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Bush designs $7.1 billion plan to counter 'super-flu'

Nov. 2, 2005

by LAURAN NEERGAARD, the Associated Press

WASHINGTON -- President Bush outlined a $7.1 billion strategy Tuesday to prepare for a possible worldwide super-flu outbreak, aiming to overhaul the vaccine industry so eventually every American could be inoculated within six months of a pandemic's beginning.

Such a huge change would take years to implement -- Bush's goal is 2010 -- and his plan drew immediate fire from critics who said it wouldn't provide enough protection in the meantime. States, too, got an unpleasant surprise, ordered to purchase millions of doses of an anti-flu drug with their own money.

Associated Press
President Bush remarks on the administration's national strategy for pandemic influenza preparedness Tuesday at the National Institutes of Health in Bethesda, Md.
The long-awaited strategy also stresses expanded attempts to detect and contain the next super-flu before it reaches the United States, with particular attention to parts of Asia that are influenza incubators, a global focus that flu specialists have insisted the government adopt.

"Early detection is our first line of defense," Bush said in a speech at the National Institutes of Health. He called on other countries to admit when super-flu strains occur within their borders. "No nation can afford to ignore this threat," he said.

At the same time, Bush sought to reassure a public jittery over the spread of bird flu, called H5N1, which has killed at least 62 people in Asia since 2003 and caused the death or destruction of tens of millions of birds.

There is no evidence that a human pandemic, of H5N1 or any other super-strain, is about to start, Bush said repeatedly.

Still, there have been three flu pandemics in the last century and the world is overdue for another.

Concern is growing that the bird flu could provide the spark if it one day mutates so that it can spread easily from person to person.

"Our country has been given fair warning of this danger to our homeland, and time to prepare," Bush said.

Topping Bush's strategy:

•$1.2 billion to stockpile enough vaccine against the current H5N1 flu strain to protect 20 million Americans, the estimated number of health workers and other first-responders involved in a pandemic.

•$1 billion for the drugs Tamiflu and Relenza, which can treat and, in some cases, prevent flu infection. Enough to treat 44 million people and prevent infection in 6 million others is headed for the federal stockpile. States were told to buy 31 million treatment courses, but Bush is funding only a quarter of the states' anticipated bill.

•$2.8 billion to speed production of pandemic vaccines, including better-matched strains, by learning to manufacture them in easier-to-handle cell cultures, instead of today's slow method that relies on millions of chicken eggs.

•$251 million for international preparations, including improving early-warning systems to spot human infections with novel flu strains.

•$100 million for state preparations, including determining how to deliver stockpiled medicines directly to patients.

•$56 million to test poultry and wild birds for H5N1 or other novel flu strains entering the U.S. bird population.

•A call for Congress to provide liability protection for makers of a pandemic vaccine, which unlike shots against the regular winter flu would be experimental, largely untested.

Bush's announcement came after his administration was battered by criticism over its lethargic response to Hurricane Katrina.

Public health specialists, briefed on the strategy but awaiting details, called it a good start.

"Clearly this is the No. 1 public health issue on the radar screen," said Michael Osterholm of the University of Minnesota, who advises the government on infectious disease threats.

But it's not strong enough, said Sen. Edward Kennedy, D-Mass., who helped lead Senate passage of $8 billion in emergency funding for pandemic preparations last month.

"Stockpiles alone aren't enough without the capacity to make use of them," he said, calling for steps to help states, cities and hospitals prepare for a flood of panicked patients.

"There is a gaping hole" in the plan, added Sen. Charles Schumer, D-N.Y., who said the nation should stockpile enough Tamiflu for half the population, not the quarter that would be covered if the states added their share under Bush's plan.

The states' contribution will be difficult, said Republican Arkansas Gov. Mike Huckabee, chairman of the National Governors Association.

"They expect us to pay 75 cents on a dollar for flu medicine, that's going to be a tough pill to swallow," he said through a spokeswoman.

The states' collective tab would reach $510 million, said Kim Elliott, deputy director of the nonpartisan Trust for America's Health. She worried some wouldn't buy any, and that others wouldn't share their Tamiflu stash if a pandemic struck in a part of the country that ran out.

"It depends on where you live and the state of your state's budget as to whether or not you might receive a treatment drug," she said.