What is particularly disturbing to public health professionals and others is that Simonson is in charge of insuring that the country has adequate vaccines and antivirals to combat an avian flu outbreak. "Mr. Simonson is a lawyer, not a medical expert," declared Representative Henry Waxman, who highlighted Simonson in a list of five "inexperienced individuals with political connections." The California Democrat warned that the appointment of people like Simonson has "led to legitimate public concern that those in government, particularly those who are relied upon to keep us safe from harm, are not competent or independent in their judgments." As evidence of this, Waxman cited Simonson's July appearance before the House Government Reform Committee, where Simonson "claimed he had sufficient funds to purchase influenza vaccine and antiviral medication for the nation. The next day his office submitted a funding request to Congress seeking an additional $150 million for flu vaccine and antiviral medication."

But it is Simonson's acquiescence in the Bush Administration's reordering of priorities in the name of the "war on terror" that has most distinguished him throughout his career at HHS. Shortly after 9/11 Thompson and Simonson began plans to create an office within HHS dedicated to combating terrorism, which became OPHEP. "When Stewart came into this, he was deputy counsel to the secretary and a very close friend of the secretary's," says Donald "DA" Henderson, named by Thompson as the founding director of OPHEP, who was given the Presidential Medal of Freedom by Bush. "Within a short period of time, this became all [Simonson] was doing--without a title."

In mid-2002, as the White House aggressively sought to convince the world that Iraq possessed weapons of mass destruction, it was engaged on another front of the propaganda war at home: convincing Americans that Saddam was poised to deploy biological weapons in an attack on American soil. It was a battle that would pit Vice President Cheney and his now-indicted chief of staff Lewis "Scooter" Libby against a team of public health experts at HHS, led by then-OPHEP chief Jerry Hauer. Inside HHS it was Simonson who emerged as the White House's key strategic ally.

From his days as Defense Secretary during the Gulf War, Cheney was intensely interested in biological warfare. Libby, who worked for Cheney as an under secretary from 1990 to '92, shares his boss's obsession with biowar. Known in the Administration as "germ boy," Libby was obsessed with pre-emptively vaccinating the entire population against smallpox. (The fixation even extended to Libby's 1996 novel, The Apprentice, about a smallpox epidemic.) Shortly after 9/11 Cheney and Libby were briefed on a war game called Dark Winter, which simulated a smallpox attack on the United States. Interestingly, New York Times reporter Judith Miller, who penned a book called Germs, had taken part in the exercise, playing a reporter covering the attack. "It's a dramatic briefing," Libby told the Washington Post, "but we were well on this road already." Libby said that Cheney advocated "a forward-leaning position on protecting Americans from this threat."

Many in the public health community regarded Cheney and Libby's calls for mass smallpox vaccinations as fearmongering. Hauer, who also took part in Dark Winter, was among those asking uncomfortably probing questions. Hauer butted heads directly with Libby and his deputy on homeland security, Carole Kuntz. Another veteran of the first Bush Administration, Kuntz was Libby's special assistant at the Pentagon when Cheney was Defense Secretary. "The risks of vaccinating the whole country were greater than what we saw as the threat," says Hauer. "You're so focused on smallpox you lose perspective on all the other planning you're trying to do and nobody could make a good medical or public health case." Hauer, who ultimately would have been in charge of implementing Libby's program, says he had no choice but to oppose the plan. "There were times I felt you had to not be a yes man. You do an enormous disservice when you do that." Hauer says that when he raised objections to mass smallpox vaccinations, Kuntz became "downright offensive." Hauer adds, "It was very clear that I was not giving her the answers she wanted or telling her what she wanted to hear."

Like so many other instances when expert knowledge was discarded in the run-up to war, the bioterror obsession could well have long-term consequences. "It has been four years of throwing money at a perceived threat with very little to show for it," says Columbia's Dr. Redlener. Many public health experts say that the billions spent preparing for these imagined threats have left the country dangerously unprepared for actual ones, including the very real possibility of an avian flu outbreak, which is only now being addressed.

Cheney's office was eventually forced to back off its call for universal vaccinations, but the Administration persisted in hyping the threat of a bioterror attack. In early 2003 Bush announced a major biodefense initiative during his now infamous State of the Union address, laced with references to Iraq's alleged WMDs, including the fraudulent evidence about Iraq attempting to import uranium from Niger. Bush spoke of the prospect of terror attacks with anthrax, botulinum toxin, Ebola and plague. "We must assume that our enemies would use these diseases as weapons," he told the nation. The $6 billion plan was called Project Bioshield. Bush named Cheney as his point man on the project; at HHS it was Stewart Simonson.

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