Bush Pandemic Flu Strategy: Detection, Treatment, Response

BETHESDA, Maryland, November 1, 2005 (ENS) - Outlining a three-part strategy to combat an influenza pandemic arising from bird flu, President George W. Bush today asked Congress to provide $7.1 billion in emergency funding to strengthen national and international safeguards.

Speaking at the National Institutes of Health in Bethesda, Maryland, the President outlined the three parts of his plan - detection, treatment, and readiness to respond.

"Our strategy is designed to meet three critical goals," Bush said. "First, we must detect outbreaks that occur anywhere in the world; second, we must protect the American people by stockpiling vaccines and antiviral drugs, and improve our ability to rapidly produce new vaccines against a pandemic strain; and, third, we must be ready to respond at the federal, state and local levels in the event that a pandemic reaches our shores."

Bush said a pandemic could strike at any time and could last from one to three years, so the nation must immediately begin preparations to detect and respond to the disease that could "happen simultaneously in hundreds, or even thousands, of locations at the same time," he said.

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President George W. Bush announced his pandemic flu strategy to an audience of health and government officials at National Institutes of Health in Bethesda today. (Photo by Paul Morse courtesy The White House)
The President was quick to emphasize that no flu pandemic exists today, pointing out that while the H5N1 strain of avian flu has infected over 120 people in Thailand, Cambodia, Vietnam and Indonesia, since December 2003 and killed 62, "At this point, we do not have evidence that a pandemic is imminent," Bush said.

"Most of the people in Southeast Asia who got sick were handling infected birds," Bush said. "And while the avian flu virus has spread from Asia to Europe, there are no reports of infected birds, animals, or people in the United States."

"Even if the virus does eventually appear on our shores in birds, that does not mean people in our country will be infected. Avian flu is still primarily an animal disease. And as of now, unless people come into direct, sustained contact with infected birds, it is unlikely they will come down with avian flu," said Bush.

But the President echoed the warnings of the World Health Organization, saying, "The virus has developed some characteristics needed to cause a pandemic. It has demonstrated the ability to infect human beings, and it has produced a fatal illness in humans. If the virus were to develop the capacity for sustained human-to-human transmission, it could spread quickly across the globe."

"Early detection is our first line of defense," said Bush, detailing the first part of his strategy. It began in September at the United Nations when Bush announced a new International Partnership on Avian and Pandemic Influenza, a global network of surveillance and preparedness that has now attracted the participation of 88 countries and nine international organizations.

"The partnership requires participating countries that face an outbreak to immediately share information and provide samples to the World Health Organization. By requiring transparency, we can respond more rapidly to dangerous outbreaks," the President said.

He has asked Congress for an additional $251 million to help other countries train local medical personnel, expand their surveillance and testing capacity, draw up preparedness plans, and take other actions to detect and contain outbreaks.

"A flu pandemic would have global consequences, so no nation can afford to ignore this threat, and every nation has responsibilities to detect and stop its spread," Bush said.

The President announced a new National Bio-surveillance Initiative for disease detection and response in the United States.

"This initiative will help us rapidly detect, quantify and respond to outbreaks of disease in humans and animals, and deliver information quickly to state, and local, and national and international public health officials," said Bush. "By creating systems that provide continuous situational awareness, we're more likely to be able to stop, slow, or limit the spread of the pandemic and save American lives."

In April, Dr. Anthony Fauci, chief of the National Institute of Allergy and Infectious Diseases, said, "Our vaccine production and development enterprise is very fragile and, in fact, is broken."

The President said today the "cornerstone of our strategy is to develop new technologies that will allow us to produce new vaccines rapidly." He wants to have "a surge capacity" in place if a pandemic strikes so that a new vaccine can be brought online quickly and sufficient supplies manufactured to immunize every American.

But no vaccine can be manufactured until the pandemic viral strain appears, the President pointed out.

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President Bush is asking Congress for $7.1 billion to respond to the threat of pandemic flu. (Photo by Paul Morse courtesy The White House)
"Scientists need a sample of the new strain before they can produce a vaccine against it," he said. "This means it is difficult to produce a pandemic vaccine before the pandemic actually appears - and so there may not be a vaccine capable of fully immunizing our citizens from the new influenza virus during the first several months of a pandemic."

To help protect our citizens during these early months when a fully effective vaccine would not be available, researchers at the National Institutes of Health (NIH) have developed a vaccine based on the current strain of the avian flu virus; the vaccine is already in clinical trials, Bush said.

He is asking that the Congress provide $1.2 billion for the Department of Health and Human Services to purchase enough doses of this vaccine from manufacturers to vaccinate 20 million people.

