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[Note: This material is copyright by the Press-Citizen, and is reproduced here as a matter of "fair use" for non-commercial, educational purposes only. Any other use may require the prior approval of the Iowa City Press-Citizen.]

A cause for alarm? No, the levee is not broken and the water is not flowing through.

A cause for concern? Definitely. We need to understand that the levee is vulnerable, and why.

Rapid, routine influenza testing was proposed in the lab's program Iowa Vanguard -- Protecting Your Health, yet unfunded. Absent rapid testing, the appearance of new influenza strains won't be apparent soon enough. And antiviral medications won't be reliably directed to actual cases of pandemic influenza. This may amplify the outbreak and could cause civil unrest if there is competition for limited supplies of antivirals. Thus, Vanguard needs to be funded.

The Hygienic Lab's staff members are its most important element and the reason it's a good lab in the face of the long-standing building issues. Longevity brings wisdom. Their salaries need to be competitive so they can be retained.

The building issues have, indeed, been long-standing. To insure public health preparedness, governance changes are necessary. The lab should be strongly affiliated with, but not subordinate to, the University of Iowa, as proposed below.

The problems

Recent events have been an education for all of us. We've learned since at least Sept. 11, 2001, that there are serious challenges out there waiting for us, among them bioterrorism, West Nile Virus, SARS, avian flu, our vulnerability to anthrax, and global warming which is likely to expose Iowa to subtropical and tropical diseases we used to think only other people got. In just the recent past, we've learned that we can't even depend on the spinach we buy at the supermarket or the fresh foods we eat at a restaurant.

But that isn't all. We've known for a long time that the Hygienic Lab, our first line of defense against pandemic and infectious diseases, life-threatening childhood diseases, threats to the environment and worker safety, not to mention homeland security, is overstretched, under supported and ill-housed. We've also learned that the lab's mode of governance is itself an obstacle to bringing it up to speed.

How to fix the problems

The details are complicated. But as I've learned in 11 years at the Hygienic Lab and a professional lifetime in health administration, the basic issues are bumper-sticker clear. If we want to do something about the real and present dangers to our public health, we need to do something about the governance and autonomy of the Hygienic Lab while the going is good. Though the details are again complicated, the elements of what needs doing are easily understood.

First, the Hygienic Lab needs to remain intact and at UI for all possible reasons: resources and knowledge base, the benefits and retirement system that staff depend on, the collateral educational and employment opportunities for staff spouses and families. Given the diversity of its mission, there is no single state agency that could adequately replace it.

Second, the very different responsibilities of the Hygienic Lab and UI make conflict almost inevitable. The lab's responsibility is public health. UI's responsibility is teaching and research. Where both are equally important, it is in the interest of neither to subordinate the lab to the Office of UI's Vice President for Research. Relocation of responsibility for the Hygienic Lab to University Hospitals, where it resided and worked well until 1995, is at least a short-term solution.

Third, an attractive long-term solution -- easily transferable to Iowa -- can be found as close to home as Wisconsin, where the State Laboratory of Hygiene enjoys the advantages of proximity to the University of Wisconsin-Madison, but submits its funding requests straight to the governor and legislature via a supervisory board of its own.

Fourth, the name University Hygienic Lab is an anachronism that only obscures the importance of its mission. A simple change of name to Iowa Health Laboratory would do wonders to clarify what it exists to do.
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Mary Gilchrist is the former director of the University Hygienic Laboratory, Iowa's state public health laboratory.