nation's uniformed branch of the public health service into a ready-response force to defend against bioterrorism has provoked a backlash from officers who say the plan could set back public health.
Although few dispute that change is overdue, opponents say that routinely sending key scientists on bioterror missions could thin the ranks of experts needed to combat health threats, among them SARS, AIDS and West Nile virus.
Mandatory deployment, the plan's opponents say, also could discourage talented young scientists from joining the organization, called the U.S. Public Health Service Commissioned Corps.
One of the oldest branches of the military, the corps has evolved into the backbone of crucial health agencies, including the Centers for Disease Control and Prevention, the National Institutes of Health and the Food and Drug Administration. The corps not only promotes health programs, but it also responds to national and international emergencies with physicians, dentists, nurses and veterinarians.
Tommy Thompson, the U.S. secretary of Health and Human Services, says the corps' 6,000 members are ideal shock troops in the war on terrorism. In July, he announced that he would turn the corps into a force that could be quickly dispatched worldwide.
Officials are still haggling over the plan's details, including yardsticks for promotion. Among them: Scientists and public health experts would have to meet new fitness requirements. And no junior officer would be promoted unless he or she signs up for immediate deployment in emergencies. Many officers now volunteer.
The surgeon general -- the corps' leader since 1871 -- would be replaced as the corps' commander by a civilian deputy to the secretary of health.
''This is a complex issue, and it's evolving,'' Surgeon General Richard Carmona says. ''My opinion is that the surgeon general needs to be in control.''
Playing out mainly behind the scenes, the debate has divided the ranks -- and, to a degree, Thompson and his key lieutenants, pitting him against Carmona, Julie Gerberding of the CDC, and FDA Commissioner Mark McClellan, among others.
All have expressed concern about provisions in the secretary's plan.
McClellan advised Thompson in a letter Aug. 15 that the deployment mandate ''may well end up reducing participation and thus availability of officers.''
The proposals have prompted countless closed-door gripe sessions. ''The plan is a work in progress, and the dialog is robust,'' the CDC's Gerberding acknowledges.
Thompson aides referred questions to Carmona, who defended his boss and called the transformation necessary to meet ''the new threats before us.''
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