Witnesses at House Hearing Say United States Unprepared To Address Flu Pandemic
The United States has ordered 2.3 million doses of flu treatment Tamiflu, enough to treat less than 1% of the U.S. population in the event of an avian flu pandemic, the CEO of Tamiflu maker Hoffmann-La Roche told lawmakers at a House Government Reform Committee hearing on Thursday, CQ HealthBeat reports. The World Health Organization recommends that nations have stockpiles capable of treating 25% of their populations with the drug, which is the only effective treatment for avian flu on the market, to prepare for a global flu pandemic.
Hoffmann-La Roche CEO George Abercrombie said the United States is "woefully behind" other nations in ordering the drug. The United Kingdom, France, Switzerland, Finland, Norway and New Zealand have ordered enough doses for 20% to 30% of their populations, Abercrombie said.
Tamiflu can speed recovery for flu patients and prevent people exposed to the virus from getting sick if the treatment is taken within 48 hours of exposure (CQ HealthBeat, 6/30).
Committee members questioned why the U.S. government has not ordered more doses of the drug (Neergaard, AP/Boston Globe, 7/1).
Abercrombie said, "I cannot answer why the large order commitment has not come," noting that the company could have delivered "tens of millions of doses" this year if the United States had placed an order one year ago. Abercrombie said it would take eight to 12 months to fill a large U.S. order, but he then changed his estimate to six months, according to CQ HealthBeat. Abercrombie said, "We cannot rely on the ability to flip a switch and suddenly make large quantities."
Committee Chair Tom Davis (R-Va.) -- at the urging of Rep. Dan Burton (R-Ind.) -- said the committee will send a letter to President Bush asking why the federal government has not placed a large order. Davis said, "We need to have more" of the drug, noting that the current U.S. order is 62 million doses below WHO's recommendation (CQ HealthBeat, 6/30).
According to the AP/Globe, "negotiations are underway" for the United States to order an additional two million doses. The order would bring the supply to enough doses to cover about 2% of the population. Anthony Fauci, director of NIH's National Institute of Allergy and Infectious Diseases, said that even with the added doses, "certainly we don't have enough" (AP/Boston Globe, 7/1).
Rep. Henry Waxman (D-Calif.) and other committee members also questioned officials from CDC and HHS on why a federal plan for addressing a potential flu pandemic is taking so long to finalize, the Atlanta Journal-Constitution reports. A draft plan was published in August 2004, but it will not be finalized until later this month, officials told the committee (Nesmith, Atlanta Journal-Constitution, 7/1).
The Government Accountability Office said the draft plan failed to explain the role of the federal government in purchasing and distributing vaccines during a pandemic. The draft also did not set priorities for who should receive treatments first during a shortage (CQ HealthBeat, 6/30).
Bruce Gellin, head of the HHS National Vaccine Program, said CDC this week is discussing strategies to prioritize distribution of vaccines and antiviral drugs and final recommendations will be included in the plan later this month. Drug makers cannot manufacture a flu vaccine for up to six months after a new strain is transmitted human to human, the Journal-Constitution reports. CDC officials said that once a vaccine becomes available, critical health care workers and vaccine manufacturing plant employees will receive first priority for the inoculation, while people at the highest risk of contracting the flu will follow.
Waxman said the avian flu virus, known as H5N1, is "arguably the most serious threat to human health in the world." He added, "Are we ready? Unfortunately, we are not" (Atlanta Journal-Constitution, 7/1).
Gellin agreed with the seriousness of the pandemic threat, saying, "The threat of a pandemic is real, whether it comes in 10 days or 10 years from now" (Goldstein, Kansas City Star, 7/1).
Shelley Hearne, executive director of the Trust for America's Health, told the committee that the group's review of state plans for dealing with a pandemic found that most planning is flawed. Some states will not release their plans to the public, which prevents outside scrutiny, Hearne said.
CDC should be required to review each state plan to "ensure nationwide preparedness standards and to facilitate regional coordination," she said. Hearne also recommended that the federal government stockpile medical supplies -- such as masks, gloves and gowns -- because many of the supplies are produced in Asia, "which may be the epicenter of a pandemic" (CQ HealthBeat, 6/30).
Meanwhile, the Bush administration has proposed a $130 million cut in funding to state and local agencies that would respond to a flu emergency, according to the Star.
Mary Selecky, secretary of the Washington State Department of Health and a member of the Association of State and Territorial Health Officials, said, "This is the wrong time for the federal government to cut state and local preparedness funding" (Kansas City Star, 7/1). Selecky said state and local agencies need more resources to address added responsibilities of planning for a pandemic.
States have continued to make preparations while awaiting a federal plan, Selecky testified. "States have not sat back and just waited for the plan to come out," she said (CQ HealthBeat, 6/30).
The Baltimore Sun on Friday published an interview with Michael Osterholm, director of the University of Minnesota's Center for Infectious Disease Research and Policy, who asserts that nations are unprepared for a potential avian flu outbreak.
Osterholm said countries have insufficient vaccine and antiviral drug stockpiles, in addition to lacking adequate supplies of basic medical equipment such as masks, ventilators and hospital beds. Osterholm also talked about the likelihood of avian flu mutation to allow for human-to-human transmission, the aftereffects of a pandemic and the potential difficulties of dealing with a pandemic (Bor, Baltimore Sun, 7/10).