If someone tried to kill Americans with Bacillus anthracis spores today, the nation would have a better medical tool chest for treating the sick and those potentially exposed than it had 10 years ago, when the anthrax letter attacks killed five people, but anthrax defenses are still a work in progress.
In the event of an anthrax attack, federal response plans call for treating those at risk with a 60-day regimen of antibiotics, and also for offering three doses of anthrax vaccine for longer-term protection against the risk of late-germinating B anthracis spores.
The government has enough doses of antibiotics in its civilian stockpile to treat 60 million people for the recommended 60 days... US Department of Health and Human Services (HHS) officials won't disclose the amounts of materials in the Strategic National Stockpile (SNS), citing national security concerns.
The SNS also contains enough doses of anthrax vaccine—the same one that was in use in 2001—to protect a few million people... Meanwhile, several companies are working on second-generation vaccines with the aim of providing protection with fewer doses at less cost, but their availability is still several years away.
The government also has something it didn't have 10 years ago: a supply of antitoxins—anthrax immune globulin (Cangene's AIG, serum extracted from vaccinated servicmembers, at $14,000/dose) and other antibody products (Human Genome Science's monoclonal antibody, at $8,000/dose)—that could be used to treat people with anthrax infections potentially too far advanced for successful antibiotic therapy. None of these have yet been approved by the Food and Drug Administration (FDA), but they can be used under emergency authorizations if needed, federal officials say. One of them was used in a man who was treated in Minnesota for inhalational anthrax in August....Great. So we are "ready" for anthrax. Except, if we are well prepared for anthrax, any serious enemy would pick some other microorganism. Smallpox, anyone? Plague? Tularemia? Ebola? How about a newly synthesized bug?
If the US government really wanted to protect us, instead of wasting our childrens' tax dollars on pet pork, it would not have walked out of negotiations to strengthen the Biological Weapons Convention. It would have cooperated with nearly the entire world to enact provisions in this treaty for verification of compliance, including inspections and sanctions. But this logical and relatively cheap approach to reducing the threat from state actors has been unpopular in US government circles.
OTOH, can we afford to keep spending $60 billion every few years for a piecemeal, very limited response to the BW threat? Our current approach offers no meaningful protection against an apparition that, given the technology, can take millions of forms.