Editor's Note: This is an expanded version of a story published earlier today (Nov 1, 2005).
Nov 1, 2005 (CIDRAP News) – President George W. Bush today proposed $7.1 billion in spending to prepare for an influenza pandemic, including $5 billion for vaccines and drugs, as his administration released an outline of its preparedness strategy.
"At this moment, there is no pandemic influenza in the United States or the world," Bush said in a speech in Bethesda, Md., today. "But if history is our guide, there is reason to be concerned."
He explained the threat posed by the H5N1 avian flu virus, saying it is "still primarily an animal disease" but could spread around the world if it gained the ability to pass efficiently from person to person. "Our country has been given fair warning of this danger to our homeland—and time to prepare," he said.
Bush said his strategy has three main elements: detecting outbreaks anywhere in the world; stockpiling vaccines and antiviral drugs while improving the ability to make new vaccines for a pandemic virus; and improving general readiness at the federal, state, and local levels.
The president called for the following spending measures:
- $1.2 billion to buy enough doses of the H5N1 vaccine now being tested to protect 20 million people. The government is already spending $162.5 million for this vaccine under existing contracts with Sanofi Pasteur and Chiron. Bush said the vaccine probably would not be a "perfect match" for a pandemic virus but would probably offer some protection.
- $2.8 billion to develop cell-culture technology for producing vaccines, with the aim of being able to make enough vaccine for all Americans within 6 months of the start of a pandemic.
- $1 billion for antiviral drugs, "so that we have enough on hand to help treat first responders and those on the front lines, as well as populations most at risk in the first stages of a pandemic."
- $583 million for developing "effective pandemic emergency plans," including $100 million for state plans.
- $251 million to help Asian countries control and monitor avian flu by training medical personnel, increasing surveillance and testing capabilities, and writing preparedness plans.
Bush asked Congress to enact liability protection for vaccine makers, blaming concern over litigation for the fact that only one company now makes flu vaccine in the United States.
The president also announced the launch of a new Web site, pandemicflu.gov, to help the country keep up on pandemic preparations and what individuals can do to protect themselves.
The government is also storing critical medical supplies in the Strategic National Stockpile, since a pandemic is likely to trigger shortages of hospital beds, respirators, masks, and protective equipment, the president said.
"To meet all our goals, I'm requesting $7.1 billion in emergency funding from the United States Congress," the president said.
The White House also released a 17-page version of its preparedness plan, with a promise that the full plan will be released tomorrow morning. The summary gives few specifics, but it does call for:
- Subsidizing state-based stockpiles of antiviral drugs
- Possible use of quarantines and restrictions on travel and the shipment of goods
- Possible use of the military to maintain the nation's infrastructure.
The document says the government will "prioritize" the allocation of vaccines and antiviral drugs before and during a pandemic, but it doesn't say which groups would have priority. Another section says the government aims to ensure that the country can produce enough vaccine to "vaccinate front-line personnel and at risk populations, including military personnel."
As another step to boost vaccine production capacity, the plan calls for expanding "the public health recommendations for domestic seasonal influenza vaccination."
To contain outbreaks, the document says the federal government, where appropriate, will use its authority to "limit non-essential movement of people, goods, and services into and out of areas where an outbreak occurs." It adds that Washington will provide guidance to other levels of government on the use of quarantines, restrictions on gatherings, and other containment measures.
The plan promises that the government will "determine the spectrum" of activities that the military and other arms of government could support during a pandemic. These could include activities in medicine, public health, and maintaining infrastructure.
The document also says that individuals and families will play a critical role in coping with a pandemic. People will need to be prepared to heed restrictions on public gatherings, avoid nonessential travel, and keep enough supplies at home "to support essential needs of the household for several days if necessary."
The Infectious Diseases Society of America (IDSA) praised the administration's plan while promising to scrutinize the details when they are released.
"By strengthening global surveillance activities and reinvigorating the development of vaccines and antivirals, the president's strategy will go a long way toward pandemic influenza preparedness," said IDSA President Martin J. Blaser, MD. "This preparedness will yield important health benefits, even if the next pandemic does not appear for years. IDSA specifically supports the proposed investments for new cell-based vaccine technologies and incentives to lure new manufacturers into the vaccine and antimicrobial market, such as liability protections."
Michael T. Osterholm, PhD, MPH, a leading advocate of pandemic preparedness, expressed a mixed reaction to the plan as revealed so far. "I think it's aggressive and provides a good start for addressing the vaccine and drug issues," he said. "But I'm concerned that too many people are putting all their eggs in the drug basket in determining preparedness around that issue." Osterholm is director of CIDRAP, publisher of this Web site.
He said using antiviral drugs to fight a pandemic will involve difficult logistical problems, since the drugs must be taken within the first 2 days of illness or they won't help.
Transcript of Bush speech
Nov 1 IDSA press release