Senate Leaders Consider Funding Mechanism for Pandemic Flu Plan
Senate Republican leaders on Thursday said they will not go forward with a plan to add $3.95 billion for pandemic flu preparations to the pending budget reduction package, CQ HealthBeat reports (CQ HealthBeat, 11/2).
Senate Majority Leader Bill Frist (R-Tenn.) and Senate Budget Committee Chair Judd Gregg (R-N.H.) earlier this week said they would offer an amendment to the budget reconciliation bill (S 1932) that would earmark $3.95 billion to help offset the costs of the national flu preparation plan released this week.
Bush on Tuesday announced that he will ask Congress for $7.1 billion in emergency funding for a flu pandemic preparation strategy that calls for improving disease surveillance, stockpiling and boosting production of antiviral medications and vaccines, and increasing preparedness among state and local governments (California Healthline, 11/2).
Other funding for pandemic flu preparations has been attached to two fiscal year 2006 spending bills that have passed the Senate -- $8 billion in the FY 2006 spending bill (HR 3010) for HHS and the departments of Labor and Education and $3.9 billion in the FY 2006 Department of Defense appropriations bill (HR 2863). Both amendments were sponsored by Sen. Tom Harkin (D-Iowa).
According to CQ HealthBeat, Senate leaders have not yet decided which spending bill ultimately will include the funding for flu preparations. However, emergency spending for the effort "could face opposition in the House, where fiscal conservatives are demanding that offsets be found to help pay" for the $7.1 billion proposal, CQ HealthBeat reports (CQ HealthBeat , 11/3).
Meanwhile, "early discord over federal assistance with local flu planning suggests" Bush's request for $7.1 billion in preparation funds "might face a tougher battle in Congress than expected," Knight Ridder/San Jose Mercury News reports (Pugh, Knight Ridder/San Jose Mercury News, 11/3).
Public health and state and local health officials continue to express concern about the funding for state and local preparation efforts.
Georges Benjamin, executive director of the American Public Health Association, said the plan "is a great start, but we've still got work to do. The biggest issue at the end of the day is still going to be about money." He noted that "a lot" of states will not be able to fund the stockpiling of antiviral treatments called for in the plan and that many state and local health departments already are understaffed and will not be able to effectively triage pandemic flu cases, coordinate the distribution of vaccine and antiviral medications and implement effective communications strategies during a pandemic. Benjamin also said providers will need additional funding to stockpile medical equipment.
Rex Archer, president of the National Association of County and City Health Officials, said he welcomed the Bush administration's "comprehensive" plan but added that federal officials seemed to decide that they "were not going to step up to the plate" in terms of funding. Archer called for an "across-the-board" doubling of funding for CDC programs over the next three or four years to help improve response to public health threats and increase funding for state and local health departments (CQ HealthBeat , 11/3).
Leavitt responded to criticism about the plan to have states pay 75% of the cost of stockpiling 31 million courses of antiviral treatment. He noted that the federal government itself will purchase enough doses for 44 million U.S. residents and also "downplayed" the role of antiviral drugs in a pandemic, saying the national plan relies instead on the development of vaccines, according to the AP/Las Vegas Sun.
Some lawmakers also voiced concern about proposed legislation to protect vaccine manufacturers from lawsuits while providing "basically no recourse" to consumers if they are harmed by a flu vaccine, the AP/Sun reports (Freking, AP/Las Vegas Sun, 11/3).
Bush this week submitted to Congress the Pandemic Flu Countermeasure Liability Protection Act of 2005, which would "protect producers and distributors of emergency vaccines from injury suits except in cases of 'willful misconduct,'" the Los Angeles Times reports. However, the administration plan does not authorize consumers to file claims for injuries linked to pandemic flu vaccines under the National Vaccine Injury Compensation Program.
Rep. Henry Waxman (D-Calif.) said on Thursday that he is "reluctant to agree to immunization of the manufacturers at all, but if there's going to be something like that, there's got to be some sort of compensation system."
White House spokesperson Trent Duffy said the Bush administration "anticipate[s] a healthy discussion" in Congress about Bush's legislation (Levin, Los Angeles Times, 11/4).
States on Thursday also began assessing how their own pandemic flu preparation plans "mesh with what the federal government expects of them," the AP/Sun reports. According to the AP/Sun, a "review of several state plans" shows they have considered the potential death rate from the pandemic, with Texas citing the potential for up to 250,000 deaths and Georgia saying up to 6,210 people could die.
Most states also are planning for a shortage of medications and are working to determine who would receive antiviral treatments first. States including North Carolina are establishing flu surveillance regulations, while others, including Kansas, are addressing the issue of quarantines.
William Raub, who oversees health emergency preparedness at HHS, said the government will work with local and state health officials to incorporate the federal government's advice into their plans. He described states' current plans as "uneven" in some areas (Freking, AP/Las Vegas Sun, 11/4).