GAO assesses avian and pandemic flu planning

Jun 27, 2007 (CIDRAP News) – The Government Accountability Office (GAO) issued two reports that address avian and pandemic influenza planning last week, one examining how well the US Department of Agriculture (USDA) is prepared to respond to avian flu outbreaks and the other assessing efforts by US and international agencies to help vulnerable countries.

USDA makes progress, but some problems cited
Though the USDA has taken several steps to prepare for an H5N1 avian flu outbreak, the GAO pointed out problems that could slow the agency's response, such as poorly understood leadership roles and undefined capabilities for carrying out crucial tasks.

The GAO—Congress's investigative agency—based its conclusions on a review of federal response plans and regulations, visits to poultry operations, interviews with federal, state, and industry officials in five states that have experienced other types of avian flu outbreaks, and a review of 19 state plans.

The 60-page report, sent to congressional committees on Jun 11, emphasizes the importance of USDA's avian flu plans. "A well-planned, coordinated emergency response is essential when dealing with highly pathogenic AI [avian influenza] in order to mitigate financial losses to the $28 billion US poultry industry," the report says. "The US is the world's largest producer and the second largest exporter of poultry meat."

The GAO says the USDA has made several important strides toward helping the nation prepare for H5N1 outbreaks. For example, the agency has:

  • Established mechanisms to prevent the importation of H5N1-contaminated poultry and poultry products
  • Launched several avian flu surveillance programs
  • Developed response plans for H5N1 outbreaks and begun testing the plans in conjunction with other federal agencies, states, and industry
  • Begun creating a National Veterinary Stockpile containing, for example, equipment for responding to animal diseases
  • Expanded its indemnification regulations
  • Developed strategies to inform the public about avian flu
  • Started critical avian flu research projects

However, the GAO cites several shortcomings that it says could slow response to an H5N1 outbreak and delay recovery. One problem is that the USDA has factored in the Department of Homeland Security (DHS) as the lead agency if widespread poultry outbreaks warrant the declaration of a national emergency or disaster.

During the GAO's investigation, the USDA said DHS involvement wouldn't be needed unless there were multiple outbreaks, a potential agroterrorism event, or a human pandemic. USDA officials also said it's not clear if presidential emergency declarations would apply to a highly pathogenic avian flu outbreak.

"However, the decision to involve DHI is not USDA's to make," the GAO report states, adding that the president's role is to declare a national emergency if the outbreak warrants federal assistance.

Because the USDA's avian flu plans lack details about coordination with DHS, the federal response may be slowed if the agencies need to clarify their roles at the time of an outbreak, the GAO says.

The GAO also concluded that the USDA's planning lacks:

  • Information about capabilities, such as which entities carry out tasks and what resources are needed
  • Criteria for states to use in formulating their response plans; 14 of 19 state plans lacked important components for rapidly containing outbreaks, such as time frames for specific response activities
  • Information on the numbers and locations of backyard birds

The report says the USDA agreed with all of its recommendations, except for a suggestion that the agency develop a memorandum of understanding with DHS about how the agencies will work together in the event of a national disaster. However, the USDA agreed with the need to clarify the two agencies' roles and to test the coordination in formal exercises.

Gauging US and international aid for pandemic preparation
Based on requests from two Senate committee chairmen—Edward Kennedy, D-Mass., and Daniel Akaka, D-Hawaii—the GAO detailed progress the United States and the international community have made toward identifying countries' pandemic risk and providing the most vulnerable countries with resources for pandemic prevention efforts.

The 78-page report, sent to the senators on Jun 20, was based on interviews with government officials and analysis of data from US agencies, international organizations, and nongovernmental experts.

Though the US and international organizations have identified widespread pandemic influenza risks, information gaps have made it difficult for officials to compare risk levels by country. For example, for some countries, a limited understanding of the role of poultry trade or wild birds impaired the reliability of the groups' conclusions.

"Despite these limitations, the US Homeland Security Council has used available information to designate about 20 countries for US assistance," the GAO report says. The highest-risk countries include Indonesia, Egypt, Nigeria, and a few Southeast Asian countries, the report states.

The United States has taken a lead role in improving global avian and pandemic flu preparedness, committing the largest share of funds through 2006: about $377 million, which is 27% of the $1.4 billion pledged by all donors.

The report says the US Agency for International Development (USAID) and the Department of Health and Human Services have provided most of the funds for a range of measures, including personal protective equipment stockpiles and training of foreign health professionals on outbreak response.

In the months ahead, USAID will focus its efforts on developing more effective approaches for controlling the spread of H5N1 in small backyard farms, where high-risk agricultural practices are common, the report says.

See also:

GAO report on USDA's avian influenza plans

GAO report on global influenza planning

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