The former Secretary of the Department of Health and Human Services, Donna Shalala, indicated in an address in 1999 that complacency needs to be replaced with a sense of urgency in order for us to deal successfully with the threats of bioterrorism. The attack on September 11, 2001 and the anthrax threats have made our vulnerability clear. We are now living in a new and frightening world. Our complacency is gone. The victims and the survivors shall remain forever in our minds. Dr. Jeffery Koplan, Director, Centers for Disease Control and Prevention in his broadcast, Building Infrastruture to Protect the Public Health said we must look at preparedness in a new way. We need to: build a solid public health infrastructure with grant monies; rapidly address the problem of inadequately trained staff; and address the capacity of a laboratory to produce timely and accurate results for the diagnosis of agents in the investigation of outbreaks. We must take action to prepare the healthcare system to rapidly meet any challenge, overt or covert, that may emerge.