According to a newly released report the U.S. remains unprepared to deal with disasters such as biological attacks and flu pandemics.
The report by the Trust for America's Health says many states still lack a stockpile of drugs, masks, gloves and other equipment needed to battle with a pandemic despite five years of constant and detailed warning.
The report says until all states measure up, the United States is not safe and also says overall federal funding for state and local preparedness has declined.
Trust for America's Health is a nonprofit organisation which has been issuing reports every year for five years.
According to the report seven states performed adequately in each of the 10 categories that were measured, which earned them a score of 10; top scores went to Illinois, Kentucky, Nebraska, New Jersey, Pennsylvania, Tennessee and Virginia, while bottom were Arkansas, Iowa, Mississippi, Nevada, Wisconsin and Wyoming.
The Trust says the 2001 anthrax attacks, in which five people died, and the disasters caused by hurricanes Katrina and Rita in 2005, should have been a wake-up call and galvanized more action.
The report says though those disasters highlighted a range of problems with U.S. preparedness, preparedness remains 'spotty' and 13 states are without adequate plans to distribute emergency vaccines, antidotes, and medical supplies from the Strategic National Stockpile.
Another 21 states do not have statutes that allow for adequate liability protection for healthcare volunteers during emergencies and 12 states do not have a disease surveillance system compatible with the Centers for Disease Control and Prevention's National Electronic Disease Surveillance System.
Seven states have not purchased any portion of their federally subsidized or unsubsidized antivirals to use during a pandemic flu and seven states and along with Washington D.C. lack sufficient capabilities to test for biological threats.
The Department of Health and Human Services say states have until June 2008 to get their orders in.
This is despite health experts worldwide predicting the threat of a pandemic of some sort, with the H5N1 avian influenza currently doing the rounds as the most likely candidate.
Experts have expressed concern that federal funding levels for hospital preparedness, now at about $400 million annually, are inadequate and health officials say money for emergency preparedness needs to be distributed through the states.
World Health Organization experts are currently investigating a cluster of human H5N1 cases in Pakistan where some form of human to human transmission of the virus appears possible.
The virus which is a disease passed between birds usually involves close contact with infected fowl to affect humans.