"This vaccine would not be a perfect match to pandemic flu because the pandemic strain would probably differ somewhat from the avian flu virus it grew from. But a vaccine against the current avian flu virus would likely offer some protection against a pandemic strain, and possibly save many lives in the first critical months of an outbreak," the President said.

Bush said the government also is increasing stockpiles of antiviral drugs such as Tamiflu and Relenza.

Antiviral drugs cannot keep people from getting the flu, but they can reduce the severity of the illness when taken within 48 hours of getting sick.

To stockpile enough antiviral medications to treat first responders and those on the front lines, as well as populations most at risk in the first stages of a pandemic, the President is asking Congress to provide $1 billion.

Currently, the NIH is working with vaccine makers to develop new cell-culture techniques that will create a pandemic flu vaccine faster in the event of an outbreak.

"Right now," Bush said, "most vaccines are still produced with 1950s technology using chicken eggs that are infected with the influenza virus and then used to develop and produce vaccines. In the event of a pandemic, this antiquated process would take many, many months to produce a vaccine, and it would not allow us to produce enough vaccine for every American in time."

Since American lives depend on rapid advances in vaccine production technology, we must fund a crash program to help our best scientists bring the next generation of technology online rapidly.

The President said he is asking Congress for $2.8 billion for a "crash program" to accelerate development of cell-culture vaccine technology.

"By bringing cell-culture technology from the research laboratory into the production line, we should be able to produce enough vaccine for every American within six months of the start of a pandemic," the President said.

Bush said he would ask Congress to remove the growing burden of litigation from the vaccine industry by legislating liability protection for vaccines manufacturers.

"In the past three decades, the number of vaccine manufacturers in America has plummeted, as the industry has been flooded with lawsuits. Today, there is only one manufacturer in the United States that can produce influenza vaccine. That leaves our nation vulnerable in the event of a pandemic," Bush said.

The third part of our strategy is to ensure that we are ready to respond to a pandemic outbreak. "We must have emergency plans in place in all 50 states and every local community. We must ensure that all levels of government are ready to act to contain an outbreak. We must be able to deliver vaccines and other treatments to frontline responders and at-risk populations," Bush said.

Health and Human Services Secretary Mike Leavitt will bring together state and local public health officials from across the nation to discuss their plans for a pandemic, and to help them improve pandemic planning at the community level.

The President said he is asking Congress to provide $583 million for pandemic preparedness, including $100 million to help states complete and exercise their pandemic plans "now, before a pandemic strikes."

To respond to a pandemic, we need medical personnel and adequate supplies of equipment. In a pandemic, everything from syringes to hospital beds, respirators, masks and protective equipment would be in short supply.

So the federal government is stockpiling critical supplies in locations across the country as part of the Strategic National Stockpile, Bush said.

The Department of Health and Human Services is helping states create rosters of medical personnel who are willing to help alleviate local shortfalls during a pandemic. And every federal department involved in health care is expanding plans to ensure that all federal medical facilities, personnel, and response capabilities are available to support local communities in the event of a pandemic crisis.

"Every American must take personal responsibility for stopping the spread of the virus," said the President, so to provide Americans with more information about pandemics, the government is launching a new website, pandemicflu.gov.

The website will provide information about the preparations underway, steps they can take now to prepare for a pandemic, and what every American can do to decrease their risk of contracting and spreading the disease in the event of an outbreak.

The American Medical Association (AMA) today applauded the introduction of the pandemic flu national strategy by President Bush. "Preparation and planning are key to containment. We encourage Congress to provide appropriate funding to government agencies to support the expanded development and production of vaccines and antiviral drugs," the AMA said.

"Everyone can take sensible steps to prepare for the current annual flu season, which can potentially provide added protection against pandemic flu," the AMA said. "Make an appointment with your physician to get the annual flu vaccine. Wash your hands to avoid germs that cause the flu. Stockpiling of antivirals, such as Tamiflu, is not recommended."

The AMA advises against stockpiling "because of the risk that symptoms not related to avian flu will prompt people to initiate unnecessary treatment."

"Needlessly taking an antiviral may contribute to the problem of resistance to that antiviral drug, which would then make the drug less useful in the event of an actual avian flu outbreak," the AMA said.

President Bush said his strategy will require "the combined efforts of government officials in public health, medical, veterinary and law enforcement communities and the private sector" as well as "the active participation of the American people."

"And it will require the immediate attention of the United States Congress so we can have the resources in place to begin implementing this strategy right away. If an influenza pandemic strikes," said President Bush, "every nation, every state in this Union, and every community in these states, must be ready."