Scientists are generally praising President George W. Bush's release this week of a plan to spend $7.1 billion to help prepare the nation for an influenza pandemic that potentially could kill 2 million Americans. A new report released today provides further details about the possible pandemic and who would be protected first.
Speaking at the National Institutes of Health yesterday, Bush noted growing concerns that the H5N1 avian flu now spreading west from Asia could acquire the ability to be transmitted from human to human (ScienceNOW, 13 October). "If we wait for a pandemic to appear, it will be too late to prepare," he said. He is asking Congress for $251 million to help other countries detect and respond to outbreaks and $644 million to help U.S. national, state, and local officials get ready. Another $2.5 billion would go for stockpiling antiviral drugs and making enough of a vaccine based on the current H5N1 strain for 20 million people. (The vaccine could offer some protection against an H5N1 pandemic strain.) In addition, Bush wants Congress to pass legislation to shield vaccine companies from lawsuits. Some Democrats oppose that step, but "you will never get companies to make hundreds of millions of doses" of vaccine without it, says immunologist Paul Offit of the University of Pennsylvania, Philadelphia.
Bush also wants to spend $2.8 billion on a "crash program" to speed up cell-based vaccine technology so that if a pandemic strikes, the U.S. could manufacture a new vaccine matching the pandemic strain for all Americans within 6 months. Experts praise this effort to shore up the country's weak vaccine infrastructure, but note that the "surge capacity" to meet this goal won't come online until 2010. David Fedson, a retired medical director of Aventis-Pasteur, argues that to stretch capacity now, the U.S. should be testing very low doses of H5N1 vaccine with an additive called an adjuvant that boosts the body's immune response.
Today, the Department of Health and Human Services released more details in a 396-page pandemic preparedness plan that says up to 1.9 million Americans could die in a severe pandemic. The report describes who should get antivirals and vaccines first, such as public health workers, the elderly, and government leaders. "This is what states are waiting for" to finish their flu plans, says epidemiologist Arnold Monto of the University of Michigan, Ann Arbor, who served on an advisory group that helped make the list.
Bush's plan, which also includes a new web site for the public (www.pandemicflu.gov), comes a week after the Senate approved nearly $8 billion in emergency funds for pandemic flu preparedness. Congress is now holding a flurry of hearings on pandemic flu, and it is expected to meld its wishes with the president's request as it finalizes 2006 spending bills.