We use this work every day in North Carolina. All of these investments are not one-time. They require a sustained commitment.

We are far better prepared to deal effectively with a public-health threat than we were in 2001, a time when America's public-health infrastructure was crumbling due to decades of neglect.

No single state, and no community within any state, has reached a full level of preparedness. The act has made a tremendous difference, but the safety of the American public requires us to do more.

It's about early detection and rapid response. The threats are not going away.

Now is not the time to be backing up.