The issues discussed are the nature and success of preparedness efforts of Federal, State, and local entities; the need to develop a strong partnership between the private and public sectors; and the structure and organization of the Center for Disease Control and Prevention's (CDC's) bioterrorism preparedness and response program. Among the issues discussed regarding the nature and success of preparedness efforts of Federal, State, and local entities are the top down approach of Federal planning; issues of coordination; the Office of Emergency Preparedness; the clash of cultures (differing perspectives of public safety and public health occupations); the incident command system; the integration of the public health and medical communities; and the integration of State and Federal assets. In discussing the partnership between the private and public sectors, the paper considers the following general issues: developing a public and private dialog on issues of common concern, understanding differing motivations and perspectives, cooperatively defining roles and responsibilities, and addressing burden-sharing issues. A discussion of key industry sectors in the public-private partnership focuses on hospitals and medical care providers, the print and electronic media, the pharmaceutical and medical supply industry, and information technology and telecommunication. The paper concludes with a discussion of the features of CDC's Office of Bioterrorism Preparedness and Response Program (BPRP). This includes a delineation of issues that pertain to the BPRP's and the CDC's current strategy for building bioterrorism preparedness, their internal organization and structure, and how each of these has influenced the current state of preparedness. Recommendations and possible next steps are proposed.