U.S. Begins International Conference on Flu Pandemic Preparedness
The federal government on Thursday launched a major organizing effort to address a possible outbreak of avian flu as the Bush administration, the State Department and members of Congress crafted strategies for accelerating vaccine development and ensuring international cooperation, Reuters/Houston Chronicle reports (Reuters/Houston Chronicle, 10/6). Meetings are being held this week as part of an international avian flu initiative announced by President Bush at the U.N. summit in September. The conference is being hosted by the State Department and involves eight international organizations, HHS, USDA and the U.S. Agency for International Development (Wall Street Journal, 10/7).
Bush on Thursday met with leading U.S. health and security advisers to discuss ways to handle a possible pandemic. Earlier this week, the Bush administration said it is considering a number of plans for handling an outbreak, including increasing vaccine stockpiles, imposing quarantines and using the military to enforce compliance (Curl, Washington Times, 10/7).
Michael Osterholm, director of the University of Minnesota's Center for Infectious Disease Research and Policy, said "basic planning of how to get our communities through 12 to 18 months of a pandemic" is needed. He added, "Ninety-five out of 100 will live. But with the nation in crisis, will we have food and water? Are we going to have police and security? Will people come to work at all?" Federal health officials said they are "very close to releasing a final draft of a national pandemic preparedness plan," the Washington Post reports (Weiss, Washington Post, 10/7).
As part of the conference, Bush has scheduled a meeting on Friday at the White House with U.S. and foreign vaccine manufacturers to discuss production acceleration (Washington Times, 10/7). The meeting will include the CEOs of GlaxoSmithKline, Sanofi-Aventis, Wyeth, Chiron and Merck, among others, a spokesperson for GSK said. The goal of the meeting will be to "explore ways to revive and bring the pharmaceutical sector back into the vaccine field," according to White House spokesperson Trent Duffy (Reuters/Houston Chronicle, 10/6).
"Avian flu is a global threat that is a serious concern," White House spokesperson Scott McClellan said (Washington Times, 10/7). He added, "We want to press ahead to expand our manufacturing capacity to address this risk" (Neergaard, AP/Philadelphia Inquirer, 10/7). According to the Post, vaccine manufacturers have expressed concerns about liability issues and financial risks related to the rapid production and emergency distribution of experimental vaccines.
In addition, the State Department on Friday will host a meeting of health officials from about 80 countries to develop an international strategy for handling a possible outbreak of avian flu (Washington Post, 10/7). The Bush administration plans to push the countries participating in the meeting to increase transparency in reporting and sharing of disease data. Possible strategies include persuading nations to establish incentives for local reporting and possibly paying farmers to kill their birds in case of an epidemic (Wall Street Journal, 10/7).
On Thursday, HHS Secretary Mike Leavitt said the risk of a pandemic from the H5N1 avian flu strain is "relatively low," according to scientists and physicians with whom he has consulted, but he added that if an outbreak occurs, "We're not prepared as a country. No one is prepared in the world. We're not alone in this" (Reuters/Houston Chronicle, 10/6). He said that in the event of an outbreak, U.S. health officials would immediately travel overseas to where the outbreak occurred and work with local officials to contain the virus. "If you can get there fast enough and apply good public health techniques of isolating and quarantining and medicating and vaccinating the people in that area, you can ... squelch it or you can delay it," Leavitt said (AP/Philadelphia Inquirer, 10/7).
According to the Post, Leavitt on Saturday is planning to travel to Asia to discuss international cooperative efforts to combat avian flu. He will meet with officials from Vietnam, Laos, Cambodia, Thailand and Indonesia, HHS spokesperson Bill Hall said. Hall added that Leavitt's goal "is to solidify relationships and express the importance of transparency in surveillance and sharing of data." Meanwhile, USAID said its top priority currently is avian flu.
Meanwhile, members of Congress are "starting to focus on several bills that take aim at the looming threat" of a flu pandemic, the Post reports (Washington Post, 10/7). Senators have developed several bills that "differ from ongoing administration initiatives by proposing guaranteed markets for flu vaccines, the appointment of a pandemic preparedness director and stockpiling of far larger quantities of antiviral drugs than the administration has proposed to do thus far," CQ HealthBeat reports (CQ HealthBeat , 10/6). Sens. Hillary Rodham Clinton (D-N.Y.) and Pat Roberts (R-Kan.) on Thursday introduced a bill designed to improve U.S. defenses against avian flu (Harris, New York Times, 10/7).
The bill would increase production of vaccines against seasonal flu as a first step toward increasing manufacturing capacity; authorize the federal government to guarantee a market for flu vaccines; establish an electronic tracking system to determine the availability of flu vaccine and number of high-risk patients on a county-by-county basis; increase education efforts to improve vaccination rates; and authorize the HHS secretary to give limited periods of liability protection to manufacturers and those who administer vaccines. Rodham Clinton said, "We cannot handle the threats we face today with a broken flu vaccine system."
A separate measure sponsored in part by Senate Minority Leader Harry Reid (D-Nev.) focuses specifically on the threat of a pandemic and would create a "Director of Pandemic Preparedness and Response" in the executive office of the president. The bill also would carry out activities and spending in a Senate amendment earmarking $4 billion toward preparedness; authorize the federal government to guarantee a market for flu vaccines; create a final pandemic preparedness plan focusing on low-income, uninsured and minority populations; and create an international fund to help control avian flu abroad before it reaches pandemic potential (CQ HealthBeat , 10/6).
In related news, the New York Times on Friday examined how the U.S. delayed its request to Roche for supplies of the antiviral drug Tamiflu and now "will have to wait in line to get the pills." Tamiflu is one of the only available medications proven to reduce the duration and severity of the flu if it is taken within 48 hours of infection. According to Terence Hurley, a spokesperson for Roche, 40 countries have ordered Tamiflu to stockpile in case of a pandemic, with many countries in Europe ordering enough to treat 20% to 40% of their populations. By contrast, the U.S. is still considering placing its order for Tamiflu, which would treat less than 2% of the U.S. population.
Hurley said the U.S. has ordered two million courses of the drug, and Roche will be able to fill that order this year. Some Democrats are expressing concern that the delay in the federal government's order "has put Americans in jeopardy," the Times reports. Sen. Tom Harkin (D-Iowa) said, "The administration has just drug its feet through this whole process." He has urged legislation to purchase more courses of Tamiflu.
According to Sen. Barack Obama (D-Ill.), Leavitt has said the U.S. will order 81 million courses of the drug. That amount would be enough to cover more than 25% of the U.S. population, according to the Times (New York Times, 10/7).
Several newspapers on Friday examined issues related to avian flu. Summaries appear below.
Boston Herald: The Herald examines concerns among some state and federal lawmakers about the qualifications of Stewart Simonson, HHS assistant secretary for public health emergency preparedness, given that he "lacks a medical or public health management background" (Heslam, Boston Herald, 10/7).
CQ HealthBeat: CQ HealthBeat examines the flu pandemic of 1918 and the research by Tulane University historian John Barry into the effects of the pandemic and the response of health and government officials (CQ HealthBeat , 10/6).
New York Times: The Times examines how a number of experimental flu treatments that were previously abandoned might be "resurrected" as a result of concerns about a possible shortage of Tamiflu (Pollack, New York Times, 10/7).
San Jose Mercury News: The Mercury News examines efforts to increase supplies of antiviral medications and experimental avian flu vaccines (Johnson, San Jose Mercury News, 10/7).
USA Today: USA Today examines some experts' concerns that a worldwide flu pandemic "could shut down travel, disrupt supply chains, overwhelm health care systems and devastate economies globally" (Appleby, USA Today, 10/7).
Wall Street Journal: The article examines Indonesian public health officials' concerns that some chickens carrying the H5N1 virus appear to be healthy, meaning the virus might have mutated and eliminated their "best early warning system of an outbreak -- dead flocks" (Zamiska, Wall Street Journal, 10/7).
Several broadcast programs reported on preparations for an avian flu vaccine:
- APM's "Marketplace": The segment includes comments from Paul Glezen of Baylor University's Influenza Research Center; Gigi Groenvall, immunologist at Pittsburgh University's Biosecurity Center; and Osterholm (Palmer, "Marketplace," APM, 10/6). The complete segment is available online in RealPlayer.
- CBS' "Evening News": The segment includes comments from Bush and David Lucci of Georgetown Medical School (Andrews, "Evening News," CBS, 10/6). The complete segment is available online in RealPlayer.
- NPR's "Morning Edition": The segment includes comments from Rodham Clinton, Obama, Reid and Roberts, as well as Alfred Summer, former dean of the Bloomberg School of Public Health at Johns Hopkins University (Rovner, "Morning Edition," NPR, 10/7). The complete segment is available online in RealPlayer